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

Ophthalmology Census 2021: A Demographic Characterisation of Ophthalmologists in Portugal

INTRODUCTION

Human resources in ophthalmology have recently received particular attention, and it has been questioned whether there is a sufficient number of workers. The aim of this study was to analyze and characterize Portugal's ophthalmologist population.

METHODS

In this descriptive, cross-sectional study, an online questionnaire was sent to all ophthalmologists registered with the Portuguese College of Ophthalmology in December 2021. Information on the following variables was collected and analyzed: demographic factors, professional qualifications, professional activity, weekly professional activity and medium-term plans.

RESULTS

Among the 910 registered ophthalmologists, a response rate of 64.7% was achieved. There were 0.9 ophthalmologists for every 10 000 inhabitants, 0.45:10 000 working in the public sector (0.35:10 000 full-time equivalent). Among the respondents, 57.6% were over 50 years old (59.6% male), 97.3% were Portuguese, 46.7% completed their residency in the Lisbon region, 27.3% complemented their programme with additional training, 9.5% had a PhD and approximately 58% lived and worked in large urban centres. Regarding professional activity, 58.5% of the respondents worked in the public sector (4.2% exclusively), while 67.9% worked in different economic sectors. The median number of weekly working hours reported was 45 hours, with those in the public sector reporting 35 hours. Private/social sector work and public sector work accounted for 12 926 hours/week and 10 808 hours/week, respectively. It was found that 31.4% of the respondents provided emergency medical services and that 52.8% performed surgical procedures more than once a week. Looking ahead, 38.7% of the ophthalmologists intended to reduce their workload within the next five years due to family reasons, fatigue and demotivation. The projected rate of retirement or cessation of activity in the next five years was estimated to be 1.7%, while an average of 20 new ophthalmologists are expected to enter the profession annually, resulting in a generational balance of 0.8%.

CONCLUSION

While the number of ophthalmologists in Portugal meets the international recommendations, there is a shortage in the public sector and most ophthalmologists work in large urban centres. The number of ophthalmologists in Portugal is expected to be stable for the next five years.

No Two Workforces Are the Same: A Systematic Review of Enumerations and Definitions of Public Health Workforces

The delivery and coordination of public health functions is essential to national and global health, however, there are considerable problems in defining the people who work in public health, as well as estimating their number. Therefore, the aim of this systematic review was to identify and explore research which has defined and enumerated public health workforces. In particular, how were such workforces defined? Who was included in these workforces? And how did researchers make judgments about the size of a workforce? In this systematic review, we identified 82 publications which enumerated a public health workforce between 2000 and November 2018. Most workforce definitions were unique and study-specific and included workers based on their occupation or their place of work. Common occupations included public health nurses and physicians, epidemiologists, and community health workers. National workforces varied by size, with the United States and Switzerland having the largest public health workforces per-capita, although definitions used varied substantially. Normative assessments (e.g., assessments of ideal workforce size) were informed through opinion, benchmarks or “service-target” models. There are very few regular, consistent enumerations within countries, and fewer still which capture a substantial proportion of the public heath workforce. Assessing the size of the public health workforce is often overlooked and would be aided by fit-for-purpose data, alignment of occupations and functions to international standards, and transparency in normative methods.

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.

Education and training in public health: is there progress in the European region?

BACKGROUND

The Association of Schools of Public Health in the European Region (ASPHER) is confronted with challenges to improve education for public health professionals. In this article, we attempt to answer the question: Did ASPHER members improve their organization and programmes to enable their graduates to acquire the competences to tackle the diverse areas of public health defined in the Ten Essential Public Health Operations (EPHOs)?

METHODS

ASPHER run two surveys among its membership: In 2011, 66 Schools and Departments of Public Health (SDPHs) took part (82.5%), while in 2015-16, 78 SDPHs (81.3%). The performance of graduates was estimated using a Likert scale.

RESULTS

In 2015-16, the SDPHs delivered 169 academic programmes (2.2 on average per SDPH). Among the SDPHs participating in both surveys, significant differences could not be determined, neither for the organization (except increasingly using social media) nor for teaching areas. The performance of graduates did not show significant differences except for the deterioration of EPHO-8 ('assuring sustainable organizational structures and financing'). However, the qualitative data revealed progressive dynamics regarding innovations in the organizational set-up, digitalization, teaching/training, introduction of new modules and research.

CONCLUSIONS

The results generated do not allow us to state that the innovative elements introduced after the first survey in 2011 have had a clear impact reflected in the second survey carried out in 2015-16, but perhaps this is due to the need for a broader follow-up in order to objectify the potential consequences derived from the boost generated by the changes introduced.

Sustaining success: aligning the public health workforce in South-Eastern Europe with strategic public health priorities

OBJECTIVES

To map out the Public Health Workforce (PHW) involved in successful public health interventions.

METHODS

We did a pilot assessment of human resources involved in successful interventions addressing public health challenges in the countries of South-Eastern Europe (SEE). High-level representatives of eight countries reported about success stories through the coaching by experts. During synthesizing qualitative data, experts applied triangulation by contacting additional sources of evidence and used the framework method in data analysis.

RESULTS

SEE countries tailored public health priorities towards social determinants, health equalities, and prevention of non-communicable diseases. A variety of organizations participated in achieving public health success. The same applies to the wide array of professions involved in the delivery of Essential Public Health Operations (EPHOs). Key enablers of the successful work of PHW were staff capacities, competences, interdisciplinary networking, productivity, and funding.

CONCLUSIONS

Despite diversity across countries, successful public health interventions have similar ingredients. Although PHW is aligned with the specific public health success, a productive interface between health and other sectors is crucial for rolling-out successful interventions.

Enumerating the preventive youth health care workforce: Size, composition and regional variation in the Netherlands

The progress in workforce planning in preventive youth health care (YHC) is hampered by a lack of data on the current workforce. This study aimed to enumerate the Dutch YHC workforce. To understand regional variations in workforce capacity we compared these with the workforce capacity and the number of children and indicators of YHC need per region. A national survey was conducted using online questionnaires based on WHO essential public health operations among all YHC workers. Respondents (n=3220) were recruited through organisations involved in YHC (participation: 88%). The YHC workforce is multi-disciplinary, 62% had >10 years working experience within YHC and only small regional variations in composition existed. The number of children per YHC professional varied between regions (range 688-1007). All essential public health operations were provided and could be clustered in an operational or policy profile. The operational profile prevailed in all regions. Regional differences in the number of children per YHC professional were unrelated to the indicators of YHC need. The essential public health operations provided by the YHC workforce and the regional variations in children per YHC professional were not in line with indicators of YHC needs, indicating room for improvement of YHC workforce planning. The methodology applied in this study is probably relevant for use in other countries.