Governments are moving towards creating public health cadres, says Prof. K Srinath Reddy, president, Public Health Foundation of India, New Delhi
What needs are public health managers/professionals supposed to fulfil? Can you tell us how they are different from MBAs in healthcare or hospital management?
Public health professionals can be broadly trained generalists engaged in designing and developing health programmes or specialists with additional expertise in fields such as epidemiology, health economics, health policy, biostatistics, clinical research, environmental and occupational health, public health nutrition, social and behavioural services, health communication, health promotion or public health management. They generate the knowledge needed to identify the dimensions and determinants of major health problems that different sections of our population experience and help to develop the appropriate policy and programme responses. They also possess the right skill mix to evaluate health programmes and provide correctives when needed.
Public health management combines essential knowledge of public health with relevant management skills for improving the delivery of a wide range of public health services, such as immunization programmes, or the HIV-AIDS prevention programme, control programmes for tuberculosis or hypertension which have to be delivered across the country. While performance with profit is the mantra of classical MBA training, performance with equity is the mantra of public health management which is especially concerned with public health problems of the poor. Public health management adds management principles to core public health knowledge and adapts them for application to enhance the efficiency of the health system. Hospital management is confined to the functioning of hospitals only and does not extend to all other components of the health system. It is, however, also a sub-component of public health management.
The concept of public health as well as of public health professionals is relatively new in India? How is it going? What are the challenges before public health professionals in the country?
There is a greater commitment by the Central and most state governments for strengthening health services, especially in primary health care, and for improving the performance of health programmes. However, the need for public health professionals is just beginning to get recognised. Contractual appointments, now available in major public health programmes, like the National Rural Health Mission (NRHM), provide early opportunities for engaging public health professionals with health services even as states move towards the creation of public health cadres. The soon-to-be launched National Urban Health Mission (which along with NRHM will form a common National Health Mission) will expand the employment opportunities for public health professionals.
Last year, you had said that there is no clear-cut career path for non-medical professionals entering public health services. Has anything changed about this? Do you have any new information on the committee under the Director General of Health Services (DGHS), which was looking into the eligibility requirements and career options for both medically- and non-medically-qualified public health professionals? Is there any scope of employment for people with, for example a PG diploma in public health management, in the private sector?
The DGHS Committee recommendations are still awaited. However, some states are beginning to engage non-medical health professionals, too, in some of the NRHM-related positions. This trend is expected to increase over the next two years. NGOs, foundations, international organisations dealing with health and development as well as health research organisations are seeking such professionals in increasing numbers. The private sector will also open up soon, with positions in industrial public health, hospital management, clinical research and health financing.
Any new plans of PHFI?
PHFI is set to open its fourth Indian Institute of Public Health (IIPH) at Bhubaneswar, in July 2010. Its currently functioning IIPHs at Gandhinagar, Hyderabad and Delhi are running four post-graduate diploma programmes, a certificate course in diabetes management and several short-term training programmes. Distance education programmes are soon to commence in epidemiology, public health nutrition, health promotion and chronic care management. PHFI is also seeking university status and will commence MPH (Master of public health) and PhD programmes as soon as it obtains this status.
What are the pros and cons of a job in public health?
The pros of a public health job are that it responds to a great social need, connects you to many people and communities, provides inter-disciplinary learning and multi-sectoral experience, and will surely grow in demand over the next two decades.
The cons are that it is an emerging field and career growth may have a slow trajectory in the initial years and may also involve considerable travel to the ‘field’ (where health programmes are being implemented).
For people who want to change society for the better, through committed action and not just by slogans, public health will be an excellent career choice. It is what ‘people who love people’ will really enjoy doing. As Barbara Streisand memorably sang, aren’t such people the luckiest people?
Interviewed by Rahat Bano