Concept of International health and its evolution Comparing Global health, International health and Public Health

1. 203.5-PHCIH:- International
Health
Sandeep Ghimire
MPH-GH
2018

2. International Health
•Introduction to International Health
•Current Global Health Issues
PHCIH_BPH_3rd Semester 2

3. Introduction to International
Health
Concept and evolution of global
health/International Health
PHCIH_BPH_3rd Semester 3

4. Public Health
• “…the art and science of prolonging life, preventing disease
and promoting health, through the organized efforts of
society…” (Acheson, 1988).
• “…assuring the conditions in which people can be healthy, by
generating organized community efforts, in applying
scientific & technical knowledge to promote health and
prevent disease…” (IOM, 1988).
PHCIH_BPH_3rd Semester 4

5. Public Health
• “Public health is the science and art of preventing disease,
prolonging life and promoting physical health and efficacy
through organized community efforts for the sanitation of
the environment, the control of communicable infections,
the education of the individual in personal hygiene, the
organization of medical and nursing services for the early
diagnosis and preventive treatment of disease, and the
development of social machinery which will ensure every
individual in the community a standard of living adequate
for the maintenance of health; so organizing these benefits
in such a fashion as to enable every citizen to realize his
birthright and longevity.”(Winslow,1920)
PHCIH_BPH_3rd Semester 5

6. Public Health
•Last defined public health as “one of the efforts to
protect, promote and restore the people’s health. It is
the combination of sciences, skills and beliefs that is
directed to the maintenance and improvement of the
health of all the people through collective or social
actions”.(Last, 2001)
PHCIH_BPH_3rd Semester 6

7. Elements embedded in definitions
•Decision Making based on data and evidence (Vital
Data, Surveillance, outbreak investigation,)
•A focus on population rather than individuals
•A goal of social justice and equity
•An emphasis on prevention rather than curative care
PHCIH_BPH_3rd Semester 7

8. International Health
• It was the term used for health work abroad
•geographic focus on developing countries and often
with a content of infectious and tropical diseases,
water and sanitation, malnutrition, and maternal and
child health( Brown,2006)
PHCIH_BPH_3rd Semester 8

9. International Health
•International health is defined by Merson, Black, and
Mills as “the application of the principles of public
health to problems and challenges that affect low and
middle-income countries and to the complex array of
global and local forces that influence them”(Mearson
et.al,2006)
(international health is also used as a synonym for
global health)
PHCIH_BPH_3rd Semester 9

10. •International health, focuses on the health issues,
especially infectious diseases, and maternal and child
health in low-income countries. (Global Health
Action,2010)
PHCIH_BPH_3rd Semester 10

11. International Health
•The term ‘international health’ has also been used to
refer to ‘the involvement of countries in the work of
international organizations such as WHO, usually
through small departments of international health in
the Ministries of Health and as development aid and
humanitarian assistance
PHCIH_BPH_3rd Semester 11

12. Global Health
•"collaborative trans-national research and action for
promoting health for all".(Global Health Action,2010)
PHCIH_BPH_3rd Semester 12

13. •Collaborative (or collective) emphasises the critical
importance of collaboration in addressing all health
issues and especially global issues which have a
multiplicity of determinants and a complex array of
institutions involved in finding solutions.
PHCIH_BPH_3rd Semester 13

14. •Trans-national (or cross-national) refers to the
concern of global health with issues that transcend
national boundaries even though the effects of global
health issues are experienced within countries. Trans-
national action requires the involvement of more than
two countries, with at least one outside the traditional
regional groupings, without which it would be
considered a localised or regional issue.
• At the same time, trans-national work is usually
based on strong national public health institutions.
PHCIH_BPH_3rd Semester 14

15. •Research implies the importance of developing the
evidence-base for policy based on a full range of
disciplines and especially research which highlights the
effects of trans-national determinants of health.
•Action emphasizes the importance of using this
evidence-based information constructively in all
countries to improve health and health equity.
PHCIH_BPH_3rd Semester 15

16. •Promoting (or improving) implies the importance of
using a full range of public health and health promotion
strategies to improve health, including those directed
at the underlying social, economic, environmental and
political determinants of health.
PHCIH_BPH_3rd Semester 16

17. •Health for all refers back to the Alma Ata Declaration
and positions global health at the forefront of the
resurgence of interest in multi-sectoral approaches to
health improvement and the need to strengthen
primary health care as the basis of all health systems
PHCIH_BPH_3rd Semester 17

18. Global Health
•Global health is focused on people across the whole
planet rather than the concerns of particular nations.
•Global health recognizes that health is determined by
problems, issues and concerns that transcend national
boundaries
•‘worldwide improvement of health, reduction of
disparities, and protection against global threats that
disregard national borders’(Macfarlane et al,2008)
PHCIH_BPH_3rd Semester 18

19. Comparing Global Health,
International Health and Public
Health

20. Public health International health Global health
Geographic
al reach
Focuses on issues that affect
the health of the population of
a particular community or
country
Focuses on health issues of
countries other than one’s own,
especially those of low-income and
middle-income
Focuses on issues that
directly or indirectly affect
health but that can
transcend national
boundaries
Level of
cooperatio
n
Development and
implementation of solutions
does not usually require global
cooperation
Development and implementation
of solutions usually requires
binational cooperation
Development and
implementation of solutions
often requires global
cooperation
Individuals
or
populations
Mainly focused on prevention
programmes for populations
Embraces both prevention in
populations and clinical care of
individuals
Embraces both prevention in
populations and clinical care
of individuals
Access to
health
Health equity within a nation
or community is a major
objective
Seeks to help people of other
nations
Health equity among nations
and for all people is a major
objective
Range of
disciplines
Encourages multidisciplinary
approaches, particularly within
health sciences and with social
sciences
Embraces a few disciplines but has
not emphasised multidisciplinarity
Highly interdisciplinary and
multidisciplinary within and
beyond health sciences
PHCIH_BPH_3rd Semester 20

21. Evolution of International
Health
PHCIH_BPH_3rd Semester 21

22. Evolution of International Health
•Paul Russel said "Nothing in this earth is more
international than disease"
•It is obvious that health and disease of people in one
country are related to health and disease in other
countries
•This necessitates the need for international
cooperation in the area of health
PHCIH_BPH_3rd Semester 22

23. Cont..
•Health and disease have no political or geographical
boundaries
•Disease in any part of the world is constant threat to
other parts
•In order to protect from the spread of disease from
one country to another many attempts were made in
the past by individual ruler and states to place barriers
against infection by detection and isolation of
incoming travelers
PHCIH_BPH_3rd Semester 23

24. • Diseases spread from one country to another. Examples are
syphilis, plague, cholera, influenza and AIDS.
• In Indian context Syphilis was earlier known as ‘Firangi
Rog’ because it was believed to have been brought to India
by the Europeans.
• Research, knowledge and developments in the field of
health should not be confined to any one country but
should, rather, be freely available to the whole mankind.
PHCIH_BPH_3rd Semester 24

25. •Poor health conditions in a country are associated
with and lead to poor development.
•The marked disparity between the developed and
underdeveloped countries is a danger for world
peace.
PHCIH_BPH_3rd Semester 25

26. •Population explosion in the world has to be contained
if the human race has to survive.
•There are countries in the world with near zero
population growth, while there are many countries
with very high rates.
• The former cannot remain silent spectators to the
high birth rates in many parts of the world when the
survival of mankind itself is at stake.
PHCIH_BPH_3rd Semester 26

27. Cont..
•In the 14th century a procedure known as
"Quarantine" was introduced in Europe to protect
against importation of plague
•After that Quarantine become an established practice
in many countries
•Different countries adopted different quarantine
procedures
•This was the origin of International health work
PHCIH_BPH_3rd Semester 27

28. Cont...
•Due to lack of scientific knowledge regarding the
causation and mode of spread of diseases quarantine
failed in its objective
•As 40 day detention obstructed and caused serious
inconvenience to international trade and travel
•It becomes necessary for international agreement and
cooperation on quarantine matters to control
communicable disease
PHCIH_BPH_3rd Semester 28

29. Reference
• Archeson (1988) Report Public Health in England: Report of the Committee of Inquiry into the future development of the
public health function, London: Her Majesty Stationary Office (HMSO).
• Institute of Medicine (1988) Committee for the Study of the Future of Public Health, 1988, p.19 Washington DC: National
Academy of Sciences, IOM.
• Winslow C. The untilled field of public health. Mod Med 1920; 2: 183–91.
• Last J. A dictionary of epidemiology. New York: Oxford, 2001
• Brown TM, Cueto M, Fee E. The World Health Organization and the transition from “international” to “global” public
health. Am J Public Health 2006; 96: 62–72.
• Merson MH, Black RE, Mills AJ. International public health: diseases, programs, systems, and policies, 2nd edn. Sudbury
MA: Jones and Bartlett Publishers, 2006.
• Kickbush I. The need for a European strategy on global health. Scand J Public Health 2006; 34: 5615.
• Macfarlane SB, Jacobs M, Kaaya EE. In the name of global health: trends in academic institutions. J Public Health Policy
2008; 29: 383401.
PHCIH_BPH_3rd Semester 29

30. PHCIH_BPH_3rd Semester 30