Concept and Evaluation of Public Health PDF

UNIT - I CONCEPT AND EVALUATION OF PUBLIC HEALTH Health is “a state of complete, physical, mental and social well-being and not merely an absence of disease or infirmity”. Public health is defined as “the science and art of preventing diseases, prolonging life, promoting health and efficiencies...

UNIT - I CONCEPT AND EVALUATION OF PUBLIC HEALTH Health is “a state of complete, physical, mental and social well-being and not merely an absence of disease or infirmity”. Public health is defined as “the science and art of preventing diseases, prolonging life, promoting health and efficiencies through organized community effort”. It deals with the health of the whole population and the prevention of disease from which the society suffers. Public health deals with the group of people rather than individuals. Public health involves both direct and indirect approaches. In public health practice, both direct and indirect approaches are important. Direct measures in public health include immunization of children, modern birth control, hypertension and diabetes case findings. Indirect methods used in public health to protect the individual by community such as raising standards of environmental safety, assurance of a safe water supply, sewage disposal and improved nutrition. Concepts in Public health Disease control phase (1880 – 1920). Health promotional phase (1921 – 1960). Social engineering phase (1961 – 1980) & Health for All phase (1981 – 2000).  Disease control phase (1880 – 1920) Public health during the 19th century was largely a matter of sanitary legislation and sanitary reforms aimed at the control of man’s physical environment ex: water supply, sewage disposal etc. Clearly theses measures were not aimed at the control of any specific disease. These measures vastly to improve the health of people due to disease and death control.  Health promotional phase (1921 – 1960) At the beginning of the 20th century, a new concept of “health promotion” began to take place. It was realized that public health had neglected the citizen as an individual, and that the state had a direct responsibility for the health of the individual. In addition to disease control activities, one more goal was added to public health, that is, health promotion of individuals. It was initiated as personal health services such as: Mother and child health services, school health services, industrial health services, mental health and rehabilitation services. Two great movements were initiated for human development during this phase: (A). Provision of “basic health services” through the medium of Primary health centers and sub centers for rural and urban areas. (B). The second great movement was the community development programme to promote village development through the active participation of the whole community and on the initiative of the community. This programme tried to do too much too quickly with inadequate resources.  Social engineering phase (1961 – 1980) With the advances in preventive medicine and practice of public health, the pattern of disease began to change in the developed world. Many of the acute illness problems have been brought under control. As old problems were solved, new health problems in the form of chronic diseases ex; - Cancer, DM, Cardiovascular disease, Alcoholism and Drug addiction etc. These problems could not be tackled by the traditional approaches to public health such as isolation, immunization and disinfection. These problems brought new challenges to public health which needed reorientation more towards social objectives. Public health entered a new phase in the 1960s, described as “Social engineering phase”. Social and behavioural aspects of disease and health were given a new priority. Public health moved into the preventive and rehabilitative aspects of chronic diseases and behavioural problems. Health for All Phase (1981 – 2000) The health gap between rich and poor within countries and between countries should be narrowed and ultimately eliminated. In 1981, the members of the WHO pledged themselves to an ambitious target to provide “Health for All” by the year 2000, that is attainment of a level of health that will permit all peoples “to lead a socially and economically productive life”. Currently public health, along with the medical sciences and other health related sectors is engaged in this broad field of effort. Core activities in Public health includes: 1. Preventing epidemics. 2. Protecting the environment, work place, food and water. 3. Promoting healthy behaviour. 4. Monitoring the health status of the population. 5. Mobilizing community actions. 6. Responding to disasters. 7. Assuring the quality, accessibility and accountability of medical care. 8. Reaching to develop new insights and innovative solutions. 9. Leading the development of sound health policy and planning.  Evaluation of Public health Evaluation is “a systematic process to assess the achievement of the stated objectives of a programme, its adequacy, efficiency and its acceptance by all parties involved”. Evaluation is carried out by the policy makers and also by research group (who are responsible for programme development and implementation) and by the community (Students, NGOs). Programme evaluation is an essential organizational practice in public health. It is not practiced consistently across programme areas. It is sufficiently well-integrated into the day-to-day management of most programmes. Programme evaluation is also necessary for fulfilling CDC’s operating principles for guiding public health activities: which include: 1. Using science as a basis for decision-making and public health action. 2. Expanding the quest for social equity through public health action. 3. Performing effectively as a service agency. 4. Making efforts outcome oriented and 5. Being accountable. Need of evaluation: To review progress towards desired health status at national or state levels and identify reasons for gap, if any. To contribute towards better health planning. To know whether desired health outcomes are being achieved and identify remedial measures. To document results achieved by a project funded by donor agencies. To improve health programme and the health infrastructure. Allocation of resources in current and future programme. To render health activities more relevant, more efficient and more effective. Various steps involved in evaluation are: Determine what is to be evaluated. To establish standards and criteria. To plan the methodology. Gather information. Analyze the results. Take action. Re-evaluate. THANK YOU Health promotion: Is a key element in public health and is applicable in the community, clinic or hospitals and in all other service settings. Health promotion is a guiding concept involving activities intended to enhance individual and community health well being. Its purpose is to enhance involvement and control of the individual and the community in their own health. It acts to improve health and social welfare, and to reduce specific determinants of diseases and risk factors that adversely affect the health, well being and productive capacities of an individual or society. It sets targets based on the size of the problem with the possibility of successful interventions in a cost effective way. It teaches awareness and informing people about health and lifestyle factors that might put them at risk.