fulfilling public health functions for future public health leaders

7/27/2019 Fulfilling Public Health Functions for Future Public Health Leaders

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FULFILLING PUBLIC HEALTH FUNCTIONS

FOR

FUTURE PUBLIC HEALTH LEADERS

Dr Safurah Jaafar

Director Family Health Development Division

Ministry of Health Malaysia


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Ministry of Health Malaysia &

Telehealth & E-Government Unit V2

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Essential Public Health Functions


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3


http://www.wpro.who.int/publications/docs/Essential_public_health_functions.pdf


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4

Practices

Essential

Public Health

Functions& Tasks

Core

Areas of

Public

Health

Work

ServicesPublicHealth

Outcomes

Governancea

ndSteward

ship


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5

Essential Public Health Functions (EPHFs)

Public goods

Governments need to ensure the provision ofthese essential functions

Inter-sectoral action for health

Strengthening institutional capacity

A set of fundamental activities that address the determinantof health, protect a populations health, and treat disease

(Yach, 1996)


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6

F1: Health situation monitoring & analysis

F2: Epidemiological surveillance/disease prevention & control

F3:Development of policies & planning in public health

F4:Strategic management of health systems & services for population health gain

F5: Regulation & enforcement to protect public health

F6: Human resources development & planning in public health

F7: Health promotion, social participation & empowerment

F8: Ensuring quality of personal& population-based health services

F9:Research, development & implementation of innovative public health solutions



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7

EssentialPublicHealth

Function(1/9)

Task 1

Task 2

Task 3

Etc.

Practice 1

Practice 2

Practice 3

Practice 4

Etc.

Practice 1

Practice 2

Practice 3

Practice 4

Etc.

Practice 1

Practice 2

Practice 3

Practice 4

Etc.

Services

Population-based public

health services

Personalpreventiveservices

Personaltreatmentservices

Conceptual Framework


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F5: Regulation & enforcement to protect public health

development and compliance withregulation that improves health status & the qualityof life, reduces health inequalities, safeguards &protects the publics health, & reduces the burden ofdisease.

4 Tasks Each task has a

set of practices

Outcome -

Tasks for F5:

1. Promulgate and implement lawsand regulations in public health

2. Review, develop and updateregulations

3. Ensure enforcement ofregulations

4. Assess and promote compliance

Practices

Assess

Set priorities

Develop plans

Manage

Collect & use evidence

9


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9

Practices

Assess Investigate

Analyse

Advocate

Negotiate Integrate

Set priorities

Develop plans

Implement Evaluate

Communicate

Collect and use evidence

Ensure compliance withregulation

Manage

(resources and patients)

10


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10

Public Health Challenges; Yesterday, Now, Future?

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http://www.time.com/time/magazine/0,9263,7601030505,00.htmlhttp://www.time.com/time/magazine/0,9263,7601030505,00.htmlhttp://www.time.com/time/magazine/0,9263,7601030505,00.html


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Public Health Challenges

EmergingDisease

ReemergingDiseases

Bioterrorism

Food safety

NaturalDisasters

Obesity

AgeingPopulation

HealthDisparities

Equity amdAccess

Coverage andHealth

Insurance

NCD

PublicViolence

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12

Driving Issues

Pressure of changes exert on public health systems

Shifts in demographic trends

Shifts in epidemiological trends in diseases

Shifts in prevalence of risks and protective factors

New technologies for health care

Health reforms are often focused on treatment services,with little concern or understanding for Public Health

No means of describing Public Health in acomprehensive (practical) manner

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R b l i H l h P i i i


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13

Rebalancing Health Priorities

SaferHealthierPeople

Vulnerablepeople

Affected peoplewithout

complications

(undiagnosedasymptomatic)

Affected peoplewithcomplications

Generalprotection Targetedprotection Primaryprevention Secondaryprotection Tertiaryprotection

Death fromComplications

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T diti l H lth


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14

Traditional Healthcare


VulnerablePeople

Affected Peoplewithoutcomplications


Affected Peoplewith

complications

Traditional Healthcare

Disease Care

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T diti l P bli H lth


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15

Traditional Public Health


VulnerablePeople



Affected Peoplewith

complications

Public Health System

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N d t R b l H lth P i iti


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Healthcare Delivery System

Disease Care

Need to Rebalance Health Priorities

Public Health Network

Health Protection: Health Promotion,

Prevention, and Preparedness


VulnerablePeople



Affected Peoplewith

complications

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Q ti ?


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Questions?

Given the significant public health and health care

challenges we face, are Public Health Leadersadequately prepared to address these issues?

What are the requisite leadership competencies neededto address these challenges?

Do we have a system of leadership development thatcan meet this challenge?


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Structure and Functions


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Structure and Functions

Setting Agency StandardsPublic Health Accreditation Board

Setting System Standards

National Public Health Performance StandardsEstablishing Public Health Laws and Policies

Community Engagement

Local State Federal interaction

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Federal State and Local Silos


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Federal, State and Local Silos

Public

Health

Health

Care

Emergency

ManagementEducation

Law

Enforcement

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Workforce


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Workforce

Competencies for Public Health professionals

Family Health Physicians

Epidemiologists

Environmental Health Specialists

Health Management

Other team members in PH

Credentialing and certificationNational Board of Public Health

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Core Areas of Public Health Work


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Core Areas of Public Health Work

Health Promotion

Health protection

Healthy public policy

Promoting health and equitable health gain

Combating threats to public health

Injury prevention

Disease control

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Public Health Outcomes


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Public Health Outcomes

Health status and quality of life

Health inequalities

Safeguards for the publics health

Acute and chronic disease burden

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The

Public HealthLeader

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The Strategic Influence of Public Health Leaders


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The Strategic Influence of Public Health Leaders

Policy

PHLeaders

Community

Experience

Politics

Resources

Programs

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Leadership is Essential to Success


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Leadership is Essential to Success

Improved

Performance

Agency Standards

System Standards

Laws and Policies

Community Engagement

Portfolio Management

Improved

HealthOutcomes

+

Leadership

Workforce

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First things first


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First things first.

What is a successful leader?

When have you been inspired by a leader?

Who in history do you feel was a great

leader and why?

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C id M t L d hi


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Consider Meta-Leadership

Defined as:

Leadership that connects the purposes and the work of differen

organizations or organizational components to achieve a greater

good

Leaders able to influence and accomplish such collaboration ofeffort across organizations multi-jurisdictions, multi-agencies,

and public-private entities motivating inter-action, enhancing

communication, and engendering the sort of cross-organizational

confidence necessary for effective action

Dr. Leonard J Marcus and Dr. Barry Dorn of the National Preparedness Leadership

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Traditional Vs Meta Leadership


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Traditional Vs Meta-Leadership

Traditional Leaders vs. Meta-Leaders:

Traditional leaders derive their power and

influence from within their organizational silos

(i.e., job description, authority of position,

expectations of supervisor and subordinates)

1. Promotes a related set of functions

2. Controls a related set of workers

3. Is the sum of all the parts - Newtonian Systems

4. Supports a structured/familiar Organization

5. Operates under a defined set of principles

6. Is tied together by a unique culture

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Meta Leadership


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Meta-Leadership

Meta-Leadership

Big picture

Multi-dimensional perspective

Comfortable with the unfamiliar

Recognize cultural value

Can integrate diverse goals

COMPLEX ADAPTIVESYSTEMS

More than the sum of theindividual parts

Meta-Leaders strive to influence

what happens within their

organization by seeking credibility

from others outside their office or

organization where common goalsor a sense of purpose are shared

they lead across the silos

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Key Characteristics of a Meta-Leader


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y

Understands their Emotional Intelligence (EI)

Courage to take risks and manage consequences

Sensible in understanding and managing various

organizational cultures works inside and outside the silo

Curious asks sound questions

Connects all the pieces Conflict Solver recognize, manage, and solve

Focuses on the complex problem and larger solution

NATIONAL PREPAREDNESS LEADERSHIP INITIATIVE

A Joint Program of the Harvard School of Public Health

and the Kennedy School of Government at Harvard University

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The 5 Dimensions of Meta-Leadership


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The 5 Dimensions of Meta-Leadership

The Person

As Leader

Lead

the

S

ilo

Lead

Up

The Event

Lead Connectivity =OptimalResult

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Challenges in Defining the Event:


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Challenges in Defining the Event:Failure of Imagination

Substance & Natur

Scale

Size &Scope


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Tools for Your Toolbox


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2. The Event:

The meta-leader must form an accurate picture of thesituation to include the nature of the problem, theculture, the context, and what is occurring -- andarticulate this to those involved.

Value the power of imagination

Understand what feeds chaos

Create an operational picture


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3. Leading the Silo:

The leader must enable his or her individual silo toachieve maximum effectiveness. One does this byempowering those within and giving them the tools to

become more effective.

Drive the learning curve (Vision+Execution+ProgressMeasurement)

Actively create leaders and followers


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4. Lead Up

One must understand the expectations and priorities ofones superiors and deliver against them appropriately.This may mean influencing that superior toward anappropriate solution or resolution of the situation.

Work with leadership to create and understand roles

before the event exercise these roles

Emphasize shared responsibility and accountability indecision-making processes

During event Share operational picture

Manage up one level at a time be courageous


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5. Be A Meta-Leader Lead Connectivity:

One must be able to step out of their silo and effectivelyengage other silos -- either within one's own organization orin others -- in seeing the overall mission and workingtogether to accomplish it.

Connect the purposes of different organizations to achieve a

greater good

Understand and manage Emotional Intelligence (EI)

Take risks and manage consequences

Recognize, manage, and resolve conflict

Focus on the complex problem and larger solution


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ACTIVE AND PASSIVE


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ACTIVE AND PASSIVE

LEADERSHIP

GOOD

BAD

PASSIVE ACTIVEEmpowers others

Wont micromanage

Methodical progress

Indecisive

Risk averse

Seems confused

Commands/Acts

Charts the course

Thinks ~fast~forward

Ego driven

Alienates subordinates

High Emotions

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ACTIVE AND PASSIVE


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ACTIVE AND PASSIVE

LEADERSHIP

GOOD

BAD

PASSIVE ACTIVELyndon Johnson

Woodrow Wilson

Abraham Lincoln

Mike Brown (Katrina)

Jefferson Davis

Capt. of the Titanic

Winston Churchill

George S. Patton

Thad Allen (Katrina)

Alexander Haig

Napoleon Bonaparte

Nikita Krushchev

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ACTIVE AND PASSIVE


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OOD

BAD

PASSIVE ACTIVE Champion vs. Authority

Influence vs. Control

Persuasion vs. Coercion

ACTIVE AND PASSIVE

LEADERSHIP

How do you stay above the line?

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The Four Leadership Styles


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Supporting

High supportive

&

Low directive

Coaching

High supportive

&

High directive

Delegating

Low supportive

&

Low directive

Directing

Low supportive

&

High directive

Support

iveBehavior

Directive Behavior

43Pub lic HealthLeadership and Action


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Foresight Insight Act ion

(Johansen, 2007)

Anticipate needs and sense emerging trends

Forecast what might happen

Provoke new thoughts and ideas

Move from problem-solving to tackling dilemmas

Early action Better results

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Leadership Quotes


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A good plan, violently executed Now, isbetter than a perfect plan Next week."

One cool judgment is worth a thousand hasty counsels. Thething to do is to supply light and not heat.

No reason to panic, Im in charge.

We need an opposition to remind us ifwe are making mistakes. When you arenot opposed you think everything youdo is right.

45 Final Thoughts - values


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From: Prophet Mohamad SAW (PBUH)

Three things are part of the good morals of a believer.

When he is overcome by anger, his anger should not drive him to

falsehood.

When he is happy, his happiness should not take him beyond the

bounds of what is right.

When he has power, he should not stake a claim to something which isnot his.

Source:At-Tirmidhi, on the Authority of Anas Ibn Malik

It is better for a leader to make a mistake in forgiving than to make a

mistake in punishing.

Source:Al-Tirmidhi, Hadith 1011

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Fullfilling the Functions


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g

to Better Health !!

ThankYou

fulfilling public health functions for future public health leaders

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