this file useful for public health expert

1. TRANSFORMATION PUBLIC HEALTH
LEADERSHIP
Prof. Dr. Ridwan Amiruddin, SKM., M. Kes., MSc. PH
Ketua Penjaminan Mutu Fak. Kesehatan Masyarakat
Universitas Hasanuddin
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 1

2. Outline presentation
 Essential Public Health
 MDG achievement
 Public Health Challenge
 Leading the Transformation of the Public Health
System
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 2

3. Public Health
 Prevents epidemics and the spread of disease
 Protects against environmental hazards
 Prevents injuries
 Promotes and encourages healthy behaviors
 Responds to disasters and assists communities in
recovery
 Assures the quality and accessibility of health
services
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 3

4. Essential Public Health Services
 Monitor health status to identify community health
problems
 Diagnose and investigate health problems and
health hazards in the community
 Inform, educate, and empower people about
health issues
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 4

5. Essential Public Health Services
 Mobilize community partnerships to identify and
solve health problems
 Develop policies and plans that support individual
and community health efforts
 Enforce laws and regulations that protect health
and ensure safety
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 5

6. Essential Public Health
Services
 Evaluate effectiveness, accessibility, and quality
of personal and population-based health services
 Research for new insights and innovative
solutions to health problems
Seminar Nasional Alumni FKM UNHAS. Wasma
Source. 1990 Centers for25-26 Feb 2012
Kalla Disease Control and Prevention 6

7. Public Health: The foundation of a national health system
Tertiary
Medical
Care
Secondary Medical
Care
Primary Medical Care
Essential Population-Based Public Health Services
•Human Resources Development (Training)
•Information Systems
•Community Planning Systems
Capacity to Deliver Public Health Services
Public Health System Infrastructure
•Human Resources Development (Training)
•Information Systems
Seminar Nasional Alumni FKM UNHAS. Wasma •Community Planning Systems
Kalla 25-26 Feb 2012
7

8. Main characteristics of PH and CH
Public Health Collective Health
Microbial paradigm, based Critic to the positivism.
Origin biomedical model Structural adjustment
Flexner report - of experimental Proposals: "Health For All in the Year
Model of reference character of sub-individual the 2000" and Promotion
base. paradigm (Ottawa Letter)
Health-disease-intervention
Natural history of the diseases and
Object of study process’s social
physiopathology
determinant.
Endemics/epidemic
Sustentation logic control
Promotion and prevention
Proposes visions, forms, figures
Practice Preventive predictive and scenes in a holistic and
systemic context .
Public Individual Collectivities
Management, epidemiology,
Disciplines Explain the disease natural history statistic, demography.

9. Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 9

10. Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 10

11. Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 11

12. Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 12

13. Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 13

14. Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 14

15. Dengue Haemorhagic Fever
Decentralization
Source: Bappenas, 2008 15

16. Malnutrition Problem
Decentralization
MoH Projection
Source: Bappenas, 2008
16

17. Under Five Mortality
Decentralization
Source: Bappenas, 2008
17

18. Infant Mortality Rate
.
Decentralization
Source: Bappenas, 2008
18

19. Maternal Mortality Rate
Decentralization
Source: Bappenas, 2008 19

20. Delivery attended by trained health workers
Stagnant
Decentralization
20

21. Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 21

22. Public Health Challenges
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 22

23. Public Health Challenges
Emerging Diseases (SARS, Pandemic Flu)
Re-emerging Diseases (XDR-TB)
Food Safety
Bioterrorism
Natural Disasters
Obesity
Aging Population
Health Disparities
Global Warming
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 23

24. Health Care Crisis
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 24

25. SARS and Pandemic Flu
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 25

26. Health Care Crisis Population
Aging
Re-emerging Diseases
Emerging Diseases
Obesity
Health Disparities
Access to Quality Health Care
Health Insurance Costs
Uninsured and Underinsured
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 26

27. Pyramid of preparedness : components of an effective public health
system (from Rowitz 2006)
Categorical Public Health Programs:
Environmental Health, HIV/AIDS, Chronic
disease prevention and health Program
services
promotion,Immunization, Infectious
disease control, injury Leadership
prevention, occupational Safety and Health Program
capacity
Supporting scientific
and technical
capabilities Laboratory Behavioural Epidemic
Surveillance practice science investigation
Core Public Information/
Workforce Organisational
Health communication competency capacity
Infrastructure
capacity
Leadership

28. The skills of the prepared public health leader in crisis (Rowitz, 2006)
Community building Systems thinking
Assets planning
Social Capital
Knowledge of public (capacity building) Collaboration
health law
Crisis Management
Change and Visioning
resilience
Systems change
Emotional
intelligence Tipping point
PUBLIC HEALTH
awareness
INFRASTRUCTURE
Forensic Crisis and risk
epidemiology communication

29. Public Health leadership principles (from
Rowitz, 2003)
1.Core public health values
2.Health Prevention
3.Community coalitions
4. Local and state collaborations and equity in access
5.Partnerships and shared visions
6. New leaders must learn from experienced leaders
– mentoring
7.Continuous development of leadership skills
8. Commitment to lifelong learning and personal
growth

30. Public Health leadership principles
(from Rowitz, 2003) (cont.)
9. Infrastructure built on notion of health
protection for all
10. Need to think globally but act locally
11. Need to be good managers
12. Need to ‘walk the walk’
13. Proactive – not reactive
14. Leadership at all levels of an organization
15. Strong belief and commitment to
community
16. Must practice what they preach

31. Quotes on Collaboration
 None of us is as smart as all of us
 Edward C. Register, 1915
 Cooperation! What a word! Each working with
all, and all working with each.
 Warren Bennis, 1996
 Collaboration is damn tough
 Focus group participants, 1997
 All quotes from Medicine and Public Health: The power of
collaboration, Lasker, et al.

32. A mutually beneficial and well-defined
relationship entered into by two or more
organizations to achieve common goals
Amerst H. Wilder Foundation

33. Why Collaborate
 Shared Concern
 Pool Power
 Overcome Gridlock (“get unstuck”)
 Add Diversity
 Increase Ability to Handle Complex Issues

34. Context for Collaboration
 Identify the problem
 Understand what makes leadership difficult
 Identify stakeholders
 Assess extent of stakeholder agreement
 Evaluate community’s capacity for change
 Identify where the problem/issue can be most
effectively addressed
 Chrislip and Larson

35. Rebalancing Health Priorities
General Targeted Primary Secondary Tertiary
protection protection prevention protection protection
Affected people
Safer without Affected people
Vulnerable complications
Healthier with
people (undiagnosed complications
People asymptomatic)
Death from
Complications
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 35

36. Traditional Healthcare
Affected People
Safer without Affected People
Vulnerable complications
Healthier with
People (undiagnosed complications
People asymptomatic)
Traditional Healthcare
Disease Care
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 36

37. Traditional Public Health
Affected People
Safer without Affected People
Vulnerable complications
Healthier with
People (undiagnosed complications
People asymptomatic)
Public Health System
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 37

38. Need to Rebalance Health
Priorities
Affected People
Safer without Affected People
Vulnerable complications
Healthier with
People (undiagnosed complications
People asymptomatic)
Public Health Network Healthcare Delivery System
Health Protection: Health Promotion, Disease Care
Prevention, and Preparedness
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 38

39. Questions
“Given the significant public health and health care
challenges we face, are Public Health Leaders
adequately prepared to address these issues?”
“What are the requisite leadership competencies
needed to address these challenges?”
“Do we have a system of leadership development that
can meet this challenge?”
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 39

40. Transforming the Public Health
System
Seminar Nasional Alumni FKM UNHAS. Wasma
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41. Transforming the Public Health
System
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 41

42. StructureStandardsFunctions
Setting Agency
and
 Public Health Accreditation Board
Setting System Standards
 National Public Health Performance Standards
Establishing Public Health Laws and Policies
Community Engagement
Decentralization (central –local gov. interaction)
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 42

43. Transforming the Public Health
System
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 43

44. Workforce
Competencies for Public Health professionals
 Epidemiologists
 Environmental Health
 Nursing
 Nutritionist
 Etc
Credentialing and certification
 National Board of Public Health Examiners (etc.; 2005)
 Existing programs in nursing, environmental
health, laboratories
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 44

45. Transforming the Public Health
System
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 45

46. The “Strategic Influence” of Public Health Leaders
Politics
Policy Programs
PH
Leaders
Resources Experienc
e
Communit
y
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 46

47. Crisis Leadership Competency
Model
This model lays out the nine competencies that were
determined to be the most critical for leaders in a public
health emergency response situation.
Team Leadership Communication
Situational Awareness Connectivity
Crisis
Leadership
Competency
Integrative Thinking Model Courage and Perseverance
Emotional Effectiveness Credibility
Decisiveness

48. Integration
The crisis leadership competencies supplement both the four-tier leadership
competencies and the emergency response competencies.
Four-Tier HHS Leadership Competencies Emergency Response
Competencies
Basic Supervisor Manager Executive
Leadership
• Emergency
All Managers
All Supervisors Competencies,
Management Systems
All Basic Competencies, plus: • Agency Preparedness
All Core Competencies, plus: Strategic Thinking and Emergency
Competencies, plus: Creativity/ Vision Response Roles
plus: Resilience Innovation External • Informatics Support
Flexibility Conflict Financial Awareness
Interpersonal Management Management Political Savvy
for Responses
Skills Team Building Technology • Risk Communication
Self-Direction Influencing / Management and Media Relations
Technical Negotiating Entrepreneurship • All Hazards Concepts
Credibility Human Resources Organizational • Disaster Mental
Project Management Systems
Management Service Awareness
Health
Performance Motivation
Management Accountability
Leveraging
Four-Tier CDC Leadership Competencies (supplement HHS)
Diversity
• Cultural Awareness • Ethics • Leads Change
• Dealing with Ambiguity • HHS/CDC Operations • Personal Leadership
• Emotional Intelligence
Crisis Leadership Competencies
• Communication • Credibility • Emotional Effectiveness • Situational Awareness
• Connectivity • Decisiveness • Integrative Thinking • Team Leadership
• Courage and Perseverance

49. Transforming the Public Health
System
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 49

50. Goals and Priorities
National-level Goals and Priorities
 Health Protection Goals
 Healthy People
State and Community-level Goals
 State and Local Health Departments
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 50

51. Leadership is Essential to Success
Agency Standards
Leadership
System Standards
Improved
+ Laws and Policies
Improved
Performance
Health
Outcomes
Community Engagement
Workforce
Portfolio Management
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 51

52. Issues Surrounding Leadership Development
Continuum Dilemma
 Leadership vs. Management competencies
 Basic vs. Advanced
 Regional vs. National
Crisis Leadership
Integrated or single program?
Discipline specific Leadership
How to build effective networks
Fragmentation
Develop a “system” for Leadership
Shared vision, shared funding, common purpose
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 52

53. recommendation
 Leadership course for public health leader for all level
 Develop collaboration with all stakeholders
 Regular meeting to response public health issue
 Prepare response for emergency crisis
 Develop program for rebalancing health care system
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 53

54. Final Thoughts
“Success is the child of audacity”
(Disraeli)
Seminar Nasional Alumni FKM UNHAS. Wasma
Kalla 25-26 Feb 2012 54