This presentation is prepared as part of the Course assignment of "Advanced Concept of Public Health" for the Master's Degree of Public Health (MPH), Pokhara University and can be used as reference materials for Age of Socialized Public Health/Political Age of Public Health

1. Tracing back public health in
developing countries
Presenter:
Jagat Pd. Upadhyay
MPH 1st Semester
Pokhara University
Age of Socialized Public Health

2. Age of Socialized Public Health
• The 1970s and 1980s were regarded as economically and
politically unstable decades worldwide as many countries were
coming out from colonial system and effects of second world war.
• Many countries especially those that has achieved independence
late 1960s and 1970s, were still struggling for socioeconomic
growth.
• War in the Middle East in 1973 had serious consequences on the
world economy due to the oil crisis.
7/29/2022 Age of Socialized Public Health 2

3. Age of Socialized Public Health
• Developing countries continued to face traditional health
problems, such as high morbidity and mortality, as a
result of maternal and childhood diseases, infectious
diseases, and malnutrition and not able to cope with the
rapidly increasing population.
• In low and middle income countries, the infectious
communicable disease was a major health problem and
burden of non communicable disease was added to it.
7/29/2022 Age of Socialized Public Health 3

4. Age of Socialized Public Health
• The initial ideas of social medicine or the social
dimension of public health had emerged around the early
20th century.
• It mainly focused on enhancing healthy lives by
addressing risks through health promotional activities.
7/29/2022 Age of Socialized Public Health 4

5. Age of Socialized Public Health
• Cardiovascular disease: Adoption of lifestyle of developed
countries.
• Diabetes: No accessibility of insulin for major population of
developing countries.
• Cancers
 Liver and Stomach cancer: Due to high consumption of
salted, smoked, pickled and preserved food.
 Breast Cancer: Due to high calorie diet intake, lack of
physical exercise and various others reproductive factors.
 Cervical cancer: Due to increase in HPV infection.
Major Non-Communicable Diseases
7/29/2022 Age of Socialized Public Health 5

6. Age of Socialized Public Health
• Increase in tobacco and alcohol consumption led to
increase in tobacco related illness and death.
• Increase in Mental Health related diseases due to
substance abuse.
• More than 50% of aged population carried the burden
of chronic diseases.
Major Non-Communicable Diseases
7/29/2022 Age of Socialized Public Health 6

7. Achievement
• In late 1950s and 1960s new knowledge's about non-
communicable diseases like cancer, diabetes and tobacco
related illness emerged out.
• The social and behavioural aspects of disease were recognized
• Many social interventions were proposed as a part of health
promotion.
• Socialized health care had become more reasonable,
workable and acceptable approach.
• Value of health as a fundamental human right and its
attainment as an essential social goal were firmly recognized.
7/29/2022 Age of Socialized Public Health 7

8. Achievement……..
• People became more aware about social and
economic determinants impacting health.
• Empirical evidence was collected from both the
developed and developing countries.
• Debates started on the links between health and social,
economic and environmental factors.
• Many comments were made on need to give a social
and political dimensions to international public health.
7/29/2022 Age of Socialized Public Health 8

9. Drawbacks
• Dominance of biomedical science approach without
adequate focus on community resulted in failure of mass
disease control campaign (as they were too much focused
on technological advancement and use of technical
intervention).
• Education system, institutions considered public health to
be same as preventive and social medicine without
considering the basic concept of social medicine.
7/29/2022 Age of Socialized Public Health 9

10. Addressing Risk
• A comprehensive policy intervention is more effective
rather than focusing on behaviour change of sole
individual.
• Focusing on expensive specialized health care services on
individual patient who come and seek services at
advanced stage of disease is uneconomical.
• Healthy public policies are needed to change the
physical and socioeconomic environment.
• Application of cost effective interventions at
primary prevention level so that people may not
suffer from diseases.
7/29/2022 Age of Socialized Public Health 10

11. Addressing Risk.....
• Establishment of basic health facilities and community
based treatment, rehabilitative and palliative services
contributed in improving the quality of life.
• Development and modifications of healthy public
policies and appropriate health legislations, regulation
and financing mechanism.
• A strong national commitment required to expand and
strengthen national health systems in order to ensure
the greatest health benefit to the greatest number of
people at the lowest cost.
7/29/2022 Age of Socialized Public Health 11

12. WHO and World Bank during this period
• WHO had advocated a new paradigm for health that sees
health as central to development and to quality of life.
• World bank had initiated priority setting in health by
introducing notion of cost effective public health
intervention package.
• The bank had initially been formed in 1946 to assist in the
reconstruction of Europe and later expanded its mandate
to provide loans, grants, and technical assistance to
developing countries.
7/29/2022 Age of Socialized Public Health 12

13. WHO and World Bank during this period
• At first, it funded large investments in physical capital and
infrastructure; in the 1970s, however, it began to invest in
population control, health, and education, with an emphasis on
population control.
• The World Bank approved its first loan for family planning in 1970.
• In 1979, the World Bank created a Population, Health, and Nutrition
Department and adopted a policy of funding both stand-alone health
programs and health components of other projects.
7/29/2022 Age of Socialized Public Health 13

14. Public Health development in Nepal
Before Prithivi Narayan Shah
(Age of traditional Health Care)
• Faith Healing Practices:
(Traditional Healers)
• Traditional: Ayurvedic
System and Homeopathy
• Allopathic : Introduce by
Missionaries
During Rana Regime
(Contemporary Health Care
1846-1950)
• Medical Dispensaries
• Health Unit / Hospitals
• Community Ayurvedic
school
• Curative based services
• Urban Centered Services
7/29/2022 Age of Socialized Public Health 14

15. Five Year Plans of Nepal
• First Plan - 1956-1961
• Second Plan - 1962 -1965
• Third Plan - 1965- 1970
• Fourth Plan - 1970- 1975
• Fifth Plan - 1975-1980
• Sixth Plan - 1980-1985
• Fifteenth Five Year Plan 2019/20-2023/24
7/29/2022 Age of Socialized Public Health 15

16. First Five Plan (1956-1961)
• MoH was established in 1956.
• Health Assistants school established 1955.
• First intake of girls in Nursing training school at Bir
Hospital in 1956.
• Upgrading and modification of existing hospitals.
• Construction of the first Maternity Hospital (Prasuti
Griha) in 1959.
• Production of first batch of 13 Nurses in 1960.
7/29/2022 Age of Socialized Public Health 16

17. Second Five Year Plan (1962- 1965)
• Hospitals, Health post and Ayurvedic dispensaries were
established.
• Leprosy control in 1963. (Effective control began in 1963,
with the implementation of the National Leprosy Control
Program)
• Establishment of Royal Drug Research lab in 1964.
• National Health Survey was done in 1965.
• Running of Vertical project.
- Malaria eradication
- TB/Leprosy control project
- FP/MCH Project.
7/29/2022 Age of Socialized Public Health 17

18. Third Five Year Plan ( 1965-70)
• It was accepted that more focus on prevention was
very important.
• Stress on establishment of vertical Projects.
- Leprosy eradication project 1965.
- Small pox eradication project started 1967.
- FP/MCH Project 1968.
• Starting the Central Health laboratory in 1967.
7/29/2022 Age of Socialized Public Health 18

19. Fourth five Year Plan (1970- 1975)
• Integrated basic health service was started in 1971.
• IOM increase its effects on HRH Production to meet
the increasing demand.
• All the 50-bed hospitals will be developed into
‘referral’ hospitals
• First Long Term Health Plan (1975- 1990 AD) was
developed in 1975
• New Drinking water project started.
7/29/2022 Age of Socialized Public Health 19

20. Fifth Five Year Plan (1975-1980)
• Establishment of new health post and hospitals
• Small pox total eradication from country (13 April
1977)
• Nepal had sign the Alma-Ata Declaration in 1978 and
adopted PHC for achieving HFA by the year 2000AD
7/29/2022 Age of Socialized Public Health 20

21. SWOT Analysis
Strength
• Focus on technological
advancements and the use of
technical interventions
• Social Medicine concept
emerged
• Health promotion activity
• Socialized health care
approach emerged
• People became more aware of
the social and economic
determinants impacting health.
Weakness
• Failure of mass disease control
campaign (biomedical science
approach)
• Lack of trained health worker
• Armed conflicts within and
between countries and ethnic
groups
• Multiple burden of disease at
the same time (High morbidity
and mortality)
7/29/2022 Age of Socialized Public Health 21

22. SWOT Analysis
Opportunity
• National commitment to
expand and strengthen
health system
• Adoption of international
policy from developed
countries. (cholera outbreak)
Threat
• Political instability
• Pandemic
7/29/2022 Age of Socialized Public Health 22

23. Conclusion
Health promotion and prevention are core function of
public health was recognized for being effective in
reducing the burden of both communicable and non
communicable disease and in mitigating the social and
economic impact of such disease.
7/29/2022 Age of Socialized Public Health 23

24. References
• Detel. R, Beagle hole R., L. Mary, G. Martin; “Oxford
Textbook of Public Health”;5th edition, volume 1, Oxford
Medical publication
• Five-Year Plans of Nepal, https://thephnow.com/five-year-
plans-of-nepal
• History of development of public health in developing
countries https://medtextfree.wordpress.com/2010/11/21/1-3
7/29/2022 Age of Socialized Public Health 24

25. Thank You
7/29/2022 Age of Socialized Public Health 25