Title: STRENGTHENING PUBLIC HEALTH WORKFORCE IN THE AMERICAS

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Section/SPIG: International Health

Issue Date:

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Amy Hagopian, an IH Section session strategic planning coordinator, represented APHA at an August meeting of the Pan American Health Organization to discuss “Strengthening the capacity of the public health workforce to achieve the Millennium Development Goals.” The group comprised about 30 individuals from PAHO offices, as well as universities, ministries of health and public health associations in Mexico, Brazil, Costa Rica, Canada, Chile, Jamaica, Cuba and the United States. The meeting was held in San Jose, Costa Rica.

The goals of the meeting were to:
1) build greater knowledge about the human resources for public health (HR) crisis;
2) achieve clarity on functions of public health schools and other stakeholders; and
3) create a strategic plan for joint action between the World Federation of Public Health Associations and to strengthen HR capacity.

There were four themes the organizers hoped to cover:
1) scaling up of HR during the decade 2006-2015.
2) characterizing the public health workforce.
3) recommending tools to establish core competencies.
4) taking multilateral action at regional and international levels.

We were reminded that in Latin America, more than one in four of the 500 million inhabitants have no real access to basic health care, both for reasons of inadequate resources and because of geographical barriers. More than 150 million lack access to potable water.

PAHO has three pillars of work: technical, policy advocacy, and social mobilization. Primary health care, essential public health functions, protection of social and health status, and human resources are all critical. PAHO is the Regional Office of the World Health Organization for the American Region.

There was discussion about two important tasks: adopting a set of common core competencies for the public health workforce and agreeing on an approach for enumerating the public health workforce in each of our countries.

The competencies reviewed included (although there was no final agreement):

1. Have a command of the essential public health sciences.
2. Conduct analysis and assessment (health surveillance), using both quantitative and qualitative methods.
3. Develop policy, plan programs & set priorities.
4. Identify the financial and human resources required and advocate to obtain them.
5. Create partnerships, collaborate & communicate, using global and interdisciplinary approaches.
6. Appreciate and be skillful with socio-cultural diversity (including gender differences and special groups).
7. Understand the social determinants of health and how to organize to eliminate inequalities and other origins of poor health.
8. Employ leadership skills and systems approaches.
9. Understand and apply a code of ethics.
10. Promote healthy behaviors and primary care.
11. Knowledge and handling of legal and normative frameworks.
12. Develop political capacities across sectors: public/private, networks, strategic alliances.
13. Develop citizens, facilitate community development, mobilization of the citizenry.

To enumerate the workforce, there was general agreement that countries should first assemble a minimum data set, to determine how many public health workers in each category are employed in the public sector. Subsequently, a “luxury” data set could be assembled to determine how many public health workers are employed across ALL sectors. Finally, the effort should include an attempt to sample the workforce to characterize public health workers’ education, functions, and needs.

--Amy Hagopian, MHA, PhD, E-mail: hagopian@u.washington.edu