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Volume 8
J Community Med Health Educ, an open access journal
ISSN: 2161-0711
Public Health 2018
February 26-28, 2018
Page 40
conference
series
.com
PUBLIC HEALTH AND NUTRITION
3
rd
World Congress on
February 26-28, 2018 London, UK
Jens Byskov, J Community Med Health Educ 2018, Vol 8
DOI: 10.4172/2161-0711-C1-31
DEMOCRATIC PRIORITYSETTING INHEALTH SYSTEMSASAN ETHICALIMPERATIVE
FOR SUSTAINABILITY OF POPULATION HEALTH
Introduction
: The ever-increasing evidence and technical developments supporting population health have not yet reached
the goal of health for all. The decision making for population health has not led to optimally accountable, fair and sustainable
solutions. Technical experts, politicians, managers, service providers, community members, and beneficiaries each have their
own values, expertise and preferences, to be considered for necessary buy-in and sustainability. Some of these are well recognized
and partly addressed, but those not addressed or hidden constitute vested interests that may be the main constraint for achieving
population health. The increase of mortal conflict and environmental degradation are the main longer term threat to population
health. Can the health sector advise on control of those health determinants ?
Within the context of the Sustainable Development Goals we aimed to assess and strengthen health systems outcomes and impact
on population health and reviewed health systems literature by open web and PubMed searches.
Findings
: We identified main characteristics of Health Systems developments from their first well documented development to
date.
1. Hospital Services and Hygiene focused Public Health in the 1950´s but coverage was poor
2. Better coverage by extended primary contact level services in the 1960´s
3. Comprehensive health systems WHO technical guidance in 1974
4. Global health system by Primary Health Care from 1978 based on five principles - Equity, Cross Sector Collaboration,
Appropriate Technology, Community Participation, Focus on Prevention.
5. Fragmentation into selective primary contact level programs in the late 1980´s
6. Service and intervention efficiency from 1993 based on Disability Adjusted Life Years.
7. Sector wide and uniform global programs being main donor approaches from around 2000
8. Localized developments to include values, ethics and more user inclusive priority setting in early 2000´s. Accountability
for Reasonableness conditions of relevance, publicity, appeals and revisions.
9. Provision improvements from about 2010 by Systems Thinking and Universal Health Coverage
10. Sustainable Development Goals by 2016 associated with One Health for humans, animals and the environment and with
Health in All Policies. A revival of 3. and 4. ?
Conclusions
: Based on findings key themes emerged which need to be addressed for the health sector to optimally support
achievement of not only the health targets of SDG three, but also health related targets of other SDGs. They are: Accountability
in priority setting, control of vested interests, ethics imperative for population health of similar or higher importance than
individual care ethics, and sustainability by applying more democratic mutually committing processes throughout societies and
internationally.
Jens Byskov
University of Copenhagen, Denmark