PUBLIC HEALTH AND HEALTH PROMOTOIN

Public Health And Health Promotoin

Public Health And Health Promotoin

Introduction

Poverty reduction is the number one objective of the Millennium Development Goals (MDGs) and a significant component of the U.S. Foreign Assistance Framework, which strives to build democratic states that “respond to the needs of their people” and “reduce widespread poverty.” Moreover, eligibility for international development loans and debt relief is increasingly being tied to a country's demonstrated progress in meeting the needs of its poorest citizens. The links between poverty reduction and reproductive health (RH) issues are well known. Satisfying unmet need for family planning (FP) can lower population growth and reduce the strain on scarce national- and household-level resources. Improving maternal health has a ripple effect on families. Healthy mothers are better able to contribute to their children's health and education as well as to household resources. The HIV epidemic is reversing national development gains in heavily-affected countries and bankrupting families through lost wages and high medical costs—highlighting the need to expand access to prevention, treatment, and care, especially for underserved groups.(Brownson and Bright, 2004)

Discussion

Progress in public health and community-based interventions has been hampered by the lack of a comprehensive evaluation framework appropriate to such programs. Multilevel interventions that incorporate policy, environmental, and individual components should be evaluated with measurements suited to their settings, goals, and purpose. In this commentary, the authors propose a model (termed the RE-AIM model) for evaluating public health interventions that assesses 5 dimensions: reach, efficacy, adoption, implementation, and maintenance. These dimensions occur at multiple levels (e.g., individual, clinic or organization, community) and interact to determine the public health or population-based impact of a program or policy. The authors discuss issues in evaluating each of these dimensions and combining them to determine overall public health impact. Failure to adequately evaluate programs on all 5 dimensions can lead to a waste of resources, discontinuities between stages of research, and failure to improve public health to the limits of our capacity. The authors summarize strengths and limitations of the RE-AIM model and recommend areas for future research and application.(Gostin, 2000)

On 1 April 2005 the National Institute for Health and Clinical Excellence (new NICE) opened its doors for business. It was in part business as usual because NICE's work on of appraising new pharmaceutical products and interventional procedures and its development of clinical guidelines continues. But with the closure of the Health Development Agency (HDA), NICE assumed some of that agency's functions. With the acquisition of the public health evidence-based work of the HDA, it was decided that new NICE would take on the new responsibility for producing public health guidelines. This is the first time in the UK that a national body has had the task of producing evidence-based public health guidelines. Public health in this context is defined to include health promotion and health education as well as broad public health concerns.

NICE will produce two types of guidance on public health called public health intervention guidance and public health programme ...