Impact of EU Accession on Public Health in Croatia Towards A European Framework for Public Health Competencies Andrija Stampar School of Public Health 17 th January 2011 Christopher Birt

Competencies Competencies these are increasingly under discussion generally, being applied to many professional disciplines; these are increasingly under discussion generally, being applied to many professional disciplines; are being applied in health services in both medical and non-medical situations; are being applied in health services in both medical and non-medical situations; attempts to apply them to public health since around attempts to apply them to public health since around 1990.

What is a competency? Typically, competencies are general descriptions of the abilities needed to perform a particular role in an organisation. Competencies should be described in terms such that they can be measured. ( Free Management Library, June 07) Typically, competencies are general descriptions of the abilities needed to perform a particular role in an organisation. Competencies should be described in terms such that they can be measured. ( Free Management Library, June 07)

Approaches in PH USA: Schools of PH defined few general competencies to inform curricula – top / down approach USA: Schools of PH defined few general competencies to inform curricula – top / down approach UK: Faculty of PH defined competencies as basis for determining progress in training UK: Faculty of PH defined competencies as basis for determining progress in training UK: UK PH Skills and Career Framework; attempt to define competencies for 7 levels of PH employment – bottom / up, starting with workforce UK: UK PH Skills and Career Framework; attempt to define competencies for 7 levels of PH employment – bottom / up, starting with workforce

What health organisations are now using in UK

Meanwhile… Meanwhile… employers are defining ever more precisely the qualifications, experience and skills required for specific posts (including in PH); in PH they are beginning to use the Skills and Career Framework. employers are defining ever more precisely the qualifications, experience and skills required for specific posts (including in PH); in PH they are beginning to use the Skills and Career Framework.

In USA: In USA: Competencies sound like essay questions! e.g. “Describe how social, behavioural, environmental, and biological factors contribute to specific individual and community health outcomes.”

Still in USA… Other competencies appear to be aspirations! e.g. “Engage in dialogue and learning from others to advance public health goals” or “Engage in dialogue and learning from others to advance public health goals” or “Apply social justice and human rights principles when addressing community needs”. “Apply social justice and human rights principles when addressing community needs”.

So the problem is that American competencies (thus far) cannot be measured! that American competencies (thus far) cannot be measured!

In the ASPHER programme we were determined that: competencies should be precise, and as far as possible, measurable, and competencies should be precise, and as far as possible, measurable, and competencies should be relevant to genuine PH practice, and thus competencies should be relevant to genuine PH practice, and thus competencies should be relevant to employers, NGOs, etc. competencies should be relevant to employers, NGOs, etc.

The six “core theme” (domain) working groups Methods (epidemiology and biostatistics; qualitative methods); Social environment and health; Physical, chemical and biological environment and health; Health policy, organisation, management and economics; Health promotion and prevention; Cross-disciplinary themes, including strategy making; Ethics and related themes.

What might PH competencies be for? standard setting and curriculum setting for education and training based on real PH situations; standard setting and curriculum setting for education and training based on real PH situations; standardisation of PH training and practice across Europe; standardisation of PH training and practice across Europe; indicators of completion of stages of training; indicators of completion of stages of training; role definition and standardisation of PH job descriptions; role definition and standardisation of PH job descriptions; matching candidates to PH job vacancies; matching candidates to PH job vacancies; mobility of PH professionals across EU borders. mobility of PH professionals across EU borders.

For this ASPHER initiative, we considered that: For this ASPHER initiative, we considered that: the ASPHER Core Competencies would be designed primarily to support PH education and training; the ASPHER Core Competencies would be designed primarily to support PH education and training; however, they would stand or fall by their relevance (or not) to service public health workforces addressing real life public health problems. however, they would stand or fall by their relevance (or not) to service public health workforces addressing real life public health problems.

Currently ASPHER seeks: extension of dialogue between schools and employers (e.g. at workshops, etc.); extension of dialogue between schools and employers (e.g. at workshops, etc.); establishment of “independent” Europe- wide overseeing body (“Academy”, “Institution” – is there a better title?) responsible for the ongoing production of European lists of competencies; establishment of “independent” Europe- wide overseeing body (“Academy”, “Institution” – is there a better title?) responsible for the ongoing production of European lists of competencies; involvement of wider PH movement in Europe; involvement of wider PH movement in Europe; dialogue with and commitment from governments, health ministries, and PH employers. dialogue with and commitment from governments, health ministries, and PH employers.

Refinement of Competencies in 2011, a complete new list of competencies will be published; in 2011, a complete new list of competencies will be published; also this year, in 2011, a list of “MPH” competencies will be published; also this year, in 2011, a list of “MPH” competencies will be published; later a list of “employer-friendly” competencies will be published; later a list of “employer-friendly” competencies will be published; what other tailor-made lists should follow? what other tailor-made lists should follow?

ASPHER needs to share this work with the wider PH community! ASPHER needs to share this work with the wider PH community! ASPHER has been happy to take a lead thus far, but we have invited the following organisations to work with us to assist ASPHER to develop the project: ASPHER has been happy to take a lead thus far, but we have invited the following organisations to work with us to assist ASPHER to develop the project: EPHA (European Public Health Alliance) EHN (EuroHealthNet) EHMA (European Health Management Association)

Governance: Governance: we need to prepare for permanent body to lead on this; we need to prepare for permanent body to lead on this; with EPHA we shall arrange special meetings in major cities for main PH stakeholders, and meetings with government representatives, etc.; with EPHA we shall arrange special meetings in major cities for main PH stakeholders, and meetings with government representatives, etc.; we plan a meeting at the WHO European Conference 2011, to which EC will also be invited, leading to: we plan a meeting at the WHO European Conference 2011, to which EC will also be invited, leading to: establishment of an “Academy” or “Institute” or…. (to be named!) establishment of an “Academy” or “Institute” or…. (to be named!)

Next stages we continue to refine competencies in workshops involving all stakeholders; we continue to refine competencies in workshops involving all stakeholders; appropriate versions (the MPH version?) should be translated into other European languages; appropriate versions (the MPH version?) should be translated into other European languages; how should we next develop the project? how should we next develop the project?

What health organisations are now using in UK

The UK Skills and Career Framework would something like this at a European level assist PH capacity development? would something like this at a European level assist PH capacity development? if so, which organisations should be involved? if so, which organisations should be involved? which types of organisations would be likely to use the product? which types of organisations would be likely to use the product?

Now is time for questions and discussion – thank you for listening!