University of Gondar

Assignment on Principle and practice of public health

By:

Yosef Belay Bizuneh (BSc, MSc)

Assistant professor of Anesthesia

Department of Anesthesia

School of medicine

College of medicine and health sciences

University of Gondar

Email:phanuelyosef@gmail.com

Submitted to:

Ejigu Gebeye Zeleke (MPH)

Associate Professor of Epidemiology and Public Health
Department of Epidemiology and Biostatistics
Institute of Public Health
College of Medicine and Health Sciences
University of Gondar, Gondar, Ethiopia

Email

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Table of contents

Contents
Table of contents .......................................................................................................................................... 2

Public health ................................................................................................................................................. 3

Community Health ........................................................................................................................................ 3

Preventive medicine ..................................................................................................................................... 4

Population medicine ..................................................................................................................................... 5

Community Involvement .............................................................................................................................. 6

Community Participation .............................................................................................................................. 6

Community engagement .............................................................................................................................. 6

Community empowerment........................................................................................................................... 7

Community ownership.................................................................................................................................. 8

Community mobilization............................................................................................................................... 8

Community development ............................................................................................................................. 9

Stakeholders in public health...................................................................................................................... 10

Partner in public health .............................................................................................................................. 10

Advocacy for Public Health ......................................................................................................................... 11

Networking in public health........................................................................................................................ 12

Collaboration in public health ..................................................................................................................... 12

Governance in public health ....................................................................................................................... 12

Sustainability in public health ..................................................................................................................... 13

Public health development ......................................................................................................................... 14

Reference .................................................................................................................................................... 15

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Public health

Public health is a multidisciplinary field of study, idea, and set of principles that takes a broad
view of population health. According to the WHO, public health is both an art and a science
whose coordinated efforts aim to safeguard and enhance society's overall health as well as
prevent illness and disease. Other definitions stressed the values of justice and equality and
expanded on other public health practice concerns [1-7].

Since genetic, behavioral, and socioeconomic factors (such as housing, social networks, and
education) have an impact on health and well-being, public health is often believed to focus on
population-level rather than individual-level health initiatives [8, 9].

Public health systems

In order to ensure healthy social and physical environments, all levels of government and non-
governmental organizations must work together to create public health systems. These systems
are made up of a variety of organizations that support the fundamental aims of public health,
which are to protect and promote health in the community [10-12].

Community Health
Approaches to enhancing community members' health have undergone significant modifications
as a result of public health's development. These modifications show the impact of numerous
community-centered health developments, such as the development of national-level programs,
the creation of specialized governmental units at the federal and state levels, and the introduction
of ground-breaking health initiatives by numerous other organizations, including the CDC, at the
community level [13, 14].

Despite these advancements, it is still difficult to adequately define and distinguish the meaning
and strategic importance of community health from adjacent fields of public health practice,
community involvement, or other associated community development initiatives [15].

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The discipline of community health is founded on a long history of advancements in public
health techniques and initiatives meant to lower the prevalence of risk factors, lessen the burden
of acute and chronic diseases, reduce the frequency of injuries, and promote health [16-20].

Core principles for advancing community health

Understanding the fundamental purposes of community health science and initiatives forms the
foundation of community health's fundamental principles. The following fundamental ideas are
recommended in order to advance the field of community health science in the face of these
difficulties. Engage communities, governing bodies, academics, and other parties in creating a
common agenda for community health-related applied research; utilize community health
assessments' findings as a key component of community health improvement; Identify short- and
long-term metrics to gauge the impact of interventions or actions that serve the community's
interests on a "healthy community"; Using scientific design principles for producing and
documenting community health surveillance methods, including the creation of a case definition
for a healthy community [17, 21].

Preventive medicine
Preventive medicine is described by the American Board of Preventive Medicine as "the
specialty of medical practice that focuses on the health of individuals, communities, and
designated populations." The ultimate goal is to prevent disease, disability, and death [22, 23].

Primary and Secondary Prevention

All interventions that prevent disease from spreading at any point in its course are considered
preventive measures. It is customary to distinguish between "primary prevention," which refers
to taking steps to stop a disease from occurring, and "secondary prevention," which refers to
taking action to stop or prevent a disease or one of its complications after it has already begun.
Primary prevention involves altering a person's environment, water supply, air they breathe, and
themselves through actions like becoming vaccinated against infectious diseases. The use of
medication to stop the spread of disease to unaffected people, the identification of patients who
are most in need of early treatment, and finally the prevention or postponement of the onset of
the disease are all examples of secondary prevention.

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Epidemiology

These criteria make it clear that preventative medicine depends on understanding how disease
develops and how a person moves from a healthy to a diseased condition. In order to practice
preventative medicine effectively, new facts must be discovered as well as existing ones that
may be applied effectively. The foundational field of preventative medicine is called
epidemiology.

Population medicine
Defining Population Medicine: Population medicine is a set of measures taken by one
healthcare system alone or in partnership with partners in several sectors to improve overall
population health beyond individual needs. To ensure that everyone in the nation is as healthy as
possible, the healthcare system goes through a series of steps. When used in discussions among
specialists in the area, the phrase usually solely relates to the healthcare industry, but it can also
apply to the actions that social services, education, and even corporations take to benefit the
broader populace.

Differences from Population Health

In contrast to population health, population medicine explains the steps taken to safeguard the
health of a population, whereas population health describes the results of such steps. The best
potential health of a population, or in certain situations, the entire population of a country, is the
same aim that these two processes are working toward.

Current and Future Uses of population medicine

Population medicine has been practiced unknowingly since cultures and countries were first
established. Population medicine has been used for centuries to encourage healthy lifestyles and
preventative medicine since a country's population's health is crucial to that nation's success.

Implications of population medicine

In a society where most individuals already accept that none of their data is private, it might be
challenging to assess the consequences of population medicine. As more people become aware

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of this, criticism of population medicine is expected to come shortly in order to maintain the
population's health.

The fact is that population medicine is simply a new name for measures conducted by the
healthcare industry, which has existed for millennia but is currently more effective than it was.
Although population medicine has good intentions, it is not yet known whether this expertise
will harm the population it is intended to protect.

Community Involvement
Community involvement can be seen as a part of the participation process but does not embody
ownership. Involve means to "entangle, implicate, or complicate in thought. Community
involvement usually means that the decision-makers or the professionals define the problem or
drive the agenda but also invite the community to take part in the process. Examples are the heart
health campaign and the skin cancer prevention program [24].

Community Participation
Community Participation: "has a share; takes part in." There are two levels at which
participation can occur: the individual level and the community level. Participation is the
involvement of intended beneficiaries in the planning, design, implementation, and subsequent
maintenance of the development intervention. It means that people are mobilized, manage
resources, and make decisions that affect their lives. The objectives of such participation may
range from increased efficiency, sustainability, and cost-sharing, to improving equity, capacity-
building, and empowerment [24].

Community engagement
Various levels of community and health department involvement, decision-making, and control
are involved in community engagement, which entails dynamic relationships and conversation
between community people and local health department officials. Community involvement in

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public health refers to initiatives that support a two-way flow of knowledge, concepts, and
resources between local residents and the health department.

Local health departments should start putting the following components in place in order to be
ready to undertake such community involvement strategies: A formalized vision of community
engagement and an explanation of why it is essential to the work of the local health department,
mission and value statements that include a commitment to hear the opinions of the community
and act on them, a methodical and well-articulated decision-making process for determining the
problems that the community cares about and for which the local health department is
accountable, as well as a plan of action for addressing them, A flexible system that enables the
allocation of funds and resources to address newly identified community needs; this could
include stipends or other innovative ways to compensate local resident leaders who engage in
public health more intensely [25-28].

Community empowerment
In order to improve the social determinants of health that have an impact on communities and
groups that are enduring disadvantage and discrimination, empowerment plays a significant role
in public health and health promotion policy and practice. This brings up two crucial queries.
How can public health professionals assist empowerment for better health equity? How should
empowerment be interpreted from the perspective of health and health equity. Modern
definitions frequently tie increased personal self-care and/or the adoption of "healthier" habits to
empowerment. Community empowerment, on the other hand, is viewed from the perspective of
health equity as sociopolitical processes that interact with power dynamics and enable those who
suffer the most from social injustice to exert greater collective control over decisions and actions
that have an impact on their lives and health.

There is mounting evidence that better social determinants of health and population health
outcomes are related to stronger collective control at the population level. But there is also
evidence that many current community initiatives are not "empowering" for the individuals they
are intended to serve and may even be having detrimental effects. It is necessary to re-center
power in the planning, carrying out, and assessing local community health projects in order to
produce more favorable results. The empowerment of underprivileged communities and groups

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must also be made possible through the efforts of health professionals and organizations. They
can achieve this through elevating experiential learning, addressing stigmatizing practices
against disadvantaged groups, and creating sustainable places for laypeople's genuine
engagement [29].

Community ownership

Community ownership can be described in terms of its prerequisites, such as ability, leadership,
empowerment, value found in the provision of a service, aspirations, and participation, or it can
be described in terms of its outcomes, such as involvement, financial commitment, contributions,
and organization membership [30-32].

Community mobilization
A community is a collection of individuals who share a set of standards and beliefs, as well as
living in the same geographical area and speaking the same language. In a nutshell, a community
is a region or a town where families depend on one another for their daily needs, which results in
benefits for both parties.

Concepts of community mobilization

Get anything or someone moving by mobilizing them. Therefore, community mobilization

entails bringing together all of the community's resources in order to direct them toward the
accomplishment of a particular health program goal. With this in mind, community mobilization
is described as a process of building capacity through which people, groups, and families, as well
as organizations, organize, carry out, and assess actions on a sustained basis in order to
accomplish a common objective.

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The advantages of community mobilization

Community mobilization has a number of benefits that will support local ownership and the
long-term viability of the health programs. A community's capacity to recognize and respond to
needs is increased through community mobilization, which also fosters engagement and
involvement from all members. Additionally, community mobilization encourages long-term
dedication to and sustainability of a community change movement. Additionally, it encourages
communities to push for legislative adjustments to better meet their healthcare requirements.

Steps in community mobilization

Raise community motivation for the health issue through community planning, organizational
development, capacity building, and gathering of allies. Share information and communication
with them, support them, provide them incentives, and generate resources.

The action cycle of community mobilization

You should organize your work plan with the community to begin the mobilization process.
Following that, you can investigate all of the most significant health difficulties to comprehend
what is occurring in the neighborhood just now. You can also pinpoint the cause of any
particular issues. When considering a community's habits, beliefs, attitudes, and knowledge
connected to a particular health issue, you should examine if they are beneficial or harmful. After
thoroughly examining the health issues, you can establish priorities, create a more intricate work
plan, and implement the strategy. You should keep an eye on your activities as the program is
being implemented, and then you should evaluate them. If the program appears to be a success,
consider how you may expand on it.

Community development
The idea that the community development process might be relevant to disease prevention and
health promotion has grown in popularity in recent years. Early community development
practitioners at community health centers encountered strong hostility to their method of
operation. It is now widely acknowledged that mass media efforts contribute to widening rather
than closing the differences between high and low socioeconomic groups in terms of health
outcomes. Community development has come to be recognized as a genuine and successful

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method for health professionals as a result of the decline in confidence in these mass-media
initiatives.

Adopting this strategy, however, results in two types of theoretical confusion: first, a righteous
rhetoric surrounding the "correct" approach to community development, and second, uncertainty
on what good community development practice entails. With this article, we seek to provide
some clarity to the conversation without overdoing the hyperbole. We believe that the foundation
of any activity in community health should be the philosophical idea of community development.
So, rather than being mutually exclusive, community work and individual casework services are
both components of community development practice. In reality, as we will explore later, we
think that community development can be carried out along "stages of a continuum [33].

Stakeholders in public health

The ultimate beneficiaries (people and the environment) and the organizations tasked with
preserving them are included among the stakeholders in public health (i.e. research institutes,
government ministries, international organizations and professional bodies). However, because
complex health issues frequently influence all facets of society, it can be challenging to pinpoint
the stakeholders who will contribute to public health initiatives and create solutions.
Additionally, the inclusion of ministries, organizations, and disciplines that may not have
historically been thought of as relevant to health is necessary due to developing views about
health and its dependency on environmental resilience [34].

Stakeholders

Multilateral organizations: international organizations with greatest responsibilities in the global

health arena, namely the WHO, IMF and FAO, Regional networks and international donors,
Ministries, policy-makers and collaborating organizations, universities, non-governmental
organizations, communities [34].

Partner in public health

As part of a new "soft-focus image of government" that arose in response to a perception of
government being too rough and tough, partnerships became increasingly popular around the

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mid-1990s [35]. The substantial emphasis placed on partnership working to ensure effective
policy and service delivery across many sectors is a public policy conundrum given the research
that shows how challenging it is to make partnerships flourish and generate value as opposed to
merely consuming it. Working in a partnership is challenging and frequently requires high
upkeep. [36, 37].

Determinants of successful partnership working

A partnership that is clear about its goals and objectives, partners who are aware of their roles
and responsibilities, and a partnership that has a clear strategic overview of how it is performing
through rigorous monitoring and evaluation were reported to be the three factors that govern an
effective partnership.

Advocacy for Public Health

Public health advocacy is advocacy that is not exclusive to clinical settings and that aims to
lower death or disability in groups of people (overall or from a particular cause). Such advocacy
entails utilizing data and assets to lessen the frequency or severity of public health issues. [38].

Article collaborates with important decision-makers to help influence public policy to solve the
ongoing public health issues of today. This is done in cooperation with its members and state and
regional Affiliates. Access to care must be guaranteed, financing for essential public health
services and initiatives must be protected, and health inequities must be eliminated. The
American Public Health Association (APHA) is also working on other important public health
concerns, such as food safety, hunger and nutrition, climate change and other environmental
health challenges, public health infrastructure, disease control, international health, and tobacco
control.

Advocacy skills

Policy advocacy calls for a broad range of abilities. The ability to collaborate with many
different stakeholders, the ability to use media strategically, and the capacity to perform strategic
analysis are the three key competencies needed for effective public health advocacy.

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Challenges of public health advocacy: Inherent in the practice of public health advocacy are
numerous difficulties. Given that the majority of this work is sponsored by resources from the
public sector, the difficulties this causes for public health professionals may be the most visible
challenge related to the clearly political character of creating systemic change.

Networking in public health

Public health has often adopted an ecological framework that recognized the importance of
relational information, only relatively recently have scholars utilized a more explicit network
analytic approach. Transmission networks, social networks, and organizational networks are the
three main types of networks used in public health.

Collaboration in public health

In the literature on public health, inter-organizational collaboration has been described as both a
means and an end. It has been described as a way to increase the effectiveness and standard of
public health through the coordinated use of resources and knowledge from several
organizations. Additionally, it has been described as a more comprehensive approach to public
health, which is frequently seen as a goal in and of itself. Inter-organizational cooperation, in this
viewpoint, enables organizations to actively investigate their differences and discover solutions
that go beyond their own constrained conceptions of what is achievable.

In addition to the general need for integration, the high level of differentiation in the field of
public health creates a special need for inter-organizational collaboration. However, the
participation and desire of organizations from other sectors to participate also affect how far this
partnership goes. As previously said, voluntary agreements between organizations serve as the
primary means of achieving inter-organizational collaboration [39].

Governance in public health

Governance across a public health system: Both "governance" and "public health" have
ambiguous definitions. Participants argued that it was crucial to differentiate between health and
health care. Map the range of activities across a system that produced health and well-being,
including health protection, social care, and social and economic regeneration; develop
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governance systems that could help to mobilize public investment across the system, both to
improve health and reduce inequalities; and measure not only individual well-being but also
community well-being from both. The task facing "local champions of health improvement" was
to collaborate across national, regional, and local levels while integrating a health perspective
into other governance structures, such as local crime and disorder partnerships and children's
trusts. Interagency collaboration, however, brought up a number of governance concerns.

It was believed that local successes may be used to determine the characteristics of an efficient
public health system. For instance, local authorities that had attained "beacon status" for
addressing health inequalities shared a number of traits, such as political leadership and vision,
extensive community engagement, the use of neighborhood-based information and "real-time"
data, systematic application of innovation, and a culture that promoted the idea that health is
everyone's business [40].

Sustainability in public health

Sustainability of public health interventions is becoming more important and a source of growing
concern. An extensive review of the literature and idea mapping methodologies were used to
create a nine-domain conceptual framework for program sustainability and public health
capability. Political backing, stable finance, partnerships, organizational capacity, program
evaluation, program adaptation, communication, public health effects, and strategic planning are
among the capacity for sustainability framework's listed domains.

A shared concept of sustainability among various public health decision program stakeholders,
including decision-makers, practitioners, funders, researchers, and evaluators, is the goal of the
sustainable framework..

Improving sustainability in public health

The use of theoretically informed methodologies to direct the design, development,

implementation, evaluation, and sustainability of public health initiatives is our main proposal
for increasing the sustainability of such programs. [41-43].

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Public health development
A variety of topics, including poverty, sanitization, working conditions, hygiene, health
screening, immunization, individual lifestyles, and, more recently, community and organizational
development, have come under the umbrella of public health over time. In recent years, the terms
public health, social medicine, health promotion, and health development have been employed to
denote a shift in public health philosophy. One may argue that the phrase health development
encompasses not just present ideas but also a vision for service development in the future that is
able to unite a variety of partners and organizations in the pursuit of bettering health.

The improvement of health and welfare is one of the most crucial parts of public policy and a
crucial indicator of a country's success, and this fact is becoming increasingly acknowledged on
a global scale. According to one definition, it is "the process of ongoing, progressive
improvement of the health status of people and groups in a population," which takes into account
the wide range of difficulties we are currently facing as the new century gets under way [44].

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