The paradigms of public health practice: Lessons for disciplinary public health and community physicians in the developing countries

Abstract

Background: Public health (PH) is the application of any science or art  organizationally, for the prevention of one, a few, or several diseases; as well as the promotion of health, happiness and longevity for the people at large; and efficiently. Most of these fall within the responsibility of the government to its polity; but in the modern world, individuals and groups of public-spirited people are also getting  involved in these. Many paradigms for the practice of public health exist – the  government (public) health services on the one hand and the other vertical public health services, covering only sanitary/environmental health or other non-clinical public health sub-specialties; preventive medicine, social medicine; or community medicine and health, and primary health care as well.

Problems: Because of the two ways of entering into the public health service, disciplinarily by primary post-professional direct and full-PH or partial  specializations therein; or by the ordinary entry into the government (public health services) or by entry into any of the above six different paradigms of its practice; there is often a misunderstanding of the entire meaning, practices, relations and efficient running of these public health services.

This paper is therefore a review of these two modes of entrance and practice of PH, the distinction and relationships between all the six paradigms of practice thereof, and the benefits as well as problems associated with them. It proffers some  suggestions as to their containment, especially for the disciplinary public health physicians as the ultimate community physicians in that most efficient practice paradigm of PH. The same applies also to the disciplinary public health nurse-midwives, similarly, as the statutory district or zonal community nurse-midwives.