More power to health

India ranks 134th among 182 countries in the 2009 Human Development Report, an annual report released by the United Nations Development Programme. Clearly, health care delivery in the country is far from perfect. The estimated shortage in India of health workers – going by WHO standards of 25 per 10,000 – is 20 per cent, or around four to six lakh, says a background paper by Dr KK Datta written for the National Consultation on Public Health Workforce in India, organised by the Ministry of Health and Family Welfare, in association with the WHO Country Office in June 2009 in Delhi.

Despite its tremendous economic growth, India is lagging on many human development indices. If you feel saddened by the poor health in our country but are not armed with an MBBS degree, you can still make a difference. This is because one’s health depends as much on the availability of clean drinking water, sanitary toilets as well as unpolluted air as on access to a primary health centre. As a public health official you could be a communication specialist, an environmental engineer, or even an economist, and ensure an illiterate mother gets her baby protected against polio, reduce the chances of a child developing asthma in a highly polluted city or make judicious use of stretched finances. Some experts have been pointing to the need of roping in such a varied profile of professionals to manage public health.

Says Dr Deepak Raut, professor and head, department of community medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, “There is plenty of scope in this area.” This includes opportunities in more than 20 national health programmes, such as the National Rural Health Programme and the Pulse Polio Immunisation programme.

Dr Raut says that the dual responsibilities of patient care and working on target-oriented national programmes excessively burden medical professionals. “So, they can’t do justice to both.”

In such a case, non-medical public health professionals can serve many roles, “from the start” of a project. They can be involved in the planning, implementation and monitoring and evaluation of a programme, says Dr Raut.

The Indian Public Health Association (IPHA) says India needs professionals with managerial skills who are also clued in to the practice of health care. “In the changing scenario, issues like public health standards, public-private partnership and accreditation, and health insurance need special inputs in the training and attitude of health managers. This requires sound knowledge and professional skills of epidemiology, biostatistics, health management, etc. This can be done by those with PG qualification in public health and not a generalist.”

Dr Datta says in his paper, “Apart from public health physicians, human resources from the allied non-medical disciplines are also needed i.e., statisticians, demographers, environmentalist(s), engineers, biologist(s), nutritionists, sociologists, economists, nurses, laboratory technicians, mass media and extension educators, vector biologist(s), public health nurses, food inspectors, drug inspectors and industry inspectors to provide preventive health care, enforce public health laws and monitor public health services,” says the paper. Also required are sanitarians, policy analysts, epidemiologists, behavioural scientists, health promoters, social workers and community health workers, etc.

These professionals or specialists are supposed to prevent diseases and improve the health of the population.

The concept of public health management is relatively new in India, but there is some forward movement. States like Tamil Nadu, Maharashtra and West Bengal have public health cadres.

So, what’s the aptitude required for it? K Srinath Reddy of PHFI says, “You should be interested in working preferably both in (executing) policies and (implementing) programmes for community-based activities for influencing determinants of health. It’s not so much about individual patient care but about policy, urban design, organisation, resourcing, monitoring and evaluation of health services.”

You may explore one of the profiles, depending on your disposition and abilities.

Author: Rahat Bano

Date: 17th March, 2010

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