Fundamentals-Public Health Policies-January 2021.pptx
- 1. University of Zambia School of Public Health Dr Rosemary Ndonyo Likwa Senior Lecturer Department of Population and Global Health Email: likwandonyodr@ gmail.com [email protected] Tel/Mobile: +260 977836764
- 2. Public Health Policies: Lecturer: Dr R. Ndonyo Likwa Sessions: 05/01/2021 Differential Terminologies: Laws and Policies Core Public Health Characteristics and Law Types of legislative Measures Local Public Health Policies (Zambia) Challenges and Way Forward
- 3. TDZ 7411: Public Health Policies Lecturer: Dr R. Ndonyo Likwa • Learning Outcomes: At the end of this lecture, you should be able to: 1. Explain the differential terminologies between laws and policies 2. Provide a better understanding of the core public health characteristics for law. 3. Interpret and discuss the various types of legislative measures applied in public health 4. Explain and apply the local public health policies in Zambia or in your own respective country. 5. Discuss local public health policy challenges and provide solutions for improving public health services for controlling epidemics and disease prevention.
- 4. Public Health Policies: (Dr Likwa) Differential Concepts of Public Health Policies and Law: • A Law- is broadly defined as a legislative action governing the administrative rules, and binding customs of a community that influence population characteristics. • It is controlled by recognized authority (i.e. the government or the State. • ‘Policy’ refers to ‘the overall plans for goals and actions or strategies made by governments-’ to translate law into action. • The concepts of law and policy usually overlap in practice.
- 5. Public Health Policies: (Dr Likwa) Core Public Health Characteristics for Law: • Core Public health characteristics- food and water sanitation, sewage and refuse disposal, vermin (i.e. parasitic worms or insect) control, and the management of zoonosis and communicable diseases- All depend on the law • For example, in the periods of Roman sewers and public health water systems, alongside ships entering ports to the earlier eradication of small pox- public health depended on the power of authority.
- 6. Public Health Policies: (Dr Likwa) • Public Health policies or laws provide power to those in authority- to perform action of promoting health of people at risk. • Their actions could be related to: seizing property, close businesses, destroy animals, or even lock away individuals for a certain period of time i.e. performing quarantine measure of control). • Without the coercive power of the state, public health and existence of modern society would be impossible.
- 7. Public Health Policies: (Dr Likwa) Types of Public Health Legislative Measures: What are the public health legislative measures? 1. Public Health and Primary Care: • Public Health law- deals with the rule of the health department as a regulatory agency. • When a health department provides health care to individuals, the health providers must follow the laid down laws on privacy and patient autonomy
- 8. Public Health Policies: (Dr Likwa) • Special public health programmes, such as tuberculosis control – must adhere to public health rules of disease prevention and control be it in a clinical setting, or community setting.
- 9. Public Health Policies: (Dr Likwa) 2. Constitutional Basis for Public Health Law: • Public Health authority- is derived from the basic power of the state- to preserve itself: the rights of societal self-defence. • The constitution grants the government broad public health powers- to control epidemic diseases threatening the social order of the public and the lives of individuals in a country.
- 10. Public Health Policies: (Dr Likwa) • For example, pestilence of yellow fever that threatened lives of most people in the USA ( New York & Philadelphia) was controlled after the ratification of the constitution by including public health powers of controlling the epidemic. • Public health powers- relate to: every country to have power of authority to control or prevent epidemics to:
- 11. Public Health Policies: (Dr Likwa) Pass and enforce quarantine, Ensure health and inspection laws- mandated to prevent diseases or pestilence provisions • Constitutional powers of public health relate also to: criminal prosecution, freedom of speech, equal protection and property rights.
- 12. Public Health Policies: 3. Public Health Law Tools: • The most important tool of effective public health practice is education • Public health depends on- voluntary cooperation of community. • In addition, public health agencies must be able to use the law- to ensure that individuals and businesses comply with public health laws
- 13. Public Health Policies: • Public health authorities have five (5) primary enforcement tools: a) Permits, licences, and registration- used to regulate activities- e.g food or sale of products, or standards for permitted activities b) Administrative orders- orders issued by public health agency to an individual or a business requiring that action be taken to mitigate the threat to public health, e.g. clean up garbage
- 14. Public Health Policies: c) Direct Abatement- public health departments can act on its own if given authority to abate a public health problem, e.g in environmental health by demolishing dangerous building, or treat stagnant water that allows mosquitoes breeding. d) Civil penalties- persons who violates public health administrative orders or statutes can be fined or jailed, but in most cases such acts are usually ignored by the Municipal courts.
- 15. Public Health Policies: e) Injunction- providing an authoritative order to restrain a person from an act- especially when the public health agency wants to mitigate a hazard prospectively
- 16. Public Health Policies: 4. Public Health Surveillance Law • All public health surveillance systems begin with collection and analysis of data about individual illness or disease. • The court explains the legal rationale for surveillance and using personal medical information in a contagious disease carrier, e.g typhoid fever
- 17. Public Health Policies: • The sanitary Code which has the force of law – requires local health officers to keep state Department of Health informed of the names, ages, and addresses of known, or suspected cases • Other measures in the surveillance Act are: a. Testing, screening and Treatment- testing and screening- are key strategies in accessing populations at risk of communicable diseases
- 18. Public Health Policies: b) Quarantine & Isolation:- • From Leviticus and the Koran, to quarantine in 14th century, to the contemporary regulations- public health practice depends on authority – to impose restrictions on individuals to prevent them from spreading diseases in the community • Isolation means to restrict the contact between an infected person and others • Quarantine means to restrict the uninfected contacts from an infected person (i.e. to prevent the person who is not infected from getting in contact with those suspected /or infected persons at the port of entry into that environment).
- 19. Public Health Policies: Local Public health laws/ Policies (Zambia): • The Public Health Act- is governed by the Zambian Constitution of the Laws of Zambia and complies with the International Public Health Laws • The Public Health Act, of Chapter 295, Laws of Zambia, Section 9 (1)- protects the right to life by providing for the prevention and suppression of diseases in Zambia, thereby protecting the lives of individuals against epidemic
- 20. Public Health Policies: • Article 1 of the Act has tabulated all the notifiable infectious diseases • Other Acts relate to: a. Environmental Protection and Pollution Control Act b. National Food and Nutrition Commission Act c. Food and Drug Act d. National Health Policy e. National HIV/AIDS/STI/TB Council- Act No.10 of 2002 by the Act of Parliament
- 21. Public Health Policies: Challenges & Way Forward: • Most of public health policies have weak enforcement by Municipal Council Offices • Policies are never reviewed to comply with the contemporary emerging infectious diseases • The need to review and amend such laws or policies are imperative for the welfare of populations and epidemic free state or country.
- 22. Public Health Policies: Conclusion: What message to take Home? • In conclusion, public health laws are legislative actions governing the public health administrative rules, and binding customs of a community that influence population characteristics and health outcomes- while a policy is a translation of a law into actions or goals. • A public health law is controlled by the government or the state- as the law governs mainly the Core public health characteristics-i.e. food, water, sanitation, sewage and refuge disposal, vermin, zoonotic and communicable diseases.
- 23. Public Health Policies: • The fundamental function of a public health policy or law is-to provide power to those in authority to perform action of promoting health of people at risk. • The types of the public health legislative measures stated include: 1) Public health and primary care legislative measures. 2) Constitutional basis for public health law authority 3) Provision of public health legislative law tools- i.e. public health education; voluntary cooperation of community; and power to use the law by public health agencies; and use of enforcement tools by public health authorities ( permits, license, registration, administrative orders, direct abatement, civil penalties and injunction).
- 24. Public Health Policies: 4) Public health surveillance law- involving provision of: a) information on population characteristics at risk or suspected cases; b) surveillance act measures of testing, screening and treatment, quarantine and isolation • With existing weak enforcement of public policies by municipal council offices, and policies that are never reviewed- review of laws and policies to set standards and guidelines are imperative to the improvement of public health services.
- 25. Public Health Policies: Additional Reading: 1. Wallace B. Robert et al. 2008. Public Health and Preventive Medicine, 15th edition, McGrawHill 2. Rothman J. Kenneth et al. 2008. Modern Epidemiology, 3rd Edition, ISBN: 13: 978-0-7818-5564-1 3. Emelia Vynnycky and Richard. G. White.2010. An Introduction to Infectious Disease Modelling, ISBN: 978-0-19-856-576-5 4. Republic of Zambia.1964. Public Health Act, Laws of Zambia 5. Park. K. 2013. Park’s Text Book of Preventive and Social Medicine, 22nd Edition 6. John. M. Last. 1995. A Dictionary of Epidemiology, 3rd Edition