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Planning Health Policy
In countries at all levels of development the major determinants of health lies outside the health care system. Moreover, inequities in health are only likely to be radically reduced through actions involving such sectors as income distribution, housing, agriculture, education and environment (WHO 1989). Planning for health needs not only to involve all sectors but all levels of government, employers, workers and communities. A distinction needs to be made between planning for health in broadest sense and planning health services. Both are needed. Planning health services.
Essentially any planning involves six steps:
1. Knowing where are you;
2. Deciding quantitatively is this possible, where you want to go and how to get there;
3. Deciding how far you can hope to get towards your target in a period of time say (Five years for example)
4. Trying to get there in five years
5. Regulation evaluation to see;
· How far you have got
· Where you are not on target
· How can do you better in future.
6. Amending The Implementation Plan
This approach is used by the World Health Organization both at global level and at regional level, once the health for all programs was adopted in 1977.twelve global health targets were drafted and agreed in 1981. Progresses towards these targets is reported to the world health assembly, every three years and an evaluation is made in the following year. Similarly each region has produced its targets. Those for Europe were agreed in 1984.Each country is attended to follow with its own health plan and its own health targets.
The European Targets, which were endorsed by the countries, are shown as below
Targets for Health for all 1984
1. Prerequisites for health
- Equity, minimum income, Nutrition , Peace, Water, sanitation , housing, Education, Work, Political Will and public Support.
2. Lifestyle
- Opportunity
- Health promotion
3. Environment
- Hazardous condition
4. Appropriate Care
- Priorities
- Primary Health Care
5. Research
- Health Knowledge
6. Health Development Support
- Policy
- Management
- Education and training
- Technology assessment
In this classification, environmental factors are split between those put under “Prerequisites” and those under the “Environment” this was a political decision. While specific targets were agreed for all other headings, there were no targets for prerequisites. It would have been very unlikely that all European governments would have agreed to endorse such targets as full employment, adequate housing for all, abolishing poverty, or securing minimum income for every citizen. The list brings in the importance of research and support for health development, and the whole list depends critically on political will and public support. The key problems are that the health development is far from being the highest priority of many governments and the public would resist certain attempts to make them healthy by passing laws such as banning alcohol and tobacco. Nor would such laws be enforceable without public support, as the experience of prohibition showed in United States in the 1920s. But the listing of the factors affecting health assets in the process of creative thinking about some of the measures of public policy, which would favour health development, if they were acceptable.
To be continued………………………………………….
In countries at all levels of development the major determinants of health lies outside the health care system. Moreover, inequities in health are only likely to be radically reduced through actions involving such sectors as income distribution, housing, agriculture, education and environment (WHO 1989). Planning for health needs not only to involve all sectors but all levels of government, employers, workers and communities. A distinction needs to be made between planning for health in broadest sense and planning health services. Both are needed. Planning health services.
Essentially any planning involves six steps:
1. Knowing where are you;
2. Deciding quantitatively is this possible, where you want to go and how to get there;
3. Deciding how far you can hope to get towards your target in a period of time say (Five years for example)
4. Trying to get there in five years
5. Regulation evaluation to see;
· How far you have got
· Where you are not on target
· How can do you better in future.
6. Amending The Implementation Plan
This approach is used by the World Health Organization both at global level and at regional level, once the health for all programs was adopted in 1977.twelve global health targets were drafted and agreed in 1981. Progresses towards these targets is reported to the world health assembly, every three years and an evaluation is made in the following year. Similarly each region has produced its targets. Those for Europe were agreed in 1984.Each country is attended to follow with its own health plan and its own health targets.
The European Targets, which were endorsed by the countries, are shown as below
Targets for Health for all 1984
1. Prerequisites for health
- Equity, minimum income, Nutrition , Peace, Water, sanitation , housing, Education, Work, Political Will and public Support.
2. Lifestyle
- Opportunity
- Health promotion
3. Environment
- Hazardous condition
4. Appropriate Care
- Priorities
- Primary Health Care
5. Research
- Health Knowledge
6. Health Development Support
- Policy
- Management
- Education and training
- Technology assessment
In this classification, environmental factors are split between those put under “Prerequisites” and those under the “Environment” this was a political decision. While specific targets were agreed for all other headings, there were no targets for prerequisites. It would have been very unlikely that all European governments would have agreed to endorse such targets as full employment, adequate housing for all, abolishing poverty, or securing minimum income for every citizen. The list brings in the importance of research and support for health development, and the whole list depends critically on political will and public support. The key problems are that the health development is far from being the highest priority of many governments and the public would resist certain attempts to make them healthy by passing laws such as banning alcohol and tobacco. Nor would such laws be enforceable without public support, as the experience of prohibition showed in United States in the 1920s. But the listing of the factors affecting health assets in the process of creative thinking about some of the measures of public policy, which would favour health development, if they were acceptable.
To be continued………………………………………….
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