The aim of this study is to map the chronological achievements of public health over the past 100 years in a small island state and to outline emerging themes. A retrospective analysis of data was conducted from the published population and vital statistics reports of the Central Statistical Office for the period of 1953-2006, as well as all available published reports of the Ministry of health. Data were also collected from the published reports of the Registrar General for the period of 1944-52. The study demonstrated the sequence in which diseases of public health importance were eliminated; these included hookworm, smallpox, malaria, cholera, typhoid, yellow fever and the vaccine preventable diseases such as measles, mumps, rubella, poliomyelitis, diphtheria, tetanus and pertussis. In addition, for the first time the mumps epidemic of 2000-2003 was identified. While much has been achieved over the past 100 years particularly with regard to infectious diseases, many challenges stand ahead. Hence, a highly trained and skilled PH workforce is required to confront a changing healthcare landscape, epidemics, rising expectations from clients, as well as to tackle key determinants of health.

Operational research (OR) is a relatively new, applied branch of mathematics, which helps provide a scientific base for the management and problem‑ solving. At present, its application in public health issues is gaining importance both nationally and internationally, particularly in program management and policy making. It is an interdisciplinary team approach that requires managers and researchers to work together toward identification of the problems and implementation of optimal solutions. There is rising importance accorded by international and national agencies to invest resources in OR and guide program implementation in public health, and the global fund to fight TB, AIDS, and malaria allows up to 10% of each grant to be allocated for OR. There are multitude of research methods used in the field of health. These fields of OR, implementation research, and health system research are a source of confusion for researchers. OR may sometimes be used interchangeably with implementation research or under the subheading of health system research. OR using various qualitative and mathematical models provides solutions which are currently being applied to overcome the obstacles in health policy making and implementation. Integration of OR with monitoring and evaluation is a new paradigm in program management. This paper aims to summarize the theme, relevance, approach, methods, and applications and challenges of OR in the field of public health and how it had led to policy changes in the field of health.