Public health need not be led by doctors alone

Source-The post is based on the article ”Public health need not be led by doctors alone” published in The Hindu on 6th September 2022.

Syllabus: GS2-Issues related to development and management of health

News-This article discusses the issues related to the concept of public health as a separate discipline. There is underrepresentation of public health experts in health sector bodies at central and state level.

Public health professionals are not present in State and Central advisory bodies of health. During pandemic as well, doctors with no experience in public health were guiding the public health issues.

This is because it is felt that public health does not require specific competencies, and anyone can do this work.

There is a difference between public health sector and public health discipline. Providing medical care at a primary health centre does not make the person a public health professional.

It is important to understand that public health is a separate profession with a specific set of competencies.

What constitutes public health?

4 A’s i.e. academics, activism, administration and advocacy, can describe public health work.

Academics: It is the brain behind public health. It means having good understanding of epidemiology and biostatistics.

Epidemiology is the study of the distribution and determinants of health and disease in populations.

Biostatistics is the study of development and application of statistical theory, methods and techniques to public health research data. Then, planning, implementation and evaluation of public health program

Activism: It is the heart of public health. It includes a good understanding of non-health determinants, including social and commercial factors. How they influence health and how these can be addressed?

Administration: It means administering health systems from a primary health centre to the district, State, and national level. It means implementing and managing health programmes, addressing human resource issues, supply and logistical issues, etc.

Advocacy: In public health, individual can hardly make a difference. It requires proper communication and negotiation skills with key stakeholders to enable the functioning of public health at the different levels.

How is it different to the clinical approach?

Historically, public health remained a medical college-driven discipline. However, now a specific college degree is required for public health professional.

Clinical approach is focused on individuals, which divide humans into organs or systems. However, but it is not inappropriate for a broader public health approach, aimed at working with communities or health systems.

Many doctors and other health professionals work at the grassroots level and develop a good sense of public health due to their inclination. But they do not become public health professionals as they may not have the necessary skills.

What should the course of action?

The Health Ministry has recently proposed the creation of cadres for public health professionals and health management at the State, district and block levels. It is a welcome step but there is also a need to look at the quality of public health training being provided.