International public health workforce development

A 2004 Public Health Literature Research Report was commissioned by the Ministry of Health as background health research to the development of the Te Uru Kahikatea: The Public Health Workforce Development Plan.  

This Literature Research Report, which canvassed information from America, Australia, Canada and England, provides a review of international public health workforce development as it relates to public health workforce development in New Zealand.



International approaches to public health workforce development


As is expected, internationally (America, Australia, Canada and England) there are different approaches to public health workforce development. However, the Literature Research Report identified three important fundamental workforce development considerations:

  • A systems approach is usually applied to public health workforce development
  • Workforce development is usually linked to overall public health goals
  • Modern thinking emphasises the importance of a person - and a community-centred health system approach to health workforce development; by considering the needs of an individual, family or community, rather the perceived needs of practitioners


Implications from overseas experience


From the four countries reviewed (America, Australia, Canada and England) it appears New Zealand is embarking on a public health workforce development process.  Key implications from overseas experience include:

  • The definition of essential public health services (as opposed to specific public health system professions) for the country, and possibly at an organisation level, is important
  • The development of generic competencies is a focus for workforce development strategies
  • Partnerships between health and education sectors and other stakeholders need to be fostered
  • A flexible and multi-disciplinary workforce is required for a rapidly changing environment (globally and regionally)
  • Practitioners’ need for life-long health education training, needs to be integral to a workforce development programme
  • Ensure there is a culturally diverse workforce, strengthened with cultural competence
  • A funded and co-ordinated public health workforce development strategy is fundamental to ensuring a competent workforce

Most countries have used a combination of approaches, usually commencing with an attempt to define the public health workforce, define its core public health functions and then develop competencies. Planned workforce development activities usually follow, based on an informed judgement of current and future needs.

Internationally, there are a number of commonly identified barriers that exist in assuring the ongoing competence of the public health workforce. In summary, these include:

  • Workforce planning is hampered by the absence of an updated inventory of the workforce
  • The absence of a coherent policy and funding strategy
  • There is a low level of specialist public health training and qualifications amongst the public health workforce internationally
  • The wide variety of public health professional groups means it is difficult to create opportunities to meet the diverse range of needs
  • While progress is being made to identify discipline specific competencies significant gaps remain and there is little consensus on the generic competencies or curricula needed in public health system
  • Public health training is often fragmented and varying in quality
  • Inadequate incentives exist for participation in training and continuing education
  • There is no uniform approach to evaluation

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