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Assessment of essential public health functions in countries of the Eastern Mediterranean Region

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Assessment_of_essential_public_health_functionsAssessment of essential public health functions in countries of the Eastern Mediterranean Region: assessment toolAssessing public health capacity and performance in countries of the Eastern Mediterranean Region is an initiative of the WHO Regional Director for the Eastern Mediterranean, launched in 2013. It aims to undertake an assessment of essential public health functions in selected countries of the Region in order to provide best advice for improving performance.

Essential public health functions (EPHF) are the indispensable set of actions, under the primary responsibility of the state, that are fundamental for achieving the goal of public health which is to improve, promote, protect, and restore the health of the population through collective action[1]. Through the EPHF performance assessment, countries led by their ministries of health are able to identify the strengths and weaknesses in the public health system and based on the results develop interventions designed to sustain good practices and bridge gaps.

There are several EPHF assessment frameworks that have been developed earlier. These include the Centers for Disease Control and Prevention, Atlanta, and the Pan American Health Organization essential public health functions[2]; US essential public health services[3]; WHO essential public health function categories[4]; and EURO Essential Public Health Operations [5]. Most have shared essential functions, with some differences.

The assessment of EPHF in countries of the Region provides a renewed opportunity to refine and update the existing methodologies, as well as derive concrete and focused action plans. The most appropriate framework and the assessment instruments have been reviewed and agreed among a group of experts and the secretariat, for use within the context of the Region.

The scope of assessment of public health functions is country-wide and follows a multi-sectoral approach. It is done in close collaboration with the ministry of health, as its owner. WHO is also taking this opportunity to build in-house capacity so that knowledge developed can be applied in all countries of the Region and benefit other WHO regions.

Essential public health functions in countries of the Region

  1. Surveillance and monitoring of health determinants, risks, morbidity and mortality.
  2. Preparedness and public health response to disease outbreaks, natural disasters and other emergencies.
  3. Health protection, including management of environmental, food, toxicological and occupational safety.
  4. Health promotion and disease prevention through population and personalized interventions, including action to address social determinants and health inequity.
  5. Assuring effective health governance, public health legislation, financing and institutional structures (stewardship function).
  6. Assuring a sufficient and competent workforce for effective public health delivery.
  7. Communication and social mobilization for health.
  8. Advancing public health research to inform and influence policy and practice


[1] Pan American Health Organization/World Health Organization (PAHO/WHO), Public Health in the Americas: Conceptual Renewal, Performance Assessment, and Bases for Action (Washington, DC: PAHO/WHO, 2002).

[2] Centers for Disease Control and Prevention, Centro Latino Americano de Investigaciones en Sistemas de Salud, Pan American Health Organization/World Health Organization. Public health in the Americas: national level instrument for measuring essential public health functions. Washington DC, Pan American Health Organization, 2000. Pilot test version, May 2000.

[3] Statistical Quarterly, 1998,51:44-55. 2. The public health workforce: an agenda for the 21st century. Washington DC, Department of Health and Human Services Public Health Service, United States of America, 1997.

[4] Bettcher D, Sapirie S, Goon EHT. Essential public health functions: results of the international Delphi study. World Health Statistical Quarterly, 1998,51:44-55.

[5] Regional Office for Europe, World Health Organization. The 10 Essential Public Health Operations.