摘要：Public health programs succeed and survive if organizations and coalitions address 6 key areas. (1) Innovation to develop the evidence base for action; (2) a technical package of a limited number of high-priority, evidence-based interventions that together will have a major impact; (3) effective performance management, especially through rigorous, real-time monitoring, evaluation, and program improvement; (4) partnerships and coalitions with public- and private-sector organizations; (5) communication of accurate and timely information to the health care community, decision makers, and the public to effect behavior change and engage civil society; and (6) political commitment to obtain resources and support for effective action. Programs including smallpox eradication, tuberculosis control, tobacco control, polio eradication, and others have made progress by addressing these 6 areas. WHEREAS MANY PUBLIC health programs do not achieve their potential impact, other programs succeed in improving health outcomes drastically. Limited and unstable funding, lack of automatic means to track and improve performance, workforce limitations, and insufficient political commitment can all cause public health programs to fail. Implementation can succeed and be sustained if organizations and coalitions effectively address 6 key areas: innovation, a rigorously established technical package, management, partnerships, communication, and political commitment. This concept can be illustrated as a wheel, with innovation as the central hub providing the driving force and support for other elements: the technical package, management, partnerships, and communication. These elements in turn support and are held together by political commitment, which provides the necessary traction for progress ( Figure 1 ). Open in a separate window FIGURE 1— Six key areas for effective public health program implementation.
