Public health education can promote health equity

Prof Sanjay Zodpey, President, PHFI speaks to ETHealthworld's Prathiba Raju on the importance and need to strengthen India’s public health institutions. Emphasising a wide array of learning opportunities that include master’s level programmes in public health and in hospital administration and their contribution towards creating trained manpower that can support the expanding activities in the public health space.

As the new president of PHFI, what would be your focus? What transformational change would you like to bring in?

Public health programmes and policies are instruments for assuring the health of citizens. A healthy population has higher work productivity and provides an opportunity to fulfil individual and societal aspirations. The Public Health Foundation of India (PHFI) will continue to work closely on public health issues of concern for India. The Indian health system, particularly the public sector has demonstrated great resilience during the COVID-19 pandemic. We recognise that efficient and effective health systems, driven by robust and contextual evidence, and guided by equity principles will assure further health improvements. PHFI will support the Ministry of Health and Family Welfare (MoHFW) and the state health departments in advancing initiatives in health and sustainable development.

How is PHFI contributing to the public health education space, particularly the various Indian Institute of Public Health (IIPH) located in different states? How are these IIPHs helping in the public health management space?

PHFI has a vision to strengthen India’s public health institutional and systems capability and provide knowledge to achieve better health outcomes for all. A thrust on public health education through its network of Indian Institutes of Public Health (IIPH) located in states aligns with our vision and mission. The IIPHs in their pursuit of academic excellence, value-based education and providing a conducive environment for overall skill development strive to create a public health workforce that responds to the felt needs of the country. A wide array of learning opportunities that include master’s level programmes in public health and in hospital administration are contributing towards creating trained manpower that can support the expanding activities in the public health space.

What kind of changes are needed in the public health programmes, which are being offered in India? Is there a need for a standard curriculum to exist in the country when it comes to public health?

The MoHFW designed and published a model Master of Public Health (MPH) course curriculum in 2017-18. The model curriculum is competency-driven, aligned to the needs of India and has a strong focus on public health skills. The Ministry has likewise taken several efforts in developing such model curricula in allied and healthcare streams. These are excellent efforts that guide institutions in their efforts. Overall, educational institutions have to produce graduates with the necessary skills and competencies for addressing current and future health challenges.

What are your thoughts on imparting medical education in vernacular languages, as many doctors have criticised the move?

I believe that the purpose of all education and training is to transform individuals for greater individual and societal good. Medical education at its core is a contribution to the greater societal good. In principle, knowledge acquisition is independent of the language of instruction. India has experience of several excellent degree programmes and graduates, beyond medicine, in vernacular languages. Medicine has traditionally been offered in English and consequently, there is access to a wide body of medical books and literature. A transition to vernacular languages may have some immediate short-term challenges in designing learning materials in the vernacular languages. This challenge can be overcome with systematic efforts at the state level to develop high-quality materials in a timely manner. This effort to develop high-quality materials will have to be state-led and undertaken regularly to keep pace with the development of newer interventions and therapies.

What kind of impact do you think COVID-19 has brought in the area of policy development in the public healthcare space? Tell us about the approach of PHFI on infectious diseases, epidemiology and how as a nation we should prepare for future pandemics and health security.

COVID-19 reminded the world that we must collaboratively evolve a coordinated response to health challenges. India demonstrated to the world that we can effectively manage the health challenges posed by the pandemic, produced potent vaccines and more importantly, calibrated a coherent response that evolved with the magnitude of the challenge over the past two years. We have provided our population with a digital vaccination certificate at a scale that is unparalleled in the world. This is a matter of pride for all citizens. The COVID-19 pandemic reminded us of the central role of the public health system, in detection, management and service delivery. The IDSP of the Government is sensitised to the evolving needs and under the oversight of the Ministry is geared up for training district epidemiologists and surveillance teams.

PHFI works very closely with the national and state governments. During the COVID times also, we contributed technically and on the ground through our institutional network. Going forward, we are planning to establish a dedicated multidisciplinary team to work on infectious disease epidemiology and the economic consequences of such diseases to highlight the need for pandemic preparedness and health security.

With rising zoonotic diseases like COVID-19, and monkeypox how do you look at One-health? What kind of surveillance strategies should be implemented?

Human health is influenced by multiple factors which are outside the conventional health sector. An excellent example is the provision of water, sanitation and education. Similarly, there is now a clear acknowledgement that the health of people, animals and the environment are interrelated. One-health integrates these ideas to address root causes. Surveillance systems will have to eventually keep pace globally within the larger One-health framework. This will require greater coordination between relevant departments and operational clarity at the state and district levels.

How has 2022 been for the healthcare industry and what transformations should we see in 2023?

The recent pandemic has reminded us that we must invest in primary healthcare systems. We need prompt diagnosis with laboratory support, timely referral transport and state-of-the-art clinical care. The healthcare sector will have to build these services on the background of a sufficient and skilled workforce. We learnt about the potential of digital health and its ability to transform last-mile access. We can witness accelerated growth in the vaccines and biologicals market in addition to our dominance in medicinal products. The potential of yoga in holistic health is also increasing and we are likely to see it emerge as a global phenomenon in the next decade.

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