NJALA UNIVERSITY

COLLEGE OF MEDICAL SCIENCES

PUBLIC HEALTH SERVICES MANAGEMENT- MPH Program
Lecture note-1
Brief history of Public health

A review of the historical development of public health, which began in ancient times,
emphasizes how various public health concepts have evolved. Historical public health measures
included quarantine of leprosy victims in the Middle Ages and efforts to improve sanitation
following the 14th-century plague epidemics. Population increases in Europe brought with
them increased awareness of infant deaths and a proliferation of hospitals. These
developments in turn led to the establishment of modern public health agencies and
organizations, designed to control disease within communities and to oversee the availability
and distribution of medicines.

Most of the world’s ancient peoples practiced cleanliness and personal hygiene, often for
religious reasons, including, apparently, a wish to be pure in the eyes of their gods. The Bible,
for example, has many adjurations and prohibitions about clean and unclean living.
Religion, law, and custom were inextricably interwoven. For thousands of years societies looked
upon epidemics as divine judgments on the wickedness of humankind. The idea that pestilence
is due to natural causes, such as climate and physical environment, however, gradually
developed. This great advance in thought took place in Greece during the 5th and 4th
centuries BCE and represented the first attempt at a rational, scientific theory of disease
causation. An association between malaria and swamps, for example, was established very
early (503–403 BCE), even though the reasons for the association were obscure. In the
book Airs, Waters, and Places, thought to have been written by Greek physician Hippocrates in
the 5th or 4th century BCE, the first systematic attempt was made to set forth a causal
relationship between human diseases and the environment. Until the new sciences
of bacteriology and immunology emerged well into the 19th century, this book provided a
theoretical basis for the comprehension of endemic disease (that persisting in a particular
locality) and epidemic disease (that affecting a number of people within a relatively short
period).

Definition:

HEALTH:

The World Health Organization (WHO) defines health as the balance of mental, physical and
social health, also known as the health triangle. Having a good balance in all three areas is
essential to living a healthy lifestyle.

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 Mental Health: Mental health is a level of psychological well-being or an absence of mental
illness.
 Physical Health: Physical health refers to the state of your physical body and how well it is
operating.
 Social Health: is the aspect of overall well-being that stems from connection and community. It
is about having close bonds with family and friends, enjoying a sense of belonging to groups,
and feeling supported, valued, and loved.

Your health is one of the most important things in your life. It affects your physical, mental, and
emotional well-being. That's why it's so important to be proactive about your health and take
steps to prevent illness and disease. Being proactive in health means taking steps to improve
your health before you get serious.

Public health: is the art and science of preventing disease, prolonging life, and promoting
physical and mental health, sanitation, personal hygiene, control of infectious diseases, and
organization of health services. From the normal human interactions involved in dealing with
the many problems of social life, there has emerged a recognition of the importance
of community action in the promotion of health and the prevention and treatment of disease,
and this is expressed in the concept of public health.

Health Services Management

Health services management focuses on the planning, organization, and coordination of
healthcare services to ensure efficient and effective delivery of care to patients.
Key responsibilities of health services managers include strategic planning, financial
management, human resource management, and quality improvement.
Health services managers must stay updated on healthcare regulations and policies to ensure
compliance and provide a safe and ethical work environment for staff and patients.
They also work to improve patient satisfaction, streamline processes, and optimize resources to
achieve organizational goals.
In order to be successful in the field of health services management, individuals need strong
communication skills, problem-solving abilities, and leadership skills.
Additionally, they should have a solid understanding of healthcare operations, healthcare laws,
and regulations, and healthcare finance.

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Continuing education and professional development are important for health services
managers to stay current in the field and adapt to changes in the healthcare industry.
Public health services are a set of government-run or government-funded initiatives and
programs designed to protect and improve the health of populations. These services focus on
preventing diseases, promoting healthy behaviors, and ensuring access to essential healthcare
services for everyone in a community or society.
Public health services encompass a wide range of activities and interventions aimed at
safeguarding the well-being of individuals and populations. This can include disease surveillance
and monitoring to track the spread of illnesses, vaccination campaigns to prevent outbreaks,
health education and promotion programs to raise awareness about healthy lifestyles, and
environmental health initiatives to ensure safe living conditions.
Definition of Public Health Services:
Public health services also play a crucial role in responding to public health emergencies, such
as natural disasters, disease outbreaks, and pandemics. They work to coordinate and
implement emergency preparedness and response plans, mobilize resources to address urgent
health threats, and communicate vital information to the public to protect and safeguard their
health.
Additionally, public health services are involved in policy development and advocacy to address
systemic health issues and promote social and environmental determinants of health. They
work with various stakeholders, including community organizations, healthcare providers, and
governmental agencies, to advocate for policies that support health equity, access to
healthcare, and the overall well-being of the population.
In essence, public health services are essential components of the healthcare system that focus
on prevention, promotion, and protection of the health of populations. By providing essential
services, conducting research, and implementing evidence-based interventions, public health
services contribute to improving health outcomes, reducing health disparities, and fostering
healthier communities and societies.

Definition of Service Delivery:

Service delivery refers to the process of providing services to individuals, groups, or
communities in a timely, efficient, and effective manner. It encompasses all the activities
involved in delivering a service, from the initial contact with the service provider to the actual
provision of the service and follow-up support. Service delivery can include a wide range of
services, such as healthcare, education, transportation, utilities, social services, and more. The
goal of service delivery is to meet the needs and expectations of service users, ensuring that
they receive high-quality and satisfactory services that contribute to their well-being and

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quality of life. Effective service delivery often involves well-defined processes, clear
communication with service users, adequate staffing and resources, monitoring and evaluation
mechanisms, and a focus on continuous improvement. By prioritizing the delivery of quality
services that address the needs of individuals and communities, organizations can enhance
their reputation, build trust with service users, and achieve positive outcomes.

Key factors that are affecting public health services in Sierra Leone include:
1. Limited healthcare infrastructure: Sierra Leone faces challenges in the availability of
healthcare facilities, medical equipment, and trained healthcare personnel, particularly in rural
areas, which affects the delivery of quality healthcare services.
2. Disease outbreaks: Sierra Leone has faced significant challenges with disease outbreaks, such
as the Ebola virus outbreak in 2014, which strained the public health system and highlighted
the need for improved disease surveillance, emergency preparedness, and response
capabilities.
3. Poor sanitation and hygiene: Access to clean water, sanitation facilities, and hygiene
practices are limited in many parts of Sierra Leone, contributing to the spread of infectious
diseases such as cholera, typhoid, and diarrheal diseases.
4. Health workforce shortages: Sierra Leone has a shortage of healthcare workers, including
doctors, nurses, and community health workers, leading to challenges in providing adequate
healthcare services, particularly in underserved areas.
5. Limited access to healthcare services: Barriers to accessing healthcare services, such as
geographic remoteness, lack of transportation, financial constraints, and cultural beliefs,
prevent many Sierra Leoneans from seeking timely and appropriate healthcare when needed.
6. Weak health information systems: Sierra Leone faces challenges in collecting, analyzing, and
using health data for decision-making, hindering the ability to monitor population health, track
disease trends, and evaluate the effectiveness of public health programs.
7. Poverty and socioeconomic inequalities: Poverty, food insecurity, and limited access to
education and employment opportunities contribute to poor health outcomes in Sierra Leone,
exacerbating health disparities and limiting access to healthcare services for marginalized
populations.
8. Political instability and conflict: Sierra Leone has experienced periods of political instability
and conflict, which have disrupted healthcare services, weakened healthcare infrastructure,
and impeded the delivery of public health interventions.

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9. Limited funding for healthcare: Sierra Leone’s healthcare system is underfunded, leading to
challenges in maintaining and expanding healthcare services, procuring essential medical
supplies, and ensuring the sustainability of public health programs.
10. Global health challenges: Sierra Leone is vulnerable to global health threats such as
pandemics, climate change, and emerging infectious diseases, which require coordinated
efforts with international partners and organizations to address and mitigate their impact on
public health services.

The Principles of Public Health Services

Public health principles are fundamental guidelines and practices aimed at improving the well-
being of communities and preventing health problems. In simple terms, these principles include
things like promoting good hygiene, ensuring clean water, preventing diseases, and
encouraging healthy lifestyles.

1. Population-based approach: Public health services focus on improving the health of entire
populations rather than individual patients, addressing health challenges at the community
level and considering social determinants of health.
2. Prevention orientation: Public health services emphasize prevention strategies aimed at
reducing the incidence and impact of diseases and health problems, through interventions such
as vaccination campaigns, health education, and policy changes.
3. Health equity: Public health services strive to achieve health equity by addressing disparities
in health outcomes and access to healthcare services among different population groups,
ensuring that everyone has the opportunity to attain their highest level of health.
4. Interdisciplinary collaboration: Public health services involve collaboration across multiple
disciplines, including healthcare providers, community organizations, policymakers, and
researchers, to address complex public health challenges and leverage diverse expertise.
5. Evidence-based practice: Public health services rely on scientific evidence and research to
inform decision-making, program development, and policy implementation, ensuring that
interventions are effective, efficient, and based on best practices.
6. Community engagement: Public health services engage with communities to understand
their unique health needs, involve them in decision-making processes, and develop culturally
sensitive interventions that reflect the values and priorities of the population.
7. Advocacy for policy change: Public health services advocate for policies and regulations that
promote public health and address underlying social determinants of health, striving to create
environments that support healthy behaviors and reduce health disparities.

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8. Emergency preparedness and response: Public health services develop plans and strategies
to respond effectively to public health emergencies, such as disease outbreaks, natural
disasters, or bioterrorism events, ensuring a coordinated and timely response to protect the
health of the community.
9. Continuous quality improvement: Public health services engage in ongoing monitoring,
evaluation, and improvement of programs and services to ensure efficiency, effectiveness, and
accountability in achieving public health goals and outcomes.
10. Ethical and legal considerations: Public health services adhere to ethical principles and legal
standards in their work, ensuring respect for individual rights, confidentiality, informed
consent, and transparency in decision-making processes.

Examples of Public Health Services

1. Vaccination programs: Public health departments often organize and provide immunization
services to ensure community members are protected from preventable diseases.
2. Disease surveillance: Public health agencies monitor and track the occurrence of diseases in a
population to detect outbreaks, identify trends, and implement control measures.
3. Health education campaigns: Public health services often conduct health promotion and
education programs to raise awareness about healthy behaviors, disease prevention, and
access to healthcare services.
4. Environmental health regulations: Public health agencies enforce regulations and policies
related to clean air, clean water, food safety, and sanitation to protect the health of the
community.
5. Emergency preparedness: Public health services develop emergency response plans and
coordinate with other agencies to respond to natural disasters, infectious disease outbreaks,
and other public health emergencies.
6. Community health assessments: Public health departments conduct assessments of
community health needs and assets to identify priorities for health interventions and allocate
resources effectively.
7. Chronic disease prevention programs: Public health services may provide programs and
resources to prevent and manage chronic conditions such as diabetes, heart disease, and
obesity through lifestyle modifications and access to healthcare services.
8. Maternal and child health services: Public health agencies offer services such as prenatal
care, infant immunizations, breastfeeding support, and early childhood screenings to promote
the health and well-being of women and children.

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9. Tobacco and substance abuse prevention: Public health services develop and implement
programs to reduce tobacco use, alcohol consumption, and substance abuse through
education, counseling, and policy interventions.
10. Access to healthcare services: Public health agencies may work to increase access to
healthcare services for underserved populations through initiatives such as mobile clinics,
community health centers, and outreach programs.
Essential Tips about Public Health Services
 Public health services address the health needs of communities and populations, rather
than individuals.
 Key components of public health services include health promotion, disease prevention,
surveillance, and emergency preparedness.
 Public health services aim to improve the overall health of a population through
interventions such as vaccination campaigns, health education programs, and public
health policy development.
 Public health services often involve collaboration with government agencies, healthcare
providers, community organizations, and other stakeholders to address public health
issues.
 Public health services prioritize health equity and aim to reduce health disparities
among different population groups.
 Public health services play a critical role in preventing and controlling the spread of
infectious diseases, responding to public health emergencies, and promoting healthy
behaviors.
 Effective public health services require strong leadership, data-driven decision-making,
and collaboration across sectors to address complex health issues at the population
level.
 Continued investment in public health services is essential to protect the health and
well-being of communities and prevent disease outbreaks.

Public Health Services play a crucial role in promoting and protecting the health of
communities and populations. Some of the key importance of public health services include:
1. Disease prevention: Public health services focus on preventing the spread of infectious
diseases through vaccination programs, disease surveillance, and health education. This helps
to reduce the overall burden of illness in the community.
2. Health promotion: Public health services educate and empower individuals to adopt healthy
behaviors and lifestyles, leading to a reduction in chronic diseases such as diabetes, heart
disease, and obesity.

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3. Emergency preparedness: Public health services develop plans and strategies to respond to
natural disasters, disease outbreaks, and other public health emergencies, ensuring a prompt
and coordinated response to protect the health and safety of the community.
4. Environmental health protection: Public health services implement regulations and policies
to safeguard environmental quality, ensuring clean air, water, and food to prevent adverse
health outcomes.
5. Health equity: Public health services work to address health disparities and inequities in
access to healthcare services, aiming to improve the health outcomes of all community
members, regardless of socioeconomic status or background.
6. Policy advocacy: Public health services advocate for evidence-based public health policies
and regulations to promote population health, including policies related to tobacco control,
food safety, and workplace health and safety.
7. Community engagement: Public health services engage with communities to assess their
health needs, provide culturally appropriate services, and build partnerships with stakeholders
to address health issues collaboratively.
8. Prevention of outbreaks: Public health services play a critical role in monitoring and
controlling the spread of infectious diseases, preventing outbreaks, and protecting the
community from the rapid spread of illnesses.
9. Healthcare cost savings: By focusing on prevention and early intervention, public health
services can reduce healthcare costs associated with treating preventable diseases,
hospitalizations, and chronic conditions.
Overall, public health services are essential in ensuring the health and well-being of
populations, preventing disease, promoting healthy behaviors, and addressing health
disparities to create healthier and more resilient communities.