Who is responsible for public health? The tendencies and its benefits –or not– on Health Education around the world

This article was exclusively written for the Sting by Ms Gabriela Amaral, medical student from Brazil. Mrs Amaral is affiliated to the International Federation of Medical Students Associations (IFMSA). Since the Ancient Greece, when Hippocrates instituted a new concept of medical analysis – Normality x Pathology – until nowadays where the scientism rules, medicine has acquired different roles into people’s lives going from distant observer until a caring father. Today the relationship between doctors and patients obtain different aspects based on the latter needs, but it is known that there has been a great effort to raise people’s awareness on their responsibility in their own health. There is where the concept of Health Education goes in the discussions daily topics of the greatest governors and health organizations. “Health education is any combination of learning experiences designed to help individuals and communities improve their health, by increasing their knowledge or influencing their attitudes” (WHO). In this context, Primary Health Care has grown, since the Alma- Ata in 1978, to be now the leading guideline of most of the countries health policies. This concept states clearly that “Education concerning prevailing health problems and the methods of preventing and controlling them” (Alma Ata – 1978) should be priority when it comes to sustainable development. Each country has then tried to fulfill these requirements on their health system, what in case of Brazil correspond the Basic Health Units, implemented by Unique Health System (UHS), which work on the Family Health Strategy (FHS). One of the concerns of this strategy is to educate the population against the endemic diseases of the country and the referred community – most tropical or chronical diseases like Zika, STDs, obesity, odontological problems and other more. So, how – and how well – is it working? It works based on lectures, dynamics, captation of the risk groups and interaction between the health team and the population. We can say that it works very well promoting sanitation and prevention, diminishing the infant and maternal mortality and facilitating the treatment pathway as well. However, the problems that affect Brazil and most of the developing and poor countries are still bureaucracy, lack of organization and resources for more expensive treatments. On the other hand, “around 450 schools of public health worldwide” (Swiss School of Public Health) work primarily on workforce training. Nevertheless, they insist on the idea of medicalization and according to the article “Public Health Education in Europe: Old and New Challenges”, written by Fred Paccaud, Alison Weihofen and Sandra Nocera and published on Public Health Reviews, Vol. 33, No 1, 66-86, one problem that affects developed countries is “delayed development of the nonmedical dimensions of public health”. This information shows that neither technology nor basical attention alone can build public health, instead, when it comes to medical care, they shall work side-by-side. Therefore, every country can learn with the others health policies and even more with its population needs to incentivize the deficient areas on their own system. Only then, when everyone feels responsible for common health, will we reach “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (WHO), the meaning of health.