Public health leadership & mdg
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The document discusses the need to transform public health leadership and systems. It outlines challenges facing public health like emerging diseases, aging populations, and health disparities. Effective leadership is needed to address these challenges. The transformation requires developing workforce competencies, setting standards, engaging communities, and establishing goals. Leadership development programs need to cover issues like crisis response, collaboration skills, and balancing health protection and disease treatment priorities. Overall, strong public health leadership is essential to improving health outcomes through transforming systems.
Public health leadership & mdg
- 1. TRANSFORMATION PUBLIC HEALTH LEADERSHIP Prof. Dr. Ridwan Amiruddin, SKM., M. Kes., MSc. PH Ketua Penjaminan Mutu Fak. Kesehatan Masyarakat Universitas Hasanuddin Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 1
- 2. Outline presentation Essential Public Health MDG achievement Public Health Challenge Leading the Transformation of the Public Health System Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 2
- 3. Public Health Prevents epidemics and the spread of disease Protects against environmental hazards Prevents injuries Promotes and encourages healthy behaviors Responds to disasters and assists communities in recovery Assures the quality and accessibility of health services Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 3
- 4. Essential Public Health Services Monitor health status to identify community health problems Diagnose and investigate health problems and health hazards in the community Inform, educate, and empower people about health issues Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 4
- 5. Essential Public Health Services Mobilize community partnerships to identify and solve health problems Develop policies and plans that support individual and community health efforts Enforce laws and regulations that protect health and ensure safety Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 5
- 6. Essential Public Health Services Evaluate effectiveness, accessibility, and quality of personal and population-based health services Research for new insights and innovative solutions to health problems Seminar Nasional Alumni FKM UNHAS. Wasma Source. 1990 Centers for25-26 Feb 2012 Kalla Disease Control and Prevention 6
- 7. Public Health: The foundation of a national health system Tertiary Medical Care Secondary Medical Care Primary Medical Care Essential Population-Based Public Health Services •Human Resources Development (Training) •Information Systems •Community Planning Systems Capacity to Deliver Public Health Services Public Health System Infrastructure •Human Resources Development (Training) •Information Systems Seminar Nasional Alumni FKM UNHAS. Wasma •Community Planning Systems Kalla 25-26 Feb 2012 7
- 8. Main characteristics of PH and CH Public Health Collective Health Microbial paradigm, based Critic to the positivism. Origin biomedical model Structural adjustment Flexner report - of experimental Proposals: "Health For All in the Year Model of reference character of sub-individual the 2000" and Promotion base. paradigm (Ottawa Letter) Health-disease-intervention Natural history of the diseases and Object of study process’s social physiopathology determinant. Endemics/epidemic Sustentation logic control Promotion and prevention Proposes visions, forms, figures Practice Preventive predictive and scenes in a holistic and systemic context . Public Individual Collectivities Management, epidemiology, Disciplines Explain the disease natural history statistic, demography.
- 9. Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 9
- 10. Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 10
- 11. Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 11
- 12. Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 12
- 13. Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 13
- 14. Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 14
- 15. Dengue Haemorhagic Fever Decentralization Source: Bappenas, 2008 15
- 16. Malnutrition Problem Decentralization MoH Projection Source: Bappenas, 2008 16
- 17. Under Five Mortality Decentralization Source: Bappenas, 2008 17
- 18. Infant Mortality Rate . Decentralization Source: Bappenas, 2008 18
- 19. Maternal Mortality Rate Decentralization Source: Bappenas, 2008 19
- 20. Delivery attended by trained health workers Stagnant Decentralization 20
- 21. Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 21
- 22. Public Health Challenges Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 22
- 23. Public Health Challenges Emerging Diseases (SARS, Pandemic Flu) Re-emerging Diseases (XDR-TB) Food Safety Bioterrorism Natural Disasters Obesity Aging Population Health Disparities Global Warming Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 23
- 24. Health Care Crisis Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 24
- 25. SARS and Pandemic Flu Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 25
- 26. Health Care Crisis Population Aging Re-emerging Diseases Emerging Diseases Obesity Health Disparities Access to Quality Health Care Health Insurance Costs Uninsured and Underinsured Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 26
- 27. Pyramid of preparedness : components of an effective public health system (from Rowitz 2006) Categorical Public Health Programs: Environmental Health, HIV/AIDS, Chronic disease prevention and health Program services promotion,Immunization, Infectious disease control, injury Leadership prevention, occupational Safety and Health Program capacity Supporting scientific and technical capabilities Laboratory Behavioural Epidemic Surveillance practice science investigation Core Public Information/ Workforce Organisational Health communication competency capacity Infrastructure capacity Leadership
- 28. The skills of the prepared public health leader in crisis (Rowitz, 2006) Community building Systems thinking Assets planning Social Capital Knowledge of public (capacity building) Collaboration health law Crisis Management Change and Visioning resilience Systems change Emotional intelligence Tipping point PUBLIC HEALTH awareness INFRASTRUCTURE Forensic Crisis and risk epidemiology communication
- 29. Public Health leadership principles (from Rowitz, 2003) 1.Core public health values 2.Health Prevention 3.Community coalitions 4. Local and state collaborations and equity in access 5.Partnerships and shared visions 6. New leaders must learn from experienced leaders – mentoring 7.Continuous development of leadership skills 8. Commitment to lifelong learning and personal growth
- 30. Public Health leadership principles (from Rowitz, 2003) (cont.) 9. Infrastructure built on notion of health protection for all 10. Need to think globally but act locally 11. Need to be good managers 12. Need to ‘walk the walk’ 13. Proactive – not reactive 14. Leadership at all levels of an organization 15. Strong belief and commitment to community 16. Must practice what they preach
- 31. Quotes on Collaboration None of us is as smart as all of us Edward C. Register, 1915 Cooperation! What a word! Each working with all, and all working with each. Warren Bennis, 1996 Collaboration is damn tough Focus group participants, 1997 All quotes from Medicine and Public Health: The power of collaboration, Lasker, et al.
- 32. A mutually beneficial and well-defined relationship entered into by two or more organizations to achieve common goals Amerst H. Wilder Foundation
- 33. Why Collaborate Shared Concern Pool Power Overcome Gridlock (“get unstuck”) Add Diversity Increase Ability to Handle Complex Issues
- 34. Context for Collaboration Identify the problem Understand what makes leadership difficult Identify stakeholders Assess extent of stakeholder agreement Evaluate community’s capacity for change Identify where the problem/issue can be most effectively addressed Chrislip and Larson
- 35. Rebalancing Health Priorities General Targeted Primary Secondary Tertiary protection protection prevention protection protection Affected people Safer without Affected people Vulnerable complications Healthier with people (undiagnosed complications People asymptomatic) Death from Complications Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 35
- 36. Traditional Healthcare Affected People Safer without Affected People Vulnerable complications Healthier with People (undiagnosed complications People asymptomatic) Traditional Healthcare Disease Care Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 36
- 37. Traditional Public Health Affected People Safer without Affected People Vulnerable complications Healthier with People (undiagnosed complications People asymptomatic) Public Health System Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 37
- 38. Need to Rebalance Health Priorities Affected People Safer without Affected People Vulnerable complications Healthier with People (undiagnosed complications People asymptomatic) Public Health Network Healthcare Delivery System Health Protection: Health Promotion, Disease Care Prevention, and Preparedness Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 38
- 39. Questions “Given the significant public health and health care challenges we face, are Public Health Leaders adequately prepared to address these issues?” “What are the requisite leadership competencies needed to address these challenges?” “Do we have a system of leadership development that can meet this challenge?” Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 39
- 40. Transforming the Public Health System Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 40
- 41. Transforming the Public Health System Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 41
- 42. StructureStandardsFunctions Setting Agency and Public Health Accreditation Board Setting System Standards National Public Health Performance Standards Establishing Public Health Laws and Policies Community Engagement Decentralization (central –local gov. interaction) Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 42
- 43. Transforming the Public Health System Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 43
- 44. Workforce Competencies for Public Health professionals Epidemiologists Environmental Health Nursing Nutritionist Etc Credentialing and certification National Board of Public Health Examiners (etc.; 2005) Existing programs in nursing, environmental health, laboratories Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 44
- 45. Transforming the Public Health System Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 45
- 46. The “Strategic Influence” of Public Health Leaders Politics Policy Programs PH Leaders Resources Experienc e Communit y Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 46
- 47. Crisis Leadership Competency Model This model lays out the nine competencies that were determined to be the most critical for leaders in a public health emergency response situation. Team Leadership Communication Situational Awareness Connectivity Crisis Leadership Competency Integrative Thinking Model Courage and Perseverance Emotional Effectiveness Credibility Decisiveness
- 48. Integration The crisis leadership competencies supplement both the four-tier leadership competencies and the emergency response competencies. Four-Tier HHS Leadership Competencies Emergency Response Competencies Basic Supervisor Manager Executive Leadership • Emergency All Managers All Supervisors Competencies, Management Systems All Basic Competencies, plus: • Agency Preparedness All Core Competencies, plus: Strategic Thinking and Emergency Competencies, plus: Creativity/ Vision Response Roles plus: Resilience Innovation External • Informatics Support Flexibility Conflict Financial Awareness Interpersonal Management Management Political Savvy for Responses Skills Team Building Technology • Risk Communication Self-Direction Influencing / Management and Media Relations Technical Negotiating Entrepreneurship • All Hazards Concepts Credibility Human Resources Organizational • Disaster Mental Project Management Systems Management Service Awareness Health Performance Motivation Management Accountability Leveraging Four-Tier CDC Leadership Competencies (supplement HHS) Diversity • Cultural Awareness • Ethics • Leads Change • Dealing with Ambiguity • HHS/CDC Operations • Personal Leadership • Emotional Intelligence Crisis Leadership Competencies • Communication • Credibility • Emotional Effectiveness • Situational Awareness • Connectivity • Decisiveness • Integrative Thinking • Team Leadership • Courage and Perseverance
- 49. Transforming the Public Health System Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 49
- 50. Goals and Priorities National-level Goals and Priorities Health Protection Goals Healthy People State and Community-level Goals State and Local Health Departments Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 50
- 51. Leadership is Essential to Success Agency Standards Leadership System Standards Improved + Laws and Policies Improved Performance Health Outcomes Community Engagement Workforce Portfolio Management Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 51
- 52. Issues Surrounding Leadership Development Continuum Dilemma Leadership vs. Management competencies Basic vs. Advanced Regional vs. National Crisis Leadership Integrated or single program? Discipline specific Leadership How to build effective networks Fragmentation Develop a “system” for Leadership Shared vision, shared funding, common purpose Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 52
- 53. recommendation Leadership course for public health leader for all level Develop collaboration with all stakeholders Regular meeting to response public health issue Prepare response for emergency crisis Develop program for rebalancing health care system Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 53
- 54. Final Thoughts “Success is the child of audacity” (Disraeli) Seminar Nasional Alumni FKM UNHAS. Wasma Kalla 25-26 Feb 2012 54