1. Prof. Sushma Acquilla, Project Director
Public health cadre development, using competency based approach in the State Health system, Odisha, India
Prof. Sushma Acquilla, Project Director
& the Odisha Team
Leena Inamdar, Catherine Hannaway, Bharat Sibal, Ankush Mittal, Anjali Pai, Gurpreet Rai,
Himanshu Negandhi,

2. Overview of Session Background to the project
Scoping study and Road map for Public Health cadre Implementation in Odisha
Training needs assessment
Training the Trainers Program
Leadership Development program
Way forward for India SIG

3. Background to Odisha (India) project
There is no defined PH structure or cadre in State based health service
Yet India has health inequality and associated public health challenges
Government of Odisha (GoO) agreed to develop a Public Health Cadre
Need development of a trained and effective public health workforce
A scoping study carried out at the start
Roadmap for implementation of public health cadre
GoO needed technical assistance for implementation of PH Cadre
GoO partnered with the UK Faculty of Public Health through an international MoU
Financial support from DfID, India

4. Odisha Project Delivery Team
Project Director: Sushma Acquilla (FPH)
Needs assessment Team:
Sushma Acquilla, Bharat Sibal, Ankush Mittal, Gurpreet Rai, (FPH) Himanshu Negandhi (PHFI/IIPH)
Training the Trainer Program Team: Sushma Acquilla, Bharat Sibal, Anjali Pai
Leadership Development Program & delivery Team
Sushma Acquilla, Catherine Hannaway, Leena Inamdar
Developing Curriculum for MPH for India
Sushma Acquilla & Suzanna Mathews

5. Scoping visit /activities in Odisha and MP
Carried out during 3 personal trips in 2014/15 by Sushma Acquilla with a report to GoO and DfID India
Although the Government agreement in place, No public health cadre structure was available
Overlap between public health and primary care role
Lack of leadership or management capability amongst senior public health professionals
Lack of direction and clarity of role for the State Institute for training
Lack of defined training, job description or promotion structure
Medical leadership with no appropriate delegation
Lack of clarity on individual role

6. Training Needs Assessment
Aim
To conduct a survey of functions and training needs assessment of practitioners in the State of Odisha, in order to assess and further develop competencies for the generic public health programmes.
Objectives
To complete a training needs analysis report of the public health functions delivered in the current State health system for the government of Odisha.
To provide recommendations to the State on the structure and competency framework for the public health cadre for Odisha.
To provide recommendation, develop and deliver training programs to public health professionals in order to help implementation of Public health Cadre.

7. Training Needs Assessment
Methods
Time period: 1 week (Feb 2016)
We performed semi-structured interviews with 29 responders at various levels of the state health system in Odisha in health centres of Puri, Kurdha and Bhubaneshwar. We identified the principal clinical and public health functions being performed at each level and identified any training provided/training gaps at each level
Main questions
What are your functions/responsibilities?
What training have you received in order to perform these functions?
What training would be useful for you to perform better in your current role.
Analysis
Mapping of functions against training received in order to identify training needs ,with
a focus on public health functions/training needs)

8. Training Needs Assessment
Results of Public Health Training Needs Assessment
Key training needs identified:
‘Train the trainer’ training
Leadership training
Health Economics/Financial Management
Partnership/Team working
Training gaps were identified across all public health functions being performed at each operational level
There is a need for a formal public health cadre in Odisha, with a set of integrated public health competencies

9. Train the Trainer workshop
Aim
To train health professionals in the state of Odisha, India to become effective public health trainers
Objectives
To provide an overview of public health system in the United Kingdom and comparative links to Odisha, India
To understand the theoretical basis of learning and teaching methods and models
To demonstrate how techniques learnt can be implemented in practice
To provide opportunities to discuss and learn from each other

10. Train the Trainer 2 Training Content and Delivery
Two training workshops held : 2.5 days each
In July 2016: SIHFW, Bhubaneshwar, India
43 senior clinical and public health officers at the Department of Health and Family Welfare, Bhubaneshwar, Odisha attended
Resource material from the NHS Education for Scotland, Train the Trainer toolkit
Training material was adapted to the Indian public health context
Training methods: power point presentation, flip charts, case studies, group work
Handouts and training material were shared with participants

11. Train the Trainer Outcome and Key Achievements
39 participants completed full workshop
89% said expectations were well met
Facilitators were rated very good (87%) or good (13%)
67% said the materials provided were good
Overall training evaluated ‘very good’, particularly day 2 (74%)
Facilitative style of teaching, adaptability to local context and interactive elements were highly commended
Potential future ‘trainers’ identified among participants for the sustainability of the program

12. Public Health Leadership Training
Aim
To develop leadership skills of middle to senior level in public health roles in Odisha and build a cadre of strong public health leaders across Odisha
Objectives
To develop leadership skills and competencies for senior public health officials in Odisha
To develop understanding of role of middle to senior level public health leaders in whole system leadership across Odisha
To recognise own style of leadership, management and impact on others
To develop systems leadership by strong multi-disciplinary and cross-sectoral working
To develop a network of public health leaders for addressing health inequity in Odisha

13. Public Health Leadership Training
Delivered by UK FPH and PHE team with State support in March 2017
Aimed at senior to mid-level public health staff in the State
Training programme developed in consultation with State
Conducted over 5 days in interactive way in SIHFW, Bhubaneshwar
Three core elements of leadership:
An introduction to Public Health leadership
Understanding self as a Public Health leader and working with others
Leading others in complex systems, teams and partnerships

14. Public Health Leadership Training
Key achievements
Addressed a key gap in leadership development
17 mid to senior public health professionals trained
Evaluated highly by participants
Enabled participants to do self-assessment of leadership skills and identify areas for self-improvement

15. Lessons Learnt
Project should have detailed and adequate funding for the delivery
Need a fully committed project director/ Officer
Have an effective and influential local coordinator along with direct connection with the Government officers
Time scale for delivery should be fixed with 1-2 months notice to allow recruitment of appropriate team
Whilst it is important to be able to offer opportunity of experience to wider group, selected individuals need to be available and committed for the delivery of appropriate section

16. Next step for India & related country SIG
Create a competency based curriculum for public health training in India using Odisha experience, adapted to local needs
Support further training in management, leadership, and trainer development to current and future public health leaders in Odisha
Facilitate the development of an electronic training platform to track public health training and support continuing professional development
Work with central government to develop Masters in Public Health curriculum for India for approval by Government ministry.
Continue the link with the Central and State government to implement Public Health Cadre in the States of India.
Facilitate the development of public health laboratories in Odisha