School of Public Health,
The Chinese University of Hong Kong
Sian Griffiths, Josette Sin-yee Chor,
Janice Yue, Fowie Ng
Mu...
What I will cover
• The challenges for PH
• Educational recommendations
• CUHK BScPH : why we have started it and
what we ...
Current challenges for
Public Health
• Responding to emerging threats
– Infectious disease
– Environmental hazards
– Obeso...
Recommendations
• Basic and ongoing training in infection control, fundamental
epidemiology and public health principles f...
CDCs in China
Primary care
• Decades of experience tell us that primary
health care is the best route to universal
access, the best way ...
Integration of Personal and
Community Healthcare
• Better alignment of a public-health approach with personal health servi...
Primary Care in the Health System: UK
• Local health services are managed by Primary Care Trusts(PCTs)
responsible for pop...
Darzi Review: Key Points
• Create an NHS that helps people to stay
healthy
– Our efforts must be focused on six key goals:...
Public Health and Primary Care
Public health
approach
Personal
health
Public health
services
Primary care
services
Seconda...
Who Is a Public Health Professional?
• A public health professional is a person
educated in public health or a related
dis...
The Health Map. Barton & Grant 2006
Based on a public health concept by Whitehead & Dahlgren. The Lancet 1991
Waste manage...
Public Health Team
• Multidisciplinary team
• Engage people with various interests and talents
– Epidemiologist and biosta...
Competency Escalator
Design Policies
Design/Guide/plan strategies
Make decisions based on
interpretations of data
Give tec...
Policy Makers /Strategic Public Health
Leaders and Academics
Early/Middle level academicians/
NGOs/Early/Middle Level
Admi...
Schools of Public Health Recommendation
for Access to Life-Long Learning
• Schools of public health should fulfill their
r...
Training
• Who can specialise?
– The higher specialist training programme in public health
is open to both qualified medic...
UK: Areas of Specialist Practice
• Surveillance and assessment of the population’s health and well-
being (including manag...
Medical Schools—Recommendation
• The committee strongly recommends that
– all medical students receive basic public health...
Tomorrow’s Doctor - General Medical Council
(UK,1993)
• Recommendations on undergraduate
medical education
– The theme of ...
Other Schools Recommendation
• All undergraduates should have access to
education in public health.
Be the One to Make aBe the One to Make a
DifferenceDifference
Future Careers for Public Health Graduates
Three Domains of Public Health
Competency-Based Curriculum Design
BSc in Public Health Process Model
Public Health Jobs at Entry-level - Examples
• Government (Health Departments)
– Management trainees, hospital administrat...
Support from Senior officials
Professor Liming Li
Vice President of Chinese Academy of Medical Sciences
(CAMS)/ Peking Uni...
Dr York Chow, SBS, JP
Secretary for Food and Health, HKSAR Government
“Hong Kong prides herself on her public healthcare i...
Mr Stephen Leung
Country Manger of Pfizer Corporation Hong Kong Ltd.;
Chairman of the School of Pharmacy Advisory Board,
T...
Dr Homer Tso
Immediate Past Chairman of Hong Kong Council on
Smoking and Health
“Public Health is the “science and art of ...
Thank you!
Website:
http://www.sph.cuhk.edu.hk
Email address:
info_sph@cuhk.edu.hk
Multidisplinary interpretation and public health training
Multidisplinary interpretation and public health training
Multidisplinary interpretation and public health training
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Multidisplinary interpretation and public health training

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  • Prof Sian Griffiths apologies she cannot be here today
  • The SARS epidemic was a wake up call for public health . As it emerged in Hong Kong the healthcare sector was quick to respond but the government’s expert committee , chaired by Prof Griffiths, highlighted some of the weaknesses in the system .
  • In particular the weaknesses included the capacity of the public health workforce to respond. There were basic problems in control of infectious disease ,subsequently addressed by the creation of the CHP , but the epidemic also highlighted the need for greater public health capacity . The expert report made two specific recommendations :
    The Government should give a policy commitment to public health training and ensure that priority is accorded in the allocation of resources
    And
    Public health training collaborations with Mainland China should be explored
  • The authorities in mainland China also recognized that public health had been neglected ,and there has been massive investment in the CDCs. The new healthcare reforms underline this investment with commitment to strengthen public health as one of the four pathways for reform
  • In Canada, there has been a huge response in building capacity and reorienting policy towards public health
  • Another area of challenge for public health practice is the interface with primary care . As Margaret Chan has said primary health care is the best route to universal access, the best way to ensure sustainable improvements in health outcomes, and the best guarantee that access to care will be fair.
  • The need for integration of public health into health systems has been recognised by the WHO in its latest annual report
  • The challenge for public health practice is how to align public health practice with primary care practice . As Van Weel said in the Lancet :it is time to integrate personal health care and primary care
  • In the UK ,government policy emphasizes the responsibility of primary care not only for individaul care but for health improvement in the population
  • And the recent Darzi review has emphasized the health system responsibility for staying healthy to address the 6 key goals of
    Tackling obesity
    Reducing alcohol harm
    Treating drug addiction
    Reducing smoking rates
    Improving sexual health
    Improving mental health
  • The challenge we face is how to provide education for the wide range of people who therefore need some public health competence
  • Whilst the definition of a public health professional is :
    a person educated in public health or a related discipline who is employed to improve health through a population focus
    Such a person might work at different levels of the rungs on the competency escalator
  • But whilst educating
  • This is the competency escalator from the UK workforce planning group . The concept here is that different competencies need to be combined to deliver a comprehensive public health approach
  • This translated into these sorts of roles –which have varying needs of competence and therefore different educational strategies are needed to ensure not only that people are competent at the level at which they are working but that they have the opportunity within a framework of life long learning to move up the competency ladder
  • How will we achieve this model of training ?it will of course be depenedent on many factors such as culture, available resources, capacity ,etc
    In the US the Association of Schools of Public Health ,working with the Institute of Medicine ,has recommended that Schools of public health should fulfill their responsibility for assuring access to life-long learning opportunities for several disparate groups including:
    public health professionals
    other members of the public health workforce
    other health professionals who participate in public health activities.
  • In the UK the Faculty of Public Health ,the national professional organisation , has become multidisciplinary and all specialist posts within the UK are open to people who have demonstrated competencies in specialist public health . Thus specialists can be medical and non medical and they have a common training pathway .
  • The training pathway ensures that in their training they acquire sompetence in these areas
  • Whilst specialists can be from a variety of backgrounds, if we are to achieve the integration with clinicians expected in the Darzi review we also need to consider how medical education is provided all doctors [and other healthcare staff ] in their training
    The report from the US [….] also recommended that
    all medical students receive basic public health training in the population-based prevention approaches to health
    所有临床专业的医学生需接受在促进和维护人群健康方面的公共卫生学基础训练
    serious efforts be undertaken by academic health centers to provide joint classes and clinical training in public health and medicine
    学术健康中心必须加强在公共卫生学和医学方面的联合培养和临床技能训练
  • This mirrors recommendations within the UK from the general medical council that :
    The theme of Public Health Medicine should figure prominently in the curriculum, encompassing health promotion and illness prevention, assessment and targeting of population needs, and awareness of environmental and social factors in disease
    必须在课程中突出公共卫生医学的主题,包括健康促进和疾病预防,评估人群卫生需要,知晓环境和疾病的社会因素
    Public health was relevant to many parts of the curriculum and should not be compartmentalized within a public health course
    公共卫生
  • Not only should all medical students be taught public health but all undergraduates should have access to education in public health
  • Our response to this challenge at CUHK has been to initiate a new course-the BSc in public Health . Our reasons for doing this are that we believe that whilst specialists will be educated through formal training programmes in countries such as UK or through formal courses such as MPH at Schools of Public Health , there is a need for training not only for those lower down the competency ladder who fulfil important public health roles. We also believe that given the capacity gap in most countries especially in low and middle income countries that a bachelors level course can provide an education which can help to fill the capacity gap .
    We are started by offering a minor across the university last year and our poster elsewhere in the conference tells of our experience .when we added general education we found we had to define a quota as more students wanted to take the class than were able to . We have some challenges such as changing university entrance which provide opportunities for more integration in the Faculty curriculum for medical , nursing and pharmacy and TCM students .we are also condsidering double degrees and a run through MPH .
    But we want to walk before we can run !
  • The different areas in which a bachelors degree can provide a stepping stone to the competency ladder include the above
  • Using the three domains model of practice used within the UK , we will aim to provide a basic understanding of the key issues within the domains of health protection , health improvement and health services as well as core knowledge in epidemiology , biostatistics ,ethics and law .
  • And the curriculum is designed using competency based approach
  • The course allows both theoretical and practical experience
  • The sorts of posts we believe that our graduates will be qualified to apply for include these sorts of areas Government (Health Departments)
    Management trainees, hospital administrator
    Research scientist
    Executive officer
    Project assistant/ project co-ordinator/ project officer
    Non-Governmental Organisations
    Program coordinators of community projects
    Health educators in community health centers
    Health education teachers in schools
    Development and education officer
    Research and development officer
  • We have gained support from key officials , and in our first year of recruiting we have had more than 1000 applicants .
    We are on the first steps of our journey to increasing public health capacity and we aim to do this not only within Hong Kong but within our region by ensuring that we offer a strong component of global health and the opportunity of exchange . We can also see many opportunites by teaching within
  • We have gained support from key officials , and in our first year of recruiting we have had xx applicants .
    We are on the first steps of our journey to increasing public health capacity and we aim to do this not only within Hong Kong but within our region by ensuring that we offer a strong component of global health and the opportunity of exchange . We can also see many opportunites by teaching within
  • We have gained support from key officials , and in our first year of recruiting we have had xx applicants .
    We are on the first steps of our journey to increasing public health capacity and we aim to do this not only within Hong Kong but within our region by ensuring that we offer a strong component of global health and the opportunity of exchange . We can also see many opportunites by teaching within
  • We would be interested to hear from you your experiences in bachelor level teaching and whetehr you believe we will be able to address at least some of the capacity gap through this approach
  • Multidisplinary interpretation and public health training

    1. 1. School of Public Health, The Chinese University of Hong Kong Sian Griffiths, Josette Sin-yee Chor, Janice Yue, Fowie Ng Multidisciplinary integration and public health training: Moving towards undergraduate public health education
    2. 2. What I will cover • The challenges for PH • Educational recommendations • CUHK BScPH : why we have started it and what we hope to achieve
    3. 3. Current challenges for Public Health • Responding to emerging threats – Infectious disease – Environmental hazards – Obesogenic societies – Ageing populations • Systems reform and synthesizing public health and primary care approaches
    4. 4. Recommendations • Basic and ongoing training in infection control, fundamental epidemiology and public health principles for all healthcare workers • HA should rapidly address the skills shortages in clinical infectious diseases and critical care medicine • The Government should give a policy commitment to public health training and ensure that priority is accorded in the allocation of resources • The Government should consider establishing a Hong Kong field epidemiology training programme as a means of rapidly establishing a cadre of specially trained infectious disease epidemiologists • Public health training collaborations with Mainland China should be explored Report by SARS Expert Committee, 2003
    5. 5. CDCs in China
    6. 6. Primary care • Decades of experience tell us that primary health care is the best route to universal access, the best way to ensure sustainable improvements in health outcomes, and the best guarantee that access to care will be fair. – M Chan, 2007
    7. 7. Integration of Personal and Community Healthcare • Better alignment of a public-health approach with personal health services will achieve a better balance, but the balance since Alma-Ata has tilted towards personal health care at the expense of population health • It is time to integrate personal health care and public health, and organise primary care on the principle of care for individuals in the context of an identified population over time. The future of primary care, and health care in general, will depend on how effectively primary practices achieve this community-oriented primary care approach and contribute to equity and social cohesion van Weel 2008 Lancet
    8. 8. Primary Care in the Health System: UK • Local health services are managed by Primary Care Trusts(PCTs) responsible for populations of about 170,000 people. PCTs are run by Boards of local professional & lay people. They have three main functions: – Improving the health of the community, by assessing health needs, planning, tackling health inequalities, forming partnerships – Developing primary care services, including medical, dental, pharmaceutical & optical services – Commissioning care for their populations, in partnership with primary care ‘gatekeepers’, creating competition among NHS hospitals and private providers to win contracts to provide care for their populations
    9. 9. Darzi Review: Key Points • Create an NHS that helps people to stay healthy – Our efforts must be focused on six key goals: • Tackling obesity • Reducing alcohol harm • Treating drug addiction • Reducing smoking rates • Improving sexual health • Improving mental health
    10. 10. Public Health and Primary Care Public health approach Personal health Public health services Primary care services Secondary care services Tertiary care services
    11. 11. Who Is a Public Health Professional? • A public health professional is a person educated in public health or a related discipline who is employed to improve health through a population focus.
    12. 12. The Health Map. Barton & Grant 2006 Based on a public health concept by Whitehead & Dahlgren. The Lancet 1991 Waste management professionals, Farmers, Gardeners, Landscape Designers Architects, Traffic engineers, Spatial planners, Electricians, Plumbers, BuildersRestaurant owners, Caterers, Transport planners, Teachers, Business owners/Employers, Engineers, Scientists Employers, Businessmen, Bankers Religious leaders, Local Leaders, School teachers Doctors, Nurses, Pharmacists, Carers, Social Workers Political and Global Leaders, Scientists, Business Leaders, Civil Servants A sample of workforces with the potential to influence determinants of health
    13. 13. Public Health Team • Multidisciplinary team • Engage people with various interests and talents – Epidemiologist and biostatistics (mathematical modeling) – Health educators (communication, program planning and teaching skills) – Behavioral scientists (psychology) – Environmental and occupational health specialists, infectious diseases (science skills) – Health administrators (business administration, organization) – Health policy analyst (law and ethics) – Clinicians (primary health care nurses/ doctors)
    14. 14. Competency Escalator Design Policies Design/Guide/plan strategies Make decisions based on interpretations of data Give technical inputs/confirm diagnosis/analyze data/interpret data Facilitate Process/Plan further steps/collection of data Collect samples/perform basic tests/supply necessary remedy Identify & confirm the info/report Observe, Identify and report Observation
    15. 15. Policy Makers /Strategic Public Health Leaders and Academics Early/Middle level academicians/ NGOs/Early/Middle Level Administrators Technical Specialists / Public health nurses Auxiliary Nurse Midwife/Health Inspector Community workers Trained lay workers Community Self Help Groups
    16. 16. Schools of Public Health Recommendation for Access to Life-Long Learning • Schools of public health should fulfill their responsibility for assuring access to life-long learning opportunities for several disparate groups including: – public health professionals – other members of the public health workforce – other health professionals who participate in public health activities
    17. 17. Training • Who can specialise? – The higher specialist training programme in public health is open to both qualified medical doctors and those from other public health disciplines. • How long does specialist training take? – The typical training programme for specialising in public health is normally five years full time. This usually includes undertaking either one year full time, or two years part time to complete an academic course to provide the essential knowledge for the discipline
    18. 18. UK: Areas of Specialist Practice • Surveillance and assessment of the population’s health and well- being (including managing, analysing and interpreting information, knowledge and statistics) • Promoting and protecting the population’s health and well-being • Developing quality and risk management within an evaluative culture • Collaborative working for health • Developing health programmes and services and reducing inequalities • Policy and strategy development and implementation • Working with and for communities • Strategic leadership for health • Research and development • Ethically managing self, people and resources (including education and continuing professional development)
    19. 19. Medical Schools—Recommendation • The committee strongly recommends that – all medical students receive basic public health training in the population-based prevention approaches to health – serious efforts be undertaken by academic health centers to provide joint classes and clinical training in public health and medicine
    20. 20. Tomorrow’s Doctor - General Medical Council (UK,1993) • Recommendations on undergraduate medical education – The theme of Public Health Medicine should figure prominently in the curriculum, encompassing health promotion and illness prevention, assessment and targeting of population needs, and awareness of environmental and social factors in disease – Public health was relevant to many parts of the curriculum and should not be compartmentalized within a public health course
    21. 21. Other Schools Recommendation • All undergraduates should have access to education in public health.
    22. 22. Be the One to Make aBe the One to Make a DifferenceDifference
    23. 23. Future Careers for Public Health Graduates
    24. 24. Three Domains of Public Health
    25. 25. Competency-Based Curriculum Design
    26. 26. BSc in Public Health Process Model
    27. 27. Public Health Jobs at Entry-level - Examples • Government (Health Departments) – Management trainees, hospital administrator – Research scientist – Executive officer – Project assistant/ project co-ordinator/ project officer • Non-Governmental Organisations – Program coordinators of community projects – Health educators in community health centers – Health education teachers in schools – Development and education officer – Research and development officer
    28. 28. Support from Senior officials Professor Liming Li Vice President of Chinese Academy of Medical Sciences (CAMS)/ Peking Union Medical College (PUMC); Chairman of the Ministry of Education Steering Committee for Education in Preventive Medicine, China “I would like to congratulate to The Chinese University of Hong Kong for its exciting launching of the BSc in Public Health, which is a great news to Hong Kong and the Asia region. It is generally recognised that public health in a country symbolizes its development and civilization, as well as the protection of population health and quality of life. Government commitment and law enforcement are just as important as high quality professions who are ready to serve. The BSc in Public Health is a timely product of economic and health globalization. Undoubtedly, it will have a great influence on health protection and promotion in Hong Kong.”
    29. 29. Dr York Chow, SBS, JP Secretary for Food and Health, HKSAR Government “Hong Kong prides herself on her public healthcare infrastructure of international standard, and public health education at the tertiary education level plays a key role in sustaining this leading edge. The School of Public Health of The Chinese University of Hong Kong has long demonstrated her unfailing dedication in providing comprehensive education, nurturing talents and carrying out research of high quality. The new Bachelor of Science in Public Health Programme of the School will further enhance competencies in various important areas of public health in Hong Kong including health protection, community healthcare and health services. Its advent would mark another important step towards improving public health in Hong Kong.”
    30. 30. Mr Stephen Leung Country Manger of Pfizer Corporation Hong Kong Ltd.; Chairman of the School of Pharmacy Advisory Board, The Chinese University of Hong Kong “Congratulations to The Chinese University of Hong Kong for launching the new Bachelor of Science in Public Health, another new horizon for CUHK’s public health portfolio offering. Health is wealth. Investment in health is an investment in human capital. To maintain Hong Kong’s admirable healthcare statistics and economic prosperity, we need to pay attention not only to sick-care but also to health-care. Having a good public health system is the key for our future success and our gift to the next generation. With experienced faculty experts offering global perspectives, we are confident that this new programme will add enormous value to Hong Kong by developing our future professionals in this important discipline of Public Health.”
    31. 31. Dr Homer Tso Immediate Past Chairman of Hong Kong Council on Smoking and Health “Public Health is the “science and art of preventing disease, prolonging life, and promoting health through organised efforts of society”. It ahs roots in antiquity from the beginning of human civilization and is now an important concept representing a complete physical, mental and social well-being of mankind. I wish to extend my congratulations to The Chinese University of Hong Kong on the development of such a far sighted undergraduate course, which will provide a broad and sound foundation for those who are dedicated to devote themselves to becoming professionals in Public Health. In the longer run, we hope people from all walks of our community benefiting when issues such as AIDS prevention and anti-smoking are managed in the hands of well=trained professionals.”
    32. 32. Thank you! Website: http://www.sph.cuhk.edu.hk Email address: info_sph@cuhk.edu.hk
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