Public Health
Core Functions and Essential Services
What is Public Health ?
The Sum of all officials or
Government efforts to “Promote”,
“Protect” and “preserve” the
people’s Health
Public Health
“The Science and art of preventing disease, prolonging life, promoting
health and efficiency through organized community effort.”
-CEA Winslow, 1920
“The process of mobilizing and engaging local, state, national, and
international resources to assure the conditions in which people can be
healthy”
-The Oxford Textbook of Public Health
Public Health
“The science and practice of protecting and improving the health of
the community, as by preventive medicine, health education, control
of communicable diseases, application of sanitary measures, and
monitoring of environmental hazards.”
-The American Heritage Dictionary of Public Health
Public Health
• Public health is what we, as a society, do collectively to assure the
conditions in which people can be healthy.”
-Source: Institute of Medicine Report (IOM). THE FUTURE
OF PUBLIC HEALTH. Washington DC: National Academy
Press.1988.
• Public health is a science and art of saving the lives of millions at once
by a single decision or intervention.
Public Health
A System
A Method
A Profession
Government Service
The Health of the Public
The Public Health system
Community
Government Health care
public health delivery
infrastructure system
Assuring the
conditions
for
Population
health
Employes
Academia and
business
The
Media
Public Health Approach
Public health Model Medical Model
• Population • Individual
• Disease Prevention • Diagnosis
• Health Promotion • Treatment
• Interventions • Intervention
• Environment • Medical care
• Human behavior • Private (Some public)
• Public (Some private)
Core Functions of Public Health
Core Activities of Public Health
Prevents epidemics and the spread of disease
Protects against environmental hazards
Responds to disasters and assists communities in
recovery
Prevents injuries
Promotes healthy behaviors
Assures the quality, accessibility and accountability
of health services
Core Activities of Public Health
Monitoring the health status of the population
Mobilizing community action
Reaching out to link high-risk and hard-to-reach
people to needed services
Researching to develop new insights and
innovative solutions
Leading the development of sound health
policy and planning Core Activities of Public
Health
Ten Great Public Health Achievements
Vaccination
Motor-vehicle safety
Safer workplaces
Control of infectious diseases
Decline in deaths from coronary heart disease and stroke
Safer and healthier foods
Healthier mothers and babies
Family planning
Fluoridation of drinking water
Recognition of tobacco use as a health hazard CDC, 1999
Public Health Problems And Diseases
Communicable diseases
Non communicable diseases
Environmental pollution
Maternal child health problems
Malnutrition and micronutrient deficiency
Municipal and hospital waste
Geriatric health problems
Population problems
Public Health Problems And Diseases
Measles
Influenza
Poliomyelitis
Tuberculosis
Cholera
Dengue
Malaria
HIV/AIDS
Obesity
Cancer
Diabetes
Public Health Organization
Non Governmental
National
NFHP
FPAN
Nepal Red Cross
PLAN Nepal
International
CARE
United Mission to Nepal
Save the Children
Marie Stopes International
Public Health Organization
United Nation
WHO
WFP
FAO
UNICEF
UNDP
Public Health Organizations
Governmental
District health office
Public health office
Regional health directorate
Regional training center
Department of health services
Ministry of health and population
Primary health care institutions
Public Health Organizations
Others
Academic institutions
Research organizations
Community development organizations
Quality control offices
Health training centers
Local development offices
A Sampling of Public Health Profession
Population, Family Planning & Reproductive Health
Maternal Child health
Public Health Education and Health Promotion
Community health planning and policy development
Public health administration
Epidemiology and disease control
Alcohol, tobacco and other drugs
Environmental & occupational health and safety
Food and nutrition
A Sampling of Public Health Profession
Gerontological health
HIV/AIDS
Injury control and emergency health Services
International Health
Mental Health
Oral Health
Public Health Nursing
School Health Education and Services
Women’s health and gender development
Functions Of Public Health
Assessment
Monitor health status to identify community health problems
Diagnose and investigate health problems and health hazards in the community
and evaluate the effectiveness, accessibility, and quality of personal and
population-based health services
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
Enforce laws and regulations that protect health and ensure safety.
Functions Of Public Health
Assurance
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
Functions Of Public Health
Assessment
• Monitor health status to identify community health problems
• Accurate, periodic assessment of the community’s health status
Identification of health risks
Attention to vital statistics and disparities
Identification of assets and resources
• Use of methods and technology (e.g., mapping technology) to interpret
and communicate data
• Maintenance of population health registries
Functions Of Public Health
• Diagnose and investigate health problems and health hazards
in the community
• Timely identification and investigation of health threats
• Availability of diagnostic services, including laboratory
capacity
• Response plans to address major health threat
Functions Of Public Health
Policy Development
Inform, Educate, and Empower People About Health Issues
Initiatives using health education and communication sciences to
Build knowledge and shape attitudes
Inform decision-making choices
Develop skills and behaviors for healthy living
Health education and health promotion partnerships within the
community to support healthy living
Media advocacy and social marketing
Functions Of Public Health
Policy Development
Mobilize Community Partnerships to Identify and Solve Health
Problems
Constituency development
Identification of system partners and stakeholders
Coalition development
Formal and informal partnerships to promote health improvement
Functions Of Public Health
Policy Development
Develop policies and plans that support individual and community
health efforts
Policy development to protect health and guide public health practice
Community and state improvement planning
Emergency response planning
Alignment of resources to assure successful planning
Functions Of Public Health
Policy Development Enforce laws and regulations that protect health
and ensure safety.
Review, evaluation, and revision of legal authority, laws, and
regulations
Education about laws and regulations
Advocating for regulations needed to protect and promote health
Support of compliance efforts and enforcement
Functions Of Public Health
Policy Development
Enforce laws and regulations that protect health and ensure safety.
Review, evaluation, and revision of legal authority, laws, and
regulations
Education about laws and regulations
Advocating for regulations needed to protect and promote health
Support of compliance efforts and enforcement
Functions Of Public Health
Assurance
Link people to needed personal health services and assure the
provision of health care when otherwise unavailable
Identification of populations with barriers to care
Effective entry into a coordinated system of clinical care
Ongoing care management
Culturally appropriate and targeted health information for at-risk
population groups
Transportation and other enabling service
Functions Of Public Health
Assurance
Assure a Competent Public and Personal Healthcare Workforce
Assessing the public health and personal health workforce
Maintaining public health workforce standards
Efficient processes for licensing /credentialing requirements
Use of public health competencies
Continuing education and life-long learning
Leadership development
Cultural competence
Functions Of Public Health
Assurance
Evaluate the Effectiveness, Accessibility, and Quality of Personal and
Population-Based Health Services
Evaluation must be ongoing and should examine
Personal health services
Population-based services
The public health system
Quality Improvement
Functions Of Public Health
Assurance
Research for New Insights and Innovative Solutions to Health Problems
Identification and monitoring of innovative solutions and cutting-edge
research to advance public health
Linkages between public health practice and academic/research
settings
Epidemiological studies, health policy analyses and public health
system
Core Competence of Public Health
Core competencies are the fundamental knowledge, skills, and attributes a
person or organization holds that allow an individual or company to succeed
and grow.
In the public health sector, core public health competencies allow the
workforce to operate effectively and carry out the core function of public
health including population health assessment, monitoring, health
promotion, disease and injury prevention, health protection, and emergency
preparedness.
Some public health employers may refer to the core competencies to
develop job descriptions in postings, performance objectives and
assessments, and workforce development plans to ensure a skilled workforce
Core Competence of Public Health
• Seven core competencies of Public Health are,
1. Biostatistics
2. Environmental Health Sciences
3. Epidemiology
4. Health Policy and Management
5. Social and Behavioral Sciences
6. Critical thinking
7. Problem-solving
Biostatistics
Competencies in biostatistics enable
public health professionals to address
and solve problems in public health by
analyzing and interpreting data and
applying statistical reasoning and
methods.
Problem-solving
Epidemiology
• Epidemiology
• Often associated with public health and public health degree programs, the
epidemiology competency is the ability to study diseases and injury within
populations
Environmental Health Sciences
• This competency focuses on how biological, physical and chemical
environmental factors affect human health.
Health Policy and Management
• It’s the ability to use both a
managerial and a policy
perspective to focus on the
delivery, accessibility, quality,
organization, and health care costs
for individuals and populations.
Social and Behavioral Sciences
• This competency in public health examines how behavioral, social,
and cultural matters contribute to public health issues.
Emerging Public Health Competencies
1) Evidence-based approaches to public health
2) Public health and health care systems
3) Planning and management to promote health
4) Policy in public health
5) Leadership
6) Communication
7) Inter-professional practice
8) Systems thinking
Emerging Public Health Competencies
Evidence-based Approaches to public health
1) Apply epidemiological methods to the breadth of settings and
situations in public health practice.
2) Select quantitative and qualitative data collection methods
appropriate for a given public health context.
3) Analyze quantitative and qualitative data using biostatistics,
informatics, computer-based programming, and software, as
appropriate.
4) Interpret the results of data analysis for public health research,
policy, or practice.
Emerging Public Health Competencies
Public health and healthcare systems
5) Compare the organization, structure, and function of health care,
public health and regulatory systems across national and international
settings.
6) Discuss how structural bias, social inequities and racism undermine
health and create challenges for achieving health equity at the
organizational, community and societal levels.
Emerging Public Health Competencies
Planning and management to promote health
7) Assess population needs, assets and capacities that affect
communities’ health.
8) Apply awareness of cultural values and practices to the design or
implementation of public health policies or programs.
9) Design a population-based policy, program, project or intervention.
10) Explain the basic principles and tools of budget and resource
management.
11) Select methods to evaluate public health programs.
Emerging Public Health Competencies
Policy in public health
12) Discuss multiple dimensions of the policy- making process,
including the roles of ethics and evidence.
13) Propose strategies to identify stakeholders and build coalitions
and partnerships for influencing public health outcomes.
14) Advocate for political, social or economic policies and programs
that will improve health in diverse populations.
15) Evaluate policies for their impact on public health and health
equity.
Emerging Public Health Competencies
Leadership
16) Apply principles of leadership, governance, and management,
which include creating a vision, empowering others, fostering
collaboration and guiding decision making.
17)Apply negotiation and mediation skills to address organizational
or community challenges
Emerging Public Health Competencies
Communication
18) Select communication strategies for different audiences and sectors.
19)Communicate audience-appropriate public health content, in writing
and through oral presentation.
20)Describe the importance of cultural competence in communicating
public health content.
Inter-Professional practice
21)Perform effectively on interprofessional teams.
Systems thinking
22)Apply systems thinking tools to a public health issue.
Scope of Public Health
1. Mental health
Mental health research, examine stress, anxiety, depression, self-harm, and suicide
Technology and social media and its impacts on bullying and self-image, issues of
loneliness and isolation.
2. Bio-terrorism
The use of biological weapons in war
Identification of the event. This can be achieved by generating awareness, having a
high degree of suspicion, and having a good surveillance system to assist in quick
detection
3. Demography
making forecasts about future population size and structure to analyze both the
present and the future necessitates a review of the past
The size of the population as a whole to determine fertility, mortality, migration etc.
Scope of Public Health
5. Health financing
Health economics and outcomes research
Economic evaluation: Demand vs supply, Cost- Minimization Analysis, Cost-Effectiveness
Analysis, Cost-utility Analysis, Cost-benefit Analysis
Efficient and equitable allocation of healthcare resources in public health.
6. Addressing social determinants of Health & health Policy
Social determinants of health research
The influences and interactions of personal characteristics (sex, age, ethnicity, disability, and
hereditary factors)
Social and community networks (family and wider social circles)
Living and working conditions (work, housing, education)
General socioeconomic, cultural, and environmental conditions (taxation, availability of
work) on public health and well-being.
Scope of Public Health
7. Environmental health
Hygiene promotion and sanitation plan
Water source sanitation and hygiene Plan
Latrine management plan
Waste disposal and management plan
Shelter planning
Shelters will be equipped with long-lasting insecticidal nets (LLIN)
8. Infectious disease prevention to chronic disease prevention
Immunization and child vaccination
Hygiene and sanitation
Safe food and safe water distribution
Safe sex practice
Screening, Surveillance, and Outbreak investigation
Limiting contact with infectious persons
Incorporating human rights protections into quarantine and isolation laws
Other Scope of Public Health
Health Promotion
Mass media advertisement
Campaigning on health issues
Patient education
Environmental safety measures
Public Policy issues
Physical health
Others Scope of Public Health
Preventive and curative medical approach
Health enhancing facilities in local communities
IEC materials dissemination
Awareness programs through various methods and
media.
Counseling for the affected ones
The 10 Essential Public Health Services
[Link] health status to identify and solve community health
problems
[Link] and investigate health problems and health hazards in
the community
[Link], educate, and empower people about health issues
[Link] community partnerships to identify and solve health
problems
[Link] policies and plans that support individual and
community health efforts
The 10 Essential Public Health Services
6. Enforce laws and regulations that protect health and ensure
safety
7. Link people to needed personal health services and assure the
provision of health care when otherwise unavailable
8. Assure a competent public and personal health care workforce
9. Evaluate effectiveness, accessibility, and quality of personal and
population-based health services
[Link] for new insights and innovative solutions to health
problems
The 10 Essential Services as a Framework
• Provide a foundation for any public health activity
• Describe public health at the state, tribal, local, and territorial levels
• Used as a foundation for the National Public Health Performance
Standards (NPHPS)
• NPHPS provides a description of the essential service at an
optimal level that public health systems can use to assess their
performance
• Provided structure for national voluntary public health
accreditation
Essential Service (ES) 1 – Monitor Health to Identify
and Solve Community Health Problems
• Accurate, periodic assessment of the community’s health
status
• Identification of health risks
• Attention to vital statistics and disparities
• Identification of assets and resources
• Use of methods and technology (e.g., mapping technology)
to interpret and communicate data
• Maintenance of population health registries
ES 2 – Diagnose and Investigate Health
Problems and Hazards in the Community
Timely identification and investigation of health threats
Availability of diagnostic services, including laboratory capacity
Response plans to address major health threats
ES 3 – Inform, Educate, and Empower
People About Health Issues
• Initiatives using health education and communication
sciences to
• Build knowledge and shape attitudes
• Inform decision-making choices
• Develop skills and behaviors for healthy living
• Health education and health promotion partnerships
within the community to support healthy living
• Media advocacy and social marketing
ES 4 – Mobilize Community Partnerships
to Identify and Solve Health Problems
• Constituency development
• Identification of system partners and stakeholders
• Coalition development
• Formal and informal partnerships to promote health
improvement
ES 5 – Develop Policies and Plans That
Support Individual and Community
Health Efforts
• Policy development to protect health and guide
public health practice
• Community and state improvement planning
• Emergency response planning
• Alignment of resources to assure successful
planning
ES 6 – Enforce Laws and Regulations That
Protect Health and Ensure Safety
• Review, evaluation, and revision of legal authority, laws, and
regulations
• Education about laws and regulations
• Advocating for regulations needed to protect and promote health
• Support of compliance efforts and enforcement as needed
ES 7 – Link People to Needed Personal
Health Services and Assure the Provision of
Health Care When Otherwise Unavailable
• Identification of populations with barriers to care
• Effective entry into a coordinated system of clinical care
• Ongoing care management
• Culturally appropriate and targeted health information for at risk
population groups
• Transportation and other enabling services
ES 8 – Assure a Competent Public and
Personal Healthcare Workforce
• Assessing the public health and personal health workforce
• Maintaining public health workforce standards
• Efficient processes for licensing /credentialing requirements
• Use of public health competencies
• Continuing education and life-long learning
• Leadership development
Cultural competence
ES 9 – Evaluate Effectiveness,
Accessibility, and Quality of Personal and
Population-Based Health Services
Evaluation must be ongoing and should examine:
• Personal health services
• Population based services
• The public health system
Quality Improvement
Performance Management
ES 10 – Research for New Insights and
Innovative Solutions to Health Problems
• Identification and monitoring of innovative solutions and
cutting-edge research to advance public health
• Linkages between public health practice and academic/research
settings
• Epidemiological studies, health policy analyses and public health
systems research
