public health in somalia

SPHTI

LECTURE NOTES

For Health Science Students

Abdifatah Ahmed said, BPH

Bangladesh University of Health & science

In collaboration with the Somalia Public Health Training Initiative, The Carter Center,

The Somalia Ministry of Health, and the Somalia Ministry of Education

2015

Introduction to public

Health

Somalia

Public Health

Training Initiative

ABBREVIATIONS

AIDS -Acquired Immune Deficiency Syndrome

ALERT -All Africa Leprosy Rehabilitation and Training Center

ALRI - Acute Lower Respiratory Infection

AURI - Acute Upper Respiratory Infection

ANC - Antenatal Care

ARI - Acute Respiratory Infection

CHA - Community Health Agents

CHC - Community Health Care

CHW - Community Health Worker

CIH -COMMUNITY INVOLVEMENT IN HEALTH

CPHC - Comprehensive Primary Health Care

DPT - Diphtheria Pertussis and Tetanus

EPI - Expanded Program of Immunization

FP - Family Planning

GOBIFF -Growth monitoring, Oral rehydration, Breast-feeding, Immunization, Female education, Family Planning.

HIV - Human Immune Deficiency Virus

HLS - Household Livelihood Security

HSEP - Health Service Extension Package

IEC - Information Education Communication

MCH - Maternal and Child Health

MDG - Millennium Development Goal

MOA - Ministry Of Agriculture

MOE - Ministry Of Education

MOH - Ministry of Health

ORT - Oral Rehydration Therapy

PHC - Primary Health Care

PHCU - Primary Heath Care Unit

RH - Reproductive Health

SPHC - Selective Primary Health Care

STD - Sexually Transmitted Disease

STI - Sexually Transmitted Infection

TB - Tuberculosis

TBA - Traditional Birth Attendant

TT - Tetanus Toxoid

TTBA - Trained Traditional Birth Attendant

UNICEF - United Nation Children’s Fund

WHO - World Health Organization

Definitions of public health

What is Public Health?

"Public health protects and improves the health of individuals, communities, and populations, locally and globally."

What Is Public Health?

• “To promote health and quality of life by preventing and controlling disease, injury, and disability.

• “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity"

• Public Health’s mission is to create the conditions within which people can be healthy

• Public Health shapes the context within which people and communities can be safe and healthy.

"Public Health is the science and the art of preventing disease, prolonging life, and promoting physical health and efficiency through organized community efforts for the sanitation of the environment, the control of community infections, the education of the individual in principles of personal hygiene, the organization of medical and nursing services for the early diagnosis and preventive treatment of disease, and the development of the social machinery which will ensure to every individual in the community a standard of living adequate for the maintenance of health."

Mission of public health is "the fulfillment of society's interest in assuring the conditions in which people can be healthy." substance of public health is "organized community efforts aimed at the prevention of disease and the promotion of health."

Organizational framework of public health "encompasses both activities undertaken within the formal structure of government and the associated efforts of private and voluntary organizations and individuals."

C.E.A. Winslow, 1920

The science and art of:

• preventing disease

• prolonging life, and

• promoting physical and mental health and efficiency

• Through organized community efforts

C.E.A. Winslow’s Core Functions • Sanitation of the environment • Control of community infections • Education of the individual in principles of personal hygiene • Organization of medical and nursing service for early diagnosis and preventive treatment of disease • Development of the social machinery which will ensure to every individual in the community a standard of living adequate for the maintenance of health

1987 IOM Report

• Public Health is in disarray

• More linkages between theory and practice, between academia and field work

• Public Health’s mission is to create the conditions within which people can be healthy (paraphrase)

• WV BPH “Shape the environments within which people and communities can be safe and healthy”

The Ten Essential Public Health Functions Monitor health status to identify community health problems Diagnose and investigate health problems and health hazards in the community 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 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

Research for new insights and innovative solutions to health problems

Ten Great Public Health Achievements --- Somalia, 2015—2015:

Reductions in Child Mortality Vaccine-Preventable Diseases Access to Safe Water and Sanitation Malaria Prevention and Control Prevention and Control of HIV/AIDS Tuberculosis Control Control of Neglected Tropical Diseases Tobacco Control Increased Awareness and Response for Improving Global Road Safety Improved Preparedness and Response to Global Health Threats

Ten Great Public Health Achievements --- Somalia, 2015--2015:

Vaccine-Preventable Diseases Prevention and Control of Infectious Diseases Tobacco Control Maternal and Infant Health Motor Vehicle Safety Cardiovascular Disease Prevention Occupational Safety Cancer Prevention Childhood Lead Poisoning Prevention Public Health Preparedness and Response

Understanding Public Health is a series of books particularly aimed at students and public health practitioners who want to increase and update their knowledge and understanding of public health topics. They "provide a comprehensive account of the three main aims of public health: protecting the public from environmental hazards, improving the health of the public and ensuring high quality health services are available to all………………….

Core Functions of Public Health

http://mcgraw-hill.co.uk/cgi-bin/same_series.pl?series=PU&series_desc=Understanding%20Public%20Health

• Assessment

• Policy Development

• Assurance

• Safety Net Services (not really a CF) – When not otherwise available – Those services that are so essential that we provide them regardless of ability to pay

The Ten Essential Services

1. Monitor health status 2. Diagnose and investigate health problems

3. Inform and educate 4. Mobilize communities to address health problems

5. Develop policies and plans 6. Enforce laws and regulations

7. Link people to needed health services 8. Assure a competent health services workforce 9. Evaluate health services 10.Conduct research for new innovations

THE THREE CORE PUBLIC HEALTH FUNCTIONS and the Essential Public Health Services ……

Assessment

1. Monitor health status to identify community health problems

2. Diagnose and investigate health problems and health hazards in the community

3. Evaluate effectiveness, accessibility, and quality of personal and population-based health services

Policy Development

1. Develop policies and plans that support individual and community health efforts

2. Enforce laws and regulations that protect health and ensure safety.

3. Research for new insights and innovative solutions to health problems

Assurance

1. Link people to needed personal health services and assure the provision of health care when otherwise unavailable

2. Assure a competent public health and personal health care workforce

3. Inform, educate, and empower people about health issues

4. Mobilize community partnerships to identify and solve health problems

Essential Service: Monitor health status to identify and solve community health problems

Activities by state and/or local public health agencies

1. Determine and monitor water quality

2. Monitor water wells

3. Monitor wastewater treatment and disposal

4. Identification of water-quality problems

5. Mosquito surveillance

6. Immunizations

7. STD/HIV testing and counseling

8. Food-borne illness investigations

9. Bio-emergency preparation and coordination

10. Tracking of number of wells, abandoned wells

11. Screening for diabetes

12. Needs assessment

13. Collection of child oral health data

14. Child lead-poisoning surveillance

Essential service: Diagnose and investigate health problems and health hazards in the community


� Medical examiners

� Epidemiology

� TB

� HIV/AIDS

� Investigation and evaluation of nuisance complaints

� Wellhead assessments and site evaluations

Essential Service: Inform, educate and empower people about health issues


1. Community health education and health promotion

2. Public health education through the media, presentations, the Internet, displays, etc.3. HIV/AIDS risk reduction curriculum 4. Child-abuse education 5. Domestic violence education 6. WIC educational programs 7. Informing, educating parties involved in nuisance investigations8. Public education about well construction

Essential Service: Mobilize community partnerships and action to identify and solve health problems


1. Tobacco-free coalitions2. Bio-emergency regional collaboration 3. Collaborative efforts with private industry to combat domestic violence 4. Community partnerships with law enforcement, county attorneys, community betterment

groups, housing authorities5. Referrals and collaboration with health-care providers6. Collaboration with WIC, public health nursing, special-population advocates to meet the needs

of special populations

Essential service: Develop policies and plans that support individual and community health efforts


1. State board of health oversight and regulatory functions

2. Local board of health oversight and regulatory functions

3. Public hearings

4. Administration of state and local public health departments

5. Monitoring of contractors/providers

6. Community health planning

7. Strategic and performance planning

8. Development of a plan to address housing needs

9. Updating of health and nuisance ordinances

10. Development of policies on investigations, police assistance and trespass and safety issues

11. Board of health adoption of rules that require better management of water systems in small, rural subdivisions

12. Determination of need for community water supplies

13. Development of variance procedures

14. Establishment of procedures for water well permits

15. Establishment of civil citation authority

16. Establishment of procedures to deal with contaminated or high risk sites

17. Establishment of financial assistance for well sampling, plugging or rehabilitation

Essential service: Enforce laws and regulations that protect health and ensure safety


1. Hazardous materials and sites inspections and certifications2. Milk inspections3. Professional licensure and regulation 4. Food inspections 5. Tanning and tattoo inspections 6. Enforcement of state/county/local health-related rules and ordinances

Essential service: Link people to needed personal health services and assure the provision of health care when otherwise unavailable


1. TB program2. Public health nursing services 3. Breast and Cervical Cancer Early Detection program 4. Maternal and child health 5. WIC 6. Critical Access Hospitals 7. Linkages to regional landfills for disposal options 8. Informing the public on useful nuisance-abatement web sites

Essential Service: Assure a competent public and personal health-care work force


1. Food-service worker Safety Certification Course2. Public health certification 3. Learning management system 4. Regional bio-emergency meetings

5. Public health practitioner performance evaluations 6. Sanitarian, water-contractor training 7. Certification of environmental health professionals

Essential service: Evaluate effectiveness, accessibility, and quality of personal and population-based health services Activities by state and/or local public health agencies

1. Data management 2. Performance-plan monitoring 3. Public health contract requirements 4. Health needs assessments 5. Tracking responses to complaints 6. Permit issuance for nuisances 7. Ensuring that wells drilled by certified people 8. Sealing unused, unsafe wells

Essential service: Research new insights and innovative solutions to health problems


1. Health needs assessments 2. Bio-emergency survey participation 3. Lighten Up survey participation 4. Customer service evaluations 5. Promotion of recycling and composting 6. Study of successful public health programs in other jurisdictions 7. Research on water-treatment methods

Written by: Abdifatah Ahmed said

©Abdifatah Banaeimon