Challenges of Public Health Education in India

Syllabus: GS2/Health

Context

• The demand for skilled public health professionals faces numerous challenges, ranging from a lack of standardization in training to limited job opportunities for graduates.

About the Public Health Education in India

• Evolution: Dates back to the colonial era when the focus was primarily on epidemic control.
  • 1932: Establishment of institutions like the All India Institute of Hygiene and Public Health (AIIHPH), shift toward systematic public health training.
  • Post-independence Era: Institutions such as the National Institute of Health and Family Welfare (NIHFW) and various medical universities expanded their curriculum to include public health as a specialized field.
• Current Framework:
  • Undergraduate Programs:
    • Bachelor of Public Health (BPH): A foundational course that provides knowledge on epidemiology, health policies, and community health.
    • MBBS with Community Medicine Specialization: A component of the medical curriculum that introduces students to public health concepts.
  • Postgraduate and Doctoral Programs:
    • Master of Public Health (MPH): A specialized program available at institutions like AIIMS, TISS, and IIPH, covering epidemiology, health systems, and policy-making.
    • MD in Community Medicine: Focuses on research, preventive medicine, and health administration.
    • Ph.D. in Public Health: Offered by universities to promote in-depth research on healthcare challenges in India.
  • Short-Term and Online Courses: To cater to working professionals, various organizations, including the Indian Institutes of Public Health (IIPH) and IGNOU, offer diploma and certificate courses in health management, epidemiology, and nutrition.
• India has seen a 60% increase in institutions offering public health education over the past decade.

Key Institutions Providing Public Health Education

• All India Institute of Hygiene and Public Health (AIIHPH), Kolkata
• Public Health Foundation of India (PHFI) and Indian Institutes of Public Health (IIPH)
• Tata Institute of Social Sciences (TISS), Mumbai
• AIIMS (All India Institute of Medical Sciences), New Delhi
• National Institute of Epidemiology (NIE), Chennai

Key Challenges With Public Health Education in India

• Lack of Awareness and Recognition: Public health is often overshadowed by clinical medicine, leading to fewer enrollments in MPH programs.
  • Limited awareness about career opportunities in public health discourages students from pursuing this field.
• Shortage of Faculty and Infrastructure: Many institutions struggle with inadequate faculty trained in public health.
  • Infrastructure in public health training centers, especially in rural areas, remains underdeveloped.
• Gaps in Curriculum and Practical Training: The curriculum often lacks integration with real-world challenges, resulting in graduates with theoretical knowledge but limited practical exposure.
  • Limited fieldwork and internship opportunities affect hands-on learning.
• Regional Disparities: Most renowned public health institutions are concentrated in urban areas, leaving rural and remote regions underserved.
  • Accessibility and affordability of quality education remain a concern for students from marginalized communities.
• Lack of Standardization: Public health education in India lacks a standardized curriculum, leading to inconsistencies in the quality of training across institutions. It affects the preparedness of graduates to address real-world health challenges.
• Lack of Health Professionals: According to a report by the National Health Systems Resource Centre (NHSRC), India needs over 1.5 million trained public health professionals to address the growing healthcare needs, especially post-pandemic.
  • WHO estimates that India has only one public health professional for every 10,000 people, highlighting the need for more trained professionals.

Efforts Related To Public Health Education in India

• Allocations (Union Budget 2024-25):
  • Increased Allocation for Health: ₹1.23 lakh crore for the Ministry of Health and Family Welfare (MoH&FW).
  • Focus on Public Health Education that includes the establishment of new medical colleges and the upgradation of existing institutions to address the shortage of healthcare professionals.
  • Digital Health Initiatives including telemedicine and digital health records, to improve accessibility and efficiency.
  • Continued Support For National Health Mission (NHM)
• Literacy and Digital Health Education:
  • National Digital Health Mission (NDHM) aims to digitize health records and improve public awareness about diseases and treatments.
  • Mobile-based apps like Arogya Setu, eSanjeevani, and MyGov Health have helped disseminate health information.
  • Internet penetration in rural India has increased to 38%, improving digital health education access.
• Public Awareness Programs and Campaigns like Mission Indradhanush, National Tobacco Control Program (NTCP).
• Mental Health Awareness under the National Mental Health Program (NMHP).

Opportunities and Future Prospects

• Government Initiatives and Policy Support: The National Health Policy (2017) emphasizes the need for public health training and research.
  • Ayushman Bharat and the National Health Mission (NHM) have created demand for trained public health professionals.
• Growth of Online and Distance Learning: Platforms like SWAYAM and initiatives by IGNOU provide affordable online public health courses, making education more accessible.
• Expansion of Research and International Collaborations: Collaborations with global public health institutions such as WHO, Johns Hopkins Bloomberg School of Public Health, and Harvard TH Chan School of Public Health are improving research quality in India.
• Emerging Career Opportunities: Public health graduates are increasingly being recruited by government health departments, NGOs, international organizations (WHO, UNICEF), and private healthcare firms.

Way Forward

• Standardization of Curriculum: Establishing a central regulatory body, such as a Public Health Education Council, can ensure uniform training standards and faculty qualifications across institutions.
• Expansion of Institutions: Setting up public health schools in underserved regions can improve access to education and address regional disparities.
• Integration of Practical Training: Incorporating mandatory internships and fieldwork in government health programs can enhance the practical skills of students.
• Creation of Public Health Jobs: Introducing State Public Health Cadres and increasing recruitment in government health systems can provide dedicated employment opportunities for graduates.
• Encouraging Private Sector Participation: Incentivizing private hospitals and industries to hire public health professionals can expand job opportunities and foster collaboration between sectors.
• Increased Funding: Allocating more resources to public health education and research can strengthen the sector and support the development of a skilled workforce.

Conclusion

• The challenges facing public health education in India are significant but not insurmountable. 
• By addressing issues such as standardization, funding, and job creation, the country can build a strong public health workforce capable of meeting its healthcare needs. 
• A collaborative approach involving the government, academia, and the private sector is essential to achieve this goal and ensure a healthier future for all.

For more details, please follow the link: https://www.nextias.com/ca/editorial-analysis/10-09-2024/public-health-challenges-and-policy-gaps-in-india

Source: TH