Which level of competence and performance is expected? A survey among European employers of public health professionals

Abstract

Objectives

To explore largely unknown experience and expectations of European employers of public health professionals with regard to competences required to perform in the best way for the public health.

Methods

A survey targeting employers in Europe was carried out September 2011–October 2012. The web-based questionnaire on public health competences and expected performance levels was returned by 63 organisations out of 109 contacted (57.8 %) as provided by Schools and Departments of Public Health (SDPH) in 30 European countries.

Results

The assessment of the current and desired levels of performance did not show significant differences between employer categories. However, current and desired levels across all employers differ significantly (p < 0.001), varying around a difference of one rank of a five-point scale. On the other hand, SDPH rank the exit qualifications of their graduates with one exception (presumed competences in preparedness for public health emergencies) higher than the current performance level as determined by employers, i.e. closer to their expectations.

Conclusions

SDPH should reconsider priorities and question their estimate of exit qualifications in close contact with potential employers of their graduates.

Appendices

Appendix 1: Web-based questionnaire on the employers’ opinion (ASPHER Survey 2011–2012)

The Association of Schools of Public Health in the European Region (ASPHER) (Prepared by the Working Group on Innovation and Good Practice in Public Health Education).

Dear Employer of public health professionals,

Your contact address has been provided by a School or Department of Public Health in your country. Please be so kind to fill in the following questionnaire using your most objective judgment regarding selected public health competences:

• 1) How often are specific public health competences needed?

• 2) What is the current level of public health performance of your staff?

• 3) What is the desired/needed level public health performance of your staff?

The purpose of this survey is to evaluate the competences of public health professionals to guide their training and to identify required expertise for public health professionals in the 21st century. The results of the survey will be reported to ASPHER’s Executive Board and be published on the ASPHER website.

The survey is confidential and will not be used to evaluate your institutional performance.

Your contact details:

Name of institution:

Your name:

Position in your institution:

Full address (country, city and street):

Telephone number:

E-Mail address:

Your organisation belongs to which of the following categories:

• 1. Governmental:

• 2. Education:

• 3. Health Service:

• 4. NGO:

• 5. Others, please specify:

How many employees do you have?

How many of your employees are male and how many of your employees are female? Male: Female:

Please fill in the following table using your most objective judgment (mark your answer with letter x).

European Public Health Operations	Competences	How often public health professionals in your job environment perform a task, which requires the selected competence?
		Daily	Weekly	Monthly	As necessary	Not at all
		1	2	3	4	5
1. Surveillance of diseases and assessment of the population’s health	Analyse prevalence and incidence.
	Do regression analyses
	Interpret the Gini-coefficient
	Apply the concept of Salutogenesis (Antonovski)
	Contribute to a health impact assessment
	Contribute to a health report
	Prepare an option appraisal
	Contribute to a health needs assessment
2. Identification of priority health problems and health hazards in the community	Analyse epidemiological confounders
	Calculate DALY’s
	Analyse the influence of social determinants on population health
	Analyse the influence of physical, biochemical and biological determinants on population health
	Develop efficient political and managerial health strategies
	Apply the principles of the Ottawa Charter and the setting approach
3. Preparedness and planning for public health emergences	Prepare a disaster management plan
	Prepare the community for emergency situations
	Forecast social disasters (e.g. language change)
	Mobilize emergency response teams
	Participate in disaster simulation exercises
	Cope with the consequences of disasters
4. Health protection operations (environmental, occupational, food safety and others)	Assure the quality of policy programmes
	Communicate social regulations to target groups
	Enforce control regulations on food safety
	Strengthen and further develop public health relevant legislation
	Initiate legal procedures to develop proper sports facilities for facilitating physical activity
5. Disease prevention	Assess immunization and screening programmes
	Provide information on behavioural and medical health risks
	Maintenance of systems and procedures for involving primary health care in programmes on disease prevention
	Plan, organise and evaluate evidence-based screening programmes
6. Health promotion	Perform effect evaluation of prevention and promotion programmes
	Communicate evidence on social determinants to lay, professional and decision maker’s audiences
	Communicate evidence on physical/biological determinants to lay, professional and decision makers’ audiences
	Analyse the environment for a setting approach (acc. to Ottawa Charter)
	Plan and implement health prevention and promotion programmes
7. Assuring a competent public health and personal health care workforce	Make use of Problem-Oriented Learning as part of public health education programmes
	Execute a needs assessment for Life Long Learning of the Health Workforce
	Organise the adequate representation of minorities in study programmes
	Integrate new environmental issues into study programmes
	Mobilize the academic and political authorities to increase the training capacity and quality in public health education
	Design health promotion activities within the student population
8. Core governance, financing and quality assurance for public health	Assess public health workforce capacity
	Lead a group discussion and operationalise the outcome
	Deal with planning and management of measures against air pollution
	Provide policy counselling
	Mobilize human capital for public health planning and management in cross-sectoral governance
	Measure health indicators that reflect access to health services and health disparities
	Empower of disadvantaged groups to demand equitable access
	Plan distribution of health facilities and means of transport
	Analyse financial barriers to access health care and models of health insurance
	Integrate person-based health promotion and prevention into individual health care services
	Update on national and international quality indicators
	Involve stakeholders and respective community groups in defining quality indicators
	Disseminate information about quality of care
	Follow up on hospital acquired infections
	Contribute expertise to evidence-based policy making
9. Core communication for public health	Conduct Focus Groups
	Organise Health Household Surveys
	Work with civil society and other organisations on social development
	Work with civil society and other organisations on environmental issues
	Manage Health Conferences with policy makers/stakeholders
	Initiate community-based health promotion activities with the civil society
10. Health-related research	Critically appraise research publications in public health
	Integrate interdisciplinary research teams
	Use indicators of air pollution to derive further research questions
	Communicate successfully with funding agencies
	Perform action research

European Public Health Operations	Competences	What is the current level of performance displayed by public health professionals in your job environment for this competence?					What is the desired level of performance for public health professionals in your job environment for this competence?
		Not needed	Low	Medium	Fairly high	Very high	Not needed	Low	Medium	Fairly high	Very high
		1	2	3	4	5	1	2	3	4	5
1. Surveillance of diseases and assessment of the population’s health	Analyse prevalence and incidence.
	Do regression analyses
	Interpret the Gini-coefficient
	Apply the concept of Salutogenesis (Antonovski)
	Contribute to a health impact assessment
	Contribute to a health report
	Prepare an option appraisal
	Contribute to a health needs assessment
2. Identification of priority health problems and health hazards in the community	Analyse epidemiological confounders
	Calculate DALY’s
	Analyse the influence of social determinants on population health
	Analyse the influence of physical, biochemical and biological determinants on population health
	Develop efficient political and managerial health strategies
	Apply the principles of the Ottawa Charter and the setting approach
3. Preparedness and planning for public health emergences	Prepare a disaster management plan
	Prepare the community for emergency situations
	Forecast social disasters (e.g. language change)
	Mobilize emergency response teams
	Participate in disaster simulation exercises
	Cope with the consequences of disasters
4. Health protection operations (environmental, occupational, food safety and others)	Assure the quality of policy programmes
	Communicate social regulations to target groups
	Enforce control regulations on food safety
	Strengthen and further develop public health relevant legislation
	Initiate legal procedures to develop proper sports facilities for facilitating physical activity
5. Disease prevention	Assess immunization and screening programmes
	Provide information on behavioural and medical health risks
	Maintenance of systems and procedures for involving primary health care in programmes on disease prevention
	Plan, organise and evaluate evidence-based screening programmes
	Assess immunization and screening programmes
6. Health promotion	Perform effect evaluation of prevention and promotion programmes
	Communicate evidence on social determinants to lay, professional and decision maker’s audiences
	Communicate evidence on physical/biological determinants to lay, professional and decision makers’ audiences
	Analyse the environment for a setting approach (acc. to Ottawa Charter)
	Plan and implement health prevention and promotion programmes
7. Assuring a competent public health and personal health care workforce	Make use of Problem-Oriented Learning as part of public health education programmes
	Execute a needs assessment for Life Long Learning of the Health Workforce
	Organise the adequate representation of minorities in study programmes
	Integrate new environmental issues into study programmes
	Mobilize the academic and political authorities to increase the training capacity and quality in public health education
	Design health promotion activities within the student population
8. Core governance, financing and quality assurance for public health	Assess public health workforce capacity
	Lead a group discussion and operationalise the outcome
	Deal with planning and management of measures against air pollution
	Provide policy counselling
	Mobilize human capital for public health planning and management in cross-sectoral governance
	Measure health indicators that reflect access to health services and health disparities
	Empower of disadvantaged groups to demand equitable access
	Plan distribution of health facilities and means of transport
	Analyse financial barriers to access health care and models of health insurance
	Integrate person-based health promotion and prevention into individual health care services
	Update on national and international quality indicators
	Involve stakeholders and respective community groups in defining quality indicators
	Disseminate information about quality of care
	Follow up on hospital acquired infections
	Contribute expertise to evidence-based policy making
9. Core communication for public health	Conduct Focus Groups
	Organise Health Household Surveys
	Work with civil society and other organisations on social development
	Work with civil society and other organisations on environmental issues
	Manage Health Conferences with policy makers/stakeholders
	Initiate community-based health promotion activities with the civil society
10. Health-related research	Critically appraise research publications in public health
	Integrate interdisciplinary research teams
	Use indicators of air pollution to derive further research questions
	Communicate successfully with funding agencies
	Perform action research

1. Thank you very much. Your support is highly appreciated
2. Prof. Vesna Bjegovic-Mikanovic MD, MSc, PhD

Appendix 2: Frequencies of tasks needing performance of competences by type of organisation (ASPHER Survey 2011–2012)

Competences grouped according to EPHO 1-10	EO		NGO		HCS		GO		ALL
	N	Mode	N	Mode	N	Mode	N	Mode	N	Mode
1:analyse prevalence and incidence	19	1	11	4	11	3	17	3	58	4
1:do regression analyses	19	4	11	4	11	4	17	4	58	4
1:interpret the Gini-coefficient	19	4	11	5	9	4	17	5	56	5
1:apply the concept of Salutogenesis (Antonovski)	19	4	11	5	10	5	17	4	57	5
1:contribute to a health impact assessment	18	4	11	4	10	4	18	4	57	4
1:contribute to a health report	19	4	11	4	11	3	18	4	59	4
1:prepare an option appraisal	19	4	10	4	10	4	17	4	56	4
1:contribute to a health needs assessment	19	4	11	4	10	4	18	4	58	4
2:analyse epidemiological confounders	19	4	11	4	11	2	18	4	59	4
2:calculate DALY’s	19	4	11	5	10	4	17	4	57	4
2:analyse the influence of social determinants on population health	19	4	11	4	11	4	18	4	59	4
2:analyse the influence of physical, biochemical and biological determinants on population health	20	4	11	4	11	4	18	4	60	4
2:develop efficient political and managerial health strategies	19	4	11	4	11	3	18	4	59	4
6:apply the principles of the Ottawa Declaration and the setting approach	19	5	11	5	11	4	18	4	58	4
3:prepare a disaster management plan	19	5	11	5	11	5	17	4	59	4
3:forecast social disasters (e.g. language change)	19	5	11	5	11	4	18	4	58	5
3:mobilize emergency response teams	19	4	11	4	11	5	17	4	59	4
3:participate in disaster simulation exercises	19	4	11	4	11	5	17	4	58	4
3:cope with the consequences of disasters	19	4	11	4	10	4	17	4	58	4
4:assure the quality of policy programmes	19	5	11	4	10	4	18	4	57	4
4:communicate social regulations to target groups	19	5	11	5	10	5	18	4	58	4
4:enforce control regulations on food safety	19	4	11	4	10	4	18	4	58	5
4:strengthen and further develop public health relevant legislation	19	5	11	5	10	5	17	5	58	4
4:initiate legal procedures to develop proper sports facilities for facilitating physical activity	19	4	11	3	11	4	18	4	57	5
5:assess immunization and screening programmes	19	4	11	4	11	1	18	4	59	4
5:provide information on behavioural and medical health risks	19	4	11	5	11	1	17	3	59	4
5:maintenance of systems and procedures for involving primary health care in programmes on disease prevention	19	4	11	4	11	4	18	4	58	4
5:plan, organise and evaluate evidence-based screening programmes	19	4	11	4	11	1	17	1	59	4
6:perform effect evaluation of prevention and promotion programmes	18	4	11	3	11	4	17	4	57	4
6:communicate evidence on social determinants to lay, professional and decision maker’s audiences	18	3	11	4	11	4	18	3	58	4
6:communicate evidence on physical/biological determinants to lay, professional and decision makers’ audiences	19	4	11	4	11	4	18	4	59	4
6:analyse the environment for a setting approach (acc. to Ottawa Charter)	17	4	11	4	11	5	18	3	57	4
6:plan and implement health prevention and promotion programmes	18	4	11	1	11	4	18	1	58	4
7:make use of Problem-Oriented Learning as part of public health education programmes	20	1	11	5	10	4	18	4	59	5
7:execute a needs assessment for Life Long Learning of the Health Workforce	20	5	11	5	10	4	18	4	59	5
7:organise the adequate representation of minorities in study programmes	20	4	11	5	10	4	17	4	58	4
7:integrate new environmental issues into study programmes	21	4	11	4	9	4	17	4	58	4
7:mobilize the academic and political authorities to increase the training capacity and quality in public health education	20	4	11	4	9	4	17	4	57	4
7:design health promotion activities within the student population	19	4	11	5	8	4	18	4	56	4
8:assess public health workforce capacity	19	4	10	4	10	4	15	4	54	4
8:lead a group discussion and operationalise the outcome	19	4	11	4	10	4	16	4	56	4
8:deal with planning and management of measures against air pollution	20	5	11	5	10	5	17	4	58	5
8:provide policy counselling	19	4	10	4	10	4	17	4	56	4
8:mobilize human capital for public health planning and management in cross-sectoral governance	19	4	11	4	10	4	16	4	56	4
8:measure health indicators that reflect access to health services and health disparities	19	4	11	4	10	4	16	4	56	4
8:empower of disadvantaged groups to demand equitable access	19	4	11	5	9	4	16	4	55	4
8:plan distribution of health facilities and means of transport	19	4	11	5	10	4	17	4	57	4
8:analyse financial barriers to access health care and models of health insurance	19	4	10	5	10	4	16	4	55	4
8:integrate person-based health promotion and prevention into individual health care services	19	4	11	4	10	4	17	4	57	4
8:update on national and international quality indicators	20	4	11	4	10	4	17	4	58	4
8:involve stakeholders and respective community groups in defining quality indicators	20	4	11	4	10	4	16	4	57	4
8:disseminate information about quality of care	19	4	11	4	10	4	16	4	56	4
8:follow up on hospital acquired infections	19	4	11	5	10	5	18	4	58	4
8:contribute expertise to evidence-based policy making	19	4	11	4	10	4	17	4	57	4
9:conduct Focus Groups	19	4	11	4	10	4	17	4	57	4
9:organise Health Household Surveys	19	4	11	4	10	4	18	4	58	4
9:work with civil society and other organisations on social development	18	4	11	4	10	4	18	4	57	4
9:work with civil society and other organisations on environmental issues	19	4	11	4	10	4	18	4	58	4
9:manage Health Conferences with policy makers/stakeholders	19	3	11	4	10	4	18	4	58	4
9:initiate community-based health promotion activities with the civil society	19	4	11	4	10	4	18	4	58	4
10:critically appraise research publications in public health	20	4	11	4	10	4	18	4	59	4
10:integrate interdisciplinary research teams	19	4	11	4	10	4	18	4	58	4
10:use indicators of air pollution to derive further research questions	20	4	11	5	9	5	17	4	57	4
10:communicate successfully with funding agencies	21	4	11	4	10	4	17	4	59	4
10:perform action research	21	4	10	4	10	4	18	4	59	4

1. Note: 1-daily, 2-weekly, 3-monthly, 4-as necessary, 5-never
2. EO educational organisations, NGO non-governmental organisations, HCS health care services, GO governmental organisations