Is there a golden recipe? A scoping review of public health workforce development

Background: This study intended to design a suitable and comprehensive approach for a public health workforce development plan with the ultimate goal of meeting the health objectives in different European Region countries. Methods: We performed a scoping review, including an accurate and exhaustive country-specific hand-search process, mapping the key concepts and practices used in public health workforce development based on the available evidence worldwide. Results: We identified nine comparative measures, based on common features from a scoping literature review, for the assessment of public health workforce development plans available in selected countries. This list of nine comparative measures includes: (i) Alignment between the 10 Essential Public Health Operations (EPHOs) or core public health functions and organizational resources and public health priority areas; (ii) Regulations and Norms; (iii) Capacity Assessment; (iv) Datasets and Databases; (v) Workforce Development Strategies, Planning and Management; (vi) Education, Training, Core Competencies and Models; (vii) Licensing, Accreditation and Credentialing; (viii) Forecasting Strategies for Enumerating and Quotas and (ix) Ethical and Professional Codes of Conduct. These measures are essential to develop, sustain and modernize the public health workforce effectively. Conclusion: We propose a well-balanced set of measures for countries aiming to improve or develop their public health workforce based on instruments that are successfully used and applied in a wide range of countries with different public health systems. However, the implementation should be tailored and adopted according to the specific country context and available recourses

Aligning Best Practices: A Guiding Framework as a Valuable Tool for Public Health Workforce Development with the Example of Ukraine

Background: At present, in Ukraine, there is an insufficient capacity for up-to-date surveillance of the health status of the general population; public health (PH) promotion and disease prevention activities are scarce. Additionally, there is an urgent need to ensure, develop and support an efficient public health workforce (PHW) and appropriately address existing health issues. Ukraine currently introduces PH system reforms in line with its current burden of disease, the epidemiological profile and the Essential Public Health Services (EPHOs). This analysis aims to propose a pragmatic framework to provide guidance and recommendations related to the development, support and planning of the PHW in Ukraine. Methods: We constructed a framework based on a previously published scoping review and analyzed various policy analysis approaches. In line with the recommendations found in the literature and the best practices used elsewhere, this method enabled the construction of a framework for facilitating successful PHW development. In addition, an expert workshop was held, serving as a reality check for identifying crucial areas of the PH system in Ukraine. Results: The proposed framework includes a country’s background, the evidence and available policy options, such as the health system (including core functions, organizational resources, regulations and norms), health system capacities (including human resources; PH capacity assessment; datasets and databases; forecasting strategies; licensing, accreditation and quality assurance) and capacity building (including PH education, training, core competencies and ethical and professional codes of conduct). To facilitate and support effective implementation of the framework, we propose (1) implementing strategies to facilitate changes in attitude, behavior and practices among the citizens; (2) implementing strategies to facilitate the necessary behavioral changes in the PHW; (3) implementing strategies to facilitate the necessary organizational and institutional changes; (4) implementing strategies to facilitate system changes and (5) identification of potential barriers and obstacles for the implementation of these strategies. Conclusion: The report highlights the practical tactics and best practices for providing suggestions for PHW support and planning. The employment of prominent analytical tools and procedures in policymaking processes suggests an effective strategy for PHW development in Ukraine

Aligning best practices : a guiding framework as a valuable tool for Public Health Workforce Development with the example of Ukraine

Background: At present, in Ukraine, there is an insufficient capacity for up-to-date surveillance of the health status of the general population; public health (PH) promotion and disease prevention activities are scarce. Additionally, there is an urgent need to ensure, develop and support an efficient public health workforce (PHW) and appropriately address existing health issues. Ukraine currently introduces PH system reforms in line with its current burden of disease, the epidemiological profile and the Essential Public Health Services (EPHOs). This analysis aims to propose a pragmatic framework to provide guidance and recommendations related to the development, support and planning of the PHW in Ukraine. Methods: We constructed a framework based on a previously published scoping review and analyzed various policy analysis approaches. In line with the recommendations found in the literature and the best practices used elsewhere, this method enabled the construction of a framework for facilitating successful PHW development. In addition, an expert workshop was held, serving as a reality check for identifying crucial areas of the PH system in Ukraine. Results: The proposed framework includes a country’s background, the evidence and available policy options, such as the health system (including core functions, organizational resources, regulations and norms), health system capacities (including human resources; PH capacity assessment; datasets and databases; forecasting strategies; licensing, accreditation and quality assurance) and capacity building (including PH education, training, core competencies and ethical and professional codes of conduct). To facilitate and support effective implementation of the framework, we propose (1) implementing strategies to facilitate changes in attitude, behavior and practices among the citizens; (2) implementing strategies to facilitate the necessary behavioral changes in the PHW; (3) implementing strategies to facilitate the necessary organizational and institutional changes; (4) implementing strategies to facilitate system changes and (5) identification of potential barriers and obstacles for the implementation of these strategies. Conclusion: The report highlights the practical tactics and best practices for providing suggestions for PHW support and planning. The employment of prominent analytical tools and procedures in policymaking processes suggests an effective strategy for PHW development in Ukraine

A Systematic Review on Professional Regulation and Credentialing of Public Health Workforce

The public health workforce (PHW) counts a great variety of professionals, and how services are delivered differs in every country. The complexity and the diversity of PHW professions also reflect structural problems of supply and demand of PHW in various organizations and health care systems. Therefore, credentialing, regulation, and formal recognition are essential for a competent and responsive PHW to address public health challenges. To ensure comparability of the credentialing and regulation systems for the PHW and to enable its collective action at the macro level in the event of a health crisis, we systematically analyzed documented evidence on the PHW. A systematic review was selected to answer the research questions: (1) what are the most effective aspects and characteristics in identified programs (standards or activities) in professional credentialing and regulation of the PHW and (2) what are common evidence-based aspects and characteristics for the performance standards to support a qualified and competent PHW? The identification of professional credentialing systems and available practices of the PHW was performed systematically using a systematic review of international resources in the specialized literature published in English. The PRISMA framework was used to verify the reporting of combined findings from three databases: Google Scholar (GS), PubMed (PM), and Web of Science (WoS). The original search covered the period from 2000 until 2022. Out of 4839 citations based on the initial search, 71 publications were included in our review. Most of the studies were conducted in the US, UK, New Zealand, Canada, and Australia; one study was conducted in an international context for professional credentialing and regulation of the PHW. The review presents specific professional regulation and credentialing approaches without favoring one of the proposed methods. Our review was limited to articles focused on professional credentialing and regulation of the PHW in the specialized literature published in English and did not include a review of primary PHW development sources from international organizations. The process and requirements are unique processes displaying knowledge, competencies, and expertise, regardless of the field of practice. Continuous education, self-regulatory, and evidence-based approach can be seen as common characteristics for the performance standards on both community and national levels. Certification and regulation standards should be based on competencies that are currently used in practice. Therefore, answering questions about what criteria would be used, what is the process operation, what educational background the candidate should have, re-examination, and training are essential for a competent and responsive PHW and could stimulate the motivation of the PHW.</p

[Rational Use of Antibiotics Among Turkish Migrants In Germany: Knowledge, Attitudes and Interaction With Physicians and Pharmacists].

Erdsiek F, Aksakal T, Ozcebe H, et al. Antibiotikanutzung bei Menschen mit türkischem Migrationshintergrund – Wissen, Einstellungen und Interaktion mit ÄrztInnen und ApothekerInnen. Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)). 2019;(01):5-71.ZIEL DER ARBEIT: Kulturelle Aspekte der Medikamentennutzung in der Türkei können aufgrund ausgeprägter transnationaler Beziehungen das Nachfrageverhalten von Menschen mit türkischem Migrationshintergrund in Deutschland beeinflussen. Über die Antibiotikanutzung in dieser Bevölkerungsgruppe ist allerdings wenig bekannt. Die Studie untersucht, wie sich das Nachfrageverhalten von Menschen mit türkischem Migrationshintergrund und die Interaktion mit dem Gesundheitssystem im Zusammenhang mit der Antibiotikanutzung gestalten, welche Einstellungen zugrunde liegen und wie diese mit vorhandenem Hintergrundwissen zusammenhängen. METHODIK: Mit einem qualitativen Ansatz wurden Handlungslogiken und das Verhalten von türkeistämmigen Erwachsenen in Deutschland untersucht. Dazu wurden leitfadengestützte Fokusgruppeninterviews mit türkeistämmigen Erwachsenen und Experteninterviews mit HausärztInnen und ApothekerInnen durchgeführt und inhaltsanalytisch ausgewertet. ERGEBNISSE: Während bei jüngeren Menschen eine positive, aber vorsichtige Haltung gegenüber der Einnahme von Antibiotika vorliegt, finden sich bei Älteren teilweise übersteigerte Erwartungen an die Wirksamkeit, die auf fehlendes Faktenwissen zurückgehen. Insgesamt nehmen die TeilnehmerInnen eine passive Patientenrolle in der Interaktion mit HausärztInnen ein, wodurch bestehende Informationslücken teils nicht geschlossen werden. SCHLUSSFOLGERUNGEN: Ältere Menschen mit türkischem Migrationshintergrund haben teils unrealistische Erwartungen an die Wirksamkeit von Antibiotika. In Zusammenhang mit einer passiven Patientenrolle werden Informationsbedarfe und -bedürfnisse nicht befriedigt, was die Arzt-Patient-Beziehung belasten kann. Eine Anpassung der Kommunikation und eine migrationssensible Informationsvermittlung sind daher notwendig

Perspectives of physicians and pharmacists on rational use of antibiotics in Turkey and among Turkish migrants in Germany, Sweden and the Netherlands : a qualitative study

Background Antimicrobial resistance may result from inappropriate use of antibiotics in health care. Turkey is one of the countries with the highest antibiotic consumption in the world. Considering the role of transnational ties between Turkish migrants and their social contacts in Turkey, the attitudes and behaviors relating to rational antibiotic use in Turkey can also affect the use of antibiotics by Turkish migrants residing abroad. This study explores physicians' and pharmacists' experiences and perspectives on rational antibiotic use among Turkish adults in Turkey and among Turkish migrants in Germany, Sweden, and the Netherlands, three European countries with large populations of Turkish migrants. Methods Following a qualitative study design using convenience and snowball sampling, in-depth interviews with 21 family physicians and 24 pharmacists were conducted in the aforementioned countries. We transcribed all interviews verbatim and performed content analysis separately in the countries, followed by translation, pooling and joint interpretation of the findings. Results Physicians and pharmacists encountered irrational use of antibiotics among their patients in Turkey. Physicians interviewed in the three European countries explained that Turkish migrants differ from non-migrants with respect to their attitudes towards antibiotics, for example by more often expecting to be prescribed antibiotics. All physicians and pharmacists in the selected countries reported to inform their patients on how to use antibiotics upon prescription; however, Turkish migrants' poor language proficiency was considered as a substantial communication barrier by the physicians and pharmacists interviewed in the European countries. Conclusions The study illustrated some aspects of irrational antibiotic use among the population in Turkey and Turkish migrants in selected European countries. It emphasized the need for closer community participation, adequate information campaigns, as well as in-service training of health care providers in Turkey. The strategies and interventions on rational antibiotic use should also be supported and encouraged by health care providers, who need to reach out to people with various cultural backgrounds