CHANGING
CONCEPT IN
PUBLIC HEALTH
CHANDAN GOWDA G N
ROLL NO 2
INTRODUCTION
• In the history of public health four phases
have been demarcated namely:
1. Disease Control Phase (1880s–1920s)
2. Health Promotional Phase (1920s–1960s)
3. Social Engineering Phase (1960s–1980s)
4. Health for All Phase (1980s onwards,
Alma-Ata declaration)
Disease Control Phase
(1880s–1920s)
• • Background: Germ theory (Pasteur, Koch)
• • Goal: Control communicable diseases
• • Approach: Vertical, disease-specific
• • Strategies: Vaccination, quarantine,
sanitation, vector control
• • Infrastructure: Health labs, epidemic control
acts
• • Limitations: Narrow biomedical focus,
ignored social determinants
Health Promotional
Phase (1920s–1960s)
• • Background: Emerged after limitations of disease
control
• • Goal: Promote overall health, not just control
disease
• • Approach: Comprehensive
• • Strategies: Nutrition, MCH, school health,
housing, health education
• • Infrastructure: PH units, WHO, UNICEF
• • Limitations: Little focus on inequalities, limited
community participation
Social Engineering Phase
(1960s–1980s)
• • Background: Health problems linked to
socioeconomic issues
• • Goal: Address social determinants of health
• • Approach: Intersectoral
• • Strategies: Family planning, nutrition programs,
literacy, poverty alleviation
• • Infrastructure: Community development
programs, PHC strengthening
• • Limitations: Overemphasis on population control,
weak community participation
Health for All Phase
(1980s onwards)
• • Background: Alma-Ata Declaration (1978)
• • Goal: Health for All by 2000
• • Approach: Primary Health Care (PHC)
• • Principles: Equity, community participation,
intersectoral coordination, appropriate tech
• • 8 Elements: Health education, nutrition, water &
sanitation, MCH/FP, immunization, endemic disease
control, treatment, essential drugs
• • Infrastructure: Sub-centres, PHCs, CHCs, ASHAs
• • Limitations: Targets unmet, inequalities persist
Comparitive summary
1. Disease 2. Health [Link] [Link] for
Control Promotional Engineering All Phase
Phase Phase Phase (1980s
(1880s– (1920s– (1960s– onwards,
1920s) 1960s) 1980s) Alma-Ata
declaration)
Communic Nutrition, Socioecono :PHC,
abledisease MCH, mic Alma-Ata,
focus, housing, approach, equity,
biomedical preventive family community
model services planning, participati
literacy on
THANK YOU
REFERENCE : K. PARK