Public Health Performance Strengthening at Districts

August 20, 2017-- During Winter 2016, 20 public health experts met in Bellagio, Italy, to develop a way forward to assist countries in strengthening public health practice by improving quality and effectiveness to achieve the Sustainable Development Goals. 

“It has been my firm belief that that the majority of today’s health challenges cannot be effectively tackled unless other sectors in government are engaged and a multisectoral public health approach is followed,“ said Ala Alwan Former Regional Director Eastern Mediterranean Regional Office of WHO.

The resulting White Paper documents the proceedings from the conference and can be used by public health agencies, ministries, development partners, and practitioners as guidance on strengthening public health practice.

Executive Summary

Public health practice in a community collects data on a community’s health and shares it with policymakers from multiple sectors. This is the foundation for the effective delivery of health care, preventive care, and health promotion at a population level. A potential workforce of district health officials needs to be re-oriented and supported in the skills required to practice public health. Both pre-service and in-service approaches are needed. Public health approaches combine top-down campaigns and bottom-up efforts in organizing the efforts of society to create the conditions for health. These collaborative efforts in social organization across multiple sectors make strengthening public health practice one of the best ways to pursue all 17 of the Sustainable Development Goals. Furthermore, the concept of Universal Health Coverage includes coverage with effective public health practice. District public health staff who ought to be carrying out public health practice are present in most communities. The remaining agenda is to improve the quality and effectiveness of these district-level health sector leaders in implementing public health. Improving public health practice can be carried out for just pennies per person per year. Having countries decide on the essential public health functions for their local health officers is the first step in developing measurements that can be used to help coach the workforce in supportive supervision. National governments can staff a performance improvement unit to carry out regular efforts to collect measurements and share them with front-line workers to develop and make plans for improvement. These quality improvement efforts are a public good that enhances the success of each program in the health sector. Financing for specific programs needs to be extended to pay for the core foundational capabilities of public health required for the success of each program.

IANPHI Director, Courtenay Dusenbury (top row, third from the left) with Bellagio Working Group on Public Health Performance Strengthening

The conference was sponsored by the Rockefeller Foundation, the Alliance for Health Policy and Systems Research (AHPSR) Alliance HPSR and the Future Health Systems consortium which is supported by the Department for International Development (DFID).
If you would like to find out more and contribute to putting White Paper ideas into action, please join the Alliance for Health Policy and Systems Research (AHPSR) in the Alma Ata 40th Anniversary for 2018 culminating in events at Health Systems Global Congress or write to Dr. David Bishal,

You can find the White Paper here>>


Additional Resources

Public Health Performance Strengthening at Districts

Transforming Public Health Systems for Improved Global Health

IANPHI—10 years of collaboration for institutional public health

The Staged Development Tool is an instrument designed to help NPHIs function better and increase impact.

Learn More about the SDT

IANPHI celebrates a decade of creating, connecting, and transforming. Read more about our progress.

10 Year Report

The CHAMPS network collects and shares data, collaborating with local, national and global stakeholders, including NPHIs and ministries of health to engage and strengthen capacity for high quality high efficiency data collection and policy making that targets child mortality.

Learn more about CHAMPS