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THE VALUE OF COUNTY PUBLIC HEALTH CAPACITY BUILDING – TWELVE YEARS OF THE HEALTH-PLAN FOR IT PROGRAM IN CROATIA
SELMA ŠOGORIĆ
orcid.org/0000-0002-2314-2146
; Sveučilište u Zagrebu, Medicinski fakultet, Škola narodnog zdravlja „Andrija Štampar“, Zagreb, Hrvatska
SILVIJE VULETIĆ
orcid.org/0000-0002-0620-8107
; Sveučilište u Zagrebu, Medicinski fakultet, Škola narodnog zdravlja „Andrija Štampar“, Zagreb, Hrvatska
JOSIPA KERN
orcid.org/0000-0002-0896-3018
; Sveučilište u Zagrebu, Medicinski fakultet, Škola narodnog zdravlja „Andrija Štampar“, Zagreb, Hrvatska
ALEKSANDAR DŽAKULA
; Sveučilište u Zagrebu, Medicinski fakultet, Škola narodnog zdravlja „Andrija Štampar“, Zagreb, Hrvatska
Sažetak
The aim of this study was to assess the value of the “Health-Plan for It” Program for the capacity of Croatian counties to plan health and implement services based on locally recognized health needs. From 2002 to 2008, the county health teams formed in twenty Croatian counties passed the first set of training modules. First assessment was conducted in 2006. Based on assessment results, in 2008-2009 a new set of training modules was organized and attended by six counties. In
second assessment conducted in 2012, three instruments were applied: Local Public Health Practice Performance Measures Instrument and Procedure Chart as self-reporting instruments, and tutorial notes assembled/analyzed by the Faculty. All 13 county health teams that participated in second assessment showed an increase in the 2012 score compared to 0-point. The score change showed statistical significance on both the overall core public health functions and on any
of its components (assessment, policy development, assurance). All counties showed improvement in assessment and policy development functions. The assurance function was improved in counties that attended the second set of training modules. The Procedure Charts showed that all counties had developed their own health profiles and health plans, with prioritized health needs and identified actions to address them. Like the first evaluation workshop in 2006, results of the second evaluation workshops in 2012 showed that the Program increased the counties’ public health capacity. Two of the counties that had enrolled late in the Program (2007/2008) achieved much better results than ‘older’ counties, showing that the time spent in the Program was not a key factor contributing to local project success. Different levels of achievement due to ‘institutional or personal capacity to change’, reported by other authors, are in line with our findings that individual county success in the Program depended on the team composition and the level of (regional) political stability. In conclusion, the program showed improvement of all core public health functions in all counties. Assurance function showed generally a higher change in counties that had passed both sets of modules. The counties’ capacity for change differed and the Program was not equally efficient in all of them. The differences in county achievements could be explained by stability of political support at the county level, team composition, and commitment of the team leader.
Ključne riječi
counties; public health capacity building; decentralization
Hrčak ID:
199106
URI
Datum izdavanja:
20.4.2018.
Posjeta: 1.128 *