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Joint Project CDC/PAHO: Performance Measurement of Essential Public Health Functions in Latin America and the Caribbean

Project Description

A recent study by the World Health Organization (WHO) has shown that it is possible for global consensus to be achieved on a set of Essential Public Health Functions. Many developed countries are already developing their own core essential functions or services in an attempt to better define the role and image of public health. Essential public health functions provide a framework on which to build a public health delivery system. These functions can be prioritized according to the national context and an efficient delivery system based on a well-organized approach, designed around them. Reasons for reforming the health care systems along these lines vary but chief amongst them is the accountability to policy makers for a defined set of services which can be budgeted for by a finite amount of resources. This approach to public health is important to developing regions of the world where limited resources have to be utilized without sacrificing issues of equity of finance and assuring equal accessibility to health care, especially for vulnerable populations. In this region, limited financial resources have to be used in such a way as to yield the greatest equity and efficiency in health care delivery as well as a better coordination among public, private and social security health care providers.

The National Public Health Performance Standards Program (NPHPSP) has partnered with the Pan American Health Organization (PAHO) to share expertise in the area of performance measurement and development of standards in public health practice. A common vision emerged from the collaborative exercise by sharing the concept of essential public health services as visioned by the United States with that of PAHO's research of essential public health functions. One of the main objectives of this vision has been to design a measurement tool suitable for use throughout the Americas to assess the current capacity of public health infrastructure at a regional level. The tool was pilot tested in Bolivia, Jamaica and Colombia and over the period of 1 year was applied in 41 countries of the region (see What's New section). Data on the public health systems in these countries has been published in a joint CDC/PAHO publication entitled "Public Health in the Americas". Both the instrument and the measurement methodology was received enthusiastically by all countries. In addition to measuring public health performance, the use of this framework helped many countries to define a national role for public health, helping them to formulate more effective national level public health programs and initiatives within national contexts. The instrument also provided each country with a national focus for developing optimal standards of public health practice. The collaboration project has played an important role in the PAHO "Public Health in the Americas" initiative. This initiative will be one of major benefit to both CDC and PAHO. A meeting will be held later in 2002 to determine the next steps in this project, including the planning of strategic interventions to enhance public health delivery. Plans are also in the pipeline to develop a similar measurement methodology for public health systems in use at the regional and local levels.

To further facilitate this collaborative role, the WHO has designated The Public Health Practice Program Office (PHPPO) at the Centers for Disease Control and Prevention (CDC) as a World Health Organization Collaborating Center for Public Health Practice. The center will focus on sharing the wide base of expertise available through PHPPO with initiatives in other countries and international health organizations in the area of performance measurement and development of standards for public health. The center will facilitate and accelerate the development and implementation of these initiatives and do much to formulate a common framework that not only defines the role of public health but also sets optimal standards for health systems globally. The NPHPSP is already exercising a leadership role in measuring the public health capacity and infrastructure in the United States. It is anticipated that by collaborating with other countries and agencies, performance measurement of public health systems will play an expanded role and improve the practice of public health on a global scale.

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This page last reviewed: August 17, 2004
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