Public health leadership & mdg

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Public health leadership & mdg

  1. 1. TRANSFORMATION PUBLIC HEALTH LEADERSHIP Prof. Dr. Ridwan Amiruddin, SKM., M. Kes., MSc. PH Ketua Penjaminan Mutu Fak. Kesehatan Masyarakat Universitas Hasanuddin Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 1
  2. 2. Outline presentation  Essential Public Health  MDG achievement  Public Health Challenge  Leading the Transformation of the Public Health System Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 2
  3. 3. Public Health Prevents epidemics and the spread of disease Protects against environmental hazards Prevents injuries Promotes and encourages healthy behaviors Responds to disasters and assists communities in recovery Assures the quality and accessibility of health services Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 3
  4. 4. Essential Public Health Services  Monitor health status to identify community health problems  Diagnose and investigate health problems and health hazards in the community  Inform, educate, and empower people about health issues Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 4
  5. 5. Essential Public Health Services  Mobilize community partnerships to identify and solve health problems  Develop policies and plans that support individual and community health efforts  Enforce laws and regulations that protect health and ensure safety Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 5
  6. 6. Essential Public HealthServices Evaluate effectiveness, accessibility, and quality of personal and population-based health services Research for new insights and innovative solutions to health problems Seminar Nasional Alumni FKM UNHAS. WasmaSource. 1990 Centers for25-26 Feb 2012 Kalla Disease Control and Prevention 6
  7. 7. Public Health: The foundation of a national health system Tertiary Medical Care Secondary Medical Care Primary Medical Care Essential Population-Based Public Health Services •Human Resources Development (Training) •Information Systems •Community Planning Systems Capacity to Deliver Public Health Services Public Health System Infrastructure •Human Resources Development (Training) •Information SystemsSeminar Nasional Alumni FKM UNHAS. Wasma •Community Planning SystemsKalla 25-26 Feb 2012 7
  8. 8. Main characteristics of PH and CH Public Health Collective Health Microbial paradigm, based Critic to the positivism.Origin biomedical model Structural adjustment Flexner report - of experimental Proposals: "Health For All in the YearModel of reference character of sub-individual the 2000" and Promotion base. paradigm (Ottawa Letter) Health-disease-intervention Natural history of the diseases andObject of study process’s social physiopathology determinant. Endemics/epidemicSustentation logic control Promotion and prevention Proposes visions, forms, figuresPractice Preventive predictive and scenes in a holistic and systemic context .Public Individual Collectivities Management, epidemiology,Disciplines Explain the disease natural history statistic, demography.
  9. 9. Seminar Nasional Alumni FKM UNHAS. WasmaKalla 25-26 Feb 2012 9
  10. 10. Seminar Nasional Alumni FKM UNHAS. WasmaKalla 25-26 Feb 2012 10
  11. 11. Seminar Nasional Alumni FKM UNHAS. WasmaKalla 25-26 Feb 2012 11
  12. 12. Seminar Nasional Alumni FKM UNHAS. WasmaKalla 25-26 Feb 2012 12
  13. 13. Seminar Nasional Alumni FKM UNHAS. WasmaKalla 25-26 Feb 2012 13
  14. 14. Seminar Nasional Alumni FKM UNHAS. WasmaKalla 25-26 Feb 2012 14
  15. 15. Dengue Haemorhagic Fever DecentralizationSource: Bappenas, 2008 15
  16. 16. Malnutrition Problem Decentralization MoH ProjectionSource: Bappenas, 2008 16
  17. 17. Under Five Mortality DecentralizationSource: Bappenas, 2008 17
  18. 18. Infant Mortality Rate . DecentralizationSource: Bappenas, 2008 18
  19. 19. Maternal Mortality Rate DecentralizationSource: Bappenas, 2008 19
  20. 20. Delivery attended by trained health workers Stagnant Decentralization 20
  21. 21. Seminar Nasional Alumni FKM UNHAS. WasmaKalla 25-26 Feb 2012 21
  22. 22. Public Health Challenges Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 22
  23. 23. Public Health ChallengesEmerging Diseases (SARS, Pandemic Flu) Re-emerging Diseases (XDR-TB) Food Safety Bioterrorism Natural Disasters Obesity Aging Population Health Disparities Global Warming Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 23
  24. 24. Health Care Crisis Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 24
  25. 25. SARS and Pandemic Flu Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 25
  26. 26. Health Care Crisis Population Aging Re-emerging Diseases Emerging Diseases Obesity Health Disparities Access to Quality Health Care Health Insurance Costs Uninsured and Underinsured Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 26
  27. 27. Pyramid of preparedness : components of an effective public healthsystem (from Rowitz 2006) Categorical Public Health Programs: Environmental Health, HIV/AIDS, Chronic disease prevention and health Program services promotion,Immunization, Infectious disease control, injury Leadership prevention, occupational Safety and Health Program capacitySupporting scientificand technicalcapabilities Laboratory Behavioural Epidemic Surveillance practice science investigationCore Public Information/ Workforce OrganisationalHealth communication competency capacityInfrastructure capacity Leadership
  28. 28. The skills of the prepared public health leader in crisis (Rowitz, 2006) Community building Systems thinking Assets planning Social Capital Knowledge of public (capacity building) Collaboration health law Crisis Management Change and Visioning resilience Systems change Emotional intelligence Tipping point PUBLIC HEALTH awareness INFRASTRUCTURE Forensic Crisis and risk epidemiology communication
  29. 29. Public Health leadership principles (fromRowitz, 2003)1.Core public health values2.Health Prevention3.Community coalitions4. Local and state collaborations and equity in access5.Partnerships and shared visions6. New leaders must learn from experienced leaders – mentoring7.Continuous development of leadership skills8. Commitment to lifelong learning and personal growth
  30. 30. Public Health leadership principles(from Rowitz, 2003) (cont.)9. Infrastructure built on notion of health protection for all10. Need to think globally but act locally11. Need to be good managers12. Need to ‘walk the walk’13. Proactive – not reactive14. Leadership at all levels of an organization15. Strong belief and commitment to community16. Must practice what they preach
  31. 31. Quotes on Collaboration None of us is as smart as all of us  Edward C. Register, 1915 Cooperation! What a word! Each working with all, and all working with each.  Warren Bennis, 1996 Collaboration is damn tough  Focus group participants, 1997  All quotes from Medicine and Public Health: The power of collaboration, Lasker, et al.
  32. 32. A mutually beneficial and well-definedrelationship entered into by two or moreorganizations to achieve common goals Amerst H. Wilder Foundation
  33. 33. Why Collaborate Shared Concern Pool Power Overcome Gridlock (“get unstuck”) Add Diversity Increase Ability to Handle Complex Issues
  34. 34. Context for Collaboration  Identify the problem  Understand what makes leadership difficult  Identify stakeholders  Assess extent of stakeholder agreement  Evaluate community’s capacity for change  Identify where the problem/issue can be most effectively addressed  Chrislip and Larson
  35. 35. Rebalancing Health Priorities General Targeted Primary Secondary Tertiary protection protection prevention protection protection Affected people Safer without Affected people Vulnerable complications Healthier with people (undiagnosed complications People asymptomatic) Death from Complications Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 35
  36. 36. Traditional Healthcare Affected PeopleSafer without Affected People Vulnerable complicationsHealthier with People (undiagnosed complicationsPeople asymptomatic) Traditional Healthcare Disease Care Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 36
  37. 37. Traditional Public Health Affected PeopleSafer without Affected People Vulnerable complicationsHealthier with People (undiagnosed complicationsPeople asymptomatic)Public Health System Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 37
  38. 38. Need to Rebalance HealthPriorities Affected PeopleSafer without Affected People Vulnerable complicationsHealthier with People (undiagnosed complicationsPeople asymptomatic)Public Health Network Healthcare Delivery SystemHealth Protection: Health Promotion, Disease CarePrevention, and Preparedness Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 38
  39. 39. Questions“Given the significant public health and health carechallenges we face, are Public Health Leadersadequately prepared to address these issues?”“What are the requisite leadership competenciesneeded to address these challenges?”“Do we have a system of leadership development thatcan meet this challenge?” Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 39
  40. 40. Transforming the Public HealthSystem Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 40
  41. 41. Transforming the Public HealthSystem Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 41
  42. 42. StructureStandardsFunctionsSetting Agency and  Public Health Accreditation BoardSetting System Standards  National Public Health Performance StandardsEstablishing Public Health Laws and PoliciesCommunity EngagementDecentralization (central –local gov. interaction) Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 42
  43. 43. Transforming the Public HealthSystem Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 43
  44. 44. WorkforceCompetencies for Public Health professionals  Epidemiologists  Environmental Health  Nursing  Nutritionist  EtcCredentialing and certification  National Board of Public Health Examiners (etc.; 2005)  Existing programs in nursing, environmental health, laboratories Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 44
  45. 45. Transforming the Public HealthSystem Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 45
  46. 46. The “Strategic Influence” of Public Health Leaders Politics Policy Programs PH Leaders Resources Experienc e Communit y Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 46
  47. 47. Crisis Leadership CompetencyModel This model lays out the nine competencies that were determined to be the most critical for leaders in a public health emergency response situation. Team Leadership Communication Situational Awareness Connectivity Crisis Leadership Competency Integrative Thinking Model Courage and Perseverance Emotional Effectiveness Credibility Decisiveness
  48. 48. IntegrationThe crisis leadership competencies supplement both the four-tier leadershipcompetencies and the emergency response competencies. Four-Tier HHS Leadership Competencies Emergency Response Competencies Basic Supervisor Manager Executive Leadership • Emergency All Managers All Supervisors Competencies, Management Systems All Basic Competencies, plus: • Agency Preparedness All Core Competencies, plus: Strategic Thinking and Emergency Competencies, plus: Creativity/ Vision Response Roles plus: Resilience Innovation External • Informatics Support Flexibility Conflict Financial Awareness Interpersonal Management Management Political Savvy for Responses Skills Team Building Technology • Risk Communication Self-Direction Influencing / Management and Media Relations Technical Negotiating Entrepreneurship • All Hazards Concepts Credibility Human Resources Organizational • Disaster Mental Project Management Systems Management Service Awareness Health Performance Motivation Management Accountability Leveraging Four-Tier CDC Leadership Competencies (supplement HHS) Diversity • Cultural Awareness • Ethics • Leads Change • Dealing with Ambiguity • HHS/CDC Operations • Personal Leadership • Emotional Intelligence Crisis Leadership Competencies • Communication • Credibility • Emotional Effectiveness • Situational Awareness • Connectivity • Decisiveness • Integrative Thinking • Team Leadership • Courage and Perseverance
  49. 49. Transforming the Public HealthSystem Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 49
  50. 50. Goals and PrioritiesNational-level Goals and Priorities  Health Protection Goals  Healthy PeopleState and Community-level Goals  State and Local Health Departments Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 50
  51. 51. Leadership is Essential to Success Agency StandardsLeadership System Standards Improved + Laws and Policies Improved Performance Health Outcomes Community EngagementWorkforce Portfolio Management Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 51
  52. 52. Issues Surrounding Leadership Development Continuum Dilemma  Leadership vs. Management competencies  Basic vs. Advanced  Regional vs. National Crisis Leadership Integrated or single program? Discipline specific Leadership How to build effective networks Fragmentation Develop a “system” for Leadership Shared vision, shared funding, common purpose Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 52
  53. 53. recommendation Leadership course for public health leader for all level Develop collaboration with all stakeholders Regular meeting to response public health issue Prepare response for emergency crisis Develop program for rebalancing health care system Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 53
  54. 54. Final Thoughts “Success is the child of audacity” (Disraeli) Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 54

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