Formulating Healthy Public Policy

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Formulating Healthy Public Policy (HPP) :

Formulating Healthy Public Policy ( HPP ) Health care public policy (HPP) Need for HPP Adelaide Conference – 1988 Advantages and disadvantages of HPP Approaches in implementing HPP Issues in framing HPP Empowerment model of health promotion By : Dr. Sam A. Thamby; Faculty of Pharmacy; AIMST University (Malaysia)

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HEALTH CARE POLICY Defined by WHO Health policy can be defined as the " decisions , plans , and actions that are undertaken to achieve specific health care goals within a society ." It defines a vision for the future ; outlines priorities and the expected roles of different groups ; and it builds consensus and informs people . Healthcare policy focuses on treatment of individuals regarding access to healthcare . healthcare services delivery . funding for various healthcare programmes . accountability for various healthcare programmes .

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Why does the need for a Healthy Public Policy (HPP) constantly exist ? Because health is a public problem. Health is a fundamental right and necessity that is essential for our well being & functioning as human beings. Affordable health care for everyone is a must. Some factors that affect health must be pursued collectively ( eg sanitation). Concerted efforts such as from government and private sectors , are needed to ensure all people have fair access to health care.

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Healthy Public Policy (According to the Adelaide Conference 1988 ) 2 nd International Conference on Health Promotion , Adelaide, South Australia, 5-9 April 1988 The main aim of HPP is to create a supportive environment to enable the people to make healthy choices and lead healthy lives . Based on ‘ Declaration of Alma-Ata’ (WHO 1978) – recognition of health as a fundamental social goal; emphasized people's involvement, cooperation between sectors of society and primary health care as its foundation . All relevant government sectors like agriculture, trade, education, industry and finance need to give important consideration to health as an essential factor during their policy formulation. ‘The healthier choice is the easier choice for all people’.

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Types of approach to implementing HPP ECONOMIC APPROACH Budget allocation to be considered; Provide incentives ( returnable deposit on recyclable bottles ); Regulating service fees Impose sanctions ( fines for speeding, not wearing seat belts ); Increase taxes, duties or service fees ( cigarette & alcohol taxes, service fees on recreational facilities ); Offer tax breaks ( no sales tax on certain foods );

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Types of approach to implementing Policy REGULATORY APPROACH Regulate products manufacture and sales (entry into consumers’ market) Regulate consumers’ purchase (legal age limit for tobacco usage) . Regulate service providers ( who can prescribe medications, who can produce pharmaceuticals). Regulate promotion/advertising (restrict tobacco or alcohol ads, health claims made by certain products)

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MEDICAL APPROACH Aim: freedom from medically-defined disease and disability such as infectious diseases. Involves medical intervention to prevent or ameliorate ill-health. BEHAVIOURAL CHANGE APPROACH Aim: to change people’s individual attitudes and behaviour so that they adopt a healthy lifestyle. Through public announcements (via media), free health camps, work shops etc. EDUCATIONAL APPROACH Educating the public regarding healthy life styles. Through public announcements (via media), free health camps, work shops etc.

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Advantages of policy as an intervention tool Usually it is inexpensive. High reach-out (through media sources) Can be highly effective.

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Disadvantages of HPP It is not easy to influence the policy process . The process moves very slowly . It is not easy to ‘tailor to’ all needs . There are almost always unintended consequences .

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Issues in policy making Must provide guidance, trust & legitimacy while respecting the stakeholders’ (and especially the public ) perspective and interests . Regulatory organizations should be able to modify (addendums included) to HPP, without affecting it’s original objective - to improve health). Are there rules that are clear & acceptable for public centralization & decentralization and providing channels to allow patients (and vulnerable groups) to make their concerns heard?

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Issues in Policy Making: Equitable health care? Equal share and equal access : Is this possible? Equal share but unequal access : population is not uniform (rich, poor) , W ho gets access to health care ??? W ho is excluded? (persons below poverty line) Medications or treatments (free or charged)

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Formulating Policy: Successful Policy ….. It is focused on performance improvement Open & transparent . There is a wide range of enforcement strategies . The regulatory agency is accountable & independent . Policy must be subjected to continuing evaluation & review. Feedback from stakeholders must be taken into consideration.

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Empowerment model of Health Promotion Programme Health Education and a Healthy Public Policy are key components of the health promotion programme. The development and implementation of healthy public policy is the essential precursor for the emergence of health-promoting ‘environmental’ influences. Education empowers (strengthens) each individual and the community for better health-related initiatives. Health Promotion = Health Education + Healthy Public Policy

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HEALTH EDUCATION & TRAINING HEALTHY PUBLIC POLICY Individual empowerment Lifestyle change Environmental influences Community empowerment Health Services and regulations Better Medical Services

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