Özet:

Public Health is a lesser-known medical specialty, as physicians who choose to practice it have responsibilities related in particular to ensuring the health of the population or vulnerable groups, respectively to the organization and functioning of different types of health services and the health care system, as a whole. These doctors do not follow the classic model of the medical professions, of doctor-patient direct interaction, with predilection in case of disease, but use complex methods and tools, usually applicable to the general population, vulnerable communities or groups, or health services, by which they analyse the health problems of those groups and figure out ways to ensure the most appropriate response from the health system, implicitly from the state to these problems, by virtue of the constitutional right to health care. The specialty “Public Health and Management”, as it is called in Romania, is a medical specialty recognized in the European Union, based largely on international concepts and definitions, agreed by the World Health Organization and which is particularly important for population analysis. Among the graduates of the faculties of medicine, the addressability to this specialty has increased in recent years, probably due to the attraction for the integrative vision that this specialty offers and for the indissoluble link with public health policies, programmes and interventions. More and more doctors of other specialties are choosing Public Health as the second speciality. Public Health, a more “discreet” medical specialty before the pandemic, suddenly became very visible to the general public in the last year and a half, when the general population began to become familiar with the terms and institutions dealing with public health. Many of the protection measures applied during the pandemic in Romania have passed through the filter of public health specialists. The last two years have been a difficult time for the whole health system, both for public health officials and institutions and for the health care system. All the measures taken with an impact on the activity of the population involved the elaboration of some methodologies, such as the closing/opening of schools, kindergartens etc. In addition to epidemiologists and doctors from other preventive medicine specialties, public health specialists were involved in these activities. Also, the planning of the activities regarding the quarantine, isolation, monitoring of people infected with SARS-CoV-2 was done with the involvement of public health specialists from the local public health directorates. With regard to public health challenges, mention must be made of the capacity to respond to health problems and changes at population level. In the last 2 years, within the context of the pandemic, the difficulty of organizing and adapting health services and organizational structures to the continuous changes that have occurred has been much felt, not only in terms of healthcare for COVID-19, but especially in terms of the response of health services to all other problems of the population, and especially to the requirement of medical services for chronic diseases. Moreover, one of the major challenges was the urgent need for human resources in the field of public health and other specialties directly involved in the treatment of patients with COVID-19. It was proved, during the pandemic, that there were insufficient specialist doctors at the level of the structures that were dealing with various public health activities, such as public health directorates. Another public health challenge is the development of preventive services, in general. As it is known, the fundamental quality of public health is its preventive nature, and prevention is much more effective and much less expensive than treatment. Specifically, in Romania, the access to preventive services is reduced, not only because of the poor funding of the health system (Romania is the EU state with the lowest health expenditure per capita per year), but also because of the low demand for these services from the part of the population, which is somewhat paradoxical and absolutely damaging, in the situation in which Romania also has some of the most deficient health indicators in the EU. Mortality that can be prevented by public health interventions is high, especially for alcohol-related PUBLIC HEALTH AND MANAGEMENT AMT, vol. 26, no. 4, 2021, p. 2 deaths. Romania has high rates of smoking among men, and deaths from lung cancer, especially among women and men over 65, have risen steadily and account for 4% of all deaths (2014). The standardized death rate in Romania for alcoholrelated mortality (42 per 100,000) is the highest among EU countries. Another public health challenge is population aging. The health care system will have to deal with this change. Another very important activity that is also the responsibility of public health specialists is the information, education, communication campaigns among the population, on topics related to the main chronic diseases: diabetes, cardiovascular diseases, tumours, to the determinants of health-related lifestyle: smoking, alcohol consumption, unhealthy eating, physical activity that are performed within the national health, preventive programmes of the Ministry of Health. The National Institute of Public Health (INSP) through the National Centre for Health Evaluation and Promotion (CNEPSS) develops the necessary materials for these campaigns, which are approved by the Ministry of Health and reach the local public health directorates, where they are implemented at territorial level. Health communication campaigns aim at informing, persuading/influencing, motivating people to adopt behavioural changes useful in maintaining and improving their health status. The aim of these campaigns is to raise awareness and improve public awareness of some aspects of public health; to influence perceptions, attitudes, beliefs, unhealthy behaviours, to combat certain myths or preconceived ideas in order to increase the demand for health services. A successful communication campaign is based on: 1. High quality messages and choosing the most appropriate sources and channels of transmission; 2. Disseminating the message to the target audience, frequently, consistently and sustainably; 3. Encouraging interpersonal communication on the topic of the campaign; 4. Changes in awareness, current knowledge, behaviour; 5. Producing changes at the level of community, society; It is very important for public health professionals to acquire communication skills. Communication in public health is a challenge in our country, at the moment. It must be strategic, timely and effective in protecting people’s health, preventing and controlling the occurrence of diseases, improving the quality of life and promoting health. In fact, it requires knowledge of certain techniques to inform, influence and motivate individuals, institutions, the general public about the important aspects of public health

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