Public health thinking in the WHO European region: How does it contribute to Commonwealth Countries and beyond?

The WHO Regional office for Europe (WHO Euro) in Copenhagen, Denmark, held an important workshop this week aiming to build a coalition of partners to take forward Public Health Services (PHS) across the WHO European region. Though only 3 of the 52 Commonwealth Countries are in the WHO European region (Cyprus, Malta, UK) the work being done in this region will be of interest to hub users for a number of reasons.

The work of WHO Euro through its European Action Plan for Strengthening Public Health Services and Capacities (known as the ‘European Action Plan’ or EAP) aligns closely with the Commonwealth Secretariat’s Systems Framework for Healthy Policy (SFHP). The EAP-PHS which was agreed in 2012 is based around Ten Essential Public Health Operations (10 EPHOs) whilst the SFHP is based on eight components. Indeed, the intellectual journey leading to the development of the SFHP came through the EAP and other WHO regions as well as the World Federation for Public Health Association’s (WFPHA) Charter for the Public’s Health. Hub members will also be aware that the Commonwealth Secretariat are working closely with the Geneva based, WHO Headquarters colleagues in the Health Systems and Innovation Cluster, who were also present in Copenhagen.

WHO Euro and the European region are widely acknowledged to be a leading partner in Public Health Services thinking, hence understanding the thinking and direction being taken by the region is key as it influences public health thinking across the Commonwealth and beyond. The health hub was invited to the workshop and provides a brief summary of the issues discussed over the two days. WHO Euro will release a comprehensive report in due course.

Following a video address from WHO Euro’s regional director Dr Zsuzsanna Jakab the two day workshop was opened by Dr Hans Kluge, Director of the Division of Health Systems and Public Health at WHO Euro which hosts the Public Health Services team. Dr Kluge outlined the purpose of the event and the desired outcome.

Held in English and Russian, the workshop was focused around proposed plans for taking forward the European Action Plan. Both the European Action Plan and the Commonwealth SFHP are structured around two types of components/operations, core service delivery and enablers. The European approach is focusing on advancing the enabler operations. How to do this and which organisations would be involved in taking forward which actions was the focus of much of the workshop.

Six proposed objectives had been identified for discussion:

  1. The Public Health Workforce is recognised and valued as a profession.
  2. There is alignment between the allocation of human resources for public health and the priorities determined by the burden of disease.
  3. Public health leaders have the skills and knowledge to function as change agents.
  4. Member states have strong legislation enabling effective service delivery.
  5. Member states effectively advocate for investment in PHS and apply strategic financial management practices.
  6. PHS are organised and governed effectively and efficiently.

Examples of countries with stories of public health need in the European region were heard from Greece, Ukraine and Georgia as well as examples of ways forward from Finland and Slovenia.

…from these stories, Leadership, Inter-connectedness and systems thinking, Cooperation and empowerment and Turning points were identified as important factors in successful reform.

A successful ‘Market place’ format was used on the second day to allow the 50+ public health experts present to come together to seek collaboration on their own ‘new’ ideas as well as those which had been discussed on the previous day. Outcomes from this which might be of particular interest to hub Members could be the intention to ‘Convene health leaders to achieve high level engagement in public health change’ and to ‘Develop an implementation tool for financing public health services‘. This second outcome could also include establishment of a WHO Collaborating centre for public health financing – which would be a much needed global first.

WHO Euro now has the task of taking this information and pulling it together into a coherent ‘Agenda for Action’ moving forward. A follow up meeting is planned for June 2017 and it is hoped the health hub will again be present and able to feedback, perhaps even facilitating contributions from the hub’s Community of Practice.

This post necessarily summarises and is short on detail so if you are interested in knowing more about some of the Public Health Frameworks mentioned please follow the links below:

Commonwealth Systems Framework for Healthy Policy (SFHP)

The 10 EPHOS of the European Action Plan for Strengthening Public Health Services and Capacities (EAP-PHS)

The World Federation of Public Health Association’s Charter for the Public’s Health