The impact of public health interventions in a developing nation: an overview

Introduction: Around 80% of factors that determine population health sit outside the control of health services. It is essential we influence these factors in addition to those within the remit of health services in order to improve and protect the health of population in a developing country. Public health functions encompass working across the domains that constitute population health systems with various partners. The objective of this article is to give an overview of public health interventions that can improve the health of the population of a developing nation. Method: A descriptive study, based on a review of the literature of key public health frameworks and interventions that are likely to have significant impacts on population health. Some selected public health interventions and case studies are highlighted to illustrate the importance of priority areas in developing countries. Results: Various public health frameworks recognise the importance of wider determinants of health (socio-economic factors), effective healthcare, healthy behaviours, working with communities as critical to securing population health. Another framework adopts a life-course model of intervention starting from public health interventions during preconception period and childhood, adolescence, working life and older age. For many developing countries, the author identified some examples of priority areas for interventions such as stopping and preventing wars; improving child health, including free school meals; achieving universal healthcare through integrated primary health care; addressing commercial determinants of health; embracing new technologies; and measuring and monitoring population health. Conclusion: In order to improve the health of a population in a developing country, attention needs to go beyond health services to influence the wider determinants of health, health behaviours and adopting the World Health Organisation's roadmap on essential public health functions.

China′s strategy and experience in preventing and controlling the local spreading and epidemic of COVID-19 / 上海预防医学

After implementing a series of prevention and control strategies of Corona Virus Disease 19(COVID-19), China′s local epidemic situation has been basically blocked.While China has achieved a periodic success, global pandemic situation is still serious.Together with the timeline of China′s epidemic prevention and control this study reviewed the main strategies and measures in response to COVID-19 epidemic from Dec.2019 to Mar.23, 2020, and summarized China′s prevention and control plans and experiences.We hope all countries could fully understand the importance of non-pharmaceutical public health interventions, make positive and effective adjustments to the measures and strategies of prevention and control based on their own national conditions.

Chronic disease in the Caribbean: strategies to respond to the public health challenge in the region. What can we learn from Jamaica's experience? / Enfermedades crónicas en el Caribe: estrategias para responder a los retos de la salud pública en la región. ¿Qué podemos aprender de la experiencia de Jamaica?

With the advent of the epidemiological transition, chronic non-communicable diseases (CNCDs) have emerged as the leading cause of death globally. In this paper, we present an overview of the burden of CNCDs in the Caribbean region and use Jamaica as a case-study to review the impact of policy initiatives and interventions implemented in response to the CNCD epidemic. The findings show that while Jamaica has implemented several policy initiatives aimed at stemming the tide of the CNCD epidemic, a comparison of data from two national health and lifestyle surveys conducted in Jamaica in 2000/01 and 2007/08 revealed that there was an increase in the prevalence of intermediate CNCD risk factors such as hypertension and obesity. We therefore present recommended strategies which we believe will enhance the current CNCD response and thus reduce, or at least stem, the current epidemic of CNCDs.

Con el advenimiento de la transición epidemiológica, las enfermedades no comunicables crónicas (ENCCs) han emergido como la causa principal de muerte a nivel mundial. En este trabajo, se presenta un panorama general de la carga que las ENCCs representa para la región caribeña. Asimismo, se utiliza Jamaica como estudio de caso para examinar el impacto de las iniciativas en materia de políticas así como las intervenciones, implementadas en respuesta a la epidemia de ENCC. Los hallazgos muestran que si bien Jamaica ha implementado varias iniciativas en cuanto a políticas, dirigidas a detener la marea de la epidemia de ENCC, una comparación de datos de dos encuestas nacionales sobre salud y estilo de vida realizadas en Jamaica en 2000/01 y 2007/08 revelaron que hubo un aumento de la prevalencia de los factores de riesgo intermedios de las ENCC, tales como la hipertensión y la obesidad. Por lo tanto, se presentan estrategias recomendadas, las cuales pueden - a nuestro juicio - mejorar la respuesta actual a las ENCC, y por ende reducir - o al menos frenar - la actual epidemia de ENCCs.

Epidemiology to public health intervention for preventing cardiovascular diseases: The role of translational research.

Despite significant progress in medical research, cardiovascular diseases (CVDs) continue to be the largest contributors of morbidity and mortality both in developed and developing countries. The status of public health interventions related to CVDs prevention was reviewed to identify actions that are required to bridge the existing gap between the evidence and the policy. We used a framework comprising two steps - “bench to bedside” and from “bedside to community” to evaluate translational research. Available literature was reviewed to document the current status of CVD prevention and control at national level in India. Case studies of risk factor surveillance, tobacco control and blood pressure measurement were used to understand different aspects of translational research. National level initiatives in non-communicable diseases surveillance, prevention and control are a recent phenomena in India. The delay in translation of research to policy has occurred primarily at the second level, i.e., from ‘bedside to community’. The possible reasons for this were: inappropriate perception of the problem by policy makers and programme managers, lack of global public health guidelines and tools, and inadequate nationally relevant research related to operationalization and cost of public health interventions. Public health fraternity, both nationally and internationally, needs to establish institutional mechanisms to strengthen human resource capacity to initiate and monitor the process of translational research in India. Larger public interest demands that focus should shift to overcoming the barriers at community level translation. Only this will ensure that the extraordinary scientific advances of this century are rapidly translated for the benefit of more than one billion Indians.

Treinamentos em epidemiologia realizados em instituições conveniadas com o centro nacional de epidemiologia (cenepi): congruências e discrepâncias com indicadores

Resumo: A avaliação de intervenções na {1rea de saúde pública brasileira é uma prática que vem se consolidan­do nesses últimos anos. Diferentes modelos de avalia­ção têm sido utilizados para este fim. O presente estudo destina-se a verificar o grau de atingimento de parâmetros ou referenciais de treina­mento cm Epidemiologia estabelecidos pelo Centro Na­cional de Epidemiologia do Ministério da Saúde (CENEPI) por dez instituições de ensino superior con­veniadas por aquele Centro. Para esse propósito, foi escolhido o modelo de Stake, o qual focaliza-se em congruências e discrepâncias verificadas na prática das dez instituições conveniadas, bem assim na prática dos serviços de saúde envolvidos, em relação aos parâ­metros acima referidos. Os referenciais de treinamento em Epidemiolo­gia são oito: (a) planejamento conjunto do treinamento, (b)diagnóstico de recursos humanos em Epidemiolo­gia, (c) avaliação continuada dos convênios, (d)sclcção dos candidatos, (e) liberação dos candidatos/modulari­zação dos cursos, (f) instalação de núcleos de Epidemio­logia, (g)assessoramento de equipes após treinamento e (h)disseminação de bibliografia de treinamento. Questionários respondidos pelo CENEPT, insti­tuições de ensino superior e senriços de saúde mostra­ram que predomina a congruência entre os três grupos de órgãos com relação aos oito parâmetros ou referen­ciais do CENEPJ. Entretanto, ressaltam proporções ele­vadas de discrepâncias, bem assim de concordâncias quanto ao não atingimento dos referenciais tanto pelas instituições de ensino superior como por servi­ços de saúde.

Abstract: Public health authorities have made an increasingly regular practice to submit interventions in their services to evaluation. Numerous evaluation models have been employed to this end. The present study seeks to verify the extent to which training parameters or referents in Epidemiology established by the Epidemiology National Center (CENEPI) of the Brazilian Ministry of Health were attained by ten university level institutions contracted by the referred Center and also the local public health services. Consonant with this purpose. Stake's evaluation model was chosen. This model focuses on congruencies and discrepancies occurring in the training practices of the ten institutions regarding CENEPI's training parameters. The parameters set up by CENEPI for training in Epidemiology are eight, namely: (a) joint planning of training, (b) diagnostic of available personnel in epidemiology, (c) continned evaluation of the contracts, (d) screening of candidates € candidate discharge from service/training flexibilization, (f) establishment of state epidemiology centers, (g) support to local epidemiology groups after training, and (h) dissemination of training bibliography. Questionnaires responded by the three groups of institutions involved in the evaluation - CENEP university level institutions and local public health services - showed a predominance of congruencies among the three groups of institutions regarding the eight parameters of training in epidemiology. However, discrepancies as well as agreement concerning failure to attain CENEPI's parameters on the part of university level institutions and local public health services were noticeable.