Professionalization of Public Health in Nepal

Abstract

Background: The need for a professionalized and highly skilled public health workforce is essential to improving and protecting the health of populations, especially in Nepal. This study aimed to explore: (i) the current trends in public health in Nepal and (ii) the opportunities and barriers to the professionalization of the sector.
 Methods: We employed an exploratory qualitative research design and used a combination of semi-structured interviews with senior public health professionals and a small focus group discussion with more recently qualified public health practitioners in Nepal. A total of nine professional stakeholders were interviewed and five junior practitioners joined the focus group discussion. Data was collected via Skype due to COVID-19 restrictions. Thematic analysis was used to analyze the data.
 Results: Four core themes emerged from the research: understanding the public health approach; health priorities; federalization and the impact on public health practice; professionalization and workforce development.
 Conclusions: Political federalization and more recently COVID-19 have impacted the development, capacity, and employment of this often-neglected workforce. Public health graduates with their broad-ranging knowledge and skills are often overlooked in the health sector. This is related to a general lack of understanding of what public health is and what public health practitioners do amongst politicians and the general public.

Professionalization of the public health workforce: scoping review and call to action

“…The number of documents published in consecutive years included: 2021( n = 2/11), 19 , 20 2020 ( n = 5/11) 21–24 , 29 and 2018 ( n = 4/11). 25–28 Five articles reported on public health professionalization in one country 20 , 21 , 26–28 and other six covered multiple countries. 19 , 22–25 , 29 Research on public health professionalization was documented in 61 countries ( Supplementary material S6 ).…”

“… 20 used a review and interviews, Khatri et al . 21 used interviews and focus groups, Mansholt et al . 22 used a scoping review, focus groups and expert interviews, and Zeeshan et al .…”

“…Six studies mentioned competencies. 21 , 22 , 24 , 26 , 27 , 29 Archer et al . 24 reviewed 33 articles to determine the frameworks that were used to educate the PHW.…”

“…Three articles expressed the need to establish educational frameworks for the PHW in Nepal (2020), 21 Pakistan (2019) 26 and India (2018). 27 Such frameworks should include communication and writing skills, health management, leadership, financial planning, analytical skills and policy planning and development.…”

“… 27 Such frameworks should include communication and writing skills, health management, leadership, financial planning, analytical skills and policy planning and development. 21 , 26 , 27 They should be intertwined with key public health areas such as maternal and child health, nutrition, communicable diseases, disasters and emergency management, health systems, health care financial management, policy and strategy development. 26 [p. 816].…”