Training Of Public Health Professionals Research Articles

Ready or not? The state of emergency preparedness among Italian Public Health medical residents

Abstract Background Italy frequently experiences major events like earthquakes, floods, and migrant shipwrecks, reflecting global concerns that also include climate change, pandemics, and wars. This study aims to assess the role of public health experts and the current state of Italian post-degree Public Health schools in addressing these challenges. Methods In June 2023, a cross-sectional online survey was administered to all Italian Public Health residents enrolled in the Italian Society of Hygiene, Preventive Medicine, and Public Health (SItI). The survey investigated the availability and frequency of training and updates related to emergencies, measured the interest and perceived importance of these topics among residents, examined the impact of the COVID-19 pandemic on their awareness, and identified their primary sources of information in the subject. Results Out of 289 respondents, a significant majority (86.2%) acknowledging the importance of being trained in emergency management and 74.4% expressed interest in topic (p < 0.001). A 90.1% of residents indicated a lack of dedicated courses and 93.1% reported an absence of specialized master’s programs (p < 0.001). There was a strong correlation between recognizing the importance of the topic and the desire to attend specialized conferences (p < 0.001). The COVID-19 pandemic had a noticeable impact: 24.6% recognized the importance of the topic pre-pandemic, while 50.9% raised awareness during (p < 0.001). Conclusions The findings highlight a critical gap in the training of public health professionals in Italy, particularly in the domain of emergency preparedness and management. There is a pressing need to establish enhanced, uniform training programs across different public health training networks in Italy. Implementing such programs would ensure a more robust and effective response to future emergencies, thereby safeguarding public health and improving outcomes during crises. Key messages • Significant gap in specialized training and awareness among health professionals. • Urgent need for emergency preparedness training in public health.

HOPE—A UNIQUE MODEL TO PROVIDE ORAL HEALTH SERVICES FOR NURSING HOME RESIDENTS

Abstract Optimal oral health care is an essential component of primary health care for all individuals but especially among the older adults due to chronic health issues and polypharmacy. Moreover, there are several barriers to oral health care for the older adults that include but are not limited to cost of dental care, lack of perceived need for care, dearth of transportation, and fear for dental care. To address these barriers to access, UT Health San Antonio School of Dentistry launched Holistic Oral Health Program for Elders (HOPE) program that aims to address oral health needs of nursing home residents living within a 65-mile radius of San Antonio, TX. The HOPE team is formed of trained dental and public health professionals who work together as a group to ensure that preventive, palliative, and clinical oral health services are provided to all eligible residents of the nursing home. For successful implementation of the HOPE program, the team efficaciously completed several critical steps while planning and developing the program, such as- establishing a relationship and procuring contracts with several nursing homes, collaborating with social workers and nurses, and following an interprofessional approach to provide oral health care to the nursing home residents. Since its inception, the HOPE program has successfully signed contract agreements with several nursing homes and has addressed the oral health needs of more than 300 nursing home residents. The HOPE program aims to continue serving this vulnerable and underserved population to address their oral health needs.

7.H. Round table: Legal determinants of health - what do (global) public health professionals need to know?

Abstract Public health and legal systems have different objectives and operate under different frameworks, which can create challenges for public health professionals who need to implement policies and interventions that are legally sound. While public health seeks to promote and protect the health of the population, the legal system focuses on protecting individual rights and ensuring justice is served. One major challenge is that public health interventions can sometimes conflict with individual rights, such as privacy or freedom of movement. Another challenge is the complexity of the legal system. Public health professionals may not have the legal expertise or resources to navigate the legal system. To address these challenges, it is important for public health professionals to collaborate with legal experts and policymakers. As recognised in the 2019 Lancet-O'Neill Institute Commission on Global Health and Law, such collaboration helps to develop effective and legally sound public health policies and interventions to address the legal determinants of health and promote global health and sustainable development. Moreover, there is a growing recognition of the importance of interdisciplinary training for professionals in both law and public health. Law and public health schools are increasingly offering joint degree programs or courses that address the intersection of law and public health. This can help to build a workforce with the necessary skills and knowledge to effectively address public health issues within the legal framework. The WHO-ASPHER Competency Framework for the Public Health Workforce in the European Region was published in 2020 encompassing competencies in law and regulations. This Round Table aims to raise awareness of the importance of legal policies and practices to promote public health outcomes, and collaboration and interdisciplinary approaches, to address health-related legal issues. The three short presentations will be followed by a discussion between the panellists and participation of the audience. First, the legal determinants of health will be addressed, including the human rights dimensions, and examine the impact legislative and regulatory frameworks and jurisprudence have on the enjoyment of the right of health. Second, legal epidemiology will be discussed as an important and innovative approach to understand the complex relationships between legal policies, social determinants of health, and health outcomes, and how it works to guide policy development, advocacy, implementation and accountability for impact. Third, the importance of incorporating legal education into public health training programs is highlighted. Examples of practical measures to incorporate this information and build these skills in the training of public health professionals will be discussed. Key messages • Understanding legal determinants of health is crucial for (global) health professionals in addressing health inequities and improving health outcomes for individuals and populations. • Interdisciplinary structures are needed in which law and health work together and schools of public health are an excellent vehicle for bridging the gap. Speakers/Panelists Brigit Toebes University of Groningen, Groningen, Netherlands Scott Burris Temple University Beasley School of Law, Philadelphia, USA Kasia Czabanowska Maastricht University, Maastricht, Netherlands Monica Brînzac EUPHAnxt

A systematic review of real-world contact tracing strategies at the onset of the COVID-19 pandemic

Abstract Background Contact tracing (CT) represented one of the core activities for the prevention and control of COVID-19 in the early phase of the pandemic, before the availability of effective vaccines. Poor evidence is available on the real-world implementation of CT strategies and adoption of CT digital tools during the initial phase of the emergency. Methods We aimed to provide a comprehensive picture of the organizational aspects of CT activities during the first wave of the pandemic, through the identification and description of CT strategies used in different settings during the period March-June 2020 and of digital tools adopted in the early phase. A systematic review of published studies describing organizational models of COVID-19 CT strategies and digital tools used in real-world settings was conducted. PubMed, Embase and Cochrane Library were searched. Results We retrieved a total of 1,637 studies, 30 of which met all our inclusion criteria. Seven studies target the general population, 10 studies described CT activities carried out in specific population subgroups, 13 described the use of CT apps in real world settings. Main activities implemented to rapidly scale-up CT activities included decentralization of CT, involvement of trained non-public health resources (e.g. University students, civil servants), use of digital tools for CT management, inter-agency collaboration, community engagement. Digital apps proved to be a useful supplementary component in CT strategies, however their acceptability was hampered by privacy, equity and effectiveness's concerns. Conclusions Despite the lack of data on CT effectiveness, available evidence provides indication on coordination mechanisms and use of human and technical resources needed for the rapid scale up of CT activities. Further research on real world implementation of CT strategies during the COVID-19 pandemic would be needed to contribute to a more robust evidence-making process. Key messages • Decentralization of CT activities, involvement of trained non public health professionals, intersectoral collaboration were the key components of early COVID-19 CT strategies. • The use of smartphone apps and other digital tools proved to be a substantial support for CT activities. However, privacy, ethics and equity issues must be clearly addressed.

Quō vādis? from disaster management to building community resiliency: Medical reserve corps and their unique potential

BackgroundMedical Reserve Corps (MRC) in the U.S. provide an approach to organize and incorporate trained public health and medical professionals and supplement the current public health workforce. During the COVID-19 pandemic, MRCs provided immunizations, educated the general public, and assisted with community screening and testing. Reports of MRC activities are publicly available; however, their challenges are not well discussed. Therefore, this exploratory study aimed to identify some challenges that MRC units faced during the COVID-19 pandemic. MethodsThis cross-sectional pilot study aimed to address the composition, recruitment, and training of MRC volunteers and their responses during the pandemic. The survey consisted of 18 close-ended questions across 3 domains: (1) structure and designation of the MRC unit, (2) recruitment and training opportunities for volunteers; (3) demographics; and 2 open-ended questions. ResultsA total of 568 units across 23 states were invited to participate in this exploratory study with only 29 units completing the survey. Out of 29 respondents, 72% were female and 28% male, 45% were nurses, 10% were physicians, and 5% were pharmacists. Retired members were reported in 58% of MRC units, while 62% reported members being active professionals. Qualitative analysis revealed two themes - Obstacles faced by MRC units and Interdisciplinary Composition. ConclusionsIn this exploratory pilot study, we identified the challenges of MRC units during the COVID-19 pandemic. Our findings indicated variation in composition and type of volunteers at different MRC units that may be considered in planning for future disasters and emergencies.

Building Program Evaluation Capacity Through an Online Training for Graduate Students at Schools and Programs of Public Health.

Program evaluation is an essential function for public health professionals that is necessary to acquire funding for public health programs and support evidenced-based practice, but coverage of program evaluation principles and methodology within the master of public health (MPH) curriculum is inconsistent and may not adequately prepare students to conduct program evaluation activities postgraduation, especially on culturally responsive program evaluation. We examined the effectiveness of an online training course on program evaluation topics. In July 2021, we recruited current and recently graduated MPH students from accredited US universities to measure the effectiveness of a 1-hour online training course in program evaluation. We distributed pre- and postsurveys to eligible participants. We assessed program evaluation skills on a 4-point Likert scale to determine improvements in knowledge (from 4 = extremely knowledgeable to 1 = not knowledgeable), attitudes (from 4 = strongly agree to 1 = strongly disagree), and self-efficacy (from 4 = strongly agree to 1 = strongly disagree). Among 80 MPH students who completed the survey, respondents indicated mean (SD) increases from presurvey to postsurvey in knowledge (from 2.13 [0.66] to 3.24 [0.54]) and attitudes (from 3.61 [0.51] to 3.84 [0.30]) toward program evaluation and in self-efficacy in conducting program evaluation (from 2.92 [0.71] to 3.44 [0.52]). The course may be an effective approach for training public health professionals about program evaluation. Our results provide a basis for revising the way program evaluation is taught and practical recommendations for integrating program evaluation competencies within public health curricula, such as by incorporating a self-paced training course for continuing education.

THE GLOBAL PUBLIC HEALTH CURRICULUM: Specific Global Health Competences

The 2nd edition of the Global Public Health Curriculum has been published in the South Eastern European Journal of Public Health, end of 2016 as a special volume (editors Ulrich Laaser & Florida Beluli) at: http://www.seejph.com/index.php/seejph/article/view/106/82. The curriculum targets the postgraduate education and training of public health professionals including their continued professional development (CPD). However, specific competences for the curricular modules remained to be identified in a more systematic approach. To that end from the international literature the following references have been used as a general orientation:A) Armed Forces Medical College (AFMC) Resource Group, GHEC Committee, India: Global health essential core competencies. At: https://lane.stanford.edu/portals/ihealth-pdfs/BasicCore_Competencies_Final2010.pdfB) Dias M. Et al.: Global Health Competencies for UK Health Professionals. TECHNICAL REPORT · SEPTEMBER 2015. At: http://www.researchgate.net/publication/283086441C) Association of Schools and Programs of Public Health (ASPPH): The Global Health Competency model. At: www.aspph.org/educate/models/masters-global-health/D) World Health Organisation (WHO): WHO GLOBAL COMPETENCY MODEL. At: www.who.int/employment/competencies/WHO_competencies_EN.pdfE) Jogerst K et al.: Identifying Interprofessional Global Health Competencies for 21st Century. At: https://www.cfhi.org/sites/files/files/pages/global_health_competencies_article.pdf

Technology transfer during the COVID-19 pandemic: report on the first face-to-face practical training course in Brazil.

Technology transfer can take place at large events, as long as safety protocols are strictly enforced. It is important to disseminate, at these events, the concepts of the Responsible Research and Innovation (RRI). Implications for services: Face-to-face training course is fundamental for training public health professionals. Technology transfer between research institutions and health services results in updating and improving health system performance. Based on the success of the reported technology transfer, a new module will be incorporated into the next edition of VEME (Panama 2022), entitled Virus Evolution to Public Health Policy Makers. The objective of this report was to describe the first face-to-face course aimed at training public health professionals in performing real-time genomic surveillance during the pandemic period. Experience report on a theoretical-practical course focusing on genomic research and surveillance, including mobile sequencing technologies, bioinformatics, phylogenetics and epidemiological modeling. There were 162 participants in the event and it was the first major face-to-face training course conducted during the COVID-19 epidemic in Brazil. No cases of SARS-CoV-2 infection was detected among the participants at the end of the event, suggesting the safety and effectiveness of all safety measures adopted. The results of this experience suggest that it is possible to conduct professional training safely during pandemics, as long as all safety protocols are followed.

The Impact of Air Pollution on the Incidence of Asthma: A Comparative Analysis of Regional Factors

Air quality is closely related to human health and has attracted the attention of governments and people around the world. This paper aims to study whether there is a concrete link between the development of asthma and air pollution. By adopting comparative analysis, it examines three regions (Seoul, Sydney, and San Joaquin Valley) in terms of how different sources of air pollution affect the incidence of asthma. The results indicate that agricultural and industrial pollution cause asthma outbreaks worst in certain areas. The implication of this paper is that the local governments should develop programs to train public health professionals through public health networks. These health networks provide practical training in epidemiology and strategic planning, and help achieve effectively Communication with other health professionals and the public through public speaking, academic reports and scientific investigations, while advocating for other community managers for improved community health. In the meanwhile, it is crucial to improve local air quality through reasonable environmental regulation.

Training Public Health Professionals on Adaptive Challenges-An Innovative Approach Using Remote Learning Modalities.

Remote learning opportunities increase access to public health training. Innovative approaches are needed to promote active engagement and learning when tackling more complex, adaptive challenges that are nuanced, lack quick and easy solutions, and require a transformation of values and beliefs. The Rocky Mountain Public Health Training Center's (RM-PHTC's) training framework considers the complexity of the challenge (technical to adaptive) when selecting the learning modality. Remote learning opportunities on adaptive challenges are addressed using virtual workshops, online courses, ECHO (Extension for Community Healthcare Outcomes) series, and communities of practice that include a combination of multiple sessions, cohort-based learning, peer learning, practice-based application, and live, interactive sessions. The specific modality chosen depends on the audience and amount of content delivery. Virtual workshops are single events that encourage peer learning using a blend of instruction and practice-based work. Online courses deliver content to learning cohorts through an online platform combined with multiple, facilitated "live learning sessions." ECHO series include a short delivery of content, combined with multiple, facilitated, face-to-face, case-based learning sessions with a cohort of peers. Communities of practice encourage a bidirectional peer exchange of resources, approaches, and challenges through online sharing platforms and virtual meetings. Using the Kirkpatrick training evaluation model, learners of public health reported that their understanding of the subject matter improved and that they had identified actions that they would apply to their work. In qualitative feedback, learners shared feedback on elements that facilitated learning on adaptive challenges, including interactive breakout groups with peers and practice-based applications. Remote learning opportunities increase access for public health professionals in rural areas and encourage knowledge exchange region-wide. The RM-PHTC's training framework matches learning opportunities that address adaptive challenges with modalities that include elements that encourage the sharing of ideas and cocreation of solutions.

Student reflections on an interdisciplinary pandemics course utilising systems thinking.

The complexity and uncertainty of the COVID-19 pandemic highlights the need to change training of public health professionals in higher education by shifting from siloed specialisations to interdisciplinary collaboration. At the end of 2020 and 2021, public health professionals collaboratively designed and delivered, a week-long intensive course-Public Health in Pandemics. The aim of this research study was to understand whether the use of systems thinking in the design and delivery of the course enabled students to grasp the interdisciplinary nature of contemporary health promotion and public health practice. Two focus group interviews (n=5 and 3/47) and a course opinion survey (n=11/47) were utilised to gather information from students regarding experiences and perceptions of course design and delivery, and to determine if students felt better able to understand the complex nature of pandemics and pandemic responses. Students provided positive feedback on the course and believed that the course design and delivery assisted in understanding the complex nature of health problems and the ways in which health promotion and public health practitioners need to work across sectors with diverse disciplines for pandemic responses. The use of an integrated interdisciplinary approach to course design and delivery enabled students used systems thinking to understand the complexity in preparing for and responding to a pandemic. This approach may have utility in preparing an agile, iterative and adaptive health promotion and public health workforce more capable of facing the challenges and complexity in public health.

Meeting case investigation and contact tracing needs during COVID-19 in Alberta: the development and implementation of the Alberta Health Services Pod Partnership Model.

SettingIn Alberta, a small team of specialized public health experts typically complete case investigation and contact tracing. High COVID-19 case counts and a shortage of trained public health professionals required a rapid and significant adaptation of staffing models to meet the population’s needs.InterventionA tiered, interdisciplinary staffing model, based on those in critical care, was developed, piloted, and implemented in the Alberta Health Services’ Communicable Disease Control department in late 2020 to complete case investigation and contact tracing. The final model included novice, non-regulated professionals divided into pods of four to six investigators, led by an experienced regulated investigator. Team leads oversaw five pods. Communicable disease nurses provided an additional tier of clinical expertise. During the model development, roles and responsibilities of team members were delineated, ratios for supervision were tested, and rapid training was provided.OutcomesThe tiered staffing model began in November 2020 with staff members in two pods. At its peak in early May 2021, 72 pods of 502 non-regulated members, 134 regulated investigators, and 4 communicable disease nurses completed 780–973 case investigations daily, or 40–45% of all positive cases in Alberta. In comparison, the same number of regulated investigators working independently in the traditional staffing model without non-regulated pods completed, on average, 249 case investigations daily.ImplicationsA tiered staffing model can be effective at maximizing the skills of the experienced members of the case investigation team to maintain case investigation and contact tracing activities during a pandemic.

Increasing the Capacity of Youth-Serving Professionals: Evaluation of the Online Social Justice Approach to Youth Engagement Course

There has been increased commitment to youth engagement in public health. However, those seeking to engage youth often lack the knowledge and skills to sustain meaningful youth engagement, constraining the potential positive impacts. Unfortunately, there is a paucity of training programs for practitioners who seek to increase their capacity to engage youth authentically. Given the need to train adults who work with youth, we developed and evaluated an online course to support public health and social service professionals in a social justice approach to youth engagement. During this 7-week course, grounded in social justice youth development theory, participants analyzed how power, privilege, and oppression operated in their own lives and engaged in conversations about disrupting systems of power that oppress young people. Fifty-eight participants completed the course as part of four cohorts, and 41 participants completed a survey (71% response rate) at all four time points (pre, post, 3-month, and 6-month follow-up). Paired t tests showed that participants experienced significant changes ( p < .0001) in their confidence to implement practices and curricula associated with social justice youth development, critique and provide evidence-informed recommendations to their organizational setting, and describe and disrupt adultism—the systematic subordination of youth by adults. Effects were sustained 6 months post course. Qualitative responses to survey items further supported the positive benefit of the course on their professional youth work. This course provides a promising model for training public health and social service professionals on how to authentically work with youth through a social justice lens.

Training Public Health Professionals to Tackle Women, Children, and Families Health Issues: A "Skill-Based Qualitative Learning Approach".

Purpose: There are several teaching and learning approaches but finding the one that is appropriate for a particular field or training program is an arduous task. The purpose of this paper is to introduce the “Skill Based Qualitative Learning Approach” (SBQLA) in training health professionals.Description: The SBQLA is a pedagogical approach via which learners are trained in developing qualitative questionnaires and interview skills to learn from experts in the Public Health (PH) field. This teaching approach arms students with interview skills that help them identify and address PH roadblocks and get them authentic information from experts. It also equips them with techniques on how to do formalized presentations and come up with projects and interventions that help mitigate and eliminate drivers of health problems among women, children and families.Assessment: Learners' field experiences are shared in a professional presentation style in a class to help trainees benefit from each other's information and to get formalized feedback on their presentation. Assessment in this learning approach is based on a synthesis and an analysis of data collected from professionals.Conclusion: Findings from this learning approach enables experts to shed light on true stories shared by real and authentic individuals whose faces can be associated with their shared experiences. This learning approach makes it possible for trainees to also initiate projects that help them tackle existing and emerging public health issues in their future work.

Evaluation of Advanced Field Epidemiology Training Programs in the Eastern Mediterranean Region: A Multi-Country Study.

Field Epidemiology Training Programs (FETPs) are competency-based training programs aiming to strengthen the epidemiologic capacity of the public health workforce. This study aimed to evaluate the impact of the advanced FETPs in the Eastern Mediterranean region (EMR) and ascertain whether the expected objectives of the programs are met. A descriptive study was conducted based on Kirkpatrick's model for evaluating training programs. Data were collected from FETP graduates and FETP technical advisers on the practices of FETP graduates, their engagement in key areas of field epidemiology, and their perceived skills and capacity to perform such activities. A total of 166 FETP graduates responded to the online survey. Almost two-thirds of FETP graduates reported that they are often engaged in managing public health surveillance systems (n = 119, 71.7%), analyzing the surveillance data (n = 116, 69.9%), training public health professionals (n = 113, 68.1%), investigations on and response to outbreaks (n = 109, 65.7%), and managing staff and resources (n = 106, 63.9%). However, only 28.3% reported that they are often engaged in writing scientific research articles. More than two-thirds of graduates reported that the FETP helped them to perform most of the field epidemiology activities and rate their skills as good. In conclusion, the FETP graduates in the EMR were well engaged in many field epidemiology activities including managing public health surveillance systems, surveillance data analysis, training public health professionals, and investigations on and response to outbreaks. Therefore, the FETPs should continue supporting the graduates to work toward strengthening surveillance systems and investigating outbreaks and to participate in regional and global efforts as part of the Global Health Security.

Atuação do psicólogo no Núcleo de Apoio a Saúde da Família: uma experiência em um programa de residência multiprofissional

INTRODUÇÃO: A residência é uma modalidade de pós-graduação que se caracteriza pelo treinamento em serviço, tendo como base a aprendizagem pela prática cotidiana. Programas de residência multiprofissional objetivam capacitar profissionais para o exercício qualificado na Atenção Básica de Saúde, a porta de entrada principal do Sistema Único de Saúde (SUS), por meio de metodologias ativas, trabalho em equipe e cuidado humanizado. OBJETIVO: Relatar a experiência e a inserção do psicólogo, enquanto residente, em um programa de residência multiprofissional em Saúde da Família. MÉTODO: Foi realizado o relato de experiência de uma profissional da psicologia enquanto residente do Programa de Residência em Saúde da Família. A presente experiência ocorreu entre março de 2018 e março de 2020 e as seguintes atividades foram descritas: (a) matriciamento, (b) acolhimentos e atendimento individuais, (c) realização de grupos, (d) educação em saúde, (e) consultas compartilhadas e (f) visitas domiciliares. RESULTADOS: Pode-se afirmar que o processo de formação de profissionais em saúde pública constitui um desafio a gestores, educadores e trabalhadores envolvidos neste processo. Dificuldades em relação ao estímulo simultâneo de habilidades profissionais, interpessoais e humanísticas, bem como senso crítico sobre responsabilidade social são comuns. Ainda assim, a proposta de programas residência é uma oportunidade significativa de aprendizado e contato com outras áreas de saúde. CONCLUSÃO: Diversas limitações puderam ser identificadas ao longo das atividades cotidianas da residência, tal como falta de conhecimento dos profissionais sobre a estratégia de saúde da família e o papel da residência multiprofissional no serviço de saúde.

Faculty Perspectives on Teaching Public Health at Community Colleges: An Exploratory Snapshot

The role of community colleges in training public health professionals is of growing importance to the continuum of public health education. Some 5 years have passed since the Framing the Future initiative outlined curricular models at community colleges, and colleges deploying these models are serving as learning sites for public health education at community colleges. While past research has focused on capturing insights from community college executives and program administrators, this study captures perspectives from teaching faculty. Drawing on a national sample of teaching faculty at community colleges and universities accepting transfer students throughout the United States, an online survey of teaching faculty affiliated with public health programs was coupled with follow-up interviews. This study characterizes the nature and scope of public health programming in community colleges and transfer settings, and highlights associated challenges and opportunities as public health becomes further integrated into health professions pathways in 2-year settings and beyond.

Case for rethinking system leadership and its development in public health

Abstract Background There is growing recognition of the importance of leadership in Public Health (PH) practice, and the need to embed it into the education and training of PH professionals. However the theoretical discourse within leadership research has changed significantly and there is recognition that previous conceptualisations of leadership, and our ways of developing it may be flawed, and need to be changed in practice. Objectives This presentation will discuss development of leadership theory, and system leadership. In particular it will highlight how System Leadership differs from previous understandings of leadership and the implications of this for ph practitioners and those charged with developing system leadership capacity within public health. Body of the session Leadership in organisations is mostly focused on current/anticipated internal challenges (strategy, performance management, staff engagement, etc.). Leaders are generally developed via individual leader development rather than a focus developing Leadership capacity across organisations/systems. Within PH it is increasingly realised that single organisations can no longer respond effectively to the “wicked” issues they face. They do not possess sufficient know-how to address the complex and multi-dimensional problems faced, so leadership models based on a single hierarchical organisation are not sustainable. There is a need to work collectively in an ecosystem-based approach (not an ego-based system). System Leadership development requires that participants are actively engaged in real attempts to improve PH System. Development requires that underlying values are made explicit, explored and diversity embraced. The emphasis will be on supporting learners in the doing rather than critiquing or talking about it. Conclusions There is need to appreciate fully the nature of systems leadership, together with implications for PH practice and the development of system leadership capacity throughout the PH workforce.

Capacity building in the public health field in the Tunisian medical faculties

Abstract Over the past years, Tunisia has experienced important reforms in the field of public health. The Tunisian medical faculties (Universities of Sfax, Tunis el Manar, Sousse and Monastir) play a key role in this endeavor by training public health professionals who can contribute to the modernization of the health system. Funded by the EC through Erasmus+ programme, the CONFIDE project (coordinated by Babes-Bolyai University, having as EU partners the Universities of Southern Denmark and Trnava, and the above mentioned Tunisian universities) has established the Research into Policy training programme by strengthening their capacity to provide public health training. The Research into Policy training programme has been delivered by the Centres for Evidence into Health Policy (C4EHPs) established within the Tunisian partner universities for the needs of CONFIDE. The training programme was implemented in four steps: (1) train the trainer sessions - the European experts trained 18 Tunisian trainers; (2) shadowing sessions - the trainers participated in shadowing sessions in the European partner institutions; (3) training delivery - the CONFIDE trainers, assisted by the European experts, delivered the training to an interdisciplinary group of 25 students and professionals; (4) internships - the students participated in internships in local health institutions. Three modules have been built within the Research into Policy training programme: Public health research, Health promotion policies and Evidence based public health policy. They contributed to increasing the public health knowledge and skills of the professionals trained. The training programme was well received by the Tunisian universities and the material developed so far during the project was adapted to the Tunisian context in the third step of implementation. On the long term, the project is expected to have an impact at the national level and produce updates at curricula level in the Tunisian medical faculties. Key messages Research into Policy training programme developed by the EC partners and culturally adapted by the Tunisian partners to the Tunisian public health context. Research into Policy training is a well-received tool for the high quality learning process in the public health field in Tunisian medical faculties.

Managerial and Operational Hindrances to Polio Eradication: A Case Study of Tehsil Katlang, Mardan, Pakistan

The study aims to analyse managerial and operational hindrances to polio eradication process in Tehsil Katlang, District Mardan using quantitative research method i.e. questionnaire and statistical analysis. A sample size of 200 respondents i.e. polio workers of health department, staff of WHO and UNICEF are selected through proportionate stratified random technique. Bi-variate analyses are conducted with the help of Chi-square test. The study results concludes a significant association between polio eradication process and maintenance of cold chain, lack of transportation facility to polio staff, accessibility with reference to locality, training opportunities of polio workers, lack of trained public health professionals, workers dissatisfaction from salaries, timely payment of NIDs remuneration, unnecessary bureaucratic interventions and influences in Expended Program on Immunisation (EPI), lack of proper evaluation of National Immunisation Days (NIDs) campaign and security threats to polio workers. Further, a non-significant association is ascertained between polio eradication and timely availability of vaccines to EPI workers, effects of load shedding on maintenance of cold chain and proper monitoring of NIDs campaign. The findings state that the program needs proper management process for cold chain and transportation facilities. Salaries of the workers need to be increased and NIDs remuneration needs to pay on time. Various training programs should be initiated for workers and shortage of staff should be removed. Security arrangements for polio workers may be enhanced.