Practical competencies for public health education: a global analysis

OBJECTIVES

We quantified the contents of existing public health competency frameworks against the elements of the World Federation of Public Health Associations' Global Charter for the Public's Health.

METHODS

We conducted a desktop analysis of eight public health competency frameworks publicly available on the internet. Using a pre-formed template, competency statements from each framework were mapped against the elements of the Global Charter-core public health services (Protection, Promotion and Prevention) and overarching enabling functions (Information, Governance, Capacity, and Advocacy). We then quantified coverage of the Charter's elements in each of the frameworks.

RESULTS

We found that although the public health competency frameworks vary considerably in terms of coverage and focus, they all cover every element contained in the Global Charter. However, there were a number of areas of competency identified in some frameworks not explicitly referred to in the Charter including cultural safety, human rights and systems thinking.

CONCLUSIONS

The Global Charter provides a mechanism for comparing competency sets, checking public health curricula content, informing competency framework and curricula (re)design, and planning and monitoring workforce needs.

A questionnaire study of the negative outcomes for UK health professional volunteers in low and middle income countries

INTRODUCTION

Past research has reported considerable benefits of international health professional volunteering for British healthcare professionals; however, there are also some negative outcomes reported. Negative outcomes reportedly happen on a personal, professional and organisational level. However, there is little evidence of the frequency they might occur.

METHODS

We aimed to understand what the negative outcomes of health professional volunteering in low-income and middle-income countries were, and how frequently they occurred, in an opportunistic sample of UK health professionals. We used a questionnaire developed using potential negative outcomes reported in the peer-reviewed papers. We conducted secondary analysis on cross-sectional questionnaire data from 222 healthcare professionals.

RESULTS

This research provides an indication of the frequency that negative outcomes might occur. Post hoc analyses revealed that some outcomes were experienced by the majority of health professional volunteers, for example, lack of formal recognition (131/169, 78%) and financial cost (92/169, 68%). While others happened less, for example, a reliance on agency or locum work (12/169, 7%) and loss of pension (31/169, 18%).

CONCLUSION

The outcomes reported in this research quantify some of the concerns that have been raised in previous literature. Negative outcomes might be associated with certain features of volunteering and further research is needed to prospectively compare different features. Organisers of volunteering opportunities should be aware of the potential negative outcomes and engage with the research into negative outcomes to generate and apply findings about minimising potential negative outcomes, carefully balancing these against the needs of the host country.

Fit for the future? The place of global health in the UK's postgraduate medical training: a review

OBJECTIVES

That health is now global is increasingly accepted. However, a 'mismatch between present professional competencies and the requirements of an increasingly interdependent world' has been identified. Postgraduate training should take account of the increasingly global nature of health; this paper examines the extent to which they currently do.

DESIGN

Trainees across 11 medical specialties reviewed the content of their postgraduate curriculum.

SETTING

Not relevant. PARTCIPANTS: None.

MAIN OUTCOME MEASURES

Competencies were coded as 'UK' (statement only relevant to UK work), 'global' (statement with an explicit reference to aspects of health outside the UK) or generic (relevant both to the UK and international settings).

RESULTS

Six of the 11 curricula reviewed contained global health competencies. These covered the global burden or determinants of disease and appropriate policy responses. Only one College required trainees to 'be aware of the World Health Organization', or 'know the local, national and international structures for health care'. These cross-cutting competencies have applicability to all specialties. All 11 curricula contained generic competencies where a global health perspective and/or experience could be advantageous, e.g. caring for migrant or culturally different patients.

CONCLUSION

Trainees in all specialties should achieve a minimum requirement of global health awareness. This can be achieved through a small number of common competencies that are consistent across core curricula. These should lead on from equivalent undergraduate competencies. Addressing the current gap in the global health content of postgraduate medical curricula will ensure that the UK has health professionals that are trained to meet the health challenges of the future.

Placements in global health masters' programmes: what is the student experience?

BACKGROUND

Global health training is increasingly part of public health training in high-income countries, with placements as key components. We sought preliminary evidence of student placement experiences and learning through masters' programmes at the universities of Oxford and Toronto.

METHODS

In a mixed-methods design, we drew on existing programme records, student feedback surveys (Oxford only) and semi-structured interviews with graduates.

RESULTS

Students participated in practice, informed policy and conducted research across a wide variety of topics, and with a range of different tasks, mostly overseas. Building on existing collaboration- or partnership-facilitated placement setup. Clear communication and face-to-face time with organizational representatives or on-site supervisors helped clarify placement objectives. Flexibility on students' and supervisors' part enabled students to take advantage of urgent public health activities for learning. Students valued the opportunity to make cross-country comparisons, to see first-hand the role of international organizations and to learn concrete skills in project design, questionnaire formulation, qualitative and quantitative analysis and writing up.

CONCLUSIONS

Placements were valuable to public health professionals in training. We encourage other programmes to share placement experience of their students, field supervisors and host organizations.