Withdrawn as Duplicate: Public Health competences: Prioritisation and leadership

Digital Public Health stands for the integration and use of digital tools, automation, use of modelling and prediction, and personalisation and precision into public health services that build on improved access to health data and analytics. To capitalise on the opportunities that digital transformations offer to the mission of public health, the public health workforce needs education and training to develop the relevant digital competencies. With few exceptions, however, digital skills still need to become a routine part of public health training. Barriers to incorporating digital public health in public health training include uncertainty about what to teach, how to teach it, and who to teach it to. Firstly, digital competencies in public health are an evolving concept, making it challenging for education designers to make the necessary changes to public health curricula. Secondly, public health programmes already incorporate considerable subject matter, making the simple addition of content challenging. Finally, the rapid development of digital technologies requires us to find ways to develop closer collaboration with experts in information and communication technologies. Across Europe, experience in overcoming these barriers is emerging. This session will examine current developments in digital public health education and training and craft a roadmap for effectively including digital public health in public health training across Europe. The workshop will feature presentations of recent or ongoing research projects in which the speakers examine efforts to define a generic set of digital competencies for public health training in Europe. The presentations will include insights from a scoping review of international guidance on digital competencies for public health practice, two Delphi studies defining digital competencies for general public health education in Germany and in Europe, expert guidance for public health schools on integrating digital competencies into curricula, and a mapping of training experiences in a course on digital health literacy for public health professionals. An interactive discussion will follow, during which the presenters and participants will critically examine the emerging set of digital competencies for public health education and discuss potential next steps for implementation. Workshop participants will leave the workshop with an in-depth understanding of the current progress and outstanding challenges in incorporating digital competencies in public health education and training across Europe. Key messages • Digital competencies are a critical component of 21st-century public health, but uncertainty about what to teach, how to teach it, and to whom to teach it needs to be addressed. • This workshop will examine progress in defining digital competencies for public health and craft a roadmap for effectively including digital skills in public health training and education in Europe.

Advancing the Science of Delivery

Reflecting on my journey as a public health student, trainee, worker, scientist, and administrator, it is always important to remind myself why I embarked on this journey in the first place. I came from a developing part of the world, where I saw my neighbor toil in the field while taking care of several young children at the same time. One day she disappeared for a few weeks from the field. I found out later that she had given birth to another child. Since immigrating to the United States, I have been privileged to be educated in two schools of public health. After many years in the public health work-force, these images from my childhood still provide me with the drive and passion for my chosen career. Over the years, I have worked under two guiding principles. First, the primary role of the public health workforce is to eliminate the health disparities among nations, peoples, communities, and neighborhoods. Second, educational institutions that provide training in public health are instrumental in preparing individuals that can make this happen. Thus, it is vital that these institutions effectively educate the future public health workforce. In the United States, the Association of Schools of Public Health represents the 40 schools of public health accredited by the Council on Education for Public Health. These accredited schools are located throughout the United States, Puerto Rico, and Mexico, and have a combined 4000-member faculty, 19000 students, and 7000 graduates per year. The number of students enrolled in doctoral public health programs has substantially increased over time. The schools also collaborate and provide technical assistance to many public health training institutions worldwide. This increased communication and shared knowledge creates an important global community of public health leaders. In recent years, the communication of knowledge and information has changed in a number of ways. The Internet has modernized the traditional modalities of public health education, ranging from universal rapid access of peer-reviewed publications to the availability of formal and informal public health education online. The open course-wares offered by some universities have been particularly helpful in broadening access to valuable coursework for populations that would otherwise be geographically or financially unable to access this information. Distance learning and open sharing of course materials have enabled on-the-job training and continuing education worldwide. Another important development is the borderless nature of emerging public health threats, such as severe acute respiratory syndrome, avian flu, or natural disasters such as tsunamis, cyclones, and earthquakes. The schools of public health can take a substantive leadership role, not only in the relief of disasters, but also in the short- and long-term rehabilitation of the victims and their families. Such initiatives can cut across many disciplines and life-span specializations within the schools. They can take these opportunities to teach and inspire their students to be active world citizens while practicing their public health skills. Schools can also rally their alumni to contribute their services to provide multiple forms of relief to disaster victims. Several articles in this issue articulate many of these ideas. These papers address topics such as public health doctoral education, educational technology, and competencies, whereas others address the effects of poverty, health disparities, and tsunamis. It is especially important during these times of recent natural disasters that the public health community unites to provide support for the world in need.

Knowing and applying the basic management functions of planning, organizing, staffing, directing, and controlling, as well as their permutations and combinations, are vital to effective delivery of public health services. Presently, graduate programs that prepare public health professionals neither emphasize teaching management theory, nor its application. This deficit puts those who become managers in public health and those they serve at a distinct disadvantage. This deficit can be remedied by enhanced teaching of management subjects.

SPECIALTY GRAND CHALLENGE article Front. Public Health, 18 July 2013Sec. Public Health Education and Promotion https://doi.org/10.3389/fpubh.2013.00020

HRSA's Investment in Public Health Training Centers.

Background:Environmental health (EH) professionals, one of the largest segments of the public health workforce, are responsible for delivery of essential environmental public health services. The challenges facing these professionals and research needs to improve EH practice are not fully understood, but 26% of EH professionals working in health departments of the United States plan to retire in 5 y, while only 6% of public health students are currently pursuing EH concentrations.Objectives:A groundbreaking initiative was recently launched to understand EH practice in health departments of the United States. This commentary article aims to identify priority EH practice challenges and related research needs for health departments.Methods:A horizon scanning approach was conducted in which challenges facing EH professionals were provided by 1,736 respondents working at health departments who responded to a web-based survey fielded in November 2017. Thematic analyses of the responses and determining the frequency at which respondents reported specific issues and opportunities identified primary EH topic areas. These topic areas and related issues informed focus group discussions at an in-person workshop held in Anaheim, California. The purpose of the in-person workshop was to engage each of the topic areas and issues, through facilitated focus groups, leading to the formation of four to five related problem statements for each EH topic.Discussion:EH professionals are strategically positioned to diagnose, intervene, and prevent public health threats. Focus group engagement resulted in 29 priority problem statements partitioned among 6 EH topic areas: a) drinking water quality, b) wastewater management, c) healthy homes, d) food safety, e) vectors and public health pests, and f) emerging issues. This commentary article identifies priority challenges and related research needs to catalyze effective delivery of essential environmental public health services for common EH program areas in health departments. An unprecedented initiative to revitalize EH practice with timely and strategic recommendations for student and professional training, nontraditional partnerships, and basic and translational research activities is recommended. https://doi.org/10.1289/EHP5161

Terms such as the public health workforce, certification, credentialing, and competencies comprise the “language” of public health practice but the challenges involved in preparing the public health workforce are extensive and range from not only defining the public health workforce but also identifying in what areas students and practitioners of this field should demonstrate competence. The challenges presented herein are not exaggerated but are very real for many public health systems. A broad view is one in which the public health worker is an individual who works to achieve the essential public health services. Yet, there are many public health practitioners who lack the Master of Public Health (MPH) degree and recent public health graduates who lack field experience. The Council on Linkages between Academia and Public Health Practice serves as our beacon for preparing a competent public health workforce. This body developed competencies in the core public health areas for the entry-level practitioner, program manager, and senior executive. This is our blueprint from which to start implementing some form of standardization in the public health workforce. A related controversial topic for many in public health practice and education has been the Certified in Public Health (CPH) credential. This is a relatively new option for public health students and graduates, and more recently for those who have an MPH degree and have been practicing public health for a while, to further assist with professionalizing the field. This chapter examines who comprises the public health workforce, issues inherent in enumerating the public health workforce, the Institute of Medicine (IOM)’s call to action to correct a dysfunctional public health system by preparing the public health workforce via education and training, and what initiatives contribute to developing a competent public health workforce.

The aim of this study is to investigate the impact of Public Health Accreditation Board (PHAB) accreditation on the delivery of public health services and on participation from other sectors in the delivery of public health services in local public health systems. This study uses a longitudinal repeated measures design to identify differences between a cohort of public health systems containing PHAB-accredited local health departments and a cohort of public health systems containing unaccredited local health departments. It uses data spanning from 2006 to 2016. This study examines a cohort of local public health systems that serves large populations and contains unaccredited and PHAB-accredited local health departments. Data in this study were collected from the directors of health departments that include local public health systems followed in the National Longitudinal Study of Public Health Systems. The intervention examined is PHAB accreditation. The study focuses on 4 areas: the delivery of core public health services, local health department contribution toward these services, participation in the delivery of these services by other members of the public health system, and public health system makeup. Prior to the advent of accreditation, public health systems containing local health departments that were later accredited by PHAB appear quite similar to their unaccredited peers. Substantial differences between the 2 cohorts appear to manifest themselves after the advent of accreditation. Specifically, the accredited cohort seems to offer a broader array of public health services, involve more partners in the delivery of those services, and enjoy a higher percentage of comprehensive public health systems. The results of this study suggest that accreditation may yield significant benefits and may help public health systems develop the public health system capital necessary to protect and promote the public's health.

The study examined the effect of employee commitment on organizational performance in public health service delivery in Accra, Ghana, against the backdrop of persistent resource constraints and service delivery challenges within the public health sector. Anchored in organizational commitment theory, the study adopted a quantitative research design to assess how affective, continuance, and normative commitment influenced key performance indicators, including service efficiency, quality of care, employee productivity, adherence to protocols, and patient satisfaction. Data were collected from 65 employees in five selected public health institutions using structured questionnaires. A stratified random sampling technique was employed to ensure representation across employee categories and facility types. Data analysis employed descriptive statistics and inferential techniques to determine the strength and direction of relationships between employee commitment and organizational performance. The findings revealed that higher levels of employee commitment were significantly associated with improved organizational performance, particularly in terms of service efficiency, teamwork, accountability, and quality of care delivery. In addition, the study found that supportive leadership practices and access to professional development opportunities significantly strengthened employee commitment, thereby indirectly enhancing organizational performance outcomes. The study concluded that employee commitment constitutes a critical driver of effective public health service delivery and organizational effectiveness. Consequently, the study provides empirical evidence to inform policy and managerial decisions, emphasizing the need for targeted human resource strategies, leadership development, and capacity-building initiatives to strengthen employee commitment and achieve sustainable improvements in public health service delivery in Ghana.

The New Public Health(NPH) is a comprehensive approach to protecting and promoting the health status of each individual member and society as a whole. NHP is not so much a philosophy to broaden the understanding of public health as it is an action plan to address current public health system. This paper`s objectives include increasing public and professional awareness of the significant changes in the national public health systems of developed countries and contributing to more effective delivery of public health services in Korea. This paper reviews articles and documents concerning NPH and the public health system, and outlines of the achievements in developed countries since NPH movement began. These include the change in the definition and function of public health, expansion of public health networks, strengthening of public health policy, reorientation of public health delivery systems, promotion of workforce capacity, and the implementation of evidence-based management. To overcome the challenges facing the public health system of Korea, we must prioritize the value of population-based approach, expand the notion of a public health system to encompass all sectors that can influence health, promote a Health in All Policies approach, focus on an evidence-based health policy and program, develop core competencies for public health workers, and establish performance standards for public health organizations based on the core functions of public health.

Strong and effective leadership is essential for the success of public health systems. It serves as the driving force that inspires, guides, and empowers individuals to improve the health of their communities and strengthen their organizations. Leadership is not merely supplementary but a core element in tackling the increasingly complex challenges facing public health today. The COVID-19 pandemic exposed significant weaknesses in our systems for emergency preparedness and response, highlighting just how critical capable leadership is within governmental public health. These challenges are magnified by persistent workforce issues, including knowledge gaps, limited development opportunities, and concerns around long-term sustainability. Further complicating the landscape are rising levels of political polarization and incidents of harassment directed at public health professionals. In response to these pressures and a growing wave of workforce attrition, there is now a heightened national focus on developing the next generation of public health leaders. This development must be intentional and structured, relying on well-designed, competency-based approaches rather than informal or inconsistent methods. Public health leaders must be equipped with the skills to navigate the evolving demands of modern health systems. In 2022, the Association of Schools and Programs of Public Health (ASPPH) convened an expert panel to develop a national leadership training agenda tailored to the governmental public health workforce. The panel consisted of 15 academic and practice leaders in the United States. Between 2022 and 2024, the panel met regularly to define the essential attributes of public health leadership and determine effective strategies for cultivating them through education and capacity-building efforts. The result of this collaborative effort is the ASPPH Public Health Leadership Competency Mapping and Training Agenda: a foundational framework designed to strengthen capabilities across current and future governmental public health professionals. This article presents that framework, marking an important step toward building a more resilient, competent, and adaptive public health workforce.

Background The COVID-19 pandemic is raising new questions on public health competences and leadership and on health workforce preparedness for global public health emergencies of this magnitude. This study aims to explore the new demand and opportunities for innovation in public health competencies, which were caused by the COVID-19 crisis. Methods We draw on secondary sources and critically review the public health competency framework recently launched by WHO and ASPHER through the lens of COVID-19. Results The WHO-ASPHER Competency Framework for Public Health Workforce illustrates an interdisciplinary, inter-professional and lifelong learning approach to public health. Five critical competency areas can be identified in relation to global public health emergencies: (1) flexibility, adaptation, motivation, communication, (2) research, analytical sensitivity, ethics, diversity, (3) epidemiology, (4) preparedness and (5) employability. However, this may not be enough. New models of public health leadership and changes in the health workforce are needed, which transform the silos of professions and policy. Such transformations would include learning, working, leading and governing differently and must stretch far beyond the public health workforce. Innovating public health competences stretches far beyond individual competence development. Moreover, it is about resilience and preparedness and calls for learning, working, leading and governing differently. Critical public health competences are not limited to the public heath workforce, but must become relevant for all healthcare professions. Conclusions To achieve transformative capacity, critical public health competences must be considered for all healthcare workers on all levels of policymaking, thus becoming the ‘heart' of health workforce resilience and pandemic preparedness. Key messages Innovating public health competencies calls for learning, working, leading and governing differently. Public health competences must be considered for all healthcare workers and transform professional silos.

Public health service delivery in South Africa is plagued by a myriad of challenges which has intensified in the last decade. Exploring barriers to service delivery is fundamental for problem-solving, and evident that solutions to healthcare challenges cannot be addressed by government alone. Collaborative efforts between public, private and civil society sectors are imperative if national development goals and international pacts are to be honoured. The empirical study looked into public-private partnerships (PPPs) to improve delivery of cataract surgery in the uMgungundlovu District, KwaZulu-Natal. Cataracts are one of the leading causes of avoidable blindness globally. Inequitable distribution of resources, fiscal limitations, neglect of infrastructure, amongst others, led to considerable delays for surgery, rendering people avoidably blind. The study explored health-related administrative and management barriers to effective public eye health service delivery establishing if a publicprivate health forum implemented in the district contributed to improved service delivery. Theorised within the Logic Model and 5C Protocol, it allowed for reflection and connection between policy and practice. Qualitatively, the study was conducted through interviews of Public-Private Eye Health Forum stakeholders including healthcare workers and managers. Results were analysed using content and thematic analysis. Emergent themes included lack of reliable patient information systems as a hindrance to eye health service delivery, and the benefit of PPPs to address cataract surgery burden in the public sector. Health forums as a means to improving access to health service delivery must leverage strengths and resources of each sector. It is recommended that a partnership model for such forums be designed with monitoring and evaluation indicators built into formative planning processes, observed and managed throughout implementation. Whilst guidelines for PPPs exists in theory, unique construct of forums in practice ought to consider administratively sound frameworks for successful implementation. Uniformity in processes and reporting systems are necessary for successful collaborative engagements.

Introduction: The future physician will face a career challenged by a number of significant changes in healthcare, including changes in demographics and disease, an increasing focus on population health and value-based care, and changes in healthcare funding. National organizations have called for medical schools to better prepare students for these challenges, and to incorporate more public health education in medical school. While many medical schools have responded, the topics covered, the timing in the curriculum, and the importance of these topics for graduation vary widely. Florida has been a site of growth in medical education in the last 10 years. Given that new medical schools were developed during a period of increased emphasis on the need for public health education, a survey was developed to assess the state of public health education in medical schools accredited by the Liaison Committee for Medical Education (LCME) in the state of Florida.Methods: The survey included questions on school location, size of the student body, date of initial LCME accreditation, presence of department or school of public health, and presence of a pathway or track in public health. The survey asked detailed questions about public health content, curricula delivery methods, and timing of the curriculum within the four-year course of study as well as the courses providing public health content. The survey asked about the value of curricular content and the survey itself. The online survey was sent to the associate or senior associate deans for education in the seven LCME accredited schools who had full or provisional accreditation as of December 2017. Data collection occurred between March 14 and March 30, 2018.Results: Six of the seven medical schools responded. Of the eleven competencies included in the survey, schools reported between five and eleven. Three schools cover nine or more of the eleven competencies. The number of competencies covered was not statistically influenced by age of the school, percentage of underrepresented students in medicine, the presence of a school or department of public health, or a special pathway or track in public health. The most common teaching method used was a didactic lecture, and the least was the structured experience with a local health organization. The fourth year of medical school saw the least amount of public health education. Five of the six respondents felt that the competencies presented here are very important to extremely important, and one school feels that they are moderately important.Discussion: Nationally, education in public health is an important component in medical education, but the topics included, educational methods used and the importance of the content varies from school to school. The state of public health education in medical schools in Florida is robust in some schools. The individuals responsible for the curriculum support the importance of these topics. The content is delivered through a diversity of pedagogical methods. The study results demonstrate a number of opportunities for enhancement.Conclusion: Given the importance of public health content in medical schools, survey methodology using established competencies to assess public health curricula could be used in the US to provide an up-to-date assessment of the strengths and opportunities for improvement in this area.