From service provision to function based performance - perspectives on public health systems from the USA and Israel

Abstract

If public health agencies are to fulfill their overall mission, they need to have defined measurable targets and should structure services to reach these targets, rather than offer a combination of ill-targeted programs. In order to do this, it is essential that there be a clear definition of what public health should do- a definition that does not ebb and flow based upon the prevailing political winds, but rather is based upon professional standards and measurements.The establishment of the Essential Public Health Services framework in the U.S.A. was a major move in that direction, and the model, or revisions of the model, have been adopted beyond the borders of the U.S.This article reviews the U.S. public health system, the needs and processes which brought about the development of the 10 Essential Public Health Services (EPHS), and historical and contemporary applications of the model. It highlights the value of establishing a common delineation of public health activities such as those contained in the EPHS, and explores the validity of using the same process in other countries through a discussion of the development in Israel of a similar model, the 10 Public Health Essential Functions (PHEF), that describes the activities of Israel’s public health system. The use of the same process and framework to develop similar yet distinct frameworks suggests that the process has wide applicability, and may be beneficial to any public health system.Once a model is developed, it can be used to measure public health performance and improve the quality of services delivered through the development of standards and measures based upon the model, which could, ultimately, improve the health of the communities that depend upon public health agencies to protect their well-being.

Development and Usefulness of a District Health Systems Tool for Performance Improvement in Essential Public Health Functions in Botswana and Mozambique

“…Each was reviewed for its appropriateness for African districts and for their ability to generate immediate feedback for practice improvement. The CDC’s NPHPSP had been used in Israel 35 and Indonesia 36 . The World Bank tool had been developed with reference to NPHPSP for use in Karnataka state in India 27 .…”

Defining and classifying public health systems: a critical interpretive synthesis

“…Public health systems were defined in 20 documents, with 10 unique definitions identified (Additional file 3). Eleven documents defined public health systems as all levels of governmental and non-governmental entities which share in the responsibility for ensuring healthy social and physical environments, and consist of a variety of organisations that contribute to the core functions of public health to protect and promote health within the community [12,[40][41][42][43][44][45][46][47][48][49] were also defined based on their composition, level of service, contributing actors, mission and activities, or a combination of these. Public health was largely seen as a governmental responsibility and included partnerships between formal (government) and informal (private sectors, volunteer) organisations.…”

Defining and Assessing Public Health Functions: A Global Analysis

“…Since then, and complementing this view with an intersectoral perspective, a number of international, national, and subnational www.annualreviews.org • Assessing Public Health FunctionsEU: European Union agencies have adopted a functional, system-wide approach to defining and assessing public health in Latin America (40), the Western Pacific (63), the Eastern Mediterranean (WHO Eastern Mediterranean Regional Office, unpublished information), the European Region (62), the European Union (2), Australia (37), the United Kingdom (13), India (11), New Zealand (39), Israel (48), and British Columbia (44). Table 1 shows the different essential functions as defined by public health organizations around the world and notes the existence of assessment tools to support them.…”