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Public Health in Quebec

Public Health in Quebec. Public Health in Quebec. The Public Health Organization in Quebec  A lain P oirier Directeur national de santé publique (National Public Health Director) and Assistant Deputy Minister Ministère de la santé et des services sociaux. Public Health Act (2001).

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Public Health in Quebec

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  1. Public Health in Quebec

  2. Public Health in Quebec • The Public Health Organization in Quebec Alain Poirier Directeur national de santé publique (National Public Health Director) and Assistant Deputy MinisterMinistère de la santé et des services sociaux

  3. Public Health Act (2001) Functions Promotion Prevention Protection Monitoring New tools Joint monitoring plan Report on the health status of the population Resource mobilization plan Trans-sector Ongoing monitoring of health determinants Sec. 54 and 55 Impact assessment National Public Health Program (2003-2012) Provides public health services Creates a national-regional-local dynamic The Public Health Action Plan

  4. Ministre de la santé et des services sociaux Institut national de Santé publique du Québec Advisory agencies Ministère de la santé et des services sociaux DNSP/SMA Regional agencies (18) / DSP Specialized regional facilities Health and social services centres (95) Public Health Network & Health and Social Services Network

  5. The goal to improve public health and well-being described on three fronts • Knowledge on the health status of the population and the transfer of that knowledge • The organization of public health services toward public responsibility • Action on determinants with other sectors local – regional - national

  6. The National Public Health Program (2003-2012) • An action-oriented approach for intervention based on convincing data • The implementation of a set of common interventions and prevention services in the following areas: development, adaptation and social integration, lifestyles and chronic illness, accidental injury, infectious disease, environmental health, workplace health • A planned approach to ensure consistency in actions and organization, coordination of actors and their accountability, and a sequence of adjustments to change

  7. Section 54 of the Public Health Act The Minister is by virtue of his or her office the advisor of the Government on any public health issue. The Minister shall give the other ministers any advice he or she considers advisable for health promotion and the adoption of policies capable of fostering the enhancement of the health and welfare of the population. In the Minister's capacity as government advisor, the Minister shall be consulted in relation to the development of the measures provided for in an Act or regulation that could have significant impact on the health of the population.

  8. Public Health in Quebec • Regional Public HealthRéal LacombeDirecteur régional de santé publique (Regional Public Health Director) Abitibi-Témiscamingue

  9. Regional Director’s Mandate • Inform the population of his/her region on: • The condition of the population’s health and priority health problems, at-risk groups, main risk factors and the most effective interventions • Health portraits, community portraits, epidemiological studies/investigations, director’s report…

  10. Regional Director’s Mandate • Identify situations that could ENDANGER the population’s health: • Epidemics, environmental hazards, workplace health risks… • Implement the measures required to PROTECT it: • Vaccinations, workplace health programs… • Resource mobilization plan

  11. Regional Director’s Mandate • Ensure health PREVENTION and PROMOTION expertise • Healthy schools, integrated prenatal and early childhood services, suicide prevention… • Advise the regional agency on prevention services to reduce mortality and morbidity • Fight against chronic diseases…

  12. Regional Director’s Mandate • Propose inter-sector action to prevent illness, injury and social problems that affect the health of the region’s population • Community development, Villes et Villages en santé, fight against social inequality …

  13. Regional Action PlanAbitibi-Témiscamingue Strategies • Community involvement • Participation in regional and local development • Youth and family • Less inequality in health and well-being • Intervention assessments • Support for innovation in local health and well-being networks

  14. Regional Action PlanAbitibi-TémiscamingueAreas for action • Community development • Social integration, adaptation and development • Lifestyle and chronic illness • Accidental injury • Infectious disease • Environmental health • Health in the workplace • Organization of services in rural areas

  15. Public Health in Quebec • Local public health activitiesMario MorandDirector General Centre de santé et de services sociaux des Sources

  16. The CSSS’s New Role • Integration of front-line responsibilities • Coordination of local networks • Population-based responsibility • Ranking of services

  17. Local Action Plan • To support promotional campaigns • To integrate activities deemed effective from the National Public Health Program • To take into account the priorities of the regional action plan • To identify community priorities • In which most activities are integrated into the teams from various departments and programs

  18. National Defining public health goals Developing protocols Regional Monitoring the protocol‘s application Training program Supplies Local challenges Training Increasing the vaccination rate: Careful follow-up with clients Systematic repetition Improved accessibility to clinics From National to LocalInfant vaccination

  19. National Defining objectives Proposing activities Regional Identifying priorities and targets Training programs Proposing tools Local challenges Developing strategies to reach the clientele Creating interest in the intensive program and maintaining regular attendance From National to LocalIntegrated prenatal services

  20. Community Development • An approach • A service • An intervention objective and location

  21. Community DevelopmentAn approach • That involves citizens in identifying problems and solutions • That fosters cooperation among organizations and actors • That focuses on taking responsibility • That fosters actions that address the determinants of health

  22. Community DevelopmentA service • That brings together professionals who are available to support organizations and user and citizen groups • That ensures the monitoring of changing community needs • That offers technical and professional support

  23. Community DevelopmentAn intervention objective • In living environments • In programs • For at-risk groups

  24. From Economic Revitalization to Social Development • An unprecedented economic crisis • Significant mobilization of the community • A strategic role for the CSSS • Revitalization plan over 10 years • The support of authorities • Local development triggers • Common priorities

  25. A Living Environment Conducive to Development • Education • Skilled labour • Demographic balance and growth • A social development plan • A positive image of the area

  26. Social Development Plan in the MRC des Sources • The expression of a need by the community • A documented problem • A legitimized, integrated and concerted course of action • Shared responsibility, formalized mandates • Significant support • A rigorous, decentralized process • The community takes charge

  27. Priority Intervention Areas • Citizen participation • Improvement in the living conditions of disadvantaged people • Mobility of the population • Balancing the age pyramid and demographic growth • Social, cultural and recreational activities • Promotion and enhancement of the area

  28. Public Health in Quebec • Institut national de santé publique du QuébecPierre JoubertDirectorDirection Recherche, formation et développement (research, training and development branch) Institut national de santé publique du Québec

  29. INSPQ: ORIGIN • Governmental organization created in 1998 (RSQ, Chapter 1-13.1.1) • To support the Minister, regional authorities and institutions in their public health mandates • To develop public health expertise and make it available • To provide specialized laboratory services • The Laboratoire de santé publique du Québec (public health lab) • The Centre de toxicologie du Québec (poison centre) • The Centre d’expertise en dépistage (screening expertise)

  30. INSPQ: MANDATES • Develop knowledge and participate in monitoring the population’s health status and its determinants • Develop and ensure the accessibility of new knowledge and approaches in health promotion, prevention and protection • Develop and promote research in cooperation with research institutions and funding organizations • Inform the Minister of Health of the impact of public policies on the health status of Quebecers

  31. INSPQ: MANDATES (continued) • Inform the population on the state of its health and well-being and on emerging problems, their causes, solutions and effective means of prevention • In cooperation with universities, make public health expertise accessible by updating training in public health, and developing and implementing professional development programs • On a national and international scale, promote cooperation and knowledge-sharing regarding public health • Meet the responsibilities regarding the provincial public health program entrusted to the Institut by the Minister

  32. INSPQ: GOVERNANCE • A president and chief executive officer who reports to the Minister of Health and Social Services • A board of directors • Mechanisms for cooperation and coordination with the provincial director of public health (ADM) and the 18 regional public health authorities

  33. INSPQ: GOVERNANCE (continued) • A responsibility to inform the population and an obligation to inform the Minister • Multiple partnerships with other public bodies, universities, research authorities, non-governmental organizations (NGOs and INGOs) • One organization with a number of sites

  34. MINISTRE DE LA SANTÉ ET DES SERVICES SOCIAUX CONSEIL D’ADMINISTRATION COMITÉ DE VÉRIFICATION DIRECTION GÉNÉRALE RECHERCHE, FORMATION ET DÉVELOPPEMENT SECRÉTARIAT GÉNÉRAL ET COMMUNICATIONS Communications Connaissance-surveillance Collaboration internationale RESSOURCES FINANCIÈRES ET MATÉRIELLES Recherche et innovation Études et analyses de l’état de santé de la population Formation Ressources financières Santé des autochtones Planification et évaluation Ressources matérielles RESSOURCES HUMAINES Gestion des ressources humaines Développement des ressources humaines RESSOURCES INFORMATIONNELLES Développement et entretien des systèmes d’information Infocentre de santé publique Technologies de l’information DÉVELOPPEMENT DES INDIVIDUS ET DES COMMUNAUTÉS SYSTÈMES DE SOINS ET SERVICES RISQUES BIOLOGIQUES, ENVIRONNEMENTAUX ET OCCUPATIONNELS TOXICOLOGIE HUMAINE LABORATOIRE DE SANTÉ PUBLIQUE DU QUÉBEC Services cliniques de dépistage Analyses & expertises de laboratoire – Unité A Centre de toxicologie Développement et adaptation des personnes Santé et environnement Performance des services de première ligne Analyses & expertises de laboratoire – Unité B Contrôle, prévention et surveillance des maladies infectieuses Développement des communautés Maladies chroniques Opérations techniques Immunisation Habitudes de vie Programmes de dépistage Radioprotection Infections transmises sexuellement et par le sang Sécurité et prévention des traumatismes Politiques publiques favorables à la santé Santé au travail

  35. ACTIVITIES: SPECIALIZED ADVICE AND ASSISTANCE • Expert advice during crises and emergencies Ex.: Outbreak of invasive meningococcal infections Ex.: Assessment of environmental risks • Scientific opinions Ex.: Prenatal intervention program Ex.: Impact of public policies • Program evaluation Ex.: Smoking cessation program Ex.: Healthy school program

  36. ACTIVITIES: SPECIALIZED LABORATORY AND SCREENING SERVICES • Specialized analyses in microbiology and toxicology • Reference laboratory • Development and accessibility of new analysis techniques and methods • Expertise in external quality assurance • Screening for breast cancer, occupational deafness and lung diseases • Mobile unit

  37. ACTIVITIES: SPECIALIZED LABORATORY AND SCREENING SERVICES

  38. ACTIVITIES: INFORMATION • Information for the population and for health-care workers • Specialized publications • Specialized documentary services • Online access portal • A few numbers: • Publications per year: 20 reference guides, 100 scientific articles and 60 other publications • Web: > 500 000 visitors/month • Newsletter Les Résonances del’Institut: > 1500 subscribers

  39. ACTIVITIES: PROFESSIONAL DEVELOPMENT • Location for internships and teaching support Ex.: Internships and residencies in public health and in microbiology • Colloquiums and symposiums Ex.: Les Journées annuelles de santé publique (JASP) • Professional development Ex.: Microprogram in public health

  40. ACTIVITIES: INTERNATIONAL JOINT ACTION • Sharing of expertise, knowledge transfer, information sharing at the international level • Specific requests (Cuba, Salvador, Benin) and via Health Canada (OMS, PAHO) • International cooperation agreements • EN3S, INPES, Université d’Été in Besançon, etc. • Work with NGOs and INGOs • UIPES, SFSP, Réfips • 3 WHO cooperative centres

  41. ACTIVITIES: RESEARCH • Research, analyses and projections on the evolution of the population’s health status ▪ Obesity and physical inactivity • Analysis of the distribution of specific health problems • Diabetes in First Nations communities • Studies on emerging health problems • Nosocomial infections: C. difficile

  42. ACTIVITIES: RESEARCH (continued) • Identification of the most effective and efficient interventions • Immunization (CIQ) • Development and validation of health indicators and intervention tools • Inequalities in health (deprivation index) • Staff: > 70 professionals and physicians with flexible hours and > 30 FTEs with university affiliations

  43. TO LEARN MORE… • The Institut’s Web site • www.inspq.qc.ca • Constituent act • www.inspq.qc.ca/institut/loi.asp • Annual report • www.inspq.qc.ca/institut/rapportannuel.asp?B=1&B1=7 • Program • www.inspq.qc.ca/institut/programmation.asp?B=1&B1=8

  44. Public Health in Quebec

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