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Honouring the Value of People in Public Health

Future Health Systems

Bishai, D., Ghaffar, A., Kelley, E., and Kieny, MP., (2015), Honouring the Value of People in Public Health: A Different Kind of P-Value, Bulletin of the World Health Organization 2015;93:661-662. doi 10.2471/BLT.14.149369

When faced with a complex public health problem there is a natural urge to find solutions. 'Solutionism' works well for circumscribed problems involving a small number of motivated individuals, where every element of the prescribed solution can be implemented as planned. However, complex problems in public health usually have elements that defy planning, because health involves people, and people are unpredictable.

Complex and dynamic public health problems require a different approach: an emphasis on the value of people. People who own the problem can anticipate the most likely social obstacles to its resolution, and their participation is essential to maintain an evolving strategy that can institutionalize an approach to the problem. Decades of community-based participatory research have shown that people from the community and their political leaders have to be included as full participants in problem solving. People are not just passive clients: they must be involved in deciding which problems need addressing, identifying the root causes and finding long-term solutions.