Op-Ed---- Public Health as I see it- India &LMICs1 The concepts of public health, one of the broad and vast scientific streams, is not getting required attention and support in India and other LMICs (low and middle income countries) like the western countries and HICs (high income countries) even in this covid-19 pandemic era. There are several reasons for this difference in public health encouragement between LMICs and HIC, the most significant factors are policies, lack of awareness and resources such as institutes, funds etc. Added to this the policy and decision makers seem to be ignorant about the significance of public health in reducing the burden of disease and health expenses at mass level. The field of public health will be more significant & useful if divided into Medical and Non-Medical branches as it incorporates scholars and experts of different fields and this division will increase significance, utility as well as efficiency of public health scholars. At present it is a mixture of scholars of different backgrounds and the title Master of Public Health seems quite inappropriate title for scholars’ of non-health field backgrounds called Master (of public health) with a simple 2 year course. Moreover the non-medical graduates will find difficulty in getting primary data related to health sciences and vice versa is also true for medical graduates and scholars. For example the non medical scholars doing research on Kala-azar don’t have enough knowledge of kala-azar to interpret the findings like spleen size, life cycle of vector, modes of transmission etc. and vice versa is also true for medical graduates. Since the preparedness and efficiency of these scholars depends on the education they receive and how effectively they use it, the training and work field should be designed as isolated fields to make the scholars’ real master instead of making jack of all trades Master of nothing. This is one of the reasons why the scholars of public health are not getting good jobs, enough attention and reputation. Added to this the credibility and reliability of public health experts can be endangered by practice of using secondary data in research largely derived from medical graduates. Hence it’s better if the public health experts department with proper division is established to reap the maximum benefits from scholars of different fields. Public health consists of experts from different fields and services which can be utilized in cases of emergency and critical support. Their abilities can be utilized while managing existing cases of non-communicable diseases like diabetes, hypertension, heart ailments, routine ante-natal care, accidents, as well as communicable disease like covid-19 if we have a clear role to be played by public health scholars. For example let the management public health expert do the management works while let medical public health experts find out the formula to deal with covid-19 as medical public health experts. Of course everyone will have importance and at the same time expertise in their respective field which can be utilized as team work to deal with various healths related issues. The significance of doctors, nurses, technicians and other hospital-based staff have been noticed and praised during this covid-19 era but still the public health experts are not getting enough attention, why? Taking example of covid-19, Public health experts may not be able to provide sophisticated complex treatments but their role in preventing, identification of cases, contact tracing, quarantine and isolation monitoring, referrals, logistic management etc. would prove helpful and significant to deal with the situation. Their ability would depend on their training about the infection and its identification, transmission, diagnostics and treatment support. India has a three-tier public health system for provision of primary (HSC, APHC, and PHC), secondary (provided by SDH, CHC, and DH specialist on referral from primary care provider) and tertiary (medical college hospitals etc. highly specialized medical care) care. All these centers must have public health experts well qualified and trained to reduce the burden of disease as well as OOPE (out of pocket expenditure) at mass level. India and other LMICs must focus now on preparing the qualified, skilled public health soldiers in order to reduce the burden of disease and health care expenses which are interfering with the nation's development.1. DR PIYUSH KUMAR, M.B.B.S., EMOC (FOGSI), PGDPHM,SENIOR MEDICAL OFFICER, HEALTH DEPARTMENT, [email protected] Mobile-+919955301119/7677833752,GOVERNMENT OF BIHAR
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