More Related Content Similar to essentials of public health.ppt Similar to essentials of public health.ppt (20) essentials of public health.ppt1. Copyright © 2014 by The University of Kansas
Ten Essential Public Health Services
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What is public health?
• Public health is the part of the civic infrastructure
that keeps communities safe and healthy.
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Who are public health professionals?
• Nurses
• Physicians
• Laboratory technicians.
• Educators
• Nutritionists
• Social workers.
• Biostatisticians
• Epidemiologists.
• Economists
• Lawyers.
• Community-based or “grassroots” workers might include concerned
parents, grandparents, or civic leaders who volunteer their time.
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What are the Ten Essential Public
Health Services?
• The core functions of public health are divided
into.
• Assessment.
• Policy Development.
• Assurance.
• The Ten Essential Public Health Services fall into
these three categories.
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*CDC Environmental Public Health Leadership Institute (EPHLI)
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Assessment:
• Monitor health status to identify community health problems.
• Diagnose and investigate health problems and health hazards in
the community.
Policy Development:
• Inform, educate, and empower people about health issues.
• Mobilize community partnerships to identify and solve health
problems.
• Develop policies and plans that support individual and community
health efforts.
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Assurance:
• Enforce laws and regulations that protect health and ensure
safety.
• Link people to needed personal health services and assure
the provision of health care when otherwise unavailable.
• Assure a competent public health and personal health care
workforce.
• Evaluate effectiveness, accessibility, and quality of personal
and population-based health services.
• Research for new insights and innovative solutions to health
problems.
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Public Health versus Medical
Models of Professional Training
Public Health Model
• Primary focus on population.
• Public service ethic, tempered by
concerns for the individual.
• Emphasis on prevention and
health promotion for the whole
community.
• Paradigm employs a spectrum of
interventions aimed at the
environment, human behavior
and lifestyle, and medical care.
Medical Model
• Primary focus on the individual.
• Personal service ethic,
conditioned by awareness of
social responsibilities.
• Emphasis on diagnosis,
treatment, and care for the whole
patient.
• Paradigm places predominant
emphasis on medical care.
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How do you use the Ten Essential Public
Health Services in Community Practice?
Monitor health status to identify community problems.
This service comprises the ongoing, systematic collection, analysis, and
interpretation of health related data, including:
• Identification of threats to health and assessment of health needs;
• Timely collection, analysis, and publication of information on access,
utilization, costs, and outcomes of personal health services;
• Attention to the vital statistics and health status of specific groups
that are at higher risk than the total population; and
• Collaboration to manage integrated information systems with private
providers and health benefit plans.
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• Monitor health status to identify community problems.
• To monitor community health status, you can use regional,
municipal, and community-level information, such as:
• Census data.
• DOH, including the National Vital Statistics System, the Cancer
Registries, etc.
• LGU “report cards” on maternal and child health and other areas,
as well as reports and statistics from the regional PHUs.
• School health reports, Community surveys.
• Information about community-level indicators
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Diagnose and investigate health hazards
in the community
• This service encompasses public health activities such as:
• Epidemiologic identification of emerging health threats;
• Public health laboratory capability using modern
technology to conduct rapid screening and high volume
testing;
• Active infectious disease epidemiology programs; and
• Technical capacity for epidemiologic investigation of
disease outbreaks and patterns of chronic disease and
injury.
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Inform, educate, and empower people
about health issues
• Social marketing and targeted media public communication
(e.g., Toll-free information lines, quitlines, etc.).
• Providing accessible health information resources at
community levels (e.g. mobile health screening initiatives).
• Active collaboration with personal health care providers to
reinforce health promotion messages and programs.
• Joint health education programs with schools, churches, and
worksites (e.g., stress reduction seminars; mothers class,
parenting support groups, etc.).
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Mobilize community partnerships to
identify and solve health problems.
• Convene and facilitate community groups and associations,
including those not typically considered to be health-
related, to undertake defined preventive, screening,
rehabilitation, and support programs.
• Build multi-sector community coalitions in order to draw
upon the full range of potential human and material
resources in the cause of community health.
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Develop policies and plans that support
individual and community health efforts.
• Leadership development at all levels of public health.
• Systematic community-level and state-level planning for health
improvement in all jurisdictions.
• Development and tracking of measurable health objectives as a
part of continuous quality improvement strategies.
• Joint evaluation with the medical health care system to define
consistent policy regarding prevention and treatment services.
• Development of codes, regulations, and legislation to guide the
practice of public health.
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Enforce laws and regulations that protect
health and ensure safety
• Full enforcement of sanitary codes, especially in the food industry.
• Full protection of drinking water supplies, clean air standards.
• Timely follow-up of hazards, preventable injuries, and exposure-related
diseases identified in occupational and community settings.
• Monitoring quality of medical services (e.g., laboratory, nursing homes,
and home health care).
• Timely review of new drug, biologic, and medical device application.
• Advocacy for needed new health and safety laws and regulations.
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Link people to needed personal health services
and assure the provision of health care when
otherwise unavailable.
• Effective entry for socially disadvantaged people into a
coordinated system of clinical care.
• Culturally and linguistically appropriate materials and staff to
assure linkage to services for special population groups.
• Ongoing “care management.”
• Outreach and support to populations in need of government
services.
• Technical assistance for effective worksite health
promotion/disease prevention programs.
• Targeted health information to high risk population groups.
• Transportation services.
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Assure a competent public health and
personal care workforce
• Education and training for personnel to meet the needs for
public and personal health service.
• Efficient processes for licensure of professionals and
certification of facilities, with regular verification and
inspection follow-up.
• Adoption of continuous quality improvement and life-long
learning within all licensure and certification programs.
• Active partnerships with professional training programs to
assure community-relevant learning experiences for all
students.
• CMEs and leadership development programs for those charged
with administrative/executive roles.
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Evaluate effectiveness, accessibility, and quality of
personal and population-based health services
• Evaluation helps public health professionals continually
refine or revise program approaches in future years of
funding.
• Evaluation data provide information about the relative costs
and effort for tasks so activity and budget adjustments can be
made.
• To ensure useful results that lead to more effective services,
it is necessary to conduct ongoing evaluations of health
programs based on analysis of health status and service
utilization data, to assess program effectiveness and to
provide information necessary for allocating resources and
reshaping programs.
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Research for new insights and innovative
solutions to health problems
• Link with appropriate institutes of higher learning and research.
• Mount timely epidemiologic (e.g., outbreak investigations) and economic
analyses (e.g., cost-benefit studies).
• Conduct needed health services research (e.g., survey design; conducting
interviews and facilitating focus groups; conducting clinical trials; and
accessing and using public records).
• Engage in collaborative research with other programs, and publicize your
results.
• Seek funding for both individual and collaborative research into health
problems.
• Publicize research results so others can use and build on them.
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COMMUNITY PARTICIPATION
• Community Definition
• vary according to different fields of investigation.
• a network of people linked by common characteristics
which distinguish them from others.
• multi-dimensional concept with different shades of
meaning: e.g. place/locality, a network of interests or a
social system
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Community Participation
• Participate, according to Oxford English Dictionary
means "have a share, take part in.“
• the individual level
• the community level.
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Community Participation
• The importance of community participation by
health professionals was formally recognized by
the 1986 Ottawa Charter in which health
promotion was defined as "the process of enabling
people to increase control over and to improve
their health" (WHO, 1986).
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Community Participation
• to achieve health for all and to reduce health
inequalities, health promotion should "work
through concrete and effective community action
in setting priorities, making decisions, planning
strategies, and implementing them to achieve
better health"(WHO, 1986).
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Community Participation
• central to this "new" health promotion is the
emphasis on community participation and
empowerment
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Community Participation
• the involvement of intended beneficiaries in the
planning, design, implementation and subsequent
maintenance of the development intervention. It
means that people are mobilized, manage
resources and make decisions that affect their
lives.
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Community Participation
• The objectives of such participation may range
from increased efficiency, sustainability, and cost-
sharing, to improving equity, capacity-building and
empowerment (AIDAB, 1991:6-7).
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Community Participation
• Degrees of participation
• on the nature of the community
• the degree of control over agenda setting,
• the degree of ownership of the process by the
community.
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Community Participation
3 types of participation
• Community control
• Community representation
• Community involvement
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Community Participation
Community Control
- takes place when the community sets the agenda and
has final say over the decision making process.
- total control by a community is rare except in the case of
locality based community with a strong group identity.
- a successful community development approach which
embodies the principles of self-determination, self-
reliance, and starting with issues identified by the
community can lead to community control or
community management.
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Community Participation
Community management
- takes local participation one step further.
- means that communities of intended beneficiaries take
principal responsibility for planning, designing,
implementation and maintenance and have ultimate
responsibility for management
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Community Participation
Community Representation
- occurs when the community participates in decision
making in a complex social system.
- used to describe a form of participating in different
group contexts.
- a formal process such as election of government
officials, representation of sectors
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Community Participation
Community Involvement
- can be seen as a part of the participation process but
does not embody ownership.
- usually means that the decision-makers or the
professionals define the problem or drive the agenda
but also invite the community to take part in the
process.
- e.g. heart health campaign and cancer prevention
program.
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Community Participation
Community Consultation
- referring to instances where information from citizens is
sought with regard to specific plans or projects, and with
little or no enduring structures or ongoing engagements
between agency sponsors and their public.
- means constantly seeking opinions from community
members but only within the terms of those surveying
for these opinions, and there is no mechanism for their
participation beyond telling officials what they think
(Labonte, 1992:24).
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Community Participation
Community Consultation
- However, prior to planning services, conducting a broad
based community needs assessment which includes the
views of key informants, community leaders, reference
groups, and especially members of the targeted group,
can effectively include community input in the decision
making process.
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Community Participation
Community Development in Health Project (1988)
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Community Development
• a process where community members are
supported by agencies to identify and take
collective action on issues which are important
to them.
• empowers community members and creates
stronger and more connected communities.
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Community Development
• Community development is a holistic
approach grounded in principles of
empowerment, human rights, inclusion, social
justice, self-determination and collective action
(Kenny, 2007).
• considers community members to be experts
in their lives and communities, and values
community knowledge and wisdom.
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Community Development
• are led by community members at every stage
- from deciding on issues to selecting and
implementing actions, and evaluation.
• has an explicit focus on the redistribution of
power to address the causes of inequality and
disadvantage.
Editor's Notes input in this case is through nominated or elected representatives taking part in a group process such as steering committee and reference groups, negotiating with members representing other sectors or interest groups.