Gaps in public health training in Ethiopia: Insights from a qualitative study

Abstract

Background: The challenges public health encounters in the 21st century in relation to social, economic, political and climatic dynamism are widely documented. Endeavors are under way at different levels to contain the challenges and ensure healthy living. However, the extent to which public health training is aligned with the demands of the century remains unclear. This study aims to explore efforts made by public health training institutions in Ethiopia to equip public health professionals with competencies that meet contemporary expectations, gaps and suggestions.

Methods: Sixteen public health experts who hold advisory and decision-making positions in the public health sector, local and international development partners and public health training institutions of higher learning were purposively selected to participate in the study. A key informant interview technique was employed to collect data on what are perceived to be the gaps in public health graduates’ competencies, and suggested improvements. A topic guide was developed to elicit the competences of graduates, identify gaps in their competences, and extract suggestions on how to fill those gaps so as to contribute to the development of public health endeavours. Interviews were held at a time and place of convenience for the experts. Data collected were categorized under key themes: training, research, and future directions. Under each of these themes, knowledge and skills on leadership and management, community practice, design and conduct of problem-solving research were specified to compile and interpret the data. Efforts were made to faithfully represent the opinion of participants, and verbatim quotes of dominant opinions were collected without identifiers.

Findings: There were four participants from training institutions, seven from public sector organizations, and five from development partners. The findings reveal the limitations of graduates to be able to take up public health functions. It was unanimously agreed that irrespective of the level of training, graduates need time to acquaint themselves with what is expected of them as a professional. It was found that public health graduates at master’s and PhD level failed to fit into the existing system fast enough to take on leadership responsibilities. Participants unanimously argued that public health training encounters major challenges in empowering students with the necessary knowledge and skills to meet contemporary public health challenges. The problem of a curriculum that does not change in line with changing public health needs, the lack of competence of teaching staff, lack of contemporary references, and lack of time and money to engage students in community practice, were identified as major drawbacks in training. The fact that the curricula of the different schools of public health were adapted from the same sources and has not been revised to fit the demands of the day was particularly emphasized by participants from universities. Students’ skill in planning and conducting problem-solving research, and skills to mobilize and engage the community to recognize and solve their own problems, were reported as limited, irrespective of the level of training and management.

Conclusions: Public health training in Ethiopia is perceived to have major limitations, particularly where graduates, irrespective of their level of training, fail to contribute to public health functions. Curricula are not revised to meet current demands. This calls for concerted action by the education and health sectors and like-minded stakeholders to improve the curricula for the different levels of training in public health education. [Ethiop.J. Health Dev. 2020; 34(Special issue 1):4-10]

Keywords: Public health training, public health competencies, community practice, problem-solving research