COVID-19 has shown that states which set up a public health experts’ group to steer the response, or those with either a public health cadre or public health oriented professionals were able to respond much more effectively.
Hence, the need of the hour is to initiate a public health cadre with dedicated function of tackling outbreaks effectively and improve the health status of the population, asserts Indian Institute of Public Health (IIPH)-Hyderabad Director G.V.S. Murthy.
With the country nearing the 5-lakh infections mark, it is time to stress the importance of public health professionals because of the pivotal role played in the earlier communicable disease outbreaks, be it influenza, small pox, plague or polio, he says.
Public health professionals are concerned with ‘protecting’ the health of populations and improving their quality of life.
Combination
A combination of infectious disease physicians, paediatricians, pathologists, microbiologists, pharmacologists and public health professionals working in tandem were able to find answers to stop these diseases in their tracks, he says.
This is by providing evidence-based guidelines, recommending policies based on the available scientific evidence after conducting relevant community-based research, implementing services to screen and protect large numbers, educating and advising people, identifying high risk populations needing additional care and support, monitor disease trends and changing patterns and study risk factors that increase risk of disease, the IIPH director explains.
“Public health professionals work on disease models and estimate the health system needs like resources, infrastructure, personnel and skills required, among others. Their work is, therefore, very different from clinicians like ophthalmologists, cardiologists, neuro surgeons, internal medicine specialists, gynaecologists and others, whose focus is primarily on treating persons when they become sick,” says Dr. Murthy.
People’s behaviour
Public health professionals study people’s behaviour and lifestyle which increases the risk of diseases, natural course of different diseases, prevention methods, screening protocols, assessing which interventions work, monitoring mechanisms, and trend analysis.
“These skills are not routinely taught to clinicians. Therefore, clinicians cannot do what public health professionals can do and public health professionals cannot do what clinicians can do. Both need to supplement each other’s skills,” he observes.
The issue is public health professionals’ work is rarely noticed because there is no “immediate gratification” unlike, say, the “immediate benefit” of a successful cataract surgery or a normal delivery! “We deal with populations where the success is measured by indicators like percentage of people recovering from COVID-19, percentage of people living on premises free of dengue mosquito breeding sites, percentage of mothers having anaemia or percentage of immunised children and so on. Changes in these parameters are then monitored over time to see how effective interventions are,” maintains Dr. Murthy.
The IIPH director warns, “If even after COVID-19 the need for a dedicated public health cadre is not perceived, never will we be in the driver’s seat but will always play a catching up game with disastrous consequences.”