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Public Health System: Needs and Requirements

Submitted by on September 23, 2012 – 6:11 PM

Public Health is the science and art of preventing disease, health surveillance, prolonging life and promoting health through the organized efforts of society.  Public Health services are an essential part of the health care system, and share with curative services the common goal of prolonging life (by preventing premature death and reducing pain ) and suffering (by preventing the occurrence of diseases and conditions that cause pain and suffering). Prevention is key to the health system’s sustainability.

Authoritative groups in several countries have defined public health in similar ways in recent years. For example, in the United Kingdom, public health is: “the science and art of promoting health, preventing disease, prolonging life and improving quality of life through the organized efforts of society” (Committee of Inquiry, 1988, as cited in National Advisory Committee on SARS and Public Health, 2003).

In Australia, public health is defined as “the organized response by society to protect and promote health, and to prevent illness, injury and disability.” (National Public Health Partnership, 2003).

In the United States it is defined as: “what we, as a society, do collectively to ensure the conditions in which people can be healthy” (Institute of Medicine, 1988).

Knowing is not enough , we must apply

Willing is not enough , we must do

–(Goethe)

So the vision of  public health is   “healthy people in healthy communities” And the mission of public health is   “to promote physical and mental health and to prevent  disease ,injury and disability” .

Public health improves the health and well-being of mankind in local communities and around the globe .It works to prevent the health problems before they occur. The challenge for the 21st century is to continue this important contribution to the betterment of society.Individual citizens, communities, the business sector, and governments all have an interest in improving health and preventing disease, injury, and disability. While these and other partners have a stake in improving public health, a strong governmental public health infrastructure is needed to protect and promote health and well-being (Institute of Medicine, 2002).

Fundamentally, public health shares the same goals as the rest of the health care system, namely to reduce premature death and to reduce the pain, suffering and the loss of enjoyment and quality of life that is associated with disease, disability, and injury. Interventions that prevent the onset conditions that cause death, pain, suffering, or disability are preferable to interventions after the onset of the condition, when some pain, suffering, and disability may have already occurred. In many cases, it is also less costly to society to prevent the condition from occurring in the first place than to treat it afterwards. Investing in prevention is as important as investing in treatment and care.

Overall ,public health is concerned with protecting the health of entire populations .These populations can be as small as a local neighborhood or as big as an entire country. Public health professionals try to prevent problems from happening or re-occuring through implementing educational programs ,developing policies, administrating services ,regulating health systems and some health professions and conducting research, in contrast to clinical professionals i.e. such as doctors and nurses ,who focus primarily on treating individuals after they become sick or injured .It is also  a field that is concerned with limiting health disparities and a large part of public health is fight for health care equity ,quality and accessibility. Much of the success and importance of public health interventions and approaches depends on the fact that everyone benefits from public health action-you cannot restrict clean air to only some people.

With the advent of network technology medical informatics has received a powerful impetus to its development. The specific cause of the breakthrough was the practice of medical informatics in the rapid development of communication networks, and methods of working with information that allowed the two to provide – and multilateral exchange of video – and audio information and any supporting documentation. The simplest case is the implementation of public health informatics is quick access to the necessary background information for the doctors. The main application of remote medical informatics is to serve those populations that were far from medical centers or have limited access to medical services.

Another important object of public health is system diagnostic centers in the regions when there is a necessity for operative relationship between the physician and the physician-diagnostician, but they are working in different hospitals, often separated by great distances. One more significant area of health informatics are first-aid situations with complicated cases that require urgent consultation of experts from the central health facilities in order to save the patient or determine the therapeutic approach in difficult situations, including the world’s largest medical centers.

With the advent of network technology medical informatics has received a powerful impetus to its development. The specific cause of the breakthrough was the practice of medical informatics in the rapid development of communication networks, and methods of working with information that allowed the two to provide – and multilateral exchange of video – and audio information and any supporting documentation. The simplest case is the implementation of public health informatics is quick access to the necessary background information for the doctors. The main application of remote medical informatics is to serve those populations that were far from medical centers or have limited access to medical services.

Another important object of public health is system diagnostic centers in the regions when there is a necessity for operative relationship between the physician and the physician-diagnostician, but they are working in different hospitals, often separated by great distances. One more significant area of health informatics are first-aid situations with complicated cases that require urgent consultation of experts from the central health facilities in order to save the patient or determine the therapeutic approach in difficult situations, including the world’s largest medical centers.

Pakistan at the time of its independence in 1947 inherited a health care delivery system that was a legacy of colonial British period. This rudimentary system was in the shape of public health services and some curative services. Up until the recent devolution initiative the health sector was not subject to major organizational and management reforms. There were some isolated attempts at reforms but most did not represent large-scale changes to the model of provincially centralized, in house provision of services using regular civil service employees.

In recent years Punjab and North West Frontier Province (NWFP, KP) have been experimenting with organizational reforms including contract employment of doctors and other cadres in an effort to achieve greater control over staffing. There have also been various initiatives to fund NGOs to deliver health and family welfare services – the most successful being the private public partnerships under the Northern Health Project. Punjab has led the way in granting a greater managerial and financial autonomy to its tertiary hospitals – accompanied by a strong drive to improve governance in these hospitals. Preliminary assessments of Punjab’s experiment suggest that gains have been made in terms of efficiency and governance. NWFP has introduced reforms to improve personnel recruitment and deployment, pilot programs for rationalizing health care services, tertiary government hospitals with greater managerial and financial autonomy and has undertaken some experiments with public/private partnerships.

So it will be worthwhile in this interim period to develop provincial goals and objectives that relate to the core public health programs, so that it is clear how these performance expectations are related to improved population health. This might include looking at existing goals, objectives, and performance expectations in jurisdictions such as Saskatchewan and Ontario, as they have already undertaken some of this work.

About the Author :  Uzma Khan is a medical student  in Bahria University Medical and Dental College, Karachi, Pakistan. She can be reached at [email protected]

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