Identifying the Gaps Between Public Health Training and Practice: A Workforce Competencies Analysis

BACKGROUND: The COVID-19 pandemic has reinforced the critical needs for a well-qualified and proficient workforce to provide comprehensive, high-quality health services, reach minorities, reduce health inequalities, and confront emerging health challenges. We aimed to generate insights on how best to enhance the compatibility between Public Health (PH) training program competencies and the implementation of competencies required by employers in addressing emerging public health needs. METHODS: We conducted an online survey, adapted from the WHO-ASPHER Competency Framework for the PH Workforce, among Israeli PH managers from August to November 2021. The survey was pretested using a modified Delphi method process. The final survey comprised 44 PH competencies divided into ten categories and was formulated to mirror Essential Public Health Operations (EPHOs). Reliability of items ranged from Cronbach's α = 0.56 to α = 0.86. Forty-nine managers participated (37.6% response rate) in the assessment of PH competencies and the core organizational PH health operations. Participants were employed at regional health departments or governmental offices (51%), followed by Ministry of Health headquarters and other governmental offices (29%). RESULTS: Analysis of the EPHOs revealed a high deficiency in Advocacy Communication and Social Mobilization for health competencies. Collaborations & Partnership and, Leadership & System Thinking were the most reported insufficient competencies, particularly in health departments and research institutes. Governmental offices reported Organizational Literacy & Adaptability competencies being deficient. Deficiencies were more impactful as the level of expertise increased. CONCLUSIONS: There is an urgent need for PH professionals to acquire versatile and innovative competencies in response to ever-changing health threats. Using a validated survey backed by an expert consensus, our analyses profiled the work needs of many PH workforce employers. KEY MESSAGES: • Leaders of PH services and PH higher education programs should discuss actionable ways to collaborate, redesign and better adapt educational programs to the evolving and demanding field needs. • Continuous evaluation of PH competencies can prepare a competent PH workforce ready to confront new health challenges and adapt to the changing population health.