Introduction To The Public Health Law 3

PUBLIC HEALTH LAW
GREEN HOPE UNIVERSITY
Dr. Abdirahman Moalim Hassan

(BSc in MBBS, BSc in GN, Master of Health service Mgt , Candidate PhD of Nursing Science )
LECTURE THREE POLICY AND HEALTH

Public vs. Private Policy
Public Policy
Policy that is established by the federal, state, and local levels of
government and any other government entity.
it is a regulatory measures, laws, and funding priorities concerning a
given topic formulated by a governmental entity or its
representatives.
Private Policy
Policy that is established by private organizations, institutions and
individuals.
• Both public and private policies are important for the improvement of
healthcare services.
• Keep in mind, without guiding public policy, private policy will bear less fruits
as a result of improper prioritization, allocation of funds, human resource
management etc.
• Therefore, private health policy needs to work within the framework of public
health policy for better planning, implementation, evaluation and
coordination of health services.
Reactive vs. proactive policy
Reactive policy is developed in response to a concern, problem, or emergency.
It is designed to remedy problems that already exist.
Reactive policy development often happens more quickly than proactive policy, as
the problems can be pressing or even urgent.
Reactive policy debate centers mostly on whether or not a certain policy

mechanism is the best way to handle a situation, not whether or not the
situation will ever become a problem. E.g. HIV Prevention Policy
Proactive policy is deliberately chosen and often designed to prevent a concern,
problem, or emergency from occurring.
Proactive policies can be more challenging in that it is often difficult politically

to get lawmakers to commit money and resources to a problem that has not
yet occurred.
E.g. Ebola Prevention Policy

Student activity
Look at the policies below and figure out whether they are reactive or proactive
in the context of Somali national health policy.
Discussion
Suicide rate reduction policy
 Tobacco control policy
Bird flue prevention policy
Breastfeeding promotion policy

Mandatory vs. Advisory Policy
In some cases policies must be observed (mandatory) whilst in other cases

policies serve as only as guidelines (advisory).
The consequences of acting in contravention to a policy, which is mandatory, will

be different to the consequences of acting in contravention to a policy, which is
advisory.
In the case of a failure to observe a policy which is mandatory there will be

prescribed penalties.
WHY HEALTH POLICY
It is fundamentally important for organizations to develop policy.
An organization without policy is an organization without control.
If there were no formal documented policies, then organization personnel at any

level would have no guidance on how to make decisions.
Imagine if you had a faulty medicines and you wished to return it to
the hospital pharmacy from which it was purchased.
If the hospital has no policy on refunds, the result on whether you

were able to obtain a refund might depend upon which person you
spoke to, or whether the person you spoke to was having a bad day.
In short, an absence of policy leads to inconsistency of decision

making.
From the point of view of healthcare system, policies provide really useful and
necessary assistance.
The health manager cannot be everywhere all the time to ensure staff carry out
their tasks correctly and responsibly.
Instead he/she will develop and communicate policies, and ask staff to read and
adhere to them.
Therefore policies help to decrease the amount of direct supervision by the

manager, and at the same time increase the efficiency of working processes.
Not everyone understands why policies exist. In reality, however, the existence
of policies provides many benefits provided they are written well and kept up to
date.
For instance, we need health policy
in:
Recruiting.
Health project implementation.
Monitoring and evaluating.
Disqualifying.
Allocation of financial resources.
Staff access to organizational resources.
Prioritizing health project locations.

Applying disciplines e.g. rewards, fines, etc.
We need policy for all of these b/c we have to be fair in order

to gain the trust of our employees
Without viable health policy, we can’t achieve community
1. trust
2. Acceptance
3. Participation
4. Ownership
Health policy is important because health is :
 a major societal resource and asset.
 Health as a basic human right.
 What makes societies prosper and flourish.
 The basis for economic performance.
 Target and ultimate goal for people: reaching the highest attainable
standard of health.
 A strong social and economic case for action.

Regulatory Health Policies
Health policies may be used as regulatory tools that call on government to
prescribe and control the behavior of a particular target group by monitoring
the group and imposing permissions if it fails to comply.
Examples of Regulatory policies Regulations or rules that impose restrictions.

intended to control the behavior of a target group by moni-toring the group and
imposing sanctions if it fails to comply.
regulatory policies include
A. prohibition of smoking in public places
B. licensure requirements for medical professions
C. processes related to the approval of new drugs.

State insurance departments across the country regulate health insurance
companies in an effort to protect customers from default on coverage in the
case of a company’s financial failure, excessive premiums, or deceptive
practices.
Private health policies can also be regulatory.
For example, physicians set standards of medical practice and hospitals undergo
accreditation assessments from accreditation service organizations, such as The
Joint Commission, to ensure compliance with all standards.
Allocative Health Policies
Allocative health policies involve the direct provision of income, services, or
goods to certain groups of individuals or institutions.
They can be distributive or redistributive. Distributive policies spread benefits

throughout society.
• Examples include the funding of medical research through the National
Institutes of Health, provision of public health and health promotion services,
training of medical personnel, and construction of healthcare facilities.
Redistributive policies take money or power from one group and give it to
another.
This approach typically creates visible beneficiaries and payers.
Examples include means-tested social insurance programs such as Medicaid,

which takes tax revenue from the more affluent residents and spends it to
provide free or low-cost health insurance to the poor, to subsidize the welfare
program, and to fund public housing.
Determinants of Health Policy
As noted earlier, the framework for health determinants include four major
categories: environment, health status, medical care, and individual
characteristics (see Exhibit 1.2).
The framework for health policy determinants is presented in Exhibit 1.4. Broad
determinants include the nature of the health problem, the socio cultural norms
that influence the perception of the problem, and the political system within
which policy is formulated.
The inner circle of the framework shows
the narrower determinants:
1. Potential solutions to the identified health problem
2. Views and efforts of the stakeholders
3. Demonstrated leadership of the policymakers
4. Available resources needed to implement the policy

Determinants of Health Policy
1.socio economic norms
2.health problem
4.health policy

THE END
THANKS ALLOT

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PUBLIC HEALTH LAW

GREEN HOPE UNIVERSITY

Dr. Abdirahman Moalim Hassan

LECTURE THREE POLICY AND HEALTH

Reactive policy is developed in response to a concern, problem, or emergency.

It is designed to remedy problems that already exist.

Reactive policy debate centers mostly on whether or not a certain policy

Proactive policies can be more challenging in that it is often difficult politically

E.g. Ebola Prevention Policy

Suicide rate reduction policy

 Tobacco control policy

Bird flue prevention policy

Breastfeeding promotion policy

In some cases policies must be observed (mandatory) whilst in other cases

The consequences of acting in contravention to a policy, which is mandatory, will

In the case of a failure to observe a policy which is mandatory there will be

It is fundamentally important for organizations to develop policy.

An organization without policy is an organization without control.

If there were no formal documented policies, then organization personnel at any

If the hospital has no policy on refunds, the result on whether you

In short, an absence of policy leads to inconsistency of decision

Therefore policies help to decrease the amount of direct supervision by the

Health project implementation.

Monitoring and evaluating.

Allocation of financial resources.

Staff access to organizational resources.

Prioritizing health project locations.

We need policy for all of these b/c we have to be fair in order

 Health as a basic human right.

 What makes societies prosper and flourish.

 The basis for economic performance.

 A strong social and economic case for action.

Examples of Regulatory policies Regulations or rules that impose restrictions.

imposing sanctions if it fails to comply.

regulatory policies include

A. prohibition of smoking in public places

B. licensure requirements for medical professions

C. processes related to the approval of new drugs.

Private health policies can also be regulatory.

They can be distributive or redistributive. Distributive policies spread benefits

This approach typically creates visible beneficiaries and payers.

Examples include means-tested social insurance programs such as Medicaid,

1. Potential solutions to the identified health problem

2. Views and efforts of the stakeholders

3. Demonstrated leadership of the policymakers

4. Available resources needed to implement the policy

1.socio economic norms

3.socio economic norms

5.socio economic norms

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