By Dr. Abdul Rouf
Public health is the science and art of preventing disease, prolonging life, and promoting health through the organized efforts of society. It is the field, which has a potential to substantially improve the health of billions of people all over the world. Itidentifies, measures, and monitors health needs and trends at the community, national, and global levels through surveillance of disease and risk factor trends for predicting or anticipating future community health problems and demands. Other main functions of Public Health include, prevention of disease and injuries and its progression, promote healthy lifestyles and good health habits, investigate and diagnose health problems, including microbial and chemical hazards, formulate, promote and enforce essential health policies, organize and ensure high-quality, cost-effective public health and healthcare services, reduce health disparities and ensure access to healthcare for all, plan and prepare for natural and man-made disasters, conduct research and evaluate health-promoting/ disease-preventing strategies, train and ensure a competent public health workforce and so on.
Public health professionals work to prevent health related problems from happening or recurring through implementing various health programs, recommending policies, administering services and conducting operational research. On the contrary, clinical professionals focus primarily on treating individuals after they become sick or injured. Nevertheless, Public health works to prevent diseases from occurring, promote health seeking behaviours and monitor health status to identify and solve community health problems. However, the preventive and curative health systems have to work together in synergy to have the best response outcome as the situation demands.
A strong public health infrastructure is needed to prepare for and respond to both acute/ emergency and chronic/ ongoing threats to protect the people’s health. We need not to compare our UT with someone with best Public Health System in world, like Canada, but we can atleast compare it to our own best performing State of countrylike Karela. The health indicators of the Karela reflects its Public Health system (infant death rate of 07 per thousand live births and mother death rate of 42 per lakh live births compared to J&K’s 22 and 76 respectively). Although our UT is performing well compared to national figures (IMR of 32 and MMR of 122) but we need to take lessons from best performing States like Karela.The health achievement made in Kerala can be attributed to several factors, including strong emphasis on Public Health and Primary health care, health infrastructure, decentralized governance, financial planning, female literacy rate, community participation and a willingness to improve systems in response to identified health problems. Public health system among above have been widely applauded nationally for the health achievements of the State. Let’s not restrict our discussion to MCH (Mother and child Health) indicators. The impact of Public Health on ongoing COVID-19 has been remarkable in Karela as has been their fight against other outbreaks like Ebola and Nipah. Karela has managed to avert spikes in number of cases and has also seen decent rate of recovery of COVID-19 cases. The first case of Covid-19 in Karela was reported on 30th January 2020 and till now the total cases have increased to 561 with just 64 active cases and 4 deaths, while in UT of J&K the first case was reported on 18th March 2020 and till date we have more than 983 cases with about 487 active cases and 11 COVID-19 related deaths. However, the number of tests done so far has been more in J&K (63515) as compared to Karela (39380), but the robust parallel dedicated Public Health system has made the difference in combact and preparedness against the COVID-19.It’s not that we do not have public health staff here in our Union territory. We have adequate preventive health staff/ field staff available with districts at all block levels (Community Health Officer, Medical social worker, Health inspector, Public Health nurse, Health educator, Block extension officer, multipurpose worker and ASHAs). However, we lack Public Health leaders in the form of Public Health specialists in the system. In the system, we mean that inspite of having more Public health specialists than the number of Medical Blocks we have in our Valley, these specialists either are working as Medical officers as part of curative system or as administrators in the same filed. Some of the Public Health specialists are on deputation to other Departments and some have gone for higher studies in Medical colleges. Instead of putting square pegs on round holes, we need to channelize our Public Health human resources and infrastructure for formation of parallel Public Health System/Department by utilizing already qualified large pool of Public Health specialists for better outcome of the crisis as we are presently facing in the form of COVID-19.
Authors is working in the Department of Community Medicine, Government Medical College Anantnag and can be reached at email@example.com