Health programs address a wide range of issues, including immunizations against infectious diseases (such as measles and diphtheria), community-based health promotion efforts to reduce behavioral risk factors for disease (such as smoking or sedentary lifestyles), and screening programs for cancer and other diseases. Each program is designed to address a specific health issue and may target specific populations or groups at higher risk for the disease.
All societies have limited resources available to allocate to any sector, and health departments must make tough decisions about which new programs to adopt or discontinue existing ones. They must consider a cost-benefit analysis, which compares the expense of a particular intervention to its expected monetary yield or savings. The costs include the direct expenses of the program, such as wages spent on staff or supplies and drugs used, plus indirect expenses, such as lost productivity due to time off from work to participate in the program. The benefits include expected monetary savings from reduced morbidity or mortality, as well as societal benefits such as decreased demands on hospitalization and nursing home services and a reduction in the number of family members needing to care for sick relatives.
Developing effective health programs requires a diverse workforce that has skills in many areas. For example, a health department must be able to quickly respond to public health threats and emergencies, such as the recent COVID-19 pandemic. This requires staff with the expertise in epidemiology, emergency preparedness and response, public health policy development and management, and communication.
A health department must also understand its local population and culture, which is essential to implementing an effective program. For example, a vaccination initiative can fail when it is not sensitive to the needs of multigenerational families. This is why it is important to identify the local context early on and incorporate it into the design of any program.
Training and capacity building are other important factors in developing successful health programs. This includes providing staff with the training and knowledge to implement new initiatives, as well as continuing education opportunities to keep their skills up-to-date. For example, a Certified Health Education Specialist (CHES) must be certified every five years to maintain their credentials.
Creating health equity as an explicit and nonnegotiable goal is also essential for health programs. This approach requires the highest offices in a health department to set and commit to aspirational equity targets at the beginning of each program and at critical milestones. It also means identifying key equity indicators and developing methodologies for tracking them over time.
Although it is challenging to measure the impact of health programs, it is possible to use a variety of metrics and performance indicators to evaluate their effectiveness. These measures can help identify potential barriers to implementation and provide opportunities for improvement. For example, a community-based participatory model could be more successful if it includes training for staff on working with the local population and incorporating cultural sensitivity into the program design.