Improving Linkages between Public Health Functions and Organizations
U.S. CDC’s National Public Health Institute (NPHI) Program recently introduced a new approach to strengthening public health systems with the publication of “Improving Linkages between Public Health Functions and Organizations: A Framework for National Public Health Institutes”. The Linkages Framework expands the focus from enhancing essential public health functions to strengthening the interactions, or linkages, between them. There is also a companion toolkit and user manual that supports NPHIs in implementing the concepts within the Framework.
“We know from experience and from the evidence base that NPHIs improve coordination and collaboration between surveillance, laboratory, risk communication, and other essential functions, as well as with other health and non-health entities. With the development of the Linkages Framework, we sought to better understand these complex relationships.” – Shelly Bratton, Lead for U.S. CDC’s NPHI Program
The COVID-19 pandemic highlighted the importance of essential public health functions (EPHFs), including workforce development, disease surveillance, public health research, laboratory services, and emergency preparedness and response. It also emphasized the critical role of public health institutions, such as NPHIs, that support these functions. Crucially, the pandemic underscored the role NPHIs serve in coordinating these essential functions. Breakdowns in this coordination between EPHFs exacerbated challenges and hampered the effectiveness of the response, even when individual functions were performing well.
“Linkages better prepare us to prevent, detect, and respond equitably to the next public health threat. We now have a vision for how public health systems can improve coordination and collaboration, based on learning from the COVID-19 epidemic.” – Dr. Kayla Laserson, Director of U.S. CDC’s Global Health Center
The Linkages Framework defines linkages as “practical, replicable activities that facilitate collaboration between public health functions or organizations to improve public health” and outlines the enabling factors that support them. It recognizes the diverse range of organizations and institutions responsible for public health—including non-health sectors—and emphasizes the importance of linkages between the NPHI and these entities in both routine public health activities and emergency response. Real-world examples, in-depth country case studies, and seven concrete steps to further enhance linkage development make diagnosing and strengthening linkages practical for NPHIs and for those that support them.
“Linkages enabled the hepatitis C elimination program to work more effectively and achieve clear, measurable health outcomes for the most vulnerable in our nation.” – Dr. Amiran Gamkrelidze, former Director General, NCDC Georgia
The Linkages Framework will be highlighted globally through a series of upcoming webinars led by WHO and CDC. IANPHI members are invited to attend the next session of the WHO World Health Emergencies Information Network for Epidemics quarterly webinar series on June 27. Interested individuals can also review a summary of the Linkages Framework’s concepts in the recent BMJ Global Health publication, Essential public health functions are not enough: fostering linkages between functions through National Public Health Institutes improves public health impact.
“The Linkages Framework provides a systematic structure of the synergistic connections between public health functions and systems. With collaboration being central to national public health institute functions the framework is an enabling tool to achieve the International Health Regulations ” – Natalie Mayet, South Africa, The National Institute for Communicable Diseases
U.S. CDC is working with countries to provide technical support for diagnosing and strengthening linkages. NPHI representatives are encouraged to attend upcoming webinars to learn more about these critical connections and can contact Linkages@cdc.gov to explore how linkages can help improve public health impact.