Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Indian Administrative Service, Lucknow, Uttar Pradesh, India.
BMC Public Health. 2020 Nov 17;20(1):1737. doi: 10.1186/s12889-020-09711-4.
Ensuring the current public health workforce has appropriate competencies to fulfill essential public health functions is challenging in many low- and middle-income countries. The absence of an agreed set of core competencies to provide a basis for developing and assessing knowledge, skills, abilities, and attitudes contributes to this challenge. This study aims to identify the requisite core competencies for practicing health professionals in mid-level supervisory and program management roles to effectively perform their public health responsibilities in the resource-poor setting of Uttar Pradesh (UP), India.
We used a multi-step, interactive Delphi technique to develop an agreed set of public health competencies. A narrative review of core competency frameworks and key informant interviews with human resources for health experts in India were conducted to prepare an initial list of 40 competency statements in eight domains. We then organized a day-long workshop with 22 Indian public health experts and government officials, who added to and modified the initial list. A revised list of 54 competency statements was rated on a 5-point Likert scale. Aggregate statement scores were shared with the participants, who discussed the findings. Finally, the revised list was returned to participants for an additional round of ratings. The Wilcoxon matched-pairs signed-rank test was used to identify stability between steps, and consensus was defined using the percent agreement criterion.
Stability between the first and second Delphi scoring steps was reached in 46 of the 54 statements. By the end of the second Delphi scoring step, consensus was reached on 48 competency statements across eight domains: public health sciences, assessment and analysis, policy and program management, financial management and budgeting, partnerships and collaboration, social and cultural determinants, communication, and leadership.
This study produced a consensus set of core competencies and domains in public health that can be used to assess competencies of public health professionals and revise or develop new training programs to address desired competencies. Findings can also be used to support workforce development by informing competency-based job descriptions for recruitment and performance management in the Indian context, and potentially can be adapted for use in resource-poor settings globally.
在许多中低收入国家，确保当前的公共卫生劳动力具备履行基本公共卫生职能的适当能力是一项挑战。缺乏一套商定的核心能力来为发展和评估知识、技能、能力和态度提供基础，这加剧了这一挑战。本研究旨在确定印度北方邦（UP）资源匮乏环境中从事中级监督和规划管理工作的卫生专业人员有效履行公共卫生职责所需的核心能力。
我们使用多步骤、互动式德尔菲技术来制定一套商定的公共卫生能力。对核心能力框架进行叙述性审查，并对印度人力资源专家进行关键知情人访谈，为最初的 40 项能力陈述在八个领域中的列表做准备。然后，我们与 22 名印度公共卫生专家和政府官员组织了为期一天的研讨会，他们在初始列表中添加和修改了内容。经过修订的 54 项能力陈述清单按 5 点李克特量表进行评分。参与者对综合陈述评分进行了讨论，然后将评分结果与他们共享。最后，修订后的清单被送回给参与者进行第二轮评分。使用 Wilcoxon 配对符号等级检验来确定步骤之间的稳定性，使用百分比一致性标准来定义共识。
在最初的 54 项能力陈述中，有 46 项在第一和第二轮德尔菲评分步骤之间达到了稳定。在第二轮德尔菲评分步骤结束时，在八个领域中达成了共识，包括 48 项能力陈述：公共卫生科学、评估和分析、政策和规划管理、财务管理和预算、伙伴关系和协作、社会和文化决定因素、沟通和领导力。
本研究产生了一套公共卫生核心能力和领域的共识，可用于评估公共卫生专业人员的能力，并修订或开发新的培训计划以满足预期的能力要求。研究结果还可用于支持印度的劳动力发展，为招聘提供基于能力的职位描述和绩效管理，并为全球资源匮乏的环境提供支持。
