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Public health workers: Stopping sickness before it starts
November 28, 2017

Nine years ago, Mandela Washington Fellow Arikawe Adeolu Oluseyi was fresh out of medical school when he became the sole physician in a village hospital. He was overwhelmed managing the facility’s 60 beds in a remote part of Nigeria.

“I needed other health professionals that [were] not doctors to assist in the job,” he says.

Sub-Saharan Africa has the greatest burden of disease of any region in the world, yet there are only 14 health professionals for every 10,000 people. Public health workers, especially those embedded in communities, can help fill that gap.

What is a public health professional?

Behind the doctors and nurses that treat the sick are the civil servants and volunteers that prevent disease outbreaks or the onset of chronic illness. Public health workers monitor and maintain a community’s collective health through public outreach, policy recommendations and education initiatives that encourage citizens to adopt better health practices.

What do they do?

Their efforts go beyond encouraging children to wash their hands (though that could be part of a broader campaign to fight contagious diseases). Public health officials address a range of health issues from childhood nutrition to HIV testing. They use their acumen as communicators, organizers, policymakers, researchers and educators to improve community well-being.

10 Essential Public Health Services

  1. Monitor health status to identify community health problems.
  2. Diagnose and investigate health problems and health hazards in the community.
  3. Inform, educate and empower people about health issues.
  4. Mobilize community partnerships to identify and solve health problems.
  5. Develop policies and plans that support individual and community health efforts.
  6. Enforce laws and regulations that protect health and ensure safety.
  7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
  8. Assure a competent public health and personal health care workforce.
  9. Evaluate effectiveness, accessibility and quality of personal and population-based health services.
  10. Research new insights and innovative solutions to health problems.

Source: Centers for Disease Control and Prevention

The 10 Essential Public Health Services chart outlines the duties of a public health system. The list was created by a coalition of American public health agencies in 1994 in an effort to better organize and define public health efforts in the United States. The World Health Organization later used it as a blueprint for its own list of obligations for public health workers worldwide.

How are they different from doctors?

Doctors and public health officers are partners, not competitors, in the medical system. They play distinct yet complementary roles.

Clinical Health Public Health
Treats individuals, has a roster of patients Treats populations, cares for communities
Heals disease and injury Prevents disease and injury
Prescribes and administers medicine, performs medical procedures Writes and enacts policy, conducts outreach and educational campaigns
Looks at the body Looks at the environment and social networks
Requires a medical degree Requires specialized knowledge in health and practical training

Why are they important?

Public health expert Sonia Sachs is “absolutely convinced” that if Liberia had had a network of trained community health workers in early 2014, then the Ebola epidemic might have been contained earlier. The thought drives her work with the 1 Million Community Health Workers project, a multinational campaign she founded to bring health workers to rural, underserved communities across sub-Saharan Africa.

While thousands of public health workers were put to work across communities in response to the Ebola crisis, those that remain continue to provide necessary care for villages far removed from regular medical services.

In early 2016, Ghana’s ministry of health and ministry of labor partnered with 1 Million Community Health Workers to train and deploy 20,000 previously unemployed youth to communities across the country in need of public health professionals. The workers are armed with smartphones to collect data on their work and their patients’ health in real time. Sachs is looking forward to having solid evidence in favor of putting a public health worker in every community.

“They’re not only a good enough patch to cover what is missing — the gap in doctors and nurses,” she says, “but they have an absolute advantage because they live in their communities.”