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Public Health Competencies

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The development of public health and dental public health compterencies along with updates from latest declarations.

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Public Health Competencies

  2. 2. “Public health impacts all of us, in every corner of the globe, every day of our lives — not only our health and safety, but also how we live, what we wear, what we eat, what happens to our environment and the stewardship of our planet” PROLOGUE 2
  4. 4. INTRODUCTION Public Health practitioners today face a growing range of population health challenges worldwide. HEALTH INEQUALITIES 4
  5. 5. 5 HEALTH INEQUALITIES Obesity epidemic and Aging populations in Developed countries Colossal burden of ill health resulting from poverty in resource-constrained developing countries A competent public health workforce and infrastructure is therefore crucial to address these often complex issues
  6. 6. BIG QUESTION??? Not enough is known about how Public Health practitioners are trained globally or whether the training received prepares them adequately to address these issues? 6
  7. 7. THE SOLUTION The training and education of public health practitioners should address the requirements of the role to be undertaken. This is achieved through adoption of a competency- based approach to education and training. 7
  8. 8. 8 'a unique set of applied knowledge, skills, and other attributes, grounded in theory and evidence, for the broad practice of Public Health.' The American Association of Schools of Public Health (AASPH) COMPETENCY BASED TRAINING
  10. 10. ACADEMICS PRACTICE Practitioner organisations were defined as those health and community-based organisations involved in the actual delivery of Public Health advice, interventions and programmes. Academic institutions as only those schools that deliver post-graduate public health masters-level courses (e.x. Mph, MDS & msc in public health). THE COMPETENCIES TAUGHT THE COMPETENCIES SOUGHT 10
  11. 11. ACADEMICS Academic institutions tended to favour elements that were more akin to research competencies such as critical appraisal, research methodologies and the dissertation component 11
  12. 12. 12 PRACTICE• Practitioner organisations on the other hand favoured applied topics such as disease control and programme management. • These may mirror the organisational realities of their responsibilities and functions.
  13. 13. THE PROBLEM • The lack of congruence between what is delivered and what is needed in Public Health education is of concern as it ill-prepares students for the real world. 13 • The lack of an internationally agreed universal set of defined competencies or approaches to public health training and education.
  14. 14. 14 SOLUTION
  15. 15. 15 Established in 1992 is a collaborative of 20 national organizations that aims to improve public health education and training, practice, and research.
  16. 16. 16 Membership Twenty national organizations are members of the Council on Linkages: American Association of Colleges of Nursing American College of Preventive Medicine American Public Health Association Association for Prevention Teaching and Research Association of Accredited Public Health Programs Association of Public Health Laboratories Association of Schools and Programs of Public Health Association of State and Territorial Health Officials Association of University Programs in Health Administration Centers for Disease Control and Prevention Community-Campus Partnerships for Health Health Resources and Services Administration National Association of County and City Health Officials National Association of Local Boards of Development of the Core Competencies The Core Competencies grew from a desire to help strengthen the public health workforce by identifying basic skills for the effective delivery of public health services Since development began in 1998, the Core Competencies have gone through three versions: 2001 version – Adopted April 11, 2001 (original version) 2010 version – Adopted May 3, 2010 2014 version – Adopted June 26, 2014 (current version)
  17. 17. 17 Organization of the Core Competencies The Core Competencies are organized into eight domains, reflecting skill areas within public health, and three tiers, representing career stages for public health professionals. 8DOMAINS 3TIERS
  18. 18. 18 TIERS Tier 1 – Front Line Staff/Entry Level Tier 1 competencies apply to public health professionals who carry out the day-to-day tasks of public health organizations and are not in management positions. Responsibilities of these professionals may include data collection and analysis, fieldwork, program planning, outreach, communications, customer service, and program support. Tier 2 – Program Management/Supervisory Level Tier 2 competencies apply to public health professionals in program management or supervisory roles. Responsibilities of these professionals may include developing, implementing, and evaluating programs; supervising staff; establishing and maintaining community partnerships; managing timelines and work plans; making policy recommendations; and providing technical expertise. Tier 3 – Senior Management/Executive Level Tier 3 competencies apply to public health professionals at a senior management level and to leaders of public health organizations. These professionals typically have staff who report to them and may be responsible for overseeing major programs or operations of the organization, setting a strategy and vision for the organization, creating a culture of quality within the organization, and working with the community to improve health.
  19. 19. 19 DOMAINS Analytical/Assessment Skills Policy Development/Program Planning Skills  Communication Skills  Cultural Competency Skills  Community Dimensions of Practice Skills  Public Health Sciences Skills  Financial Planning and Management Skills  Leadership and Systems Thinking Skills
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  23. 23. DPH DEFINITION "...the science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice which serves the community as a patient rather than the individual. It is concerned with the dental education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis.. " 23
  24. 24. • This population-based approach to professional practice is quite different from the approach required for individual patient care in private practice, though both forms of practice are integral parts of the dental profession. • Accordingly, dental public health practice demands an additional body of knowledge and a set of skills beyond those obtained in an undergraduate dental education. 24 HOW IS IT DIFFERENT?
  25. 25. Fundamental Attributes of the Dental Public Health Specialist 25
  26. 26. Being a dentist…… The scientific background and clinical skills to diagnose, prevent, and manage oral diseases and conditions inherent in a dental education provide the underlying foundation for advanced knowledge of dental public health. 26
  27. 27. Public health values Demonstration of public health values, which essentially means a view of health issues as they affect a population rather than an individual with particular emphasis on prevention, the environment in its broadest sense, and service to the community. Public health dentists usually work collaboratively as part of a multidisciplinary team of public health professionals and community representatives. 27 PREVENTION ENVIRONMENT SERVICE COLLABORATION
  28. 28. Leadership characteristics Leadership characteristics, such as influencing health policies and practice through research, education, and advocacy; articulating a vision for the organization; negotiating and resolving conflicts; etc. 28
  29. 29. Ethics Subscribing to the code of ethics set down by the Research ethics of the country. Incorporate ethical standards in oral health programs and activities 29
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  32. 32. 32 COMPETENCIES CALIFORNIA I. Plan oral health programs for populations. II. Select interventions and strategies for the prevention and control of oral diseases and promotion of oral health. III. Develop resources, implement and manage oral health programs for populations. IV. Incorporate ethical standards in oral health programs and activities. V. Evaluate and monitor dental care delivery systems. VI. Design and understand the use of surveillance systems to monitor oral health. VII. Communicate and collaborate with groups and individuals on oral health issues. VIII. Advocate for, implement and evaluate public health policy, legislation, and regulations to protect and promote the public's oral health. IX. Critique and synthesize scientific literature. X. Design and conduct population-based studies to answer oral and public health questions Journal of Public Health Dentistry, Volume 58, Supplement 1, 1998, p. 119-122.
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  37. 37. 37 COMPETENCIES
  40. 40. DENTAL PUBLIC HEALTH The scope of dental public health practice? – Is it all about: • Fluoride, seal, brush, and fill • Education • Financing of dental care 40 Demand for DPH expertise It is a commodity;
  41. 41. The Implications • From Fluoride Sealants Education • To  Addressing the causes of inequalities and inequities in health and oral health  Comprehensive dental/oral care models  Advanced oral health promotion  Social and policy changes 41
  42. 42. Future Workforce • Oral health Promotion Workforce (DDS, RDH, RN, Social Workers, others) – Community health workers (Promotors) – Community-based oral health promotion specialists – Community-based DPH clinical dentists and hygienists (NNOHA) – Advanced dental public health specialists • Epidemiology • Health management and policy • Strategic planning and social marketing • Program development and implementation • Policy and advocacy • Evaluation • Economics • Health promotion – (with a certificate in dental public health sciences) 42
  43. 43. 43 CONCLUSION Competencies in DPH are dynamic and have to be updated periodically. Periodic revisions are essential due to evolution of the specialty, financial, workforce and technological changes in health care delivery, changing characteristics of populations served, changing patterns of dental disease, developments in informatics, big data, and scientific advances. Greater engagement between academic institutions and practitioner organisations is necessary to ensure DPH courses are appropriate and up-to-date.
  44. 44. 44 REFERENCES 1. Sadana R, Mushtaque A, Chowdhury R, Petrakova A. Strengthening public health education and training to improve global health. Bull World Health Org 2007; 85: 163-4. 2. Calhoun JG, Ramiah K, Weist EM, Shortell SM. Development of a core competency model for the Master of Public Health degree. Am J Public Health 2008; 98: 1598-607. 3. Council on Linkages Between Academia and Public Health Practice. Core Competencies for Public Health Professionals (adopted May 3, 2010).Washington, DC: Public Health Foundation. (Online) (Cited 2011 March 26). Available from URL: http://www.phf.org/resourcestools/Documents/Core_Public_Health_Competencies_III.pdf. 4. Khanagar S, Naganandini S, Rajanna V, Naik S, Rao R, Reddy S. Self-perceived competency among postgraduate students of public health dentistry in India: A cross-sectional survey. J Indian Assoc Public Health Dent 2014;12:106-12. 5. 5. Chandrashekar J, Vinita S, Joe J. Public healther: The true role of public health dentist. J Indian Assoc Public Health Dent 2016;14:241-2
  45. 45. 45 6.Altman D, Mascarenhas AK. New competencies for the 21st century dental public health specialist. Journal of public health dentistry. 2016 Sep 1;76(S1). 7.Weintraub JA. The development of competencies for specialists in dental public health. Journal of public health dentistry. 1998 Dec 1;58(s1):114-8. 8. Abbas SM, Lee A, Mubashir H. Competencies required from public health professionals by health based organisations and the role of academia. JPMA. The Journal of the Pakistan Medical Association. 2014 Jan;64(1):57-63. 9. Competency Statements for Dental Public Health. Journal of Public Health Dentistry, Volume 58, Supplement 1, 1998, p. 119-122. 10. Entry-level competencies: public health dentistry (community dentistry), Dental Board of Australia, July 2016 11.Sawleshwarkar S, Negin J. A Review of Global Health Competencies for Postgraduate Public Health Education. Frontiers in public health. 2017 Mar 20;5:46. 12. Rozier RG. AAPHD Turns 60—Back to the Future: Whatever Became of Dental Public Health?. Journal of public health dentistry. 1997 Jan 1;57(1):3-4.