rationalization and programmatic approach to technical



Health problems are many . Their intensity differs according to temporospaciales considerations and persons connected mainly with health determinants such as : environmental factors, socio demographic cultural and health and even technology.

Their management is taking into account public health priorities, based on epidemiological arguments, and severity of economic and also the possibilities of preventability and cost.

It is essential that all the actions of prevention and care are addressed in a principle of efficiency and cost ( efficiency ). This concept can be realized in a health program ( Health Program ) which is a rational response by the standardization of the comprehensive care strategy.


It boils down to a set of actions of prevention and care appropriate to the nature of the problem and the resources available, to achieve specific goals and measurable, according to a schedule.


The program must be developed by a multidisciplinary group under the aegis of a coordinator.

The development of this program requires :

  1. identifying needs and health problems, a population, determined : definition of the population – diagnostic local.
  2. determining objectives for this population.
  3. the identification of activities to be undertaken to achieve the objectives and determining the resources to be allocated to the program.
  4. evaluation.


1- Identification of problems and health needs :

it stems:

  • epidemiological data of morbidity and mortality ( prevalence, incidence, mortality…)
  • the perception of health problems in the population and prevention possibilities seem preferable to him that : is the psycho sociological context in

concern for community involvement.

2- Setting priorities :

It is based on :

Frequency, the severity of the problem and its impact on this population. The cost of the disease and the actions to be taken

In a multidisciplinary, experts confer on the evaluation of health problems by combining the above mentioned criteria allowing to identify the main priorities for action.

3- Target population :

Just what is the population concerned or affected by the problem and referred by the program. It is defined:

On the basis of epidemiological data or morbidity and mortality and their breakdown by individual characteristics, time and place.

  • On the notion of exposure (risk ) and to identify exposed populations and high-risk.


1- Conditions :

the objectives must be :

relevant : actually refer to measurable considered problem : to quantify the results achievable

  • must be clearly expressed in terms of earnings for a targeted population and not actions

2- Classification :

they must être_classifïés general overall to detail or the general to the specific (elementary)


1- Actions to be implemented :

Depending on the objectives the activity is determined to be undertaken under the health program and that usually comes in :

Educational training activities, Screening and Diagnosis, care, preventative measures, communication and health education

Sometimes one activity represents a subroutine : for example regarding the program against child mortality , the EPI is a subroutine.

2- Determining Average :

We first consider the human, available financial and material. Then we evaluate the means missing and try to complete the.


She Triple :

1- Evaluation means :

It must have all the means provided for the conduct of activities to pretend to change a previous position.

2- Evaluation of services :

Stains and recommended actions must be conducted according to technical and contemplated rhythms.

2- Evaluation of results :

To verify the effectiveness of the program that will result in :

A decrease in mortality , morbidity and the risk of developing the disease Further results can be considered in relation to the conduct of activities on land and the involvement of the target population, such as the change of human behavior, the impact on the training of staff and rationalization of health expenditures and recorded profits.


The activities will take place according to a strategy based on the information, Training, service delivery and supervision taking account of the schedule.

During this phase, difficulties can arise and constitute constraints on the ground forcing the program to rectify at the formulation of objectives, the means to implement or activities to be undertaken.


A health program is the best way to control and reduce the magnitude of a public health problem.

The multisectoral approach is the rule as a good coordination between the different sectors involved in the program sequence . a contract or agreement in a regulatory institutional framework are essential

A triple interest characterizes a health program :

  • epidemiological : reducing the frequency and risk
  • Educative : change of exemplary behavior and life for the purpose of protection and health promotion
  • Economic : decrease spending ( direct and indirect )

Bibliographical references :
1- Marie Bernard.P : Introduction to applied research health. 1990 .
2- M.Jenicek R.Cléroux and Epidemiology :Principles. techniques. Applications, Edis- Maloine S.A Paris 1984.
3- S.Tessier, J-b .Andrews, M-A .Ribeiro
Action Planning Health : public health and community health Maloine 1996

Course of Dr LEMDAOUI MOHAMED CHERIF – Faculty of Constantine