Kavya Sharma

Public Health Education in India and China:History, Opportunities, and Challenges

Public health education in China and India has a long history that has been both deeply responsive to the unique needs and medical traditions of each country, and sensitive to global influences. The history of public health education in China reaches back several centuries, with substantial input from American and European organizations during the Republican Era, 1911–1949. In India, centuries-old health care traditions were influenced during the colonial period by the British Empire prior to independence in 1947. Political upheaval in both countries during the 1940s further impacted the public health systems as well as public health education.The primary goal of this review is to outline public health education in India and Mainland China, with a focus on describing the historical systems and structures that have promoted the development of formalized public health education. We examine current challenges, and analyze opportunities for improvement. Health reforms in China and India need to consider new and modern models for public health education, perhaps in independent faculties of public health, to reinvigorate public health education and strengthen the position of public health in addressing the health challenges of the 21st century.

Building Interdisciplinary Leadership Skills among Health Practitioners in the Twenty-First Century: An Innovative Training Model

Transformational learning is the focus of twenty-first century global educational reforms. In India, there is a need to amalgamate the skills and knowledge of medical, nursing, and public health practitioners and to develop robust leadership competencies among them. This initiative proposed to identify interdisciplinary leadership competencies among Indian health practitioners and to develop a training program for interdisciplinary leadership skills through an Innovation Collaborative. Medical, nursing, and public health institutions partnered in this endeavor. An exhaustive literature search was undertaken to identify leadership competencies in these three professions. Published evidence was utilized in searching for the need for interdisciplinary training of health practitioners, including current scenarios in interprofessional health education and the key competencies required. The interdisciplinary leadership competencies identified were self-awareness, vision, self-regulation, motivation, decisiveness, integrity, interpersonal communication skills, strategic planning, team building, innovation, and being an effective change agent. Subsequently, a training program was developed, and three training sessions were piloted with 66 participants. Each cohort comprised a mix of participants from different disciplines. The pilot training guided the development of a training model for building interdisciplinary leadership skills and organizing interdisciplinary leadership workshops. The need for interdisciplinary leadership competencies is recognized. The long-term objective of the training model is integration into the regular medical, nursing, and public health curricula, with the aim of developing interdisciplinary leadership skills among them. Although challenging, formal incorporation of leadership skills into health professional education is possible within the interdisciplinary classroom setting using principles of transformative learning.

Understanding the current status and exploring the potential for distance education in public health in India

Continuing education of health care providers plays an important role in producing a health work force that is efficient and effective. In India public health education has primarily relied on conventional methods of training. However, such methods have limitations in equipping the health workforce of a vast and varied country like India. This paper analyzes the current status of distance education in public health and lists the various courses that are presently available in India through the distance education mode. Presently 25 institutions in India are offering 69 courses in various domains of public health through distance education. The providers of these programs comprised both government and private educational institutions. This paper also points out the role and importance of various stakeholders in the design and delivery of distance education programs in public health and raises key areas that need attention in the governance of such programs. It urges the use of digital technology in the delivery of distance education programs and points out how distance education that is designed and delivered using the latest technology could address the current gap in training human resources for health in India.

Need and opportunities for health management education in India

Public Health Management has taken a momentous leap and seeks to provide a plausible answer to many issues related to public health. A key area identified to aid the public health objectives in the country is human resource management. The country faces a dire crunch in the available work force in almost all the healthcare network. Countering the current health situation in the country, various institutes have come up offering specialized courses in public health management. The wide gap between supply and demand for trained health care managers/ administrators to work for hospitals, pharmaceutical companies, health insurance and third party administration and other health care provider organizations needs attention. The paper is a situational analysis of all such courses offered pan India. A systematic, predefined approach was used to collect and assemble the data. All the institutes offering such courses were contacted for detailed information. Fifty one institutes have been identified which annually produce around 2122 qualified professional to work in the domain of public health management. The paper also discusses the demand analysis where these prospective students can be placed. An estimated 19,930 professionals would be required based upon the countrys present status, which reflects the dearth in their workforce capacity. The paper also enlighten the scope of strengthening the existing system, by effectively training the existing workforce for their capacity building, and highlights training opportunities for working professional to pursue a related academic program.

How can departments of community medicine shape the future of public health education in India

In order to effectively respond to a changing public health paradigm, it is imperative that the medical education and overall public health education (PHE) parallel the public health challenges faced by countries. Community medicine departments play a crucial role in PHE. This review analyzes the current situation of community medicine departments in the context of PHE, using a framework that outlines academic activities undertaken by these departments. This framework includes the syllabus of academic programs, internship, and infrastructure and faculty strength in the community medicine departments. The review also discusses how skill building of existing faculty members can help us in addressing emerging public health issues, and the role of partnerships and collaborative activities in advancing the PHE agenda, thereby continuing to shape the role played by these departments toward shaping the future of PHE in India.

An innovative National Rural Health Mission capacity development initiative for improving public health practice in India

National Rural Health Mission (NRHM) foresaw improved health management in India through sustained capacity development of in-service health personnel and their post-training duties in the public health system. Acknowledging the urgency of addressing this issue, the Indian Government, under the NRHM, launched a 1-year Post Graduate Diploma in Public Health Management (PGDPHM) to impart public health management knowledge and skills to these professionals in the state health services. Four institutes partnered this program in 2008, its first year. Between 2008 and 2011, this expanded to 10 institutes and 386 students have graduated the program. The program offered across all these institutes is uniquely identified as against other Health Management courses being offered across the country. The NRHM context in its content and pedagogy is its prime feature. The program offers multiple opportunities to encourage states and the central government to clearly delineate a much needed specialized public health cadre in India. The efforts of this program emphasize on improved public health practice and are a unique pathway to a better health system. Its multidisciplinary facets are aimed at addressing the mismatch of demand and supply of health professionals who could contribute effectively to strengthening the public health system in India through proficient public health practice.

History and evolution of public health education in India

In order to respond to the changing paradigm of public health challenges, India needs adequately trained public health professionals. Public health education is a tool to create public health professionals. Public health education in India is at cross-roads on several fronts. Traditionally, public health education in India was offered through medical schools and was open for medical graduates only. However, recently the country has witnessed an emergence of institutions offering public health programs to nonmedical background graduates. An examination of the history and current status of public health education can provide us with an insight into the evolution of the discipline in the country. This is important as in order to respond to the public health education challenges in the present time, we need to understand the historical directions taken by the discipline in the past. This review captures how the public health education efforts in the country have been aided by concerted actions within the discipline and by an enabling environment and a positive intent at the national level, whereby we can better understand the context for the recent developments in Indian public health.

Landscaping biostatistics education in India

Biostatistics plays an important role in measuring, understanding, and describing the overall health and well-being of a population. Biostatistics as a subject evolved from the application of statistics in various research aspects of biology, biomedical care, and public health. However, with a recent increase in number of health and pharmacy related research, the demand for trained biostatisticians is also increasing. The present paper is an attempt to undertake a situational analysis of biostatistics education in India. A systematic, predefined approach, with three parallel strategies was used to collect and assemble the data regarding training in biostatistics in India. Our study results show that there is paucity of programs providing specialized training in biostatistics in India. Only about 19 institutions in India are offering various courses in biostatistics/medical statistics/health statistics/biometry. It is important to look into the current capacity building initiatives in this domain. Some other means for giving importance to biostatistics could be by making it a separate branch/specialization in a majority of the institutions, particularly in medical colleges.

Demand and Supply Analysis of Human Resource Capacity for Hospital Management in India

The healthcare industry in India caters to a large population, and the sector is expected to continue growing close to previously projected rates of 10 to 12 per cent. The administrative and management complexities of a large organisation like a hospital need the frequency matching and fine-tuning of all the associated staff with the hierarchy. A qualified man-agement graduate specially trained to work within the health sector would have an advantage in the inter-disciplinary interactions, effective and efficient management of the available resources, coordination along the hierarchy, logistics and supply-chain related issues along with many other issues that are required in a hospital. It is evident that there is a huge backlog of trained hospital managers and administrators to work for hospitals, pharmaceutical companies, health insurance and third-party administration and other health care provider organisations. Despite having a diverse range of options to choose the educational institutions for such managerial courses, there is still a gap between the supply and the demand side, as no exhaustive list of program related data from these institutes is available till date. This article analyses the demand and supply issues surrounding courses offering hospital management in India, thereby attempting to highlight the current mismatch. A systematic, predefined approach was used to collect and assemble the data. All the institutes offering such courses were contacted for detailed infor-mation. Fifty one institutes have been identified which annually produce around 2500 qualified professionals to work in the domain of hospital management. The article also discusses the demand analysis where these prospective students can be placed. To estimate these numbers, various stakeholders of the hospital industry were consulted and desk reviews were performed. An estimated 21,750 professionals would be required based upon the country’s present status, which reflects the dearth in their workforce capacity. The findings could be adapted for future health work force planning in the country.

Veterinary public health capacity-building in India: a grim reflection of the developing world’s underpreparedness to address zoonotic risks

Veterinary public health (VPH) is ideally suited to promote convergence between human, animal and environmental sectors. Recent zoonotic and emerging infectious disease events have given rise to increasing calls for efforts to build global VPH capacities. However, even with their greater vulnerability to such events, including their economic and livelihood impacts, the response from low-and middle-income countries such as India has been suboptimal, thereby elevating global health risks. Addressing risks effectively at the human–animal interface in these countries will require a clear vision, consistent policies, strategic approach and sustained political commitment to reform and refine the current VPH capacity-building efforts. Only then can the discipline serve its goal of disease prevention, poverty alleviation and support for sustainable livelihoods through improvements in human and animal health.