Presentation on Public Health Competencies

Presenter: Pratikshya Kisiju (Roll
5)
PUBLIC HEALTH
COMPETENCIES
MPH 1st Sem, 2021,
Pokhara University 1

Outline
 Preface
 Key Terminologies
 Public Health Competencies
 Core Public Health Competencies
 Guiding Document/Framework
 Issues
 Way Forward
2

Concept
What?
Skills
Who?
Public Health
Professionals/Workforce
How?
Public Health
Academia/Trainings
Where?
Public Health Practice
Organizations
Why?
Public Health Goals
3

Public Health Professionals
• Public health professionals: have university-level
qualifications and occupy positions exclusively or
substantially focused on population health.
• Academia, Research, Policy Development, program
implementation and community based interventions &
health promotion in different public, private health
organizations & I/NGOs.
‘Key component & the foundation of a strong national
public health infrastructure.’
4

5
Competent public health professionals for?
Population- focused system wide health services
Evidence Based practices in policy formulation and health services
Serve the present & future public health needs and mission

A growing range of public health challenges globally and nationally
HEALTH DISPARITY
Globalization
Pandemics
POLLUTION
Non-communicable
Diseases
Poverty
Climate Change
PUBLIC
POLICY
Population
Growth
Infectious
Diseases
6

Key terminologies
 Competency
 Competency Set
 Competency Domain
 Core Competencies
 Discipline-Specific Competencies
 Cross-cutting Competencies
Major Public Health
competencies
7

Terminologies at a Glance
Competency: Combination of skills,
knowledge, abilities, behaviors, & other
characteristics that a professional needs
to carry out occupational functions
Competency Set: Describes what a PH
worker should be able to do or
demonstrate.
Competency Domain: Individual
competencies are organized into
‘Domains’.
8

Core competency : Reflect the common understanding & set of skills,
knowledge and attitudes necessary or desirable for the broad practice of
public health. Required for all public health professionals, in all positions,
throughout the organization
Discipline Specific Competencies: Special knowledge, skills or abilities that
are not possessed by all public health professionals & required for a
particular aspect of public health.
Cross-cutting Competencies: Interdisciplinary competencies that
transcend the boundaries of the specific disciplines within public health.
E.g. IPR, Communication, Leadership, Human biology, Professionalism,
Ethics, political awareness, conflict management
9

Review of the
framework by
 Established in 1992 to implement the recommendations of
the Public Health Faculty/Agency Forum.
 Adopted in May 2010 ( has 3 versions; latest version is 2014)
Mission
To improve the performance of individuals & organizations within
public health by
 fostering, coordinating, and monitoring collaboration among the
academic, public health practice, & healthcare communities;
 promoting public health education & training for health
professionals throughout their careers;
 & developing & advancing innovative strategies to build &
strengthen public health infrastructure.
10

Review of the
framework by
o A framework for Putting the Core Competencies
for Public Health Professionals into Practice
o A collaborative of 23 national organizations
11

Core competency tiers
• Each core competency differentiated into one of 3 tiers
which reflect stages of public health career development.
• The individual competencies within the tiers build upon
each other, describing desired skills for professionals at
progressive stages of their careers
Tier 1- Entry level
Tier 2- Supervisors and Managers
Tier 3- Senior Managers and Leaders/CEOs
12

Tier 1 : Entry level
• Apply to PHP carrying daily tasks of public health organizations & are not in
management positions
• Responsibilities like: basic data collection & analysis, fieldwork, outreach
activities, programmatic support, & other organizational tasks
Tier 2: Mid Level
• Apply to mid-level PHP with program management & supervisory roles
• Responsible for program development, program implementation, program
evaluation, establishing community relations, managing timelines &
workplans, presenting arguments, recommendations on policy issues.
Tier 3: Senior Level professionals
• Applies to PHPs like senior level managers &/or leaders of public health
organizations
• Responsible for major programs or functions of a public health
organization, setting a strategy/vision, &/or building organization’s culture.
E.g. ED, CEOs.
13

Core Competency PH Domains
1. Analytical/Assessment Skills
2. Policy Development/Program Planning Skills
3. Communication Skills
4. Cultural Competency Skills
5. Community Dimensions of Practice Skills
6. Public Health Sciences Skills
7. Financial Planning and Management Skills
8. Leadership & Systems Thinking Skills
14

Competency Domain & Examples
1. Analytic/Assessment Skills
o Identifying & understanding data,
o Turning data into information for action,
o Assessing needs & assets to address community health needs,
developing community health assessments, &
o Using evidence for decision making.
2. Policy Development/Program Planning Skills
o Determining needed policies & programs;
o Advocating for policies & programs;
o Planning, implementing, & evaluating policies & programs;
o Developing & implementing strategies for continuous quality
improvement; &
o Developing & implementing community health improvement plans &
strategic plans.
16

3. Communication Skills
o Assessing & addressing population literacy;
o Soliciting & using community input;
o Communicating data & information;
o Facilitating communications; &
o Communicating the roles of government, health care, & others.
4. Cultural Competency Skills
o Understanding & responding to diverse needs,
o Assessing organizational cultural diversity & competence,
o Assessing effects of policies/programs on different populations, &
o Taking action to support a diverse public health workforce.
17

5. Community Dimensions of Practice Skills
o Evaluating & developing linkages & relationships within the community,
o Maintaining & advancing partnerships & community involvement,
o Negotiating for use of community assets, &
o Evaluating effectiveness & improving community engagement.
6. Public Health Science Skills
o Understanding the foundation & prominent events of public health,
applying public sciences to practice,
o Critiquing & developing research
o Using evidence when developing policies/programs, &
o Establishing academic partnerships.
18

7. Financial Planning & Management Skills
o Engaging other government agencies that can address community health
needs,
o Leveraging public health & health care funding mechanisms,
o Developing/defending budgets,
o Motivating personnel,
o Evaluating & improving program & organization performance, &
o Establishing & using performance management systems to improve
organization performance.
8. Leadership & Systems Thinking Skills
o Incorporating ethical standards into the organization; creating
opportunities for collaboration among public health, health care, & other
organizations; mentoring personnel; adjusting practice to address
changing needs & environment; ensuring continuous quality
improvement; managing organizational change; & advocating for the role
of governmental public health.
19

Issues related to
Public Health Competency
20

How are Public Health
practitioners trained
around the Globe &
Nepal? Do those trainings prepare
them to adequately address
present & future Public
Health challenges?
21

Scenario
 There is a lack of internationally agreed universal set of
defined competencies or approaches to public health
education/training.
 Also, large inadequacies in synchronizing
‘educational competencies’ to ‘professional competencies’
(leaving them ill-prepared for the real world scenario)
22

Assessment of graduate public health education in Nepal and perceived
needs of faculty and students. Human Resource for Health , 2013
‘What the non-clinician says
is underestimated, they are
not taken
seriously.’ (Alumni)
‘…we are public health students but
there isn’t any public health expert
teacher here.’ (Student)
‘… Even though I don’t have any special
training as such in epidemiology, [in
general] I teach everything - field
epidemiology, molecular epidemiology,
medical epidemiology.’ (Faculty
member)
‘… Google is
our best
professor.’ (S
tudent)
‘The most neglected section of this institute is
public health. In that, I think the most neglected
degree is MPH.’ (Student)
‘Their background influences
their way of teaching,
perception and explanation …
they always relate medicine
with public health.’
(Student, about clinicians
as public health faculty)
‘Their attitude is that it is just a job to earn a living, not
actually to run this program. When such faculty trains
students, most of them will turn out to be the same
too.’ (Student) 23

Issues regarding PH Competency, Academia &
Professionalization in Nepal
o The Identity crisis: Being overlooked in the health sector owing to a
general lack of understanding what PHPs do, among general public
and politicians.
o Multidisciplinary & multisectoral nature of public health as a
challenge to organize public health education/competencies
o Although recently minimum criteria for university/colleges delivering
PH degrees are set, they aren’t properly adhered to & effective
monitoring systems not implemented.
o Red-tapism in public universities and public health organizations
causing delay in important decision making.
24

Issues….
o Lack of sound academic environment, specially in private/affiliated
colleges due to poor infrastructure, faculty quantity & quality as well
as political environment.
o Traditional academic system ; Unrevised curriculum; gap between the
public health theories & practice, thus a frequent trial & error
attempts to learn skills required in professional settings.
o Inadequate specializations in public health.
o Significant number of students bound to opt abroad for expensive
higher studies in public health. (both an issue as well as an
opportunity)
o Dire need of strong mechanism to evaluate the standard of skills of
PHP based on their competencies.
o Poor linkage of academic institutions with MoH, DoHS, & other health
organizations.
25

Issues…
26
o Mismatch in production & consumption of PH graduates >>
Unemployment>> switching career owing to job insecurity
o Lack of relevant public health placements as per the
qualifications.
o Low opportunities for continuing professional development
opportunities

Way forward
27
o Continuing advocacy for increased extent of awareness of significance
of public health among politicians & general public
o COVID-19 as eye-opener to rethink public health and invest on it
o Revision of current public health curricula as per the core
competencies to balance theory with practical problem-solving skills
and real world scenarios.
o Transformative competency-based curricula that subsume focus on
analytical abilities, leadership and management capabilities,
communication skills, and a culture of critical inquiry & research
o Effective mechanisms for accreditation of universities as well as the
professionals to sustain quality

Way Forward
28
o Developing & operationalizing a competency framework of public
health professionals in Nepalese context through extensive research
and collaboration
o Preparing a public health workforce that can be recognized as the
strategic lead of health in community.
o Innovative and skill based learning with exposure to advanced
technology in teaching learning like student exchange programs
o Collaboration within; between universities & multiple stakeholders
(NOT only health sector) to exchange ideas, organize panel
discussions regarding public health
o Provision of public health job opportunities at local and provincial
levels to strengthen and speed up health activities at those levels.

Way Forward
29
o Entrepreneurships and innovation in public health. E.g. Public health
apps, blogs, videos, product development, etc.

References
• Public Health Foundation (PHF). Core competencies for public health
professionals. 2014
• Mahat, A., Bezruchka, S.A., Gonzales, V. et al. Assessment of graduate public
health education in Nepal and perceived needs of faculty and students. Hum
Resour Health 11, 16 (2013). https://doi.org/10.1186/1478-4491-11-16
• Khatri R. ,Bishowkarma K., Bhandari T. Professionalization of Public Health in
Nepal. Europasian J Med Sci, 2020
30

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