Regional Director, Prof Brian Oldenburg represented APACPH at a WHO-sponsored meeting in Hanoi on November 22-24, 2005 to discuss and review the effort within the Western Pacific Region of WHO over recent years and to develop nine essential health functions (EPHFs) for the Region. The meeting was also attended by senior health ministry officials from WHO Western Pacific Region Member States.
Public health is a core element of every government’s attempts to improve and promote health. Unfortunately, there is evidence that public health systems and services are struggling to cope with current demands. This problem applies not only to traditional public health areas, but also to emerging public health threats that currently include SARS and
avian influenza. It is also relevant to newer areas of public health that includes the effects of globalization, migration and use of new technologies.
The nine essential public health functions identified are: (1) health situation monitoring and analysis (2) epidemiological surveillance, disease prevention and control (3) development of policies and planning in public health(4) strategic management of health systems and services for population health gain (5) regulation and enforcement to protect public health (6) human resource development and planning in public health (7) health promotion, social participation and empowerment (8) ensuring the quality of personal and population-based health services, and (9) research development and implementation of innovative public health solutions.
These functions have already been tested and evaluated in three country case studies in Fiji, Malaysia and Vietnam. A copy of the original WHO study from 2003 can be found at www.wpro.who.int/publications/PUB_9290610824.htm. The purpose of these case studies was to assist Member States to define more clearly and systematically the core areas of public health work for which their governments are ultimately responsible.
During the meeting the following issues were considered:
- the nine public health functions were critically reviewed particularly in relation to the ‘lessons learnt’ arising from the three country case studies
- guidelines, tools and indicators were identified, based on the public health functions, that would be useful in assisting Member States in the future to evaluate, monitor and strengthen their public health infrastructures and responsibilities
- approaches to promote the reorientation of health professionals, managers, policy-makers and government institutions towards public health, in line with the development of essential public health functions were identified, and;
- ways in which these functions can actually be used to strengthen and define more clearly the central leadership role of ministries or departments of health in addressing the public health challenges confronting the region were discussed.
Recommendations arising from this and previously conducted consultations in relation to EPHFs, included:
- to consider in more detail the appropriateness of EPHFs for emergency preparedness and disaster management
- to develop further the terminology that is required in order to reflect the role and contribution of sectors other than health in improving public health
- to consider further how EPHFs can be suitable for audiences other than public health professionals
- to conduct more detailed and thorough economic analyses to identify the contribution and importance of public health to the major priorities of Member Countries
The further development of EPHFs in the Western Pacific Region of WHO would also appear to provide an opportunity for APACPH member institutions to engage with Health Ministries in their own countries and to develop education, training and research programs that build on this work.
