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ASPHER is the key independent European organisation dedicated to strengthening the role of public health by improving education and training of public health professionals for both practice and research.
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REFLECTIONS FROM EPH2022 BY ASPHER FELLOW TARA CHEN

Publication date: 19.12.2022
Author: Tara Chen

The 15th European Public Health Conference (EPH2022) was a magical moment for the public health community, with built-up of excitement to meet in-person Berlin, Germany from the 9-12 November, 2022. For many colleagues and peers, it was the first-time meeting in-person, with strong relationships built from virtual communities on digital platforms, driving the feelings of solidarity and collegiality across attendees. At the personal level, I was overjoyed to celebrate with ASPHER, and my co-fellow Rana Orhan, bringing the refreshing motivation to achieve our climate-health agenda. 

This year, the EPH Conference and its partners, EUPHA and national public health associations highlighted the theme in the Berlin StatementStrengthening health systems: improving population health and being prepared for the unexpected. We recognize that the COVID-19 pandemic revealed the strengths and weaknesses of health and public health systems across the globe, in every space and sector. Although the long-term effects of the pandemic continues to be explored, we must question how can we learn from the lessons, and ensure our systems are prepared for the future? I continued to pose this question across the four days, not only looking at strategies, but looking to understand how do we operationalize this into action.

There are a multitude of sessions that I could highlight, but I wanted to bring attention to two particular sessions that I was involved in: 

  1. Plenary 5: Sustaining high quality care: interprofessional training for our clinical and public health workforce 

(From left to right: John Middleton, Tara Chen, Anett Ruszanov, Laurent Chambaud, Fatai Ogunlayi, Natasha Azzopardi Muscat, George Valiotis)  

Organized by ASPHER and the European Health Management Association (EHMA), I had the opportunity to coordinate and co-moderate this session with John Middleton. The objectives of the session was to provide a balanced perspective on public health and healthcare interprofessional linkages for training of the two workforces as being a critical condition for a well-functioning, responsive, and robust health system. The session was packed with keynote speeches from Natasha Azzopardi Muscat (Director of the Division of Country Health Policies and Systems, WHO Regional Office for Europe) who set the scene by sharing different roadmaps including the Health and care workforce in Europe; time to act, and a take-away message that “Today’s public health challenges cannot be tackled with a spearhead but with a net”.  George Valiotis (Executive Director, EHMA)’s keynote speech transitioned the conversation towards the BeWell Project, a blueprint that can be adopted at the local, national and european level to support the upskilling and reskilling of current professionals, including digital and green skills to address the changing nature of public health. The second half of the plenary focused on our three panelists, Fatai Ogunlayi (Public Health Speciality Registrar UK, Health Security Agency), Laurent Chambaud (Andrija Stampar Medalist), and Annett Ruszanov (EHMA), who discussed how COVID-19 emphasized how socially connected our systems are, and what that means for our interprofessional workforce. Fatai’s takeaway message emphasized that we need to take into account all professions that are responsible for operationalizing the health system, by identifying the subdisciplines, skills, abilities and competencies. He emphasized that we need to include early-career professionals in these conversations as we continue to talk about the workforce of the future, and ultimately, they will be responsible for moving these changes forward. Laurent highlighted the deficit of health professionals in France, emphasizing on three points: (1) we need to move away from competition between medical and health professionals to work together, (2) we need to do more to advocate towards health investments, and (3) we need to highlight the important role of health care managers who support the design, set-up, and implementation of organizations. Lastly, Anett expanded on the BeWell Project, focusing on its person-centred approach to build a workforce that is resilient, and can act/react to change. The opportunity to be involved is open to national and regional partnerships, working together to build a cohesive ecosystem. In summary, the session highlighted that these roadmaps, frameworks and strategies all require national ownership by stakeholders in the field, from public health academic institutions, and lead public health agencies. 

As time was limited and we were managing questions from SLIDO from the audience, I wanted to give recognition to a few questions that stood out to me that I hope can be taken away to help frame future conversations (*some questions have been grammatically restructured for the purpose of this blog)

  • There is discussion to train those outside the public health sector to address health system gaps. How can we manage to welcome and retain these “new public health co-workers”? How much is task-shifting actually happening and being regulated in Europe? 
  • Regarding of shortage of healthcare workers, can we reform the policy to accept the medical professionals of foreign applicants with minimal barriers? How do we retain professionals with good working conditions, pay and public recognition? 
  • Often times, there is a larger focus on public health professionals with the most power (e.g. academics, medics etc.). How do we amplify the needs of the professionals with less power?
  • Why is social protection not often mentioned as part of intersectoral actions?
  • How will patients, health authorities and industries be involved in the development of the blueprint shared by EHMA? How do we define compliance around partnerships? 
  • Health budgets are continuously being pressured- How can we better communicate the benefits of investment in public health training? How do we convince politicians? 
  • What are green skills, and what specific skills are related to the health workforce? What is the role of public health in the climate crisis? 

Although I could highlight every detail of the session, I want to emphasize that these messages are not new. We need to hold continuing discussions and raise the issues of brain drain, working conditions, demands, changing competencies onto the table for workforce planning. As a young public health professional, I value the importance of discussing what myfuture might look like, but I wanted to emphasize that we need to find more ways to engage with professionals at allstages of their careers (mid-, late-, etc.) to understand how we can address these issues to take coordinated action, and it must be ALL health/public health professionals involved in the conversation.

Please click here to see a copy of the presentation slides. 

  1. 10.E. - Round table: Climate emergency, health and equity education: policy and practice recommendations for Europe 

(From left to right: Laurent Chambaud, Daniel Korver, Marija Jevtic, Rana Orhan, Tara Chen, Dorota Sienkiewicz

After the plenary session, I zoomed off to a parallel roundtable, organized by ASPHER, Ecorys (Netherlands), and EUPHA-ENV. Chaired by Rana and Marija Jevtic (EUPHA-ENV), I found the session to be revitalizing with honest, direct questions from the audience. When we first began the conversation about proposing a roundtable, we wanted to highlight the EU Health Policy Joint Statement, organized by Rana and I through the thematic network, “Climate action through public health education and training”. For us, this session was about how do we move to the next stage? What comes after advocacy of raising the issue that public health and healthcare professionals need to be prepared to address the climate emergency. With my fellow panelists, we were able to set the scene and provide context to our experience and how we want to drive the conversation; but the applause must be saved for the audience. Through the use of SLIDO and open discussion, we were able to see that many of us are feeling the same way; that we want to take action but are hesitant to take the first step as the topic is broad, large, and unknown. We still have more to understand exactly what we need to include as a core competency, which is currently being explored at ASPHER. We also have to look at exactly what kind of programs exist in our education institutions; and talk the benefits and consequences about adding to curriculum, or creating new ones. How do we actually operationalize what we want to recommend into practice? What does climate-health training look like? How do we measure our success to be a prepared workforce? These questions really drove home the message that we still need to continue to learn more from each other, and climate change actors, to truly understand the role of public health actors to address the climate emergency at the European and national level. Taking the uncertainty and unknown, I look forward to revitalizing our strategy at ASPHER on how we might tackle these questions in our workplan for 2023.  

Please click here to see a copy of the abstract. 

Conclusion

3 words came to mind about #EPH2022: System, Connection, & Resilience. The pandemic has opened doors to multi-sectoral understanding of the interlinkages to health, emphasizing that the systems-thinking approach needs to be understood beyond only the health and public health system to tackle future challenges. We also realized more than ever, the importance of building connection with each other to be able to find our place in our fields where we have the space to talk about our goals, challenges, burnout, celebrations in our careers and personal lives. Being in public health is a special connection that builds our identity to our profession, which in turn strengthens our workforce by building resilience. We are a workforce and discipline that is changing, and reacting in meaningful ways to develop a sustainable public health workforce for today and the future. 

I also wanted to highlight my appreciation to ASPHER and EPH organizers for the provision of opportunities to engage in these discussions. There is an excitement from early career professionals to be systematically involved in the planning, executing, and evaluating of conferences. I challenge everyone to take the time at #EPH2023 in Dublin, to connect with the future workforce, whether it be EUPHAnxt fellows, ASPHER YPs/fellows, and/or the volunteers (often university students helping in parallel sessions). Our little actions make the collective impact; building back better for the future of public health.  

See you all in Dublin (?)

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