Abstract
BackgroundAs most low and middle-income countries seek to achieve universal health coverage targets, there is an ever-increasing need to train human resources with the required core skills and competencies. This study reports on a needs assessment conducted among health services organisations (HSOs) to understand postgraduate training needs and service gaps for selected public health disciplines – Health Policy and Systems, Health Economics, and Healthcare Management and Planning – at the University of Zambia.MethodsThe study adopted a cross-sectional design, comprising qualitative and quantitative components. Data were collected using semi-structured questionnaires administered to 32 representatives of purposively sampled public and private health service organisations based in Lusaka Zambia. The health services organisations included regulatory authorities, research institutions, government ministries, insurance firms and other cooperating partners.ResultsOverall (n = 22), more than 68% of the stakeholders reported that they had no employees that were formally trained in the three disciplines. More than 90% of the stakeholders opined that training in these disciplines would be beneficial in providing competencies to strengthen service provision. The horizontal skills mismatch for health economics, and health services management and planning were found to be 93 and 100%, respectively. Among the critical public health training needs were: policy development and analysis, economic evaluation, and strategic management.ConclusionsThis study confirms that introducing post-graduate training in the proposed public health disciplines will not only benefit Zambian health services organisations but also help strengthen the health systems in general. For other empirical contexts, the findings imply the need for the introduction of academic programmes which respond to ever-changing public health skills demanded. They should be matched with local priorities and service delivery.
Highlights
As most low and middle-income countries seek to achieve universal health coverage targets, there is an ever-increasing need to train human resources with the required core skills and competencies
We report on the levels of training in the specified public health disciplines, as well as the participant perspectives on the skills gaps, training needs and skills-mismatch among the sampled health services organisations
The skills gaps in health economics, health care financing and economic evaluation that we found in Zambia have been highlighted in a recent study on health economics knowledge needs assessment in Latin America [27], and many other Low- and middle-income countries (LMICs) [28, 29]
Summary
As most low and middle-income countries seek to achieve universal health coverage targets, there is an ever-increasing need to train human resources with the required core skills and competencies. The gap in human resources for health for clinical areas, e.g., medicine, nursing, pharmacy, etc., has been appreciated [1, 2], the need to train complementary public health experts, such as those involved in health promotion, health services management, health policy analysis, health economics, and health systems research, among others, has received inadequate attention. The limited attention on public health training in most Low- and middle-income countries (LMICs) is symptomatic of health systems that emphasize treatment and less investment in prevention. It has been found that 60% of all premature deaths in the United States are due to factors that need public health programs, namely, behavioural, social, and environmental circumstances, while medical care can only prevent 10% of all premature deaths [5]
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