The last two decades have seen massive investments in training in the area of public health. This was particularly true of low and middle-income countries, where training took centre stage in most capacity building initiatives. Anywhere you looked, you would find a technical agency conducting classroom training to build public health staff capacity. Being part of several such activities myself, a persistent question kept popping up, “What has been the impact of such exercises on the system at large?”. Did the training help people change their workplace practices?
Supply chain, management of health programmes and other similar topics are not taught in courses like Pharmacy, Medicine, Nursing etc. Therefore, there is no doubt that in-service training is required for health professionals managing these areas. Moreover, it is high time for these courses to be part of the pre-service curriculum so that health workers of future are equipped to manage public health systems.
Previously, in-service training in public health did not often lead to systemic impact guiding positive change. The majority of training courses I observed were too theoretical and lacked emphasis on the key competencies required for day to day work. More importantly, the training courses, both in content and method, focused exclusively on knowledge (too often very theoretical) rather than on an approach that blends knowledge, skills and behaviours.
In 2014, People that Deliver launched the supply chain competency compendium for public health. It was the first attempt to identify and collate the different competencies required by a health supply chain professional. Recently, the World Health Organisation in Europe too developed a similar guide for public health disciplines so that people and institutions understand the type of skills needed for these jobs. All of this has provided opportunities for development sector organisations and educational institutions to tailor supply chain capacity development initiatives (& other health system capacity development) to develop skills by making use of the competency compendiums. However, we haven’t seen many initiatives where capacity development interventions focussed on systematically cultivating individual skills to strengthen organisational objectives. How many health supply chain professionals would say that a training programme helped them gain competencies required for their actual work?
Today, supply chain organisations are stuck in a vicious cycle:
- They are unable to recruit individuals who already have basic supply chain competencies
- Therefore, they invest heavily on in-service training that is not designed to build competencies required for the job.
- Hence, they constantly face the same gap between expected competencies and available ones.
- This cycle repeats several times as many factors fuel it: external funding focussing only on quantitative targets rather than both quantitative and qualitative ones, staff turnover due to lack of personal growth or better career options within the organisation, etc.
This highlights the need for systemic change in how capacity building initiatives as a whole, and training/educational courses in specific, are designed. It also emphasizes the need to develop different competencies at different levels. Educational institutes need to ensure that students are equipped with basic to intermediate competencies that are industry-specific at the end of their course. Capacity building initiatives must acknowledge the need for career progression and hence, different sets of training curriculum should be developed for staff at different stages of the professional cycle. Organisations must invest in creating individual career maps linked with performance and competencies. This will encourage professionals to acquire relevant job skills and motivate them to apply those skills effectively to improve their performance. This will in turn urge educational institutions to invest in relevant courses.
If public health organisations are able to create a competitive environment for human resources by elevating the status of the jobs on offer and generating more demand, individuals will want to learn the relevant skills to improve their performance. This ultimately, will result in a positive impact on the system.