hiap-ppt-module-3 on public health WORLD Health Organisation

Public health ppt

1. MODULE 3 Health in All Policies (HiAP) 3 Public health, h i ap and its development

2. Learning Objectives 3 Define public health and HiAP 1 Explain the origins and development of HiAP 2 Recognize when to use a HiAP approach 3 Distinguish the HiAP approach from other public policies 4

3. Public health definition 3 Public health refers to all organized efforts to prevent disease, promote health and prolong life among the population as a whole. Its activities aim to provide conditions in which people can be healthy and focus on entire populations , not on individual patients or diseases. Public health is concerned with the total system and not only the eradication of a particular disease.

4. Public health functions 3 The three main public health functions are: Assessment – monitor health; assess the population and investigate Policy development – inform, educate, empower; mobilize partnerships; develop polices Assurance – enforce laws; link to/provide care; assure competent workforce; evaluate.

5. Public health activities 3

6. 3 HiAP is an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies and avoids harmful health impacts in order to improve population health and health equity. WHO (2013) Helsinki Statement on Health in All Policies. WHO 8 th Global Conference on Health Promotion. Definition of health in all policies (H i ap)

7. 3 Source: diagram developed by authors from analysis in Leppo K et al. (2013) Health in All Policies: Seizing opportunities, implementing policies . Finland, Ministry of Social Affairs and Health, p. 329. COMPLEX HEALTH CHALLENGES GOVERNMENT PRIORITY AFFECTING MANY SECTORS EXTERNAL POLICIES WITH HIGH IMPACT ON HEALTH Policy situations that favour a h i ap approach

8. 3 Problem or issue is of major public health importance; Several considerations are useful to help prioritize which issues to address: Problem or issue is amenable to change and change is feasible. There is sound evidence that it can be tackled; and Potential solutions are politically and socially acceptable. Prioritizing of issues for h i ap action

9. Approaches to public health: ancient times 3 For many centuries, explanations for disease were based not on science, but on religion, superstition, and myth. Around 400 BCE the idea of four bodily humours was established by Hippocrates. Greek medicine was based on these four humours – the imbalance of humours was the direct cause of all disease.

10. Approaches to public health: the 19 th century 3 The 19 th century marked a great advance in public health. The “sanitary-environmental approach” – focused on ensuring people lived and worked in healthy conditions: tied to HiAP. The “biomedical approach” – late 19 th century: enter bacteriology. Early 20 th century: move toward personal care.

11. Approaches to public health: mid- 20 th century and beyond 3 “Social-behavioural approach”, which focuses on lifestyles and behavioural change drawing on psychological theories to reduce disease risk factors. Health promotion emerges more strongly. Efforts to change behaviour have rarely had sustainable health gains in the absence of more structural changes to the conditions shaping people’s health in their everyday lives.

12. Recent history of H i AP and international milestones 3 Alma-Ata Declaration on Primary Health Care (1978) Ottawa Charter for Health Promotion (1986) International Conference on Health Promotion, Adelaide (1988) Adelaide Statement on Health in All Policies (2010) Rio Political Declaration on Social Determinants of Health (2011) UN General Assembly Resolution on the Prevention and Control of Non-Communicable Diseases (2011) Second Adelaide Statement on Health in All Policies (2017 and updated in 2019) HiAP promoted by international organizations, in particular the WHO, and also through the European Union.

13. World Conference on Social Determinants of Health Rio de Janeiro, Brazil, 19-21 October 2011 3 Rio Political Declaration on Social Determinants of Health 1 2 3 4 5 To monitor progress and increase accountability To strengthen global governance and collaboration To further reorient the health sector towards reducing health inequities To promote participation in policy-making and implementation To adopt better governance for health and development

14. Why H i AP matters ? 3 Many of the determinants of health and health inequities in populations have social, environmental and economic origins that extend beyond the direct influence of the health sector and health policies. Therefore, public policies and decisions made in all sectors and at different levels of governance can have a significant impact on population health and health equity. Health considerations need to be taken into account in policy-making: opportunities for co-benefits.

15. MULTI SECtoRAL ACTION - WHY IS THIS DIFFICULT? 3 Complex policy issues are often multi-determinate Action by a number of government agencies or institutions - working together is required Communication – issues in finding a common language Siloed thinking, conflicting interests, power imbalances Such factors make joined-up governance difficult

16. H i AP FRAMEWORK FOR COUNTRY ACTION 3 systematically takes into account the health implications of decisions seeks synergies avoids harmful health impacts World Health Assembly 68.17 (2015) Putting the action across sectors into practise Facilitate a ssessment and engagement Establish the need and priorities for action across sectors Identify supportive structures and processes Frame planned actions Establish a monitoring and evaluation m echanism Build capacity

17. End of Module 3 Please continue to Module 4 Part 1