The WHO European Region faces new challenges in public health including epidemiological and demographic changes, an increase in lifestyle-related chronic diseases and the application of new technologies that push the boundaries of what can be achieved through health interventions. The Region’s countries are also burdened with disparities in the health threats they face and in their capacities to overcome them.
The aim of public health professionals, organizations and services is to protect health, prevent disease and promote the health and well-being of the whole community. This begins with an effort to understand why some communities are healthier than others, or why some communities have a greater prevalence of some diseases. Some public health problems are relatively new, such as widespread obesity and diabetes, and they interplay with the dynamic factors affecting public health, including health inequalities, lifestyle risk factors, demographic change, globalization and technological advances.Public health services...more
Monday, July 25, 2011
Saturday, July 23, 2011
Evolution of primary health care in Thailand
Thailand has a long history of primary health care (PHC) development which started before the Declaration of Alma Ata in 1978. The National PHC programme was implemented nation-wide as part of the Fourth National Health Development Plan (1977–1981) focusing on the training of ‘grass-root’ PHC workers consisting of village health communicators and village health volunteers. Since then PHC has evolved through many innovative health activities: community organization, community self-financing and management, the restructuring of the health system and multisectoral co-ordination. Many of the essential elements of PHC have been achieved. Improvements in the nutritional status of children under five households accessiblity to clean water, immunization coverage, and the availablity of essential drugs have been observed. PHC has been successful in Thailand because of community involvement in health, collaboration between govermment and non-govermment organizations, the integration of the PHC programme, the decentralization of planning and management, intersectors collaboration at operational levels, resource allocation in favour of PHC, the management and continuous supervision of the PHC programme from the national down to the district level, and the horizontal teaining of villagers to villagers. Read more...
Author Affiliations:Correspondence: Dr Sanguan Nitayarumphong, Health Planning Division, Ministry of Public Health, Devavesm Palace Samsen Road, Bangkok 10200, Thailand.
Author Affiliations:Correspondence: Dr Sanguan Nitayarumphong, Health Planning Division, Ministry of Public Health, Devavesm Palace Samsen Road, Bangkok 10200, Thailand.
Definition of Health Promoting Hospital
A health promoting hospital does not only provide high quality comprehensive medical and nursing services, but also develops a corporate identity that embraces the aims of health promotion, develops a health promoting organizational structure and culture, including active, participatory roles for patients and all members of staff, develops itself into a health promoting physical environment and actively cooperates with its community.
Health promoting hospitals take action to promote the health of their patients, their staff, and the population in the community they are located in. Health promoting hospitals are actively attempting to become “healthy organizations”. Health Promoting Hospitals are being implemented since 1988. An international network has developed to promote the wider adoption of this concept in hospitals and other health care settings.
Health Promoting Hospital more info.
Health promoting hospitals take action to promote the health of their patients, their staff, and the population in the community they are located in. Health promoting hospitals are actively attempting to become “healthy organizations”. Health Promoting Hospitals are being implemented since 1988. An international network has developed to promote the wider adoption of this concept in hospitals and other health care settings.
Health Promoting Hospital more info.
Thursday, July 21, 2011
History of District Health Boards
District Health Boards were first introduced as an idea in the 1970s in the Green and White Paper suggested by the then in-power Labour government. This was part of a plan to nationalise primary health care as the Social Security Act of 1938 had originally intended. Labour subsequently lost the election to Rob Muldoon's National Party in the 1975 election. Muldoon's government chose however to slowly implement these reforms in trial "Area Health Boards", which can be seen as early predecessors of the District Health Boards.
The more direct pre-decessors were the Crown Health Enterprises (CHEs) and subsequent Hospital and Health Services (HHS) management structures of the 1990s; these were responsible for managing the hospitals under business ethos, albeit, with the expectation that the former would return a profit to the shareholders (i.e. the government).
In the 1990s "Regional Health Authorities" (RHA) were formed. These RHAs were amalgamated in 1997 to form the Health Funding Authority ("HFA"). The election of the Labour-Alliance government in the 1999 General Election saw the New Zealand Public Health and Disability Act 2000 passed by parliament, this led to the merging of the HFA with the Ministry of Health. Part of the HFA's funding capacity combined with the hospital management elements of the Hospital and Health Services board to form the DHBs.
The more direct pre-decessors were the Crown Health Enterprises (CHEs) and subsequent Hospital and Health Services (HHS) management structures of the 1990s; these were responsible for managing the hospitals under business ethos, albeit, with the expectation that the former would return a profit to the shareholders (i.e. the government).
In the 1990s "Regional Health Authorities" (RHA) were formed. These RHAs were amalgamated in 1997 to form the Health Funding Authority ("HFA"). The election of the Labour-Alliance government in the 1999 General Election saw the New Zealand Public Health and Disability Act 2000 passed by parliament, this led to the merging of the HFA with the Ministry of Health. Part of the HFA's funding capacity combined with the hospital management elements of the Hospital and Health Services board to form the DHBs.
District Health Board
District Health Boards (DHBs) in New Zealand are organisations established by the New Zealand Public Health and Disability Act 2000, responsible for ensuring the provision of health and disability services to populations within a defined geographical area. They have existed since 1 January 2001 when the Act came into force.There are 20 DHBs (15 in the North Island and 5 in the South Island). From their creation until 1 May 2010, there were 21 DHBs. At that date, Otago DHB and Southland DHB amalgamated their boards to form the new Southern DHB.DHBs receive public funding from the Ministry of Health on behalf of the Crown, based on a formula which takes into account the total number, age, socioeconomic status and ethnic mix of their population.
Friday, July 15, 2011
HPH: The concept
In accordance to health promotion theory, the HPH standards and strategies are based on the principles of the settings approach, empowerment and enablement, participation, a holistic concept of health (somato-psycho-social concept of health), intersectoral cooperation, equity, sustainability, and multi-strategy (Rootman et al. 2001).
In order to realise the full potential of the comprehensive HPH approach for increasing the health gain of hospital patients, staff, and the community, HPH needs to be supported by an organisatial structure: Support from top management, a management structure that embraces all organisatial units, a budget, specific aims and targets, action plans, projects, and programs, standards, guidelines and other tools for implementing health promotion into everyday business. This needs to be supported by evaluation and monitoring, professional training and education, research and dissemination.
One way to implement HPH in a hospital or other health care organisation is by linking HPH aims and targets with quality management, thus understanding health promotion as one specific quality aspect in hospitals and health care. Ideally any managerial or professional decision in an HPH should also consider the health / disease impact of that decision, together with other decision criteria (e.g. effectiveness, sustainability).
In order to realise the full potential of the comprehensive HPH approach for increasing the health gain of hospital patients, staff, and the community, HPH needs to be supported by an organisatial structure: Support from top management, a management structure that embraces all organisatial units, a budget, specific aims and targets, action plans, projects, and programs, standards, guidelines and other tools for implementing health promotion into everyday business. This needs to be supported by evaluation and monitoring, professional training and education, research and dissemination.
One way to implement HPH in a hospital or other health care organisation is by linking HPH aims and targets with quality management, thus understanding health promotion as one specific quality aspect in hospitals and health care. Ideally any managerial or professional decision in an HPH should also consider the health / disease impact of that decision, together with other decision criteria (e.g. effectiveness, sustainability).
Short history of HPH
Based on the Ottawa Charter, the first conceptual developments on HPH started in 1988. A first model project "Health and Hospital", was initiated in 1989 at the Rudolfstiftung Hosptial in Vienna, Austria, and successfully finished in 1996. 10 model documents (in German language) summarise the learnings from the pilot project and are available online to guide hospital projects related to health promotion.
In 1990, the WHO International Network of Health Promoting Hospitals was founded as a multi city action plan of the WHO Healthy Cities Network. In 1991, the HPH network, which was in the beginning an alliance of experts, launched its first policy document, the Budapest Declaration on Health Promoting Hospitals. This document introduces the HPH concept and target groups - patients, staff, community - as well as related HPH strategies and action areas.
In order to implement HPH on a broader basis, a European Pilot Hospital Project of Health Promoting Hospitals was initiated in 1993, and finisehd in 1997. 20 hospitals from 11 European countries participated, 19 of which finished the project successfully. Also in 1993, the first
international HPH conference was organised, and the first international HPH Newsletter was published.
Since 1995, national and regional networks of HPH, all coordinated by their own national or regional coordinating centres, are being implemented and developed in order to disseminate HPH to as many hospitals and health care institutions as possible. The development of the HPH networks called for a new policy document: The Vienna Recommendations on Health Promoting Hospitals were launched in 1997.
In 2009, HPH has become a global movement with national and regional networks, individual member hospitals and health promotion initiatives on all continents. HPH member hospitals currently exist in Australia, Austria, Belgium, Brasil, Bulgaria, Canada, Czech Republic, Denmark, England, Estonia, Finland, France, Germany, Greece, Ireland, Italy, Japan, Latvia, Lithuania, Northern Ireland, Norway, Poland, Russian Federation, Scotland, Serbia, Singapore, Slovakia, Spain, Sweden, Switzerland, Taiwan, and the USA.
In addition, several task forces develop specific HPH concepts, strategies and tools on specific subjects or for specific clinical areas:
- Health Promoting Psychiatric Services
- Migrant Friendly and Culturally Competent Hospitals
- Health promotion for children and adolescents in hospitals
- HPH and European Network of Smoke-free Hospitals and Health Services: Tobacco Free United
In 1990, the WHO International Network of Health Promoting Hospitals was founded as a multi city action plan of the WHO Healthy Cities Network. In 1991, the HPH network, which was in the beginning an alliance of experts, launched its first policy document, the Budapest Declaration on Health Promoting Hospitals. This document introduces the HPH concept and target groups - patients, staff, community - as well as related HPH strategies and action areas.
In order to implement HPH on a broader basis, a European Pilot Hospital Project of Health Promoting Hospitals was initiated in 1993, and finisehd in 1997. 20 hospitals from 11 European countries participated, 19 of which finished the project successfully. Also in 1993, the first
international HPH conference was organised, and the first international HPH Newsletter was published.
Since 1995, national and regional networks of HPH, all coordinated by their own national or regional coordinating centres, are being implemented and developed in order to disseminate HPH to as many hospitals and health care institutions as possible. The development of the HPH networks called for a new policy document: The Vienna Recommendations on Health Promoting Hospitals were launched in 1997.
In 2009, HPH has become a global movement with national and regional networks, individual member hospitals and health promotion initiatives on all continents. HPH member hospitals currently exist in Australia, Austria, Belgium, Brasil, Bulgaria, Canada, Czech Republic, Denmark, England, Estonia, Finland, France, Germany, Greece, Ireland, Italy, Japan, Latvia, Lithuania, Northern Ireland, Norway, Poland, Russian Federation, Scotland, Serbia, Singapore, Slovakia, Spain, Sweden, Switzerland, Taiwan, and the USA.
In addition, several task forces develop specific HPH concepts, strategies and tools on specific subjects or for specific clinical areas:
- Health Promoting Psychiatric Services
- Migrant Friendly and Culturally Competent Hospitals
- Health promotion for children and adolescents in hospitals
- HPH and European Network of Smoke-free Hospitals and Health Services: Tobacco Free United
Delelopment to Subdistrict Health Promoting Hospital
The International Network of Health Promoting Hospitals and Health Services (HPH) is a network initiated by the World Health Organization - Regional Office for Europe. It is based on the health promotion philosophy of the World Health Organization (WHO) as outlined in the WHO Ottawa Charter for Health Promotion (WHO 1986) which was re-confirmed in the WHO Bangkok Charter for Health Promotion in a Globalised World (WHO 2005). The Ottawa Charter lists five action areas for health promotion, of which health care services are one:
The responsibility for health promotion in health services is shared among individuals, community groups, health professionals, health service institutions and governments. They must work together towards a health care system which contributes to the pursuit of health. The role of the health sector must move increasingly in a health promotion direction, beyond its responsibility for providing clinical and curative services. Health services need to embrace an expanded mandate which is sensitive and respects cultural needs. This mandate should support the needs of individuals and communities for a healthier life, and open channels between the health sector and broader social, political, economic and physical environmental components. Reorienting health services also requires stronger attention to health research as well as changes in professional education and training. This must lead to a change of attitude and organization of health services which refocuses on the total needs of the individual as a whole person. (Ottawa Charter, WHO 1986)
Accordingly, HPHs aim at improving the health gain of hospitals (and other health services) by a bundle of strategies targeting
- patients
- staff and
- the community
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