Population health approach in Bangladesh

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Welcome to my
presentation
MD.Mahir Faysal
Department of Population Sciences
University of Dhaka

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Population Health Components:
Health Outcome, Health
Determinats & Policy

3. Outline
Introduction
Population Health Approach
Goals of Population Health Approach
Population Health Framework (Components)
Population Health outcome
Determinats
Policy & programs
Conclusion
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4. Introduction
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This presentation is going to inform you about three Population Health
Components: Health Outcome, Health Determinats & Policy. The details
description & their linkage will be discussed in this presentation.

5. Population Health
Approach
Population health strategies address the entire
range of factors that determine health.
Traditional health care focuses on risks and
clinical factors related to particular diseases.
Source: Minister of Supply and Services Canada 1994
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6. Goals of Population
Health Approach
1. To maintain and improve the health status
of the entire population
2. To reduce inequities in health status
between population groups.
Source: Chomik, T.A. 2001
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7. Population
Health
Framework
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Source: Kindig and Stoddart 2003.
Population Health Framework

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Population Health Framework continues….

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Population
Health
outcome

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There are two broad outcome goals of population health; increasing
overall or mean population health and eliminating disparities within the
population.

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For overall or mean population health, two components are displayed. Those are
mortality (length of life), and health-related quality of life, or morbidity. Health-
related quality of life can be defined as "a person’s subjection perception of the
impact of ill health on daily life and it includes physical, psychological and social
functioning” (US Dept. of Health and Human Services 2010). Simply put, one goal of
population health improvement is to increase years of life and the quality of those
life years.

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Another goal is to reduce the differences or disparities in these health outcomes
among different subgroups in the population. The figure indicates a number of
subgroups that are associated with significant differences or disparities in both
mortality and health-related quality of life. Those featured here are race/ethnicity,
socioeconomic status (SES), gender, and geography. Many other subgroups besides
these are associated with population health disparities. All differences are not
necessarily of policy interest or are equally important in all situations.

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Keep in Mind
that there is a
difference
between
Health Outcome
& Health status

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Health state or health status of an individual or population refers to health
at a point or narrow period of time, usually measured as morbidity or some
indicator of a health-related quality of life. When a measure of mortality or
life expectancy is added to the measure, it produces a more expansive
concept of population health outcome.

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Specific Population
Health Outcome
Measures

17. Mortality Rate
Tip
When a number is too
large or too small to
easily comprehend,
clarify it with a
comparison to
something familiar.
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18. Tip
When a number is too
large or too small to
easily comprehend,
clarify it with a
comparison to
something familiar.
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Morbidity

19. Health status
Tip
When a number is too
large or too small to
easily comprehend,
clarify it with a
comparison to
something familiar.
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 Signs - blood pressure, temperature, X-
ray, tumour size
 Symptoms - disease specific checklists
 Co-morbidity

20. Disability
Tip
When a number is too
large or too small to
easily comprehend,
clarify it with a
comparison to
something familiar.
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21. Health related
quality of life Tip
When a number is too
large or too small to
easily comprehend,
clarify it with a
comparison to
something familiar.
21

22. Determinants
of Population
Health
Outcome
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Health outcomes, however defined and measured, are produced by determinants or factors.
They often are sorted into the five categories presented on the right in the following model.

24. Health care
determinants generally
include access, cost,
quantity, and quality of
health care services
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25. Individual behavior
determinants include
choices about lifestyle or
habits such as diet, exercise,
and substance abuse
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26. Social environment
determinants include
elements of the social
environment such as
education, income,
occupation, class, social
support
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27. Physical environment
determinants include elements
of the natural and built
environment such as air and
water quality, lead exposure
etc.
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28. Genetic determinants
include the genetic
composition of individuals
or populations
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Have you ever
heard the term
“Reverse causality”
?????

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There exist some causal relationships in which what we have previously called an
outcome (e.g., morbidity) can produce a change in a determinant or risk factor,
such as a childhood illness being responsible for lower educational attainment. In
this case, the definitions are reversed, depending on the direction of the proposed
causal relationship. Here, morbidity would be the determinant, and educational
attainment, the outcome.

33. Population
Health Policies
and Programs
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Policies and programs play an important role in health improvement
through their influence on health factors as well as health outcomes.

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.
What do you think is
there any difference
between policy and
program?

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Policies can be implemented at many different levels, from an individual school or
worksite to municipalities, regions, states, and even the national level. Examples of
effective health policies include smoking bans, excise taxes on cigarettes and
alcohol, seat belt laws etc. There is an increasing call for a “health in all policies”
approach among population health academic and practice leaders.

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Programs aimed at population health improvement are extremely diverse and
address the full range of health determinants/factors. They not only encompass
efforts to improve access to health care and individual behavior but also work to
create healthy options and opportunities in the environments where people live,
learn, work, and play.

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Knowledge
transfer
Policy
maker
Policy
Policy
strategy
Intervention
Policy and intervention cycle of population health
Opportunity
cost Cost
benefit
analysis

41. Analyzing National Health Policy of
Bangladesh 2011

42. National Health Policy of Bangladesh 2011: Formed under
the supervision of Ministry of Health and Family Welfare
The Health Policy has:
• 19 objectives,
• 16 policy principles
• 14 challenges and
• 39 strategies

43. 1.Ensuring health & emergency treatment service for all
2. Increasing & expanding quality based health service for
all according to equality
3.To motive & aware people for preventing & control
disease

44. So in conclusion it can be say that the beauty of population health
perspective is that it offers a systematic approach for improving well
being and a framework for monitoring a nation’s health status
indicating where there need of improvement and where new strategies
are required.
This presentation was mailny focusing on three Population Health
Components: Health Outcome, Health Determinats & Policy. The
details description & their linkage. Here we also discussed about the
reverse causality of the components.
Both the term need & limitation are true for all governments. But the
most important thing is that the intelligence of the policy makers to
influence health determinants & its outcome in each sector.
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Conclusion

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