Medical Officers of Health, Public Health and Preventive Medicine Specialists, and Primary Care Physicians: How Do They Fit?

Corber, S

doi:10.1007/bf03405670

Cited by 4 publications

(3 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Expertise in measurement sciences contributes identifying strengths and gaps in service delivery, particularly at district level. PHM and PH trained physicians were core to municipal health services in pre-apartheid,[47] apartheid[48] and post-apartheid SA, as well as in many countries globally, such as the historical[49] and contemporary British health system,[50] Canada,[51] Italy[52] and Ghana. [53] Specifying PH training for senior district managers, and the speciality for senior professionals managing complex institutions, as in the UK and Norway,[54] requires political will and PHM’s convincing, demonstrable value.…”

Section: Discussionmentioning

confidence: 99%

Stakeholders’ perspectives on Public Health Medicine in South Africa

2019

View full text Add to dashboard Cite

South Africa (SA) is reforming its health system in preparation for an anticipated national health insurance (NHI) scheme that aims to improve the delivery of affordable, equitable, accessible health care. Public health (PH) language is explicit in the policy and skilled PH professionals would be expected to play a key role in its implementation. In South Africa, training of doctors as Public Health Medicine (PHM) specialists is funded by the state, yet there are few positions for PHM specialists in the health services. We explored stakeholders’ perspectives about this absence, and their views on PHM specialist’ roles and contribution in an era of health reform. A qualitative study was conducted in 2012–13, using in-depth interviews with thematic analysis, which elicited perspectives of 31 key stakeholders nationally reflecting diverse employer and institutional backgrounds. While some were surprised by the absence of PH professionals in SA’s health system, most agreed the reason was due to factors internal to the profession, such as its low profile and uncertain identity. External factors such as legislation and political preferences for health managers impacted on the employment of PH professionals. However, given the competencies required to implement an ambitious restructuring of the health sector, all believed that PH and PHM personnel were vital. In view of the health system’s dominant curative orientation, embedding PH personnel in the services should ensure that health protection, promotion and prevention strategies will inform health priorities. This study, the first known from a low and middle-income country, contributes to the international literature about the identity and roles of PHM physicians, who are versatile professionals with broad skills-sets. In SA, through consultation with health sector employers about potential roles, curricular redesign and trainee recruitment, PHM can graduate fit-for-purpose specialists to work in a range of institutions to address health system reform.

show abstract

Section: Discussionmentioning

confidence: 99%

Stakeholders’ perspectives on Public Health Medicine in South Africa

2019

View full text Add to dashboard Cite

show abstract

“…PHM specialists, however, offer a unique combination of skills preparing them for a range of positions including senior health leadership positions. PHM competencies include generic skills such as communication (79), leadership, management, critical appraisal, and synthesis skills (39) which together with specialized skills in epidemiology are required to transform the health services and address priority health needs. However, unless work environments encourage efficiency, autonomy, professional development, and leadership, improved remuneration alone will not attract physicians to specialize and work in the state health sector.…”

Section: Discussionmentioning

confidence: 99%

Career Paths of Public Health Medicine Specialists in South Africa

Zweigenthal

Pick

London

2019

Front. Public Health

View full text Add to dashboard Cite

Public health (PH) skills are core to building responsive and appropriate health systems, and PH personnel including medical specialists are embedded in many countries' health systems. In South Africa, the medical specialty in PH, Public Health Medicine (PHM), has existed for over 40 years. Four years of accredited training plus success in a single national exit exam allows specialist registration with the Health Professions Council of South Africa (HPCSA). However, there are few posts designated specifically for PHM specialists in SA's health system. In view of uncertain roles, this research was designed to determine specialists' career paths, their work, job satisfaction, and perspectives on the future of the specialty. We combined three databases to generate the study population and invited all specialists to participate in an online or hard-copy survey. We found that in 2010, PHM was a small specialty of less 200 physicians. Of the 151 contactable, eligible physicians, 55.6% completed the questionnaire. Participants represented an aging group (median age = 49) of specialists and recent graduates were increasingly women. They largely worked in academic institutions (as managers, teachers, and researchers) and in the public sector health system; were motivated by a sense of social justice and their training was formative, exposing them to work settings which they later entered; were largely highly satisfied at work, but many worked in non-specialist positions. Indeed, one fifth had not registered with the HPCSA as specialists. They were concerned about the specialty's poor visibility and identity, but did not see other PH professionals as a threat. They believed that the specialty should refine its competencies, demonstrate its value and advocate for service positions at all levels of the public sector health service. PHM has a contribution to make—reorienting services to protect communities, preventing ill health, analyzing disease burdens locally, identifying innovations in a resource-constrained health service, largely preoccupied with curative care services.

show abstract

“…e thank Corber, 1 Dunkley 2 and Moloughney 3 for their thoughtful responses to our commentary, 4 with each further expanding the understanding and appreciation of public health medicine's past, current and future place in Canada. We particularly appreciate Moloughney's highlighting the current lack of available data concerning the number, distribution and practice of public health medical specialists across Canada.…”

mentioning

confidence: 97%