Is the current public health workforce fit for purpose in a digital era?
Brian discusses the progress made and challenges faced in improving the public health workforce through utilising digital health to train young professionals.
Not quite yet. Here are some ways of how we might get there.
The COVID-19 pandemic has revealed that a strong public health workforce is a key component of resilient health systems. As defined by the Associations of Schools of Public Health in the European Region (ASPHER), the public health workforce comprises public health professionals, health professionals, and other professionals whose work can have a significant impact on population health. Yet, despite how vital they are to the overall global economy, job prospects for young professionals in public health remain unchanged. The unique set of barriers and challenges young professionals face as they enter the workforce (namely, inaccessibility, tokenisation, and a lack of mentorship) can hinder them from progressing at a crucial moment in their careers.
“despite how vital they are to the overall global economy, job prospects for young professionals in public health remain unchanged”
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To make matters worse, the World Health Organization (WHO) has projected a global shortfall of 18 million health workers by 2030. Although low- and lower-middle income countries are most affected, a shortage in the health workforce is a problem that all countries are confronted with—albeit to varying degrees—regardless of their current socio-economic status. While this projection has been exacerbated by the COVID-19 pandemic, these continuous shortages are a result of chronic under-investment in education and training, mismatches between education and employment in health systems, and increasing international migration from low- and lower-middle income countries.
A shortage of health workers causes issues for training and progression, as it perpetuates a cycle of difficulties with respect to training and sustaining the workforce itself. Insufficient training options, in turn, have a knock-on effect on the skills, competence, and performance of young professionals as they enter the field, with detrimental implications for health systems and outcomes. The emphasis is currently on rebuilding the infrastructure of health systems post-COVID, and spending resources have accordingly been devoted to recruitment and supply. However, building strong health systems also requires a well-trained workforce.
“building strong health systems requires a well-trained workforce”
A priority area for education and training of the next generation of public health professionals is digital health. Ongoing digital transformations in the health sector have demonstrated the potential of these technologies to improve health outcomes in innovative ways. The responsible use and effective implementation of digital technologies are contingent on a public health workforce that has a sufficient level of knowledge and skills to effectively navigate them.
“adequately training young health professionals in digital technologies is paramount for building a strong and resilient workforce that can rebuild and improve our current health systems”
Young professionals play a key role in advancing the development of digital health. To truly harness this digital potential, priority areas for education should centre on capacity building, opportunities for youth, and an ethics-driven approach. Moreover, youth have the most to gain and lose from digital transformations in all domains, including health. As such, adequately training young health professionals in digital technologies is paramount for building a strong and resilient workforce that can rebuild and improve our current health systems.
Why is ‘Digital Public Health’ so important and what can we do to train young health professionals to maximise its benefits?
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Digital Public Health
A recent viewpoint by the Digital Health Section of the European Public Health Association (EUPHA) outlines the unique opportunities, challenges, and implications of the increasing digitalisation of public health in Europe. ‘Digital Public Health’ (DPH) is a newer concept which refers to the adoption of digital tools to achieve public health goals, such as preventing disease, empowering citizens, promoting value-based healthcare, and achieving Universal Health Coverage (UHC). The central aim of DPH is to improve the health of populations from the individual to the population level by using information and communications technologies (ICT). This is one of the key factors differentiating DPH from 'digital health', the latter being predominantly focused on individual health.
“‘Digital Public Health’ (DPH) is a newer concept which refers to the adoption of digital tools to achieve public health goals”
However, while recent events have accelerated progress towards the expansion of DPH and reinforced the importance of digital health technologies, there remains significant untapped potential in harnessing, leveraging, and repurposing digital technologies for public health goals. Furthermore, findings from a recent study suggest that Europe is currently unable to host a sustainable digital society without exacerbating cross-country inequalities due to substantial differences in internet access and digital literacy. As such, investment in building digital capacity in the general population should be the primary objective of European countries to ensure they can benefit optimally, equitably, and sustainably from the advancements of the digital era.
Young Professionals are Key to Achieving Digital Health Objectives
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In the GHFutures2030 Youth Statement, youth outlined what they wish to see in the future of health governance and are calling upon various stakeholders to safeguard their health futures. A particular focus area that could support young people in addressing digital skills gaps is increased investment in digital skills and educational frameworks that underpin digital skills development.
Professor Katarzyna Czabanowska is the Chair of Public Health Leadership and Workforce Development at the Care and Public Health Research Institute (CAPHRI) at Maastricht University. She believes that the public health workforce is at an important intersection between being prepared for and adequately responding to critical twenty-first century challenges. Rapidly accelerated by the COVID-19 pandemic, digital transformation is one such challenge.
When asked what is needed for the public health workforce to be adequately prepared for digital transformation, she argues that “capacity building needs to happen at every level, starting with a training needs assessment, followed by tailored education, training, and the implementation of systemic solutions to licence and accredit new knowledge and skills”. She further posits that an adequate response to digital transformation, on the other hand, requires “specific technical competencies, digital and political savviness, and the understanding of complex and interconnected systems” in a way that “appreciates diversity and multiculturalism, while seeking to reduce inequalities”.
“it is evident that students not only recognise the importance of incorporating digital health into public health training, but are also calling for changes to current curricula”
These statements appear to resonate with public health trainees. Having spoken to students in various European schools of public health, it is evident that students not only recognise the importance of incorporating digital health into public health training, but are also calling for changes to current curricula. They are, moreover, eager to be actively involved in shaping digital health topics in their formal training to further foster and nurture these interests.
“it is crucial young professionals are meaningfully involved in the design, development, implementation, and evaluation of new programmes and policies that may directly or indirectly impact them”
Therefore, as the world embarks on the long road of rebuilding toward a ‘new normal’ and strengthening the capacity and infrastructure of public health systems, it is crucial young professionals are meaningfully involved in the design, development, implementation, and evaluation of new programmes and policies that may directly or indirectly impact them. It is especially crucial that these considerations align with the WHO’s recently launched framework for youth-centred digital health interventions. Embedding digital health into public health training will not only provide a basis for future work to develop a competency framework for digital skills in public health training, but will also help safeguard the health futures for generations to come.
The author would like to thank Prof. Katarzyna Czabanowska and Dr. Robin van Kessel for their continued support and guidance.
