[Universal prevention of substance use in school settings: the need for continuous monitoring]. / La prevención universal del consumo de drogas en el entorno escolar: el valor de la monitorización continua.

This paper documents the management of two programs for the universal prevention of substance use offered in secondary schools by the public health services of the city of Barcelona, reviewing the period from 1989-1990 to 2016-2017. Both programs had proven effectiveness in evaluations with a comparison group, they are promoted by the public health agency free of cost, and are taught by teachers, using standardized manuals with support materials and training. The coverage achieved over recent years declined from 40% to 25%. Changes observed in the acceptance and implementation of these programs could be related with logistics and follow-up by the public health services, changes in substance availability, and with budget cuts in education. The monitoring of effective programs by public health services is essential to preserve their actual implementation.

[Reinventing a public health organization]. / Reinventando una organización de salud pública.

The most advanced organizations are decentralized, collaborative and adaptive. This gives them the ability to manage complex situations. Laloux calls these organizations Teal. The aim of this manuscript is to describe the process of implementation of the Teal management model in the Agència de Salut Pública de Barcelona (ASPB). There is a triple opportunity for innovation at the ASPB: political change towards a progressive government, the organisation is in a moment of massive renewal of its staff and there is a generational change that facilitates understanding the Laloux model, and the managers have a technical background with a long history in the organisation, which makes them aware of the organisation's capabilities. The process starts with the involvement of a small group of people (Llavor group) and it is then expanded (Planter group). As well as discussing the bases of the Laloux model, six working groups are formed (How to organise more effective meetings, Physical spaces, Spaces for reflection / trust, Time bank, Annual ASPB staff day, and Space for listening to the voice of ASPB workers) and informative workshops are organised for the whole organisation in which 67 people participated. In total, some 120 people from the organisation have participated in Planter group activities. The success of the first initiatives should help to ensure that the values and principles cultivated go beyond the frontiers of the projects to become a generalised style of management.

[Public health services: reading their available reports]. / Los servicios de salud pública: una lectura de los informes disponibles.

The objective of this study is to analyze the performance of regional public health services in Spain using the information accessible in their annual reports. A search of these was conducted, and 9 were obtained from the 17 Autonomous Communities. Their analysis shows some variation in the structure of the organizations providing public health services, as well as in the published contents and in the indicators used for management. The service portfolio, annual objectives and resources allocated are not always detailed. If the evaluation of public services and its dissemination are basic for transparency and quality management, there is much room for improvement. The compilation of annual reports by public health services is not systematic, and those that exist provide insufficient information for a comparative analysis of their activity, effectiveness and efficiency.

[Adapting the service portfolio of a public health organisation to shrinking resources]. / Adaptación de los servicios de una organización de salud pública a la disminución de los recursos.

This paper describes the review process of the Agency of Public Health of Barcelona's service portfolio in response to the budget cuts introduced since 2010 in the public administrations in Spain. A working group reviewed the different business activities, taking into account their costs and generated revenue and their justification, assessing factors such as the existence of legal constraints, tied funding, explicit demands from the founding administrations and other actors that may be capable of undertaking particular activities. The changes and their consequences are described. The new service portfolio has been consolidated and is considered ratified by the Agency board, which was renewed after political changes. We conclude that this is because it was based on professional consensus and management criteria, which are key for the smooth operation of a public autonomous executive organisation.

[Health reports as the centrepiece of public health services]. / Los informes de salud como eje de los servicios de salud pública.

The main objective of health reports is to contribute to the health improvement of a specific population. They are an essential support tool for the design and planning of health policies and can also be used for accountability and evaluation. This study assesses various types of health report, including that used by the City of Barcelona (Spain), with a focus on social determinants, as well as an international health report more centred on the impact of health services. Some suggestions are proposed about the appropriateness and best use of these documents, including: the need for effective communication between technical professionals and politicians through meetings and dialogue; commitment to transparency, both authors (by means of the declaration of interests) and in terms of the information reported and with the maximum level of participation; to promote the use of a conceptual framework of social determinants of health; a focus on health inequalities; the inclusion of information relevant to policy action; the organisation of information in such a way that it allows comparison or benchmarking with similar areas and prospectively; presenting the information in an attractive way using elements such as rankings, maps or other tools; and the design of communication strategies adapted to key stakeholders.

La especialidad en Organización y Administración de Salud Pública y la Escuela Cubana de Salud Pública / The public health organization and management specialty and the National School of Public Health

Se realiza un recorrido histórico que abarca el desarrollo de la Escuela Cubana de Salud Pública, pasando por la etapa de la Escuela de Higienistas Cubanos con el Dr. Carlos J. Finlay al frente, hasta llegar al momento actual. Se destaca la negativa repercusión de la extinción de la especialidad de Organización y Administración de Salud Pública dentro de los estudios de posgrado en Cuba desde hace más de 20 años. Se hace hincapié en que hoy más que nunca en el Sistema Nacional de Salud de Cuba resulta imposible ignorar la necesidad de la existencia de la especialidad, surgida en la práctica y desarrollada desde hace más de 200 años, que si bien se ha llamado de diversos modos en el mundo, ha sido y es el diario quehacer de un sin número de profesionales que intentan dirigir sobre bases científicas las tareas propias de los sistemas de salud. Disponer de profesionales de la salud pública competentes es una prioridad absoluta para el buen desempeño y perfeccionamiento constante del Sistema Nacional de Salud y que en la consecución de este noble propósito, la especialidad de Organización y Administración de Salud Pública, una vez que surja de nuevo con este nombre o con otro, se consolide en el tiempo y cumpla su encargo social coherentemente, podrá ser de suma utilidad

A historical review covering the development of the Cuban School of Public Health, the stage of the Cuban School of Hygienists led by Dr. Carlos J. Finlay, and the present time was made. Emphasis was made on the negative impact of the elimination of the public health organization and management specialty from the graduate studies in Cuba for more than 20 years. It is stressed that today more than ever, it is not longer possible to ignore the need for this over 200 years-old specialty to be rescued; even though it has been called differently worldwide, it has been and it is the daily work of a number of professionals who attempt to lead the tasks inherent to the health systems on a scientific basis. The availability of competent professionals in public health is a priority for good performance and constant improvement of the national health systems, and to accomplish this, the public health organization and management specialty could be very useful, once it re-emerges under the same or a new name, becomes stronger and coherently fulfils its social task