Public health strategy formation and impact assessment are vital for population health enhancement and ensuring adequate resource use. Strategic planning does not only identify key health challenges but also provides pathways for their resolution through targeted actions. The purpose of this article is to discuss the essentials in the development of public health strategy, with a focus on the impact assessment that shapes and evaluates the efficacy of those interventions.
Defining Public Health Strategies
While discovering a cure for a disease is essential if it is to have any effect on the health of the public, such a finding is insufficient by itself. The public must know about the treatment and its availability to them at an affordable cost. A wide range of actors, both governmental and non-governmental, cooperate to mount complete public health strategies.
These public health workers have collaborated with communities and various sectors of society, such as education, to address health threats ranging from tobacco use, health problems caused by the built environment, and other health threats that operate at the community level. Such interagency collaboration affords an effective means of resource allocation to mitigate health inequities and enhance health outcomes for the general public.
What is health impact assessment?
Health impact assessment is a mechanism of evidence-based policy making for the enhancement of health. It encompasses a combination of methods aiming at assessing the health consequences to a population of a policy, project, or programme that may not necessarily have health as the priority purpose.
Health impact assessment is a multidisciplinary process wherein a variety of evidence regarding the health effects of a proposal is put into a structured framework. It takes the views of the people who may be affected by a proposed policy into consideration. Any proposed actions potentially affecting health are then analysed to favourably influence the process of decision-making.
Key Components of Public Health Strategies
Public health includes the entire community. It works to eliminate all those inequities created because of social determinants of health. Although they all belong to the same community, some may happen to share a number of demographics. Each community, therefore, should articulate valid public health strategies where it addresses everyone. A good public health strategy should consist of some of the key components below.
1. Disease Prevention and Control
The strong public health strategies would be disease prevention and control through strong community health assessments, individual health screenings, vaccination programmes, and community health promotion programmes. Community-level monitors, such as tracking disease outbreaks, will help speedy assessment by health professionals and prepare more effective advice regarding potential interventions and policies related.
2. Cancer-Diabetes Screening
Early Treatment, Better Outcomes, Lower Cost: Early diagnosis allows healthcare providers to initiate treatment sooner rather than later. Besides eradicating smallpox, it has greatly reduced the incidence of polio and measles, among other diseases.
Programmes for health promotion have aided in tobacco control across various age groups, as well as in the reduction of the portion of college students who indulge in excessive drinking, while improving some diabetic patients' management of their disease.
3. Health Promotion
The most effective public health strategies are those that prevent people from ever getting ill. These promote healthy activities and lifestyles, which prevent chronic diseases and improve the quality of life for all people.
Health promotion is encouraging people to take control of their health. These strategies cover various social and environmental interventions. Possible health strategies might be informing people about the hazards of smoking or designing programmes making access to walking easier.
Environmental health, on the other hand, encompasses safe houses, safe workplaces, clean air, clean water, and emission reduction as well as controls over toxic substances. The British Academy for Training and Development offers an environmental management programme designed to enhance the skills of employees about environmental health. Environmental health covers all standards and regulations that make safety within houses and house workplaces, ensure emission reduction, improve water quality and compound the effects of toxic substances. Safe House initiatives address lead exposure and mould or dampness that can, in turn, result in serious health problems such as those above.
4. Health Equity
There are some people who have easy access to all facilities necessary for leading a healthy life, while there are others – almost all of them belong to high-risk categories of diseases – who are unable to seek treatment even for those diseases that are easily preventable. Health disparity is a condition created by differences in socioeconomic characteristics such as income, education, housing, and other non-medical factors, which are mutually exclusive of health outcomes. These non-medical factors are generally referred to as the social determinants of health.
Stages of health impact assessment (HIA) methods
HIAs begin with identification of the stakeholders who are relevant to the process. This usually implies a large number of organisations are relevant. The HIA framework engages stakeholders meaningfully, allowing their messages to be aired. The whole spectrum of resources available to the project and the wider community will help direct decision-making, including developers and planners, employers and unions, local and national health workers, and the community members, the most vulnerable among them being active participants as stakeholders in the health impact assessment.
If an organisation or partnership shows willingness to consider actively the community in which it operates, thereby enabling HIA to facilitate a constructive engagement with the public who are affected by a proposal, then HIA would be facilitating an opportunity for active public participation. The evidence of the public would compete on an equal footing with expert opinion and scientific facts in weighing the totality of information needed for HIA. So decisions feel much more legitimate to everyone involved just because of the spirit of transparency and active participation that underpins them.
1. Screening
The HIA process begins with screening activities meant to rapidly establish the significance of a policy, programme or project in terms of health. The screening first seeks out the key issues and public concerns and sets limits and expectations for the HIA process. The screening stage selects an intervention, a policy or a project for which an HIA would be beneficial. The health determinants, health outcomes, and population groups that may be affected are identified. The screening leads to three types of decisions:
That an HIA is neededThat an HIA is not needed The effects are already known.That HIA is not necessary; these effects are negligible.2. Scoping
This is the second step in the HIA process and aims to plan the HIA and determine which health risks and benefits are to be considered. A steering group is formulated, which has developed and adopted terms of reference for the HIA. Scoping comprises the process of bringing together the major stakeholders of the proposal to form a steering group and develop and adopt terms of reference for the HIA. The systematic way of doing so will assist in ensuring that the final HIA will not exclusively present one side of the evidence.
3. Appraisal
Because the appraisal is the heart of any HIA activity, it concerns the collection and analysis of information and evidence on identified impacted populations – most likely health impacts. The appraisal phase entails a rapid or full appraisal of HIA impacts on health consequences in respect to the affected populations. The projections made concerning the impact will be useful in giving advice plus recommendations for actions to amplify positive health impacts and minimise negative health impacts. Depending on the context, HIA might be developed through either rapid assessment or full appraisal.
4. Reporting
An essential element of HIA is reporting on the results to the communities and decision-makers in clear terms. This description of contents ought to entail the statement of the goal, the priorities that have been determined at the very beginning, the views of stakeholders, the pieces of evidence put forth from different sources, the overall findings, and any recommendations.
5. Decision-making and recommendations
This is the stage at which the conclusions and recommendations are being worked out and laid out – usually a set of changes to the proposal considered helpful – and are being considered goodwill and ill toward the actual decision-making.
6. Monitoring
After project conclusion or as the policy is initiated, HIAs enter monitoring, during which the impact is registered and analysed to enhance the evidence base and inform subsequent endeavours. It is the last step of HIAs, which enables the evaluation of the whole process, including the strengths and weaknesses of HIAs.
The evaluation of whether the HIA gave a truly influential voice in the decision-making process (and the corresponding proposal) is one key aspect of HIA. And, like any other intervention, an evaluation is necessary to check for effectiveness.
Monitoring the implementation of the proposal is critical to ensure that any recommendations that decision-makers agreed to actually occur. Longer-term monitoring of the health of populations is sometimes a component of larger proposals. This long-term monitoring can be used to see if the predictions made during the appraisal were accurate and to see if the health, or health-promoting behaviours, of the community have improved.
Challenges and Solutions in Public Health
Limited resources and funding are some of the most severe challenges in actually implementing exhaustive public health strategies. They hinder the provision of necessary services and the construction of sound health infrastructure.
Therefore, effective policy and advocacy can give voice to these restive constraints. For example, legislators and advocates can seek funds through legislation for public health priorities by policy or by making policy expand access to health care and improve public health outcomes, as seen in the U.S. through initiatives such as the Affordable Care Act.