Training the Global Public Health Workforce Through Applied Epidemiology Training Programs: CDC’s Experience, 1951–2011

Abstract

The strengthening of health systems is becoming increasingly recognized as necessary for the achievement of many objectives promoted or supported by global public health initiatives. Key within the effort to strengthen health systems is the development of a well-prepared, skilled, and knowledgeable public health workforce. Over 60 years ago, the United States Centers for Disease Control and Prevention (CDC) began the first training program in applied epidemiology, the Epidemic Intelligence Service (EIS), a two-year, in-service training program in epidemiology and public health practice. Since 1951, the EIS has produced welltrained and highly qualified applied or field epidemiologists, many of whom later became leaders within the US public health system. In 1980, the CDC began assisting other countries to develop their own field epidemiology training programs (FETPs), modeling them after the highly successful EIS program. FETPs differ from other training programs in epidemiology in that: (1) they are positioned within Ministries of Health and the activities of the residents are designed to address the priority health issues of the Ministry; (2) they stress the principle of training through service; and (3) they provide close supervision and mentoring by trained field epidemiologists. While FETPs are designed to be adaptable to the needs of any given country, there exist many fundamental similarities in the skills and knowledge required by public health workers. Recognizing this, CDC developed a standard core FETP curriculum that can be adapted to any country's needs. Countries can further customize FETP trainings to meet their specific needs by adding specialized "tracks" or by targeting different audiences and levels of the health system. Although FETPs require substantial investments in time and resources as well as 190Public Health Reviews, Vol. 33,No 1,[190][191][192][193][194][195][196][197][198][199][200][201][202][203] Applied Epidemiology Training Programs: CDC's Experience 191 significant commitment from ministries, CDC's vision is that every country will have access to an FETP to help build its public health workforce and strengthen its public health systems.

Frontline Field Epidemiology Training Programs as a Strategy to Improve Disease Surveillance and Response

“…Since their inception in 1980, Field Epidemiology Training Programs (FETPs) have been 2-year applied training programs focused on the practice of epidemiology in a mentored environment, with a focus on “learning by doing” ( 1 ). FETPs, which are adapted to the host country context, are designed to produce highly skilled epidemiologists who will work at the ministry of health (MOH) in each country to strengthen surveillance systems and respond to public health threats.…”

“…The Centers for Disease Control and Prevention (CDC) has a long history of providing technical assistance for FETPs ( 1 , 2 ), which were mostly modeled on CDC’s 2-year applied training through service program, the Epidemic Intelligence Service (EIS). Currently, CDC provides technical assistance to >65 FETPs throughout the world.…”

Malaria in the Americas: Trends from 1959 to 2011

“…This is well-observed between 1986 and 2004 in Guatemala, where declining API would give an impression of decreasing malaria, although increasing SPR points to the problems of decreases in diagnosis and treatment coverage and associated surveillance quality. National surveillance systems and coverage of the national malaria programs have improved over the past 50 years in the endemic countries of the Americas 54,55. Countries of the Americas have moved from reporting of malaria cases as aggregate data to nominal case reporting, thereby decreasing the chances of duplication of data and improving the quality of data.…”

Editorial: Education for a Public Health Workforce in Europe and Globally

“…We include reviews of the past, present and future of public heath training in Europe 7-10 and the Americas, 11 with case studies from Canada, 12 the United Kingdom, 13 The Netherlands, 14 Chile, 15 Mexico, 16 Bulgaria 17 and Israel. 18 We examine competencies for public health from British and American perspectives, 19,20 the role of international donors in promoting schools of public health in Eastern Europe, 21 future issues in public health research, 22 the global efforts by the Centers for Disease Control to train field epidemiologists, 23 and programs preparing leaders in health systems management. 24 In a fascinating review, Bangdiwala and colleagues report on public health education in the world's most populous countries, India and China, 25 both of which have seen remarkable achievements over the past 60 years.…”