BUSINESS MANAGEMENT EDUCATION CENTRE (BMEC)

CENTRE NAME: ZOMBA INSTITUTE OF MANAGEMENT & ACCOUNTANCY

STUDENT NAME: SPHIWE KAZEMBE

STUDENT NO: 222874

COURSE NAME: GRADUATE DIPLOMA IN PUBLIC HEALTH LEVEL 6

BOARD: BMEC

SUBJECT NAME: PUBLIC HEALTH POLICY AND MANGEMENT

FROM: DEPUTY MANAGER

TO: THE CHIEF EXECUTIVE OFFICERE

SUBJECT: ASPECT OF DEMOGRAPHY AND POPULATION STUDIES

DUE DATE: 23RD DECEMBER 2022

1.0 BACKGROUND INFORMATION OF THE NATIONAL AIDS COMMISSION (NAC)

The National AIDS Commission (NAC) was established as an Independent State Institution by
the HIV and AIDS (Prevention and Management) Act Number 9 of 2018. It replaced the NAC
Public Trust, which the Government of Malawi established in July 2001 to provide overall
leadership and coordination of a Multi-Sectoral National Response to the HIV and AIDS
pandemic. Prior to this, the National AIDS Control Program (NACP), under the Ministry of
Health and Population, was mandated to coordinate a largely biomedical response to HIV and
AIDS from 1987 to 2001. The evolution in the status of the institution followed the
Government’s realization that the response to the HIV and AIDS pandemic required a multi-
sectoral approach and interface with broader issues of population, economic development and
management, social service provision, culture, community development, human rights as well as
gender, among others. The establishment of NAC as an Independent State Institution through an
Act of Parliament has enhanced the Commission’s core mandate of providing leadership and
coordination; and given authority to accredit all information on HIV and AIDS before such
information is published or disseminated.
National AIDS Commission Vision’s by 2025 NAC is recognized for its leadership and
effectiveness in the coordination of the National Response to HIV and AIDS. National AIDS
Commission will provide leadership, technical guidance and coordination of the National
Response. Confidentiality always sensitive to people’s needs and respect their privacy and
special needs. Confidentiality: are always sensitive to people’s needs and respect their privacy
and special needs. Its headquarters is in Lilongwe, Malawi (Organisation"NAC | About-Us"
http://www.aidsmalawi.org.mw/who-we-are)

2.0 INTRODUCTION

health policy is defined as the laws, regulations, actions, and decisions implemented within
society in order to promote wellness and ensure that specific health goals are met. Public
health policies can range from formal legislation to community outreach efforts. Public
health policy plays a role in multiple sectors, including: Health care Insurance, Education,
Agriculture, Business and more.
A clear public health policy definition can be hard to pin down due to its multidisciplinary
nature. However, at the core of all public health policy is a singular mission towards health.
Organizations such as the Red cross, World Health Organization, Centers for Disease Control
and Prevention, Food and Drug Administration, and other governmental and non-
governmental agencies play a large role in public health policy. These organizations perform
research and implement education and health initiatives for a population—creating laws and
policies that ensure the society has nutritious food to eat, clean water to drink, vaccines for
the sick, and access to health care. They also discuss issues which include; Discuss policy
and policy structure, explaining the stages of the policy formulation process, analyze key
factors that have been found to influence whether people are health or unhealthy and describe
how best principles of strategic management can be applied to public health.
 3.0 REPORT OBJECTIVES
 To discuss policy and policy structure, explaining the stages of the policy formulation
process.

 To discuss 5 principles of public health law.

 To analyze key factors that have been found to influence whether people are health or
unhealthy.

 To describe how best principles of strategic management can be applied to public

health.

4.0 ANALYSIS AND EVALUATION

4.1 Discuss policy and policy structure, explaining the stages of the policy formulation
process

a. The term “public policy”

refers to a set of actions the government takes to address issues within society. For example,
public policy addresses problems over the long-term, such as issues with healthcare or gun
control, and as such, it can take years to develop. Public policy addresses issues that affect a
wider swath of society, rather than those pertaining to smaller groups. To explore this concept,
consider the following public policy definition.

b. Policy structure
Definitions of public policy abound. One policy scholar defined it as “authoritative decisions
made in the legislative, executive, or judicial branches of government that are intended to direct
or influence the actions, behaviors, or decisions of others (Longest, 2006). Health policy
comprises the subset of these decisions dealing with health.

Although definition of health policy focuses on government policies, many health policies are
created in the private sector. For example, a health insurance plan might offer incentives for
enrollees to participate in physical activities. All of these represent nongovernmental policy
decisions to promote health and healthy lifestyles.

Furthermore, each level of government local, state, and federal develops health policies. The
outcomes are often the result of collaboration, negotiation, and bargaining among individuals at
different levels of government. For example, each state makes policy decisions for its Medicaid
program, but significant changes require approval of the federal government. Thus, organizations
in the private sector and all levels of government are involved with health policies.

Politics are an important component of any policy analysis. It is usually important for those
engaged in health policy to be mindful of the political issues in order to understand power
dynamics and bargaining outcomes, regardless of the setting or clinical focus.

c. Explain the stages of the policy formulation process

policy formulation process refers to the actions taken by government — its decisions that are
intended to solve problems and improve the quality of life for its citizens. At the federal level,
public policies are enacted to regulate industry and business, to protect citizens at home and
abroad, to aid state and city governments and people such as the poor through funding programs,
and to encourage social goals.

1. Agenda Setting
In this first stage, a problem or challenge that impacts the public is initially identified. Solutions
are put forward by interested parties both inside and outside of the government. Agenda setting
typically goes through these stages:

A. Systemic agenda. All issues public officials feel are worth addressing

Institutional agenda. Distilled from the systemic agenda list, these issues are chosen as the ones
policymakers should analyze and consider acting on.

B. Discretionary agenda. This list comes directly from lawmakers, not from the systemic and
institutional agendas.

Decision agenda. The final list of issues that policymakers will consider for action.

2. Policy Formation

This step involves the development of policy options within the government. This occurs after
officials narrow the range of possible policy choices by excluding infeasible options. In this step,
different interested parties attempt to have their favored policy solution rank high among the
remaining options. This step often involves a period of intense debate.

3. Decision Making

In this step, government leaders decide on a particular course of action. Ideally, it is the course
that will best address the problem for the most members of the public.

4. Policy Implementation

In this step of the policy making process, governments put the chosen public policy option into
effect. Officials use the tools of public administration that impact the distribution of government
 goods and services or make changes in how the government taxes the public. The changes should
reflect the sentiments and values of the affected parties.

5. Policy Evaluation

Interested parties both within and without the government monitor the impact of the policy and
determine if it is achieving the intended goal. This can lead to further changes in public policy
done in light of the impact of the original policy.

In reality, the policy making process is not typically so linear. However, these five steps provide
a framework to better understand public policy formation and help students identify the strengths
and weaknesses of the system.

4.2 Discuss five principles of public health law

1. Sustainability principle, ensure that our decisions and actions not only benefit people today, but
do not have adverse consequences for future generations.

It means we have a responsibility to consider public health, social, economic and

environmental needs simultaneously in the decisions we make to ensure that our decisions
and actions not only benefit people today, but do not have adverse consequences for future
generations. Although public health needs should weigh most significantly on the minds of
decision makers in the context of the Act, other interests should not be dismissed or assumed
to have been considered.
 2. Precautionary principle, when there is limited scientific evidence it is better to 'err on the side
of caution' to protect public health. It means where there is a possible threat to public health
(e.g. an outbreak of a new strain of an infectious disease) but there is a lack of scientific
evidence or certainty about the nature of the threat, then action to prevent or control the
threat should not be delayed until more is known. Cost effective steps should be taken to
prevent, control or abate the threat until evidence emerges that no harm will result. If in
doubt, it is better to ‘err on the side of caution’.

3. Principle of proportionality, Decisions and responses should be made proportionate to the public
health risk present. This principle is concerned with protecting individuals from unjustified
encroachment upon their rights. However, when protecting against a risk to public health, if the
public interest outweighs the rights of an individual, this can justify action being taken, subject to
any specific constraints in the Act.

4. Principle of intergenerational equity, the present generation should ensure that public health
is maintained or enhanced to ensure future generations benefit. This principle requires an
agency responsible for public health and wellbeing to maintain a high standard of public
health, and continually strive to enhance public health in order that succeeding generations
will benefit. Many decisions made to protect and advance public health have significance for
future generations and in these cases, long term impacts need to be considered. Recognition
of the need to consider long term impacts can support and strengthen initiatives employed to
secure more immediate benefits. For example, local strategies to create safer local
neighborhoods (by improving lighting, footpaths, cycle-ways and traffic flow) will encourage
people to become more active, while also reducing their dependence on motor vehicle use,
decreasing greenhouse gas emissions.

Principle relating to local government, the functions of local governments in relation to public
health should be acknowledged and respected. This principle acknowledges the substantial
contribution of local government to the promotion, improvement and protection of public health
through its involvement in a range of activities. These include: planning processes,
environmental monitoring and management, health promotion and more traditional public health
concerns. (“https://ww2.health.wa.gov.au/Articles/N_R/Objects-and-principles-Public-Health-
Act)

4.3 analyze key factors that have been found to influence whether people are health or
unhealthy.

Description of health in different aspects

 Health is a state of complete physical, mental and social well-being and not merely the
absence of disease or infirmity.

 The enjoyment of the highest attainable standard of health is one of the fundamental
rights of every human being without distinction of race, religion, political belief,
economic or social condition.

 The health of all peoples is fundamental to the attainment of peace and security and is
dependent on the fullest co-operation of individuals and States.

 The achievement of any State in the promotion and protection of health is of value to all.

 Unequal development in different countries in the promotion of health and control of

diseases, especially communicable disease, is a common danger.
  Healthy development of the child is of basic importance; the ability to live harmoniously
in a changing total environment is essential to such development.
 The extension to all peoples of the benefits of medical, psychological and related
knowledge is essential to the fullest attainment of health.

 Informed opinion and active co-operation on the part of the public are of the utmost
importance in the improvement of the health of the
people("https://www.who.int/about/governance/constitution)

The key factors that have been found to influence whether people are health or unhealthy.
Are as follows;

1. Lifestyle

Lifestyle indicate most either people are health or unhealthy, promote self-care and make choices
that enhance health. Lifestyle includes not only individual choices, but also the influence of
social, economic, and environmental factors on the decisions people make about their health.
Personal life “choices” are influenced by the socioeconomic environments in which people live,
learn, work and play. Further reading is available on changing patient behavior. The Life
Expectancy Calculator may be a useful tool for clinicians in helping patients understand some of
the factors within their control to improve health status (e.g. smoking, alcohol consumption,
physical activity, etc.).

2. Social Environment
The importance of social support also extends to the broader community. Social or community
responses can add resources to an individuals’ repertoire of strategies to cope with changes and
foster good health. The array of values and norms of a society influence in varying ways the
health and well-being of both individuals and populations.

3. Biology
Genetic factors with which an individual is born, family history that may suggest a risk for
disease and health problems acquired during life. For example, sickle cell anemia.

4. Access to quality health care

Access and use of services that promote health and prevent disease influence health. Simple
measures, such as protecting water supplies, often have the greatest impact on overall health.
Examining high-use populations in terms of health care utilization can be an effective way to
target interventions tailored to specific groups such as those with multiple co-morbidities. Lack
of access to health services also indicates that an individual is un health.

5. Education and Literacy

Health status improves with a person’s level of education. Education both contributes to and is a
result of social position. Education influences social position in various ways; each of the factors
indirectly influences a person’s health. Education contributes to health and prosperity by
equipping people with knowledge and skills for problem-solving, and helps provide a sense of
control and mastery over life circumstances. It increases opportunities for job and income
security, and job satisfaction. It also improves people's ability to access and understand
information to help keep them healthy. Health literacy is a related concept and is "the degree to
which individuals have the capacity to obtain, process, and understand basic health information
and services needed to make appropriate health decisions." More than 60% of Canadians are
considered to have low levels of health literacy, which poses a significant challenge for both
population and public health initiatives. A health literate health care organization supports
patient-provider communication to improve health care quality, reduce medical errors, facilitate
shared decision-making, and improve health outcomes. (Hayes MT. 1992)

4.3.1 Dimension of health

i. The physical dimension

of health refers to the bodily aspect of health. It refers to the more traditional definitions of
health as the absence of disease and injury. Physical health ranges in quality along a continuum
where a combination of diseases such as cancer, diabetes, cardiovascular disease or hypertension
are at one end and a person who is at optimum physical condition (think health not fitness) is at
the other.

Physical health can affect the other dimensions of health as a decline in physical health can result
in a decline in other forms of health. E.g. a person who suddenly gets the flu is often isolated
socially as to not infect others, struggles to focus in order to study or learn anything new, and
may feel sad as a result of their isolation.
 ii. Mental

Mental health refers to the cognitive aspect of health. Often mental health is linked to or includes
emotional health, I want to distinguish the two. Mental health is more the functioning of the
brain, while emotional health refers to a person’s mood often connected to their hormones.
Mental health then includes many mental health issues such as Alzheimer’s and dementia. It
refers to the person’s ability to use their brain and think. This may be to solve problems or to
recall information, but the focus is on the cognitive aspect of the person.

Mental healthcare affects the other dimensions of health. An increase in mental health can come
as a result of increased physical activity, and good mental health can then lead to an increase in
self-esteem as mental performance improves. Greater self-esteem then leads to more confidence
in social situations and can lead one to ask the larger questions about life leading to increased
spiritual health.

iii. Emotional

Emotional health is about the person’s mood or general emotional state. It is our ability to
recognize and express feelings adequately. It relates to your self-esteem as well as your ability
control your emotions to maintain a realistic perspective on situations. The relationship between
emotional and mental health is clear and as such some illnesses relate to both, such as:
depression and anxiety.

Emotional health affects the other dimensions of health as a person with a good self-esteem is
more confident in social settings, makes friends quickly and often performs better in physical
activity.

iv. Spiritual
Spiritual health relates to our sense of overall purpose in life. People often find this purpose from
a belief or faith system, while others create their own purpose. A person who has purpose to life
is said to be healthier than those who don’t see a purpose to life.

Spiritual health will very easily affect emotional and mental health as having a purpose in life
can help you to apply yourself to achieving goals. Having a purpose to life can also help people
to maintain a proper perspective on life and overcome adversity. Often people who are spiritual
meet together regularly around their spiritual purpose, which helps to improve their social health.
(" https://pdhpe.net/better-health-for-individuals/what-does-health-mean-to-individuals/
meanings-of-health/dimensions-of-health/)

4.4 Describe how best principles of strategic management can be applied to public health.

Strategic management in healthcare is the process of defining the future of your organization,
setting goals that will move you toward that future, and determining the major projects you’ll
take on to meet those goals. It also includes sustaining that strategy focus over a period of three
to five years.

Why is strategic management important in public healthcare?

Like other companies, healthcare organizations benefit from having a plan for the future—one
that all employees are aware of and consistently working toward. Strategy should serve as a
guidepost for all important decisions to make sure your facility stays on track.
But as we mentioned above, healthcare is even more complex than your average business—and
frequently affected by external forces. If asked to describe how strategic management helps your
facility control the future, we’d answer with the following:

The strategic planning process naturally includes assessing changes in the external environment
(through exercises like the SWOT analysis) and thus helps your organization stay on top of them.

It provides focus and direction for daily work even as circumstances (internal or external) may
change.

It provides leaders with a consistent flow of information about organizational performance,

promoting better, more timely decision-making. The availability of such data also helps
organizations reprioritize or pivot as needed.

principles of strategic management can be applied to public health as follows;

1. Keep your organization’s mission top-of-mind.

Mission and vision are the cornerstones of your organization and provide a foundation for
strategic planning. Make sure the priorities and objectives outlined in your plan support those
key elements—and reconsider any goals that are not aligned.

2. Narrow your strategy’s focus.

Too many healthcare organizations try to be everything to everyone. As a result, their strategies
touch nearly every base imaginable, from being the best at research and innovation to serving as
many potential patients as possible to being customer-centric, etc. Narrowing down your strategy
requires courage—it may feel as if you’re passing up opportunities to improve. But in reality,
you run the risk of not excelling in anything if you’re trying to achieve everything. Home in on
the areas you want to pursue and direct your resources and energy to accomplishing those
specific goals.

3. Align your plan with in-progress accreditations or certifications.

If you’re pursuing an accreditation or award like PHAB or Baldrige, your strategic plan needs to
align with that goal. Make sure your plan points you in the right direction and supports tracking
all the data required by the administering body.

4. Do a SWOT analysis.

Periodically analyzing your organization’s strengths and weaknesses, as well as external

opportunities and threats, is a useful exercise that can inform your strategic plan. Follow the
steps outlined here to complete the analysis, and see some healthcare-specific examples.

5. Communicate.

Strategic plans are only effective if everyone knows about them. Every department head should
be charged with explaining how their team fits into the strategy and why it matters. (Read some
tips here on how to effectively communicate with employees.) You’ll also need to create tailored
presentations for other stakeholders—patients, administrators, community members, etc.

And finally, remember: Don’t overload yourself and your team with goals and metrics right out
of the gate—having too many makes it hard to prioritize and makes communication difficult.
Ease into it. The first year, start by creating a high-level plan for the organization as a whole; the
following year, try to tackle planning for business units, service lines, etc. (VIad, D. 2016)
 5.0 CONCLUSION

This report has observed that NATIONAL AIDS COMMISSION should focus on
discussing policy and policy structure, explaining the stages of the policy formulation
process, discuss 5 principles of public health law, analyze key factors that have been
found to influence whether people are health or unhealthy and describe how best
principles of strategic management can be applied to public health.

6.0 RECOMMENDATIONS.

The report recommends that

 NATIONAL AIDS COMMISSION must make it a habit in training its staff on issues
concerning. Public health policy and management
 Proper care and attention should be given to different projects so as to maintain the
project objectives together with the organization’s objectives.
 Whenever recruiting different personnel for various projects being implemented by
the organization, National aids commission should make sure that these new recruits
have got adequate knowledge, skills and techniques in managing and implementing
various projects.
 Public health policy is crucial because it brings the theory and research of public
health into the practical world. Public health policies create action from research and
find widespread solutions to previously identified problems.
  Before public health policies are implemented, policymakers and officials will go
through an extensive research process to determine what public health issues need to
be addressed and formulate the best subsequent solutions.

REFERENCE
 (http://www.aidsmalawi.org.mw/who-we-are)

 (https://www.who.int/about/governance/constitution)

 (" https://pdhpe.net/better-health-for-individuals/what-does-health-mean-to-individuals/
meanings-of-health/dimensions-of-health/)

 Adams, L, M&munro, j. (2002) promoting health and practice.uk: SAGE publication L.td.

 Smith P, C Ginnelly, I &sculpher, M, (2005). Health policy and Economics: opportunities

and challenges. USA.: Open University Press

 Last, J (2005) the global Dimension of health .UK: Springer science, Business Media, Inc.

 Hayes MT. (1992) incrementalism and public policy. New York; Langomam.

 White J. (2003). false alarm: why the greatest threat to social security and Medicare IS THE
campaign to save them. Baltimore: Johns Hopkins univ. press

 VIad, D. (2016). analysis of public health policies and the use of preventive services –PhD
thesis, University of medicine and pharmacy “Carol Davila” Bucurest.