Public Health Workforce in Switzerland: are public health workers lacking?

Professional Identity Formation in Health Promotion Practitioners: Students' Perspectives during an Undergraduate Program in Switzerland

The health promotion (HP) community advocates for capacity building, quality assurance and political awareness of HP. Professional identity (PI) is of great relevance to these goals as persons who strongly identify with their profession better adopt their professional role, raising the quality, competence and common values within a professional group. However, investigations on the HP workforce are missing. In order to investigate PI formation in HP professionals, a longitudinal study was conducted with two student cohorts of a Swiss HP and prevention undergraduate program. Using a qualitative approach, focus groups were conducted at the beginning and end of the undergraduate program. Data were transcribed verbatim and condensed using thematic analysis. The results highlight the complexity of the HP’s professional profile. While students experienced difficulties to capture the profile at the beginning of the program, at the end they developed an understanding of it. The practical experience within work placements helped students to grasp the profile and specify their future professional role. Several behavioral, cognitive and motivational aspects were identified that influence HP students’ PI formation and can be fostered. For instance, universities can commit to public relations for HP practitioners and support the PI formation throughout the study program.

Professional Characteristics of Health Promotion: A Scoping Review of the German and International Literature

Objective: This scoping review investigates current developments in the professional characteristics of health promotion (HP) with a focus on the German speaking part of Europe. The conceptualization of HP is a prerequisite for progressing HP professionalization and clarifying the interconnectedness between HP and Public Health. Methods: The search strategy was informed by sociological professionalization theories. Original publications were included in a content-based analysis. Results: Ninety publications (37 original publications) were identified in the review. The results are summarized in categories based on professional characteristics: 1) profession, 2) ethics, 3) education/training 4) competencies, and 5) quality. The professionalization of HP regarding the professional characteristics is less developed in the German compared to the international literature. Conclusion: The mixed findings emphasize the relevance of a common HP conceptualization. The HP core competencies, which have been developed by the International Union for Health Promotion and Education must be further promoted. A strong HP workforce within Public Health strengthens the HP status in policy contexts and society and its contribution to promoting health and tackling social inequalities in health.

Is there a golden recipe? A scoping review of public health workforce development

BACKGROUND

This study intended to design a suitable and comprehensive approach for a public health workforce development plan with the ultimate goal of meeting the health objectives in different European Region countries.

METHODS

We performed a scoping review, including an accurate and exhaustive country-specific hand-search process, mapping the key concepts and practices used in public health workforce development based on the available evidence worldwide.

RESULTS

We identified nine comparative measures, based on common features from a scoping literature review, for the assessment of public health workforce development plans available in selected countries. This list of nine comparative measures includes: (i) Alignment between the 10 Essential Public Health Operations (EPHOs) or core public health functions and organizational resources and public health priority areas; (ii) Regulations and Norms; (iii) Capacity Assessment; (iv) Datasets and Databases; (v) Workforce Development Strategies, Planning and Management; (vi) Education, Training, Core Competencies and Models; (vii) Licensing, Accreditation and Credentialing; (viii) Forecasting Strategies for Enumerating and Quotas and (ix) Ethical and Professional Codes of Conduct. These measures are essential to develop, sustain and modernize the public health workforce effectively.

CONCLUSION

We propose a well-balanced set of measures for countries aiming to improve or develop their public health workforce based on instruments that are successfully used and applied in a wide range of countries with different public health systems. However, the implementation should be tailored and adopted according to the specific country context and available recourses.

How to Conceptualize and Implement a PhD Program in Health Sciences-The Basel Approach

OBJECTIVES

Over the past decade, several excellent guidelines have been published on how to enhance the quality of PhD education in Europe. Aimed primarily at preparing students for innovative roles in their fields, they include variously structured approaches to curricular offerings, as well as other program components applicable across specialties (eg: supervisor support, scientific conduct, transferable skills). Since 2012, the interdisciplinary PhD Program in Health Sciences (PPHS) at the Faculty of Medicine of the University of Basel in Switzerland has focused on translating these guidelines into a 21st-century health sciences PhD program.

RESULTS

The PPHS started in 2012 based on the European Union (EU) guidelines for PhD education. This article describes the resulting interdisciplinary PhD program's conceptual underpinnings, rationale, structures, and 10 building blocks, like student portfolios, thematic training, interdisciplinary research seminars, student-initiated interdisciplinary activities, financial support of course participation, top-up and extension stipends, PhD supervision, research integrity, alumni follow-up network, and promotional tools including a dedicated website. Students enter from Clinical Research, Medicine Development, Nursing Science, Epidemiology and Public Health including Insurance Medicine, Sport Science (all from the Faculty of Medicine), and Epidemiology (Faculty of Science).

DISCUSSION AND CONCLUSION

The Basel PPHS exemplifies state-of-the-art PhD education in Health Sciences based on European guidelines and offers guidance to other groups from conceptualization to rollout of an interdisciplinary health sciences PhD program.

Post-graduate medical education in public health: the case of Italy and a call for action

Public health technical expertise is of crucial importance to inform decision makers' action in the field of health and its broader determinants. Improving education and training of public health professionals for both practice and research is the starting point to strengthen the role of public health so that current health challenges can be efficiently tackled. At the Association of Schools of Public Health in the European Region (ASPHER) Deans' & Directors' 2017 Annual Retreat, we presented the structure and management of public health training system in Italy, and we reported recent data on Italian public health specialists' educational experience, employment opportunities and job satisfaction. Public health training in Italy is implemented in the context of the post-graduate medical education residency programme in Hygiene and Preventive Medicine, delivered by 34 University-based Schools of Public Health. We report relatively high employment rates across the county and wide spectrum of career opportunities for young public health specialists. However, job security is low and training expectations only partially met. We call upon other Schools of Public Health to scale up the survey within the broad ASPHER community in a shared and coordinated action of systematically collecting useful data that can inform the development of public health education and training models, their implementation and fruitful interaction with population health, health systems and services.

Environmental and occupational health needs assessment in West Africa: opportunities for research and training

OBJECTIVES

Data are lacking on environmental and occupational health risks and resources available for the prevention of related diseases in the West African subregion.

METHODS

A needs assessment survey was conducted to identify environmental and occupational health concerns, and needs and strategies for skills training in the region. The survey was followed by a consensus-building workshop to discuss research and training priorities with representatives from countries participating in the study.

RESULTS

Two hundred and two respondents from 12 countries participated in the survey. Vector-borne diseases, solid waste, deforestation, surface and ground water contamination together with work-related stress, occupational injury and pesticide toxicity were ranked as top environmental and occupational health priorities, respectively, in the region. Top training priorities included occupational health, environmental toxicology and analytic laboratory techniques with semester-long Africa-based courses as the preferred type of training for the majority of the courses. Major differences were found between the subregion's three official language groups, both in perceived health risks and training courses needed.

CONCLUSIONS

The study results have implications for regional policies and practice in the area of environmental and occupational health research and training.

Main competences and skills to perform Essential Public Health Operations, offered by Schools of Public Health in four European countries: a short pilot report

OBJECTIVES

To consider the stage of implementation of main competences and EPHO skills in selected schools of public health in four European countries-France, Poland, Portugal, and the UK.

METHODS

By use of visual analogue scales (VAS) ranging 1-5, the leads of three schools of public health (SPH) in each of the four countries, France, Poland, Portugal and the UK, reported the strength of intellectual and practical competences as well as skills to perform essential public health operations (EPHOs), offered by their education and training programmes.

RESULTS

The self-reports indicated substantial coverage of the multidimensional public health discipline. Each country representation had its overall characteristic profile, and there was found noteworthy within-country as well as between-country variation.

CONCLUSIONS

The schools should meet the challenge of establishing collaborative networks, which will be important for public health strategy making and implementation, for shaping a coherent public health profession, and thus ultimately for population health. This pilot report should be followed up by more systematically penetrating and comprehensive analyses to identify met and unmet needs in public health education and training.

Graduate public health training in healthcare of refugee asylum seekers and clinical human rights: evaluation of an innovative curriculum

OBJECTIVES

An innovative curriculum was developed to equip public health students with appropriate attitude and skills to address healthcare of asylum seekers.

METHODS

Implemented in 2005 the curriculum included: (1) didactic sessions covering epidemiology and health sequelae of torture, asylum laws, and approaches to identify survivors' healthcare needs; (2) panel discussions with survivors and advocates; and (3) participating in medico-legal process of asylum seeking. Complementary mixed methods evaluations included pre- and post-curriculum questionnaires, formal curriculum evaluations, final papers and oral presentations.

RESULTS

125 students participated. Students showed improved knowledge regrading sequelae of abuse and survivors' healthcare needs (P < 0.01), improved attitudes towards working with survivors (P < 0.05) and self-efficacy in identifying at-risk populations and addressing healthcare of survivors (P < 0.05). Students reported increased desire to pursue global health and human rights careers.

CONCLUSIONS

As an advocacy and cultural competency training in public health practice addressing healthcare of refugees domestically, this curriculum was well received and effective, and will also help students better serve other similar populations. Population case-based domestic opportunities to teach global health and health and human rights should be effectively utilized to develop a well-equipped global health corps.

How to characterize the public health workforce based on essential public health operations? environmental public health workers in the Netherlands as an example

Background

Public health workforce planning and policy development require adequate data on the public health workforce and the services provided. If existing data sources do not contain the necessary information, or apply to part of the workforce only, primary data collection is required. The aim of this study was to develop a strategy to enumerate and characterize the public health workforce and the provision of essential public health operations (EPHOs), and apply this to the environmental public health workforce in the Netherlands as an example.

Methods

We specified WHO’s EPHOs for environmental public health and developed an online questionnaire to assess individual involvement in these. Recruitment was a two-layered process. Through organisations with potential involvement in environmental public health, we invited environmental public health workers (n = 472) to participate in a national survey. Existing benchmark data and a group of national environmental public health experts provided opportunities for partial validity checks.

Results

The questionnaire was well accepted and available benchmark data on physicians supported the results of this study regarding the medical part of the workforce. Experts on environmental public health recognized the present results on the provision of EPHOs as a reasonable reflection of the actual situation in practice.

All EPHOs were provided by an experienced, highly educated and multidisciplinary workforce. 27 % of the total full-time equivalents (FTEs) was spent on EPHO ‘assuring governance for health’. Only 4 % was spent on ‘health protection’. The total FTEs were estimated as 0.66 /100,000 inhabitants.

Conclusions

Characterisation of the public health workforce is feasible by identification of relevant organisations and individual workers on the basis of EPHOs, and obtaining information from those individuals by questionnaire. Critical factors include the operationalization of the EPHOS into the field of study, the selection and recruitment of eligible organisations and the response rate within organisations.. When existing professional registries are incomplete or do not exist, this strategy may provide a start to enumerate the quantity and quality of the public health within or across countries.

Good governance competencies in public health to train public health physicians

OBJECTIVES

This study aimed at assessing public health residents' perceived health system governance (HSG) training needs and to define a competency framework for "good governance" to improve Public Health physicians' curricula.

METHODS

A questionnaire was administered to all Italian medical residents on postgraduate courses in Hygiene and Preventive medicine. Twenty-five (78.1%) of the 32 Italian Schools of Public Health and 299/535 residents (55.9%) took part in this survey. The public health governance competency framework was developed from roles and responsibility at different levels of governance in the Italian Health System context.

RESULTS

The questionnaire revealed that residents felt the need for more training on all the proposed HSG-related topics. Different governance functions, strategic planning, operational planning, and operational programming were considered when defining roles and responsibilities.

CONCLUSIONS

More efforts should be made to provide organic training plans tailored to the needs of local and national health system. The competencies framework for good governance could be useful for planning professional training in both the academic and the health system settings.

European accreditation and the future public health workforce

BACKGROUND

In 2011 the Agency for Public Health Education Accreditation (APHEA) was initially launched focusing on Master level (second cycle) education.

METHODS

Between 2012 and 2013 the Association of Schools of Public Health in the European Region, APHEA and partner schools conducted a study on the compliance of Master level programmes of public health to the accreditation criteria. A web-based survey of second cycle programmes of public health across 29 countries was conducted using the APHEA criteria. The 29 countries were categorized into four regions: Northern, Southern, Central and Eastern and Western. We applied a Chi square test to identify regional differences with regard to the compliance of the programmes to the criteria.

RESULTS

Data from 51 out of 71 schools contacted were analyzed. The compliance to the two themes of student and faculty exchange and quality management were lowest for programmes of public health throughout the EHEA. There were significant differences in the compliance between the regions with higher compliance in the Northern European region.

CONCLUSIONS

Student and faculty exchange and quality management are essential for schools and programmes of public health to improve the quality of their education through expanding international knowledge and the pertinence of skills taught within European and national contexts. The results show that there are intrinsic issues with exchange and quality management as well as the role of national accreditation agencies in defining public health education for the future workforce.

Profile of the public health workforce: registered TRAIN learners in the United States

OBJECTIVES

We analyzed data from the TrainingFinder Real-time Affiliate Integrated Network (TRAIN), the most widely used public health workforce training system in the United States, to describe the public health workforce and characteristics of individual public health workers.

METHODS

We extracted self-reported demographic data of 405,095 learners registered in the TRAIN online system in 2012.

RESULTS

Mirroring the results of other public health workforce studies, TRAIN learners are disproportionately women, college educated, and White compared with the populations they serve. TRAIN learners live in every state and half of all zip codes, with a concentration in states whose public health departments are TRAIN affiliates. TRAIN learners' median age is 46 years, and one third of TRAIN learners will reach retirement age in the next 10 years.

CONCLUSIONS

TRAIN data provide a limited but useful profile of public health workers and highlight the utility and limitations of using TRAIN for future research.

Time, place, and people: composition of the EPIET Alumni Network and its contribution to the European public health resource in 2013

The EPIET Alumni Network (EAN) is an association of professionals who have completed field epidemiology or public health microbiology training programmes in the European Union. In 2013, we conducted a survey of EAN members to investigate this network's role within European public health. We distributed an online questionnaire to members registered at the time, collecting data on demographics, professional background, and attitudes towards EAN. Out of 362 registered members, 189 (52%) responded; 97% were from Europe; 65% were female. Their mean age was 39 years. The highest academic qualification was PhD for 44% and Master's degree for 55%. The majority (60%) worked in public health institutes. They were especially satisfied with having access to job offers and professional networking via EAN, but requested more learning opportunities and knowledge-sharing between members. EAN is a unique platform where highly skilled professionals can connect to control infectious diseases locally and internationally. Having a network of professionals that know each other, speak the same 'language', and can easily access each other's expertise, represents an important resource for European and global public health, which should be nurtured by encouraging more collaborations devoted to professional development.