Experts call for revamp of public health infrastructure

Concept note shared with State govt. for consideration

With the COVID caseload low, public health experts are urging the government to seriously consider strengthening preventive healthcare with surveillance systems in place before the next ‘wave’ or pandemic hits us. Certain short-term measures can be immediately initiated while other long term steps can be discussed and planned for implementation in phases for improving public health care, say experts at the Indian Institute of Public Health-Hyderabad (IIPH).

Institute director G.V.S. Murthy, on Sunday, informed that initially, the serving personnel at different levels of the district, regional and State can be skilled through short duration programmes if they show willingness to join the public health cadre solely and not undertake clinical duties. Such personnel will need to have at least 10 years of experience at the sub-district level for district-level positions and at least 15 years of experience for State-level positions, covering primary to tertiary healthcare.

Those with a post graduation in community medicine or public health (MD, DPH, MPH) will only need to attend a short reorientation course while all others will need a certified public health programme, he explained. Long-term measures include recruitment to a dedicated public health cadre from the block level onwards, of personnel with specific mandated public health qualifications with promotion based on seniority and qualification register. Those from clinical services cadre can be considered following a mandated public health course.

Multidisciplinary cadre

Such dedicated public health cadre will be multi-disciplinary, including nurses, doctors, health administrators etc. who can make a difference to the health indicators of Telangana from bottom to top tier. The government could consider appointing an expert committee with leading public health experts at State and national levels to deliberate on the public health cadre, architecture and establishment. The panel should be tasked to submit its recommendations within six months, suggested Dr. Murthy.

Senior academic registrar at the Public Health Foundation of India’s institute, M. Jayaram pointed out that Telangana faced a double burden of diseases — emergence of non-communicable diseases adding to the existence of major communicable diseases like tuberculosis, diarrhoea and pneumonia along with vector-borne disease like malaria, dengue and chikungunya. The coronavirus pandemic has brought communicable diseases to the fore, so controlling both ends of the disease spectrum needs a concentrated effort with the responsibilities vested in a dedicated public health workforce.

Within the country, Tamil Nadu and Maharashtra with dedicated public health cadre have shown ‘remarkable’ progress in health indicators. A ‘good foundation’ of public health is considered complimentary to curative medicine, as a part of “Comprehensive Health Care” and a concept note was shared with the government for consideration, they added.