Application of the essential public health functions

Book excerpt: Experience with public health emergencies such as the COVID-19 pandemic clearly demonstrates that weak public health capacities leave populations and health, economic, and social systems vulnerable. Health system challenges are increasing in number and complexity, while health system resourcing, often seen as a cost rather than an investment, remains inadequate. The limited resources available are skewed towards clinical services and emergency response, leaving persistent weaknesses in preventive, promotive and protective capacities. World Health Assembly resolution WHA69.1 of 2016 provided the World Health Organization (WHO) with a mandate to support Member States to strengthen the essential public health functions (EPHFs) while recognizing their critical role in achieving universal health coverage. This has been reaffirmed in the Declaration of Astana on Primary Health Care, 2018, and by global partners since, creating an impetus towards and need for guidance in strengthening public health stewardship and capacities informed by the EPHFs. This technical package provides a range of technical resources and flexible tools in relation to EPHFs, to support comprehensive operationalization of public health in countries. The unified list of essential public health functions (EPHFs) consists of 12 activities that can be used to operationalize public health in a country. This comprehensive approach to public health orients health systems to population need and health system risks, and governments and societies towards health and well-being. This maximizes health gains within available resources and builds resilience, while reducing population vulnerability and the overall burden on the health system. The EPHFs can be used to plan public health systems, strengthen stewardship and coordination for public health delivery at national and subnational levels, and integrate public health capacities within health and allied sectors. The EPHFs anchor protective, promotive and preventive capacities within health systems while leveraging multisectoral efforts for health. In this way, strengthening health systems with the EPHFs is central to the primary health care approach and supports the achievement of universal health coverage, health security and healthier populations in tandem.