Public Health and Afghanistan

I was perusing my book shelf for information about the formation of our own Public Health system in order to inform my thoughts about Afghanistan. I have an interesting publication from Pfizer called Milestones in Public Health. Reading through this history of the U.S. Public Health system, I was reminded of the Essential Public Health Functions:

1. Monitor health status to identify community health problems. This would mean that Afgh needs labs. And skilled workers.

2. Diagnose and investigate health problems and health hazards in the community. This means some kind of skilled and mobile health work force.

3. Inform, educate and empower people about health issues. Some kind of communication technique/vehicle.

4. Mobilize community partnerships to identify and solve health problems. Maybe more private sector engagement in Afgh as opposed to NGOs? Don't know.

5. Develop policies and plans that support individual and community health efforts. Two levels of analysis and planning.

6. Enforce laws and regulations that protect health and ensure safety. Hard in de-centralized, tribal territories, but something to keep in mind.

7. Link people to needed personal health services and assure the provision of health care when it is otherwise unavailable. This seems to be the primary focus at the moment.

8. Assure a competent public health and personal healthcare workforce. Goes with first three points and a big problem in Afgh.

9. Evaluate the effectiveness, accessibility, and quality of personal and population-based health services. This point should have gone before point #5 in my mind. But in any case, this would take MoPH resources.

10. Research new insights and innovative solutions to health problems. Same thoughts as for #9.

I like this list because these are what the military calls "lines of effort" and imply tasks like human capacity building. Lab building. Bringing in new partners. It provides a framework for considering how to build a health system, without prescribing the steps.