Health Equity: 04/08/08

Tuesday, April 8, 2008

[EQ] The Essential Public Health Functions as a Strategy for Improving Overall Health Systems Performance

The Essential Public Health Functions as a Strategy for Improving Overall Health Systems Performance:
Trends and Challenges since the Public Health in the Americas Initiative, 2000-2007

Caroline Ramagem and José Ruales, Area of Health Systems Strengthening, Washington, D.C. February 2008

Pan American Health Organization/World Health Organization (PAHO/WHO)

Available online as PDF file [20p.] at: http://www.paho.org/english/DPM/SHD/HR/EPHF_2000-2007.pdf

“…..The Pan American Health Organization/World Health Organization (PAHO/WHO) defines the Essential Public Health Functions (EPHF) as the indispensable set of actions, under the primary responsibility of the state, that are fundamental for achieving the goal of public health which is to improve, promote, protect, and restore the health of the population through collective action.

Through the Public Health in the Americas Initiative, PAHO/WHO defined the 11 Essential Public Health Functions and developed a methodology that allows countries to evaluate in a comprehensive manner their public health systems. As part of the Initiative, 41 countries and territories of the Region of the Americas applied the assessment tool…”

Essential Public Health Function

EPHF 1 - Monitoring, evaluation, and analysis of health status

EPHF 2 - Surveillance, research, and control of the risks and threats to public health

EPHF 3 - Health promotion

EPHF 4 - Social participation in health

EPHF 5 - Development of policies and institutional capacity for public health planning and management

EPHF 6 - Strengthening of public health regulation and enforcement capacity

EPHF 7 - Evaluation and promotion of equitable access to necessary health services

EPHF 8 - Human resources development and training in public health

EPHF 9 - Quality assurance in personal and population-based health services

EPHF 10 - Research in public health

EPHF 11 - Reduction of the impact of emergencies and disasters on health

Strengthening the EPHF – Experience from WHO Regions

Regional Office for Europe (EURO)

The European Office of WHO has started a process of defining and developing a performance evaluation methodology that can be applied to public health services. A

Core Expert Group on the topic was created and was given the task of developing a Discussion Paper identifying the Essential Public Health Functions (EPHF) and

proposing a methodological framework for their assessment, in the context of European countries. The methodology will be a comprehensive questionnaire for the identification of strengths and weaknesses in public health systems and a computer-based self-assessment tool. The Discussion Paper is currently undergoing consultations.

Regional Office for South-East Asia (SEARO)

In a significant step towards strengthening public health in the South-East Asia (SEA) Region, SEARO has launched the “South-East Asia Public Health Initiative, 2004-2008.” This initiative aims to achieve the following five major goals: (i) position public health high on the regional and national agendas, and to generate strong commitment by national policy makers; (ii) support the strengthening of public health education in the countries of the SEA Region; (iii) enhance technical cooperation on the development of national public health training institution(s) in selected countries; (iv) facilitate the establishment of a public health education institutions’ network and foster regular interaction among them; and (v) help countries to define an appropriate package of essential public health functions tailored to each country’s situation and needs and support them to implement these functions.

Regional Office for the Western Pacific (WPRO)

Between 2000 and 2003, the WHO Regional Office for the Western Pacific embarked on a process of EPHF definition and assessment. The process consisted on the development of a framework for the definition of the EPHF relevant for the Western Pacific Region, followed by the identification of an evaluation methodology and its application in Fiji, Malaysia and Vietnam. Nine EPHF were identified and a range of methods were used, which included, among others, document analysis, interviews, and surveys, adapted to the context of each country. The selection of Fiji, Malaysia and Vietnam was based on the relevance of the countries for others in the Western Pacific region (considerations of geography; differing socioeconomic, demographic and epidemiological situations; and the organization of the health systems). Finally, proposals for the strengthening and sustainable delivery of functions were to be identified in each country where the methodology was applied.

One of the main findings of the study was that primary health care was found to be crucial to the sustainable delivery of the EPHF. In the three countries surveyed, the

key structural approach for delivering EPHF is through integration into PHC, which represents a significant portion of health service delivery in the three contexts. The study

also found that the main challenges for the optimal delivery of EPHF were: tensions between externally funded programs (especially vertical programs) and implementation

of the EPHF; inadequate capacity in research, development and implementation of innovative public health solutions, and inadequate funding as planning and allocation processes are dominated by hospital practitioners….”

EPHF's Publications

alt="Salud Publica">	Public Health in the Americas - conceptual renewal, performance assessment and bases for action Available online as PDF file [375p.] at: http://www.lachealthsys.org/index.php?option=com_docman&task=doc_download&gid=228
alt="FESP Brasil">	A gestão da saúde nos estados: avaliação e fortalecimento das funções essenciais
alt="FESP Peru">	Evaluación del Desempeño de las Funciones Esenciales de Salud Pública a Nivel Regional en el Perú - 48.42 Mb
alt="cover_redcolombia_es.jpg" title="cover_redcolombia_es.jpg">	Sistematizacion Experiencias en desarrollo de políticas de investigación en salud pública Red Colombia - Resumén Sistematizacion Experiencias en desarrollo de políticas de investigación en salud pública Red Colombia - (225 pags)

Documents

Public Health in the Americas - conceptual renewal, performance assessment and bases for action

Descripción del Instrumento de Medición del Desempeño de las FESP

Guía de Aplicación del Instrumento de Medición del Desempeño de las FESP

Instrumento de Medición del Desempeño de las FESP

Instrumento de Medição de Desempenho das Funções Essenciais de Saúde Pública

Instrument pour la mesure de la performance des fonctions essentielles de santé publique

Guide pour l’application de l’instrument de mesure de la performance des FESP

Instrument pour la mesure de la performance des fonctions essentielles de santé publique

Instrument for Performance Measurement of Essential Public Health Functions

Guidelines for Applying the Instrument for the Performance Measurement of EPHF's

Measurement Instrument for Performance Measurement of Essential Public Health Functions

Harmonization of EPHF with the Functional Classification of Expenditure (FCE)

Armonización de las FESP con la Clasificación Funcional del Gasto (CFG)

Strengthening the capacity of the public health workforce in support of the EPHF and MDG's

Public Health Workforce: Selected literature review

The Public Health Workforce: Its characterization and development from a gender perspective

The Public Health Workforce: Its characterization and development from an ethnic perspective

Strategies for Developing Public Health Competencies in the Health Workforce: Based on current policy

Fortalecimiento de la Capacidad de la Fuerza de Trabajo en Salud Pública en apoyo a las FESP y ODM's

Fuerza de Trabajo en Salud Pública: Su caracterización y desarrollo desde una perspectiva de género

Fuerza de Trabajo en Salud Pública: Su caracterización y desarrollo desde una perspectiva étnica

Estrategias para desarrollar las competencias para la salud pública en la fuerza de trabajo

A gestão da saúde nos estados: avaliação e fortalecimento das funções essenciais.

Salud Publica en las Americas - Libro

Evaluación del Desempeño de las Funciones Esenciales de Salud Pública a Nivel Regional en el Perú

Lineamientos de Política Nacional para la Gestion del Conocimiento en Salud Publica - Colombia 2005

Public Health Capacity in Latin America and the Caribbean: Assessment and Strengtheninghot!

Capacidades en Salud Pública en América Latina y el Caribe: Evaluación y Fortalecimiento

Sistematizacion Experiencias en desarrollo de políticas de investigación en salud pública

Sistematizacion Experiencias en desarrollo de políticas de investigación en salud pública - Resumén

Experiencia Nacional de Fortalecimiento de las Funciones Esenciales de Salud Pública - Costa Rica

Experiencia Nacional de Fortalecimiento de las Funciones Esenciales de Salud Pública - El Salvador

Experiencia Nacional de Fortalecimiento de las Funciones Esenciales de Salud Pública - Nicaragua

Experiencia Nacional de Fortalecimiento de las Funciones Esenciales de Salud Pública - Puerto Rico

Experiencia Sub Nacional de Fortalec. Funciones Esenciales Salud Pública - Argentina : Tucuman

Experiencia Sub Nacional de Fortalec. Funciones Esenciales Salud Pública - Argentina : Buenos Aires

Experiencia Sub Nacional de Fortalec. Funciones Esenciales Salud Pública - Colombia : Bogota

Experiencia Sub Nacional de Fortalec. Funciones Esenciales Salud Pública - Colombia : Bogota 2007

Experiencia Sub Nacional de Fortalec. Funciones Esenciales Salud Pública - Colombia : Caldas

Experiencia Sub Nacional de Fortalec. Funciones Esenciales Salud Pública - Colombia : Cali

Experiencia Sub Nacional de Fortalec. Funciones Esenciales Salud Pública - Perú

Experiencia Sub Nacional de Fortalec. Funciones Esenciales Salud Pública - Brasil

* * * *

This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues. [DD/ KMS Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
------------------------------------------------------------------------------------

PAHO/WHO Website: http://www.paho.org/

EQUITY List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html

    IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.

[EQ] Assessing the National Health Information System - An Assessment Tool

Assessing the National Health Information System - An Assessment Tool

VERSION 4.0 – 2008

Health Metrics Network HMN- World Health Organization

Available online as PDF file [77p.] at:
http://www.who.int/healthmetrics/tools/3_HMN_Assessment_Tool_Version_4_0_Eng.pdf

Health Metrics Network HMN is a global health partnership that focuses on two core requirements of health system strengthening in low and low-middle income countries:

- First, the need to enhance entire health information and statistical systems, rather than focus only upon specific diseases.

- Second, to concentrate efforts on strengthening country leadership for health information production and use.

In order to help meet these requirements and advance global health, it has become clear that there is an urgent need to coordinate and align partners around an agreed-upon “framework” for the development and strengthening of health information systems

Content:

1. Introduction

2. Assessment of the national health information system (HIS)

3. Scoring and interpretation of results

The HMN Assessment And Monitoring Tool: Version 4

I. Assessing national HIS resources

Table I.A National HIS information policies

Table I.B National HIS financial and human resources

Table I.C National HIS infrastructure

II. Assessing national HIS indicators

Table II.A Assessing national HIS indicators

III. Assessing national HIS data sources

Table III.A Censuses

Table III.B Civil registration

Table III.C Population surveys

Table III.D Individual records

Table III.E Service records

Table III.F Resource records

IV. Assessing national HIS data management

Table IV.A Assessing national HIS data management

V. Assessing national HIS data quality

Table V.A Under-5 mortality

Table V.B Maternal mortality

Table V.C HIV prevalence

Table V.D Measles vaccination coverage

Table V.E Attended deliveries

Table V.F Tuberculosis treatment

Table V.G General government health expenditure (GGHE) per capita

Table V.H Private expenditure

Table V.I Workforce density

Table V.J Smoking prevalence

VI. Assessing national HIS information dissemination and use

Annex I. Glossary of terms

* * * *

PAHO/WHO Website: http://www.paho.org/

EQUITY List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html

    IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.

[EQ] IADB Micro-documentaries Series: The Faces of Exclusion

MICRO-DOCUMENTARY COMPETITION:
THE FACES OF EXCLUSION

Inter-American Development Bank IADB/BID 2008

Website: http://www.iadb.org/res/ipes/2008/informacion.cfm?language=en&parid=2

In an effort to expand traditional social and economic research techniques and recognizing that the use of audiovisual technologies and documentary films is a powerful tool to stimulate reflection on our society, the Inter-American Development Bank invited audiovisual producers from its member countries to present entries in the micro-documentary competition The Faces of Exclusion.

CATEGORY 1: LACK OF ACCESS TO BASIC SERVICES

CATEGORY 2: LACK OF ACCESS TO INSTITUTIONS

CATEGORY 3: LACK OF IDENTITY DOCUMENTS

CATEGORY 4: EXCLUSION FROM THE LABOR MARKET

CATEGORY 5: SOCIAL INCLUSION PROGRAMS AND POLICIES

CATEGORY 6: ALTERNATIVE SYSTEMS OF SOCIAL AND POLITICAL REPRESENTATION

CATEGORY 7: SUBSTITUTES FOR THE ESTABLISHED SOCIAL ORDER

Prestes Maia, Bianca Suyama. Brazil
Date: July 03, 2007
Description: Winner - Category 1: Lack of Access to Basic Services.
Prestes Maia recounts the occupation by homeless families in Sao Paulo of an abandoned building with a large
amount of unpaid taxes.
The Movimiento de los Sin Techo Centro (Downtown Homeless Movement—MSTC) is a social movement that
occupies such buildings to meet the housing needs of thousands of poor families and is continually confronted by the police.

Micro-documentaries Series "The Faces of Exclusion".
View with: FLV | WMV

Salud en los Matsinguengas del Bajo Urubamba (The Health of the Matsinguengas of the Lower Urubamba River),
Henry Pilares Frisancho. Perú
Date: July 03, 2007
Description: Honorable Mention - Category 1: Lack of Access to Basic Services.
Many indigenous Matsinguenga communities near the Camisea gas pipeline lack basic health services.
The sick often have to travel by river on fragile canoes and boats to find a medical center. The documentary illustrates
the contradiction between the inhabitants’ lack of access to medical services and the wealth of the place where they live.
The income derived from the exploitation of Camisea’s natural gas deposits has been the underlying cause of the
accelerated growth that Peru has experienced since mid-2003.
The microdocumentary presents a series of testimonials by the residents of the Lower Urubamba area.

View with: FLV | WMV

El espejismo de una redención (Illusion of Deliverance), Carlos Andrés Grisales Tabares. Colombia
Date: July 03, 2007
Description: Winner - Category 2: Lack of Access to Institutions.
El espejismo de una redención is a microdocumentary that tells the story of a child of the streets who lied to
the documentary’s producers about his situation. When the filmmaker’s family attempts to reunite him with his
family they learn that he has neither a home nor a family, and they finally turn him over to the institutions
of the Colombian State.

View with: FLV | WMV

Posseiros (Squatters), Caio Chatagnier. Brasil
Date: July 03, 2007
Description: Honorable Mention - Category 2: Lack of Access to Institutions.
Posseiros tells the story of a family that practices subsistence agriculture on a piece of land passed down from
one generation to the next. The owner of that property reasserts his claim to the land, however, and resorts to
the legal system to expel the long-time squatters.

View with: FLV | WMV

Gaspar, Caio Chatagnier. Brasil
Date: July 03, 2007
Description: Winner - Category 3: Lack of Identity Documents.
At the age of 78, Gaspar has no identity documents, and none of his previous employers has registered
him with the authorities. He consequently has no access to the social security system or to rural pensions.
His income is so low that he does not even have enough money to pay for the cost of obtaining his documents.

Circo urbano ciudad de México (Mexico City Urban Circus), Jalil Rashid Graniel Espinosa. México
Date: July 03, 2007
Description: Winner - Category 4: Exclusion from the Labor Market.
Circo Urbano shows how the lack of formal employment has created a market for entertainment timed by the traffic
lights of Mexico City’s street-corners. In a wide variety of circumstances, the persons portrayed, from children to the
elderly, engage in activities that range from lying on broken glass to pantomime. For the people of Mexico City, these
images and the film’s subjects are an ever-present aspect of daily life.

View with: FLV | WMV

Jorge, Pedro Jiménez. México
Date: July 03, 2007
Description: Honorable Mention - Category 4: Exclusion from the Labor Market.
When the business where Jorge worked engaged in job cuts, he lost his job and now works as a fire-eater on
a corner in Mexico City. After several years he still considers this a temporary job. He is a father who has dreams
for his daughters, as well as for his wife and himself.

View with: FLV | WMV

Espejos (Mirrors), Lucrecia Mastrangelo. Argentina
Date: July 03, 2007
Description: Winner - Category 6: Alternative Systems of Social and Political Representation.
Espejos presents the testimony of a group of women who live in a very poor part of the city of Rosario, Argentina.
These women’s concern with confronting the afflictions of drugs and domestic violence led them to create the
Lola Mora Community Center. Coordinator Nora Rachid describes the center’s activities, along with personal
stories of great clarity and hope.

View with: FLV | WMV

Vamos pela rua (We March on the Street), Ariana Chediak Roquim. Brazil
Date: July 03, 2007
Description: Honorable Mention - Category 6: Alternative Systems of Social and Political Representation.
Vamos pela Rua presents a demonstration in Avenida Paulista, in the heart of the city of Sao Paulo, where civil society
and related groups unite in favor of the rights of persons with disabilities. The “Passeata em pro de um pais mais accesible”
(Ride for a More Accesible Country) demonstration has taken place since 2004 as part of a strategy adopted by the
Movimento SuperAção (Super Action Movement) to call society’s attention to this issue.

View with: FLV | WMV

La bajadita (The Entrance), Silvia Patricia Arispe Bazán, Nanna Spetz Palomino, Veronica Trelles. Perú
Date: July 03, 2007
Description: Winner - Category 7: Substitutes for the Established Social Order.
La bajadita presents the life of homeless children and adolescents who live near Capón Street in the District of Lima.
The objective is to give them a voice so that they can share their experiences and dreams and as their discussions show,
exclusion is a recurring theme in every moment of their lives. In a first sequence the youth answer filmmakers’ questions
in the Rimac district, far from their street. In a second sequence, the youth bring the filmmakers to their street,
and at that point the youngsters become interviewers as well as subjects.

View with: FLV | WMV

El ceibo, Andrés Esteban Dunayevich. Argentina
Date: July 03, 2007
Description: Honorable Mention - Category 7: Substitutes for the Established Social Order.
This documentary narrates the experience of El Ceibo, a socio-environmental project based on the recovery and separation
of recyclable materials (paper, cardboard, plastic, glass) by the cartoneros of the Palermo neighborhood in Buenos Aires, Argentina.
This project connects recyclers and their neighbors by means of in-person pick-up of recyclable materials separated by type.
This project does not only seeks to recover trash; it first attempts to rescue people.

View with: FLV | WMV

* * * *

PAHO/WHO Website: http://www.paho.org/

EQUITY List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html

    IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.