ESSENTIAL PUBLIC HEALTH FUNCTIONS - WHO Western …

1 I ESSENTIAL PUBLICHEALTH FUNCTIONSA three-country study in theWestern pacific RegionWorld HEALTH OrganizationRegional Office for the Western Pacific2003ii WHO Library Cataloguing in Publication DataEssential PUBLIC HEALTH FUNCTIONS : a three-country study in the Western pacific Region 1. PUBLIC HEALTH ISBN 92 9061 082 4 (NLM Classification: WA 525) World HEALTH Organization 2003 All rights designations employed and the presentation of the material in this publication do not imply the expression of anyopinion whatsoever on the part of the World HEALTH Organization concerning the legal status of any country, territory,city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.

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3 No. (632) 521-1036, iiiCONTENTSA cknowledgements .. ixChapter 1: Introduction .. 11. The Western pacific Region .. 12. ESSENTIAL PUBLIC HEALTH FUNCTIONS .. 13. PUBLIC HEALTH systems and their context .. 24. Structure and sustainability .. 75. Conceptual model for the project .. 156. 16 Chapter 2: Aims, methodology and the EPHF framework .. 211. Aims and case study objectives .. 212. Project 223. 224. Project processes .. 395. Glossary of practices .. 42 Chapter 3: Fiji case report .. 451. Contextual 452. 543. Stocktake .. 564. Analysis of strengths, weaknesses, opportunities and threats of currentorganizaton and delivery of EPHFs .. 685. Proposal to strenghten EPHF delivery.

4 706. 747. Recommendations .. 74iv Chapter 4: Malaysia case report .. 791. Contextual 792. 863. Stocktake .. 874. Analysis of strengths, weaknesses, opportunities and threatsof current organizaton and delivery of EPHFs .. 905. Proposal to strenghten EPHF delivery .. 916. 95 Chapter 5: Viet Nam case report .. 1031. Contextual 1032. 1103. Stocktake .. 1144. Analysis of strengths, weaknesses, opportunities and threatsof current organizaton and delivery of EPHFs .. 1335. Proposal to strenghten EPHF delivery .. 1356. 6: Discussions and conclusions .. 1411. Comparisons between the case studies .. 1412. Relevance of the three case studies to the Western pacific Region .. 1413. Scope, Methods and Timing.

5 1424. Extent of EPHFs and their governance and stewardship .. 1445. The structure and sustainable delivery of EPHFs .. 1466. Lessons learned .. 1497. vACKNOWLEDGEMENTSM alaysia Advisory Group:Datu Dr Mohamad Taha Arif, Director General of HealthDr Lee Cheow Pheng, Director, Communicable Disease ControlDivisionDr Narimah Awin, Director, Family HEALTH Development DivisionDatin Dr S Selvaraju, Director, Planning and DevelopmentDivisionDatin Dr Harrison Aziz, Director, Food Quality Control DivisionDato Dr Wan Mohamad Nasir Wan Osman, Deputy Director,Oral HEALTH DivisionMr Sarjit Singh, Director, HEALTH Education and CommunicationCentreProfessor Jason Teoh, Lecturer, Department of Social andPreventive Medicine, University MalayaDr Zainol Arifin Pawanchee, HEALTH Director of Kuala LumpurCity HallDr Suleiman Che Rus, Director, Institute of PUBLIC HealthProfessor Syed Mohamad Al Junid.

6 Lecturer, Community HealthDepartment, National University of MalaysiaMs Sabariah Hassan, Assistant Secretary, Human ResourceDivisionMr Zulkifli A Rahman, Chief PUBLIC HEALTH Inspector, PublicHealth DepartmentMs Datin Shamsiah Omar, Principal Matron, Malaysian NursingBoardMr Mansor Fenner, Principal Tutor, Institute of PUBLIC HEALTH .(Malaysia Advisory Group members were employees of theMinistry of HEALTH , Malaysia, unless otherwise indicated.)Malaysia Research Team (authors of Chapter 4):Dr Narimah Awin (Chairperson), Director, Family HealthDevelopment DivisionDr Maimunah A. Hamid, Head, HEALTH Systems Research,Institute of PUBLIC HEALTH (Principal Investigator for Malaysia andalso a member of the International Project Team)Completion of this project was only possible throughthe commitment and involvement of a large number ofpeople.

7 These included:Fiji Advisory Group:Dr Lepani Waqatakirewa, Director, Primary and Preventive HealthServices, Ministry of HEALTH (also a member of the InternationalProject Team)Dr Setareki Vatucawaqa, Sub-divisional Medical Officer, RewaSubdivisionDr Sala Saketa, Divisional Medical Officer, Northern DistrictMr Alan Hodgkinson, Training Adviser, Australian Agency forInternational Development (AusAID) HEALTH Management ReformProject, Ministry of HEALTH , SuvaMs Karen Denison- Biumaiwai, Lecturer in HEALTH ServiceManagement, Fiji School of MedicineMr. Navi Litidamu, Senior Lecturer in Environmental HEALTH , FijiSchool of MedicineMs Lorraine Kerse, Regional Adviser in Human ResourceDevelopment, WHO, SuvaProfessor David Phillips, Professor of PUBLIC HEALTH and PrimaryCare, Fiji School of Research Team (authors of Chapter 3):Professor David Phillips, Professor of PUBLIC HEALTH and PrimaryCare (Principal Investigator for Fiji and also a member of theInternational Project Team).

8 Mr Navi Litidamu, Senior Lecturer in Environmental HealthDr Berlin Kafoa, Lecturer in HEALTH Service ManagementDr Iris Wainiqolo, Lecturer in Primary CareDr Phyllis Hotchin, Lecturer in Primary CareMr Madhukar Pande, Lecturer in Social Science(All Fiji Research Team members were based at the Fiji Schoolof Medicine).vi Dr Safurah Hj Jafaar, Principal Assistant Director, Family HealthDevelopment Division (also a member of the International ProjectTeam)Dr Mohd Safiee Ismail, Assistant Director, Family HealthDevelopment DivisionDr Noridah Mohd Saleh, Assistant Director, Family HealthDevelopment DivisionMs Low Lee Lan, Research Officer, HEALTH Systems ResearchDivisionMs Haniza Mohd Anuar, Senior Research Officer, Institute ofPublic HealthDr Zailan Dato Hj Adnan, Principal Assistant Director, Instituteof HEALTH ManagementDr Siti Rafiaah Ismail, Senior Medical Officer of HEALTH , Instituteof PUBLIC HealthDr Zainal Abidin Abu Bakar, Assistant Director, Family HealthDevelopment DivisionMs Dayang Annie Abang Narudin, Chief PUBLIC HEALTH Matron,Family HEALTH Development DivisionMr Hj Zainal Abd Ghaffar, Senior PUBLIC HEALTH Inspector.

9 PublicHealth DepartmentMr Mohd Radzi Abdullah, Chief PUBLIC HEALTH Medical Assistant,Family HEALTH Development Division(All Malaysia Research Team members were employees of theMinistry of HEALTH , Malaysia.)Viet Nam Advisory Group:Professor Do Nguyen Phuong, Minister of HEALTH (chairman)Professor Nguyen Van Thuong, Vice Minister of Le Ngoc Trong, Vice Minister of Pham Manh Hung, Vice Minister of Nguyen Van Dip, Director, Department of Science andTraining, Ministry of Dao Ngoc Phong, Hanoi Medical Trinh Quan Huan, Director, Department of PreventiveMedicine, Ministry of Duong Huy Lieu, Director, Department of Planning, Ministryof Ngo Toan Dinh, Director, Department of Personnel, Ministryof Thi Thu Ha, Deputy Director, Department of International Co-operation, Ministry of Nam Research Team (authors of Chapter 5).

10 Dr Le Vu Anh, Dean (Principal Investigator for Viet Nam andalso a member of the International Project Team)Dr Vu Xuan Phu, Faculty member (coordinator for this project)Dr Phan Van Tuong, Deputy Head of Department (coordinatorfor this project)Dr Nguyen Van Man, Head, Training and Research DepartmentDr Pham Tri Dung, Deputy Head of DepartmentNguyen Thanh Huong, Faculty memberDr Le Nhan Phuong, Development fellowPham Viet Cuong, Faculty member.(All members of the Viet Nam Research Team were based at theHanoi School of PUBLIC HEALTH .)International ConsultantAssociate Professor Gillian Durham (International Project Teammember)Dr Durham provided substantial early work that initially enabledthe International Project Team to successfully develop theresearch methodology, including development of the essentialpublic HEALTH FUNCTIONS used in this study, during their initialmeeting in June 2000.