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You are here: Home FAQ What are the implications for Ontario Public Health Units?
What are the implications for Ontario Public Health Units? Print E-mail
Ontario Public Health Practioners

Ontario's Public Health Standards and Multiple Intervention Programming

Public health planners and evaluators have limited resources and many issues to deal with. In Ontario, to guide the work of boards of health, Ontario’s Ministry of Health and Long-Term Care released new standards for public health programs in the fall of 2008. The Ontario Public Health Standards were developed in partnership with the ministries of Health Promotion and Children and Youth Services. Created to replace the 1997 Mandatory Health Programs and Services Guidelines, the new standards are designed to promote population health and reduce inequity in health.

Under the new standards, all programs grow from a “foundational standard,” which states they must be based on population health assessment, surveillance, research and knowledge exchange and evaluation. They must also be guided by four principles: need, impact, capacity and partnership and collaboration. [ Link . See “Four Principles: Ontario Public Health Standards” for more details on considering these principles in planning multiple intervention programs.]

The new standards set desired outcomes for the mandatory programs and services each board of health must provide, although they recognize that boards tailor programs and services to meet local needs.

The standards cover five areas: chronic disease and injuries, family health, infectious diseases, environmental health and emergency preparedness, and a total of 13 programs.

The role of multiple intervention programs under the Ontario Public Health Standards

The standards actually call for multiple interventions by encouraging boards of health "to use integrated and comprehensive approaches for the assessment, planning, delivery and management of programs.” They add that “Comprehensive approaches require a broad-based, multifaceted range of activities that employ more than one health-promotion strategy" (OPHS. Principles. 2. Impact). Specifically the standards call for:

Using local data in decisions about program assessment, planning, delivery and management

This includes assessing the impact of the determinants of health on people in the area, their health status and the incidence of disease as part of continuous health-risk assessment. The socio-ecological assessment process we describe in the toolkit [link] meets this requirement.

Considering the determinants of health

Ensuring disadvantaged sub-populations are appropriately served must be one of the goals as you choose interventions. We include the determinants in the directions for choosing appropriate interventions and combinations of interventions in Module 2 and also have you consider possible synergies among different interventions that may benefit sub-populations.

Monitoring unintended consequences

Module 4 recommends monitoring for both negative and positive outcomes of comprehensive interventions (OPHS. Principles. 2. Impact)

Partnering

The standards encourage partnerships with community agencies, non-governmental organizations and various levels of government (OPHS. Principles. 4. Partnership and Collaboration). Module 1 can help you identify where and when involving partners will optimize the effectiveness and sustainability of interventions.

Using evidence

The new public health standards state "Public health programs and services that are informed by evidence are the foundation for effective public health," (OPHS. Foundational Standard) and add that it’s important to ask whether there is "reasonable evidence of the effectiveness of the intervention in the scientific literature or in reviews of best practices" (OPHS. Principles. 2. Impact). The activities in Modules 3 includes reviewing and assessing evidence; and modules 2 and 3 both focus on the using evidence to choose the right combinations and staging of interventions.

Co-ordinating for synergy

Throughout the tool kit, we emphasize the importance of co-ordinating programming to maximize impact and build synergy. That’s in keeping with the new standards to link programs at various system levels. Co-ordinated programming is more effective and efficient and can generate greater support for boards of health developing multiple intervention programs (Edwards, MacLean, Estable, & Meyer, 2006).

If you work in public health in Ontario, you may also be interested in reading about the development of the OPHS as an example to understand changing context, in Module 3.

Using the toolkit to develop and deliver public health programs should help Ontario’s boards of health to achieve the comprehensive, coordinated care the public health standards call for.

Last Updated on Monday, 22 June 2009 22:55