The process of developing a framework for code of ethics

Foundation and Continuation of Public Health ReviewsPublic Health Reviews (PHR) was founded in 1972 in Israel and published for over 30 years, with listing in Pubmed, Medline and Index Medicus and many other on-line data bases until the owner retired. The journal was purchased in 2010 by the EHESP (Ecole des Hautes Etudes en Sante Publique, the French National School of public health) and established with a distinguished international Editorial Board.The mission of PHR since 2010 has been to provide access to European and global public health students, teachers, researchers, practitioners and policy makers of theme topic reviews of high quality to promote learning and discussion of issues in public health from a multi disciplinary point of view. The Editorial Board participated actively in policy development and leadership of many of the theme issues that evolved. PHR strives to bring topical reviews to promote translation of evidence and science into applied public health policy and practice, including the evolution of health systems as part of public health spectrum [1].The theme topics PHR issues during 2010-2013 included:*The New Public Health*Ageing Societies*Public Health Education*Cardiovascular Disease*Ethics in Public Health*Mental Health as a Public Health Issue*Towards a Healthier 2020, and*Substance Use Issues: New Insights.The New Home for Public Health Reviews 2014In 2014, a further reformation of PHR was arranged with affiliation and sponsorship by the Association of Schools of Public Health in the European Region (ASPHER), along with continued sponsorship by EHESP, and an additional sponsor, a Swiss School of public health. An agreement was signed with Biomed Central to publish PHR as an online open access journal. The new arrangements for sponsorship and operation of PHR provided for the continued mission of each issue addressing concepts such as health disparities, social determinants of health, demographic shifts and changing patterns of health needs, education of the public health workforce and policy makers, and healthcare delivery systems. [1].A new Editorial Board (EB) was organized with a strengthened European, international and multi-disciplinary composition to continue the excellent work of the previous EB. A core group of ASPHER representatives working with the editorial team provided important support over the transition period. The previous policies of theme issues will be augmented by accepting individually submitted review papers which fit in with topical issues. PHR will strive to achieve monthly issues, yielding 30 articles annually, with free for online access, including archived previous volumes.The Opening Issue of PHR in 2015The initial issue is a follow up to the 2012 volume on public health ethics. A second issue of PHR on this theme within four years of a previous issue is based on the initiative of ASPHER to prepare curriculum material for formal and informal teaching of public health ethics in the European context as explained in the Lee and Royo-Bordonada editorial [2], and Towards Public Health Ethics [3]. A European oriented curriculum will need relevant case studies for the organized teaching of ethics in public health education programs for undergraduate and graduate degree programs in Europe, in parallel to current Canadian and U.S. initiatives in public health ethics case studies [4].Public health has many enormous achievements to its credit adding many years of life expectancy globally. But public health has also suffered from past ethical failures of staggering proportions in the 20th century through association with eugenics. The most egregious of these was the active and passive participation of medical and public health professionals in interpretations of eugenics which led to mass sterilization and the murder of handicapped people, and participation in the Holocaust perpetrated by Nazi Germany. …

The complex nature of contemporary public health issues requires a multidisciplinary public health workforce, including professionals from various backgrounds who have been sensitized to the public health approach. In many countries, the field has traditionally been led by medical doctors who undergo further training in preventive branches of medicine such as epidemiology, hygiene, social medicine, biostatistics, or more recently, Global and One Health. Other countries have separate public health education programs independent of medical studies, offering various graduate and postgraduate courses. Over the years, efforts have been made to define the essential skills of public health professionals, led by organizations like the World Health Organization and the Association of Schools of Public Health in the European Region (ASPHER). These competencies continue to expand, necessitating more investment in public health infrastructure and training. The current lack of recognition, competitiveness, and appeal of a career in public health is leading to a restriction of the necessary build-up of qualified professionals. Many countries anticipate a shortage of public health workers due to an aging workforce, increased demand, and difficulties in attracting and training new professionals (3). The COVID-19 pandemic and severe climate events highlight the crucial role of the public health workforce in effective disaster management and preparedness, prompting decision-makers to take notice. It is the responsibility of the public health community to lead this effort and shape the future of the profession. Lessons from the last decades transfer to us several key points underlining the need for improved communication skills as well as the need for enhanced public health brokering roles for decision-makers and the general public.

Development of a strategy in public health (PH) education is crucial for Macedonia in providing modern education for actual PH practice. Establishing a School of Public Health (SPH) is vital for a country in a health transition with high rates of preventable diseases. The main strategic goals in modern PH education in Macedonia should be capacity building, improving the competencies of PH professionals, serving communities, participating in the policy, and partnership development. Expectations were expressed through two key points: strengthening institutional capacity in the area of PH and institutional development of SPH. The organizational structure of the new Center of Public Health is based on existing human resources and infrastructure. Medical Faculty initiated development of a postgraduate PH teaching program [Master of Public Health (MPH)] provided by the newly formed Center of Public Health within the Medical Faculty Skopje. The Macedonian MPH program has been developed with modular-type courses as a part-time teaching program in four semesters within a 2-year period. This program is designed to cover all the basics of PH sciences and practice, including basic and elective courses, workshops, research forum. and master's thesis with a credit transfer system in PH education. The main assets for SPH development are knowledge and skills of the constantly improving teaching staff. Successful preliminary evaluation of the Macedonian SPH project, being qualified “as a model for SPH development,” led to full Association of Schools of Public Health in the European Region (ASPHER) membership. Sustainability of this program will require continuing support although a remarkable beginning has been achieved. The next strategic goal is continuing development of SPH with fiscal and academic autonomy and preparing formal ASPHER Public Health Education European Review (PEER). This SPH recognized the main communicating message of the New Public Health: “Moving with the time.” New Public Health is determined by a dual approach: to be modern, and to grow and to build the tradition in PH education. The development of Macedonian SPH represents a new orientation toward science, philosophy, culture, and life and promotes new spirit and movement in PH in this region of Europe.

Background International collaborations are valuable yet often undervalued assets that enhance the quality of public health education and bolster the development of the public health workforce. Objectives The Humphrey Fellowship Program, part of the Fulbright Exchange Program, facilitates mid-career professionals’ visits to US-based host universities for an academic year. Fellows engage in a semi-structured fellowship period to achieve self-defined goals, emphasizing professional development, expanded experience, and intercultural exchange. This study advocates for the program’s contribution to enhancing public health education. Results Currently, two universities host fellows in public health. Over decades, fellows have engaged with faculty and professionals, participated in classes and meetings, visited institutions for development purposes, and completed US-based affiliations, contributing significantly to their own and the public health workforce’s advancement. This interaction-based learning approach aids in navigating social and ethical challenges by fostering a deeper understanding of public and global health issues across countries. Conclusions The Humphrey Fellowship Program in public health stands as a commendable model. Similar initiatives could be beneficially replicated in the European region, leveraging local and global successes to strengthen ties with public health education institutions, student communities, and beyond. Key messages • Programs that facilitate international interactions can enhance public health professionals’ understanding of global perspectives. • The Humphrey Fellowship Program in the US stands as a commendable practice for mid-career public health professionals, contributing significant value to the education at host universities.

Introduction: Public health is continuously challenged by a shortage of workforce. There are various reasons for this: 1) public health is less visible than traditional health professions and people may be unfamiliar with the nature and opportunities involved in entering this career field; 2) lack of official recognition of public health as a professional category; and 3) no umbrella organization that supports its members and governs professional standards as is the case of other more established professions. To adequately address the challenges of public health for the 21st century, a key policy element will need to focus on adequately cultivating, training and growing the future workforce of professionals in the field. The aim of this study was to examine why professionalization of public health in Europe is not as robust as it deserves to be and what steps can be taken to assure an adequate supply of professionals with the proper education and training background, and career guidance to tackle the public health needs of the future. Method: A case study approach was used collecting data via a scoping literature review, a focus group with public health students and interviews with public health experts for convergence. Data was analysed using directed content analysis and pattern matching logic. Results: Public health fulfilled five out of seven attributes of a profession, such as skills, training and education, certification and an altruistic service. Recognition of Public Health as multidisciplinary and multi-professional field, derived from the interviews as an additional characteristic. A code of ethics and professional conduct and a formal organization were missing. Conclusion: Public health professionals and organisations that govern best practices in this field should consider introducing a shared code of ethics and professional conduct as well as establishing a coordinated body to help advance the public status as a the profession to increase interest in studying and specializing in this area.

Is Africa prepared for tackling the COVID-19 (SARS-CoV-2) epidemic. Lessons from past outbreaks, ongoing pan-African public health efforts, and implications for the future

Shortage of public health independence and advocacy in the UK

Rita Giacaman and Rana Khatib: promoting health for Palestinians

In 2009, the European Centre for Disease Prevention and Control (ECDC) developed a competency framework to support European Union countries and the European Commission in ensuring a competent public health workforce for Europe. The coronavirus disease (COVID-19) pandemic emphasised the importance of harmonised public health strategies and competencies across international boundaries, specifically for infectious diseases. This perspective presents the process to update the competency framework for applied infectious disease epidemiology, highlighting ECDC’s efforts to support countries with using the framework. ECDC commissioned the Association of Schools of Public Health in the European Region (ASPHER) to update the framework through publication and dissemination of a technical report and a self-assessment tool linked to training resources. A mixed methods approach to gather input from experts in relevant specialities included qualitative interviews with 42 experts, workshops with ECDC Technical Advisory Group and an online survey of 212 public health professionals across Europe and beyond. Modifications resulted in 157 core competencies in 23 domains, each mapping to one of six subject areas of importance in applied infectious disease epidemiology. The framework serves as a basis to update the curriculum of the ECDC Fellowship programme with two alternative paths: intervention epidemiology or public health microbiology.

SPECIALTY GRAND CHALLENGE article Front. Public Health, 18 July 2013Sec. Public Health Education and Promotion https://doi.org/10.3389/fpubh.2013.00020

Purpose To analyze information needs of the Russian public health professionals Methods Statistical, sociological, bibliometrics and content analysis Objectives To analyze results of a survey of information needs of public health professionals; To analyze requests by public health professionals; To present topics and types of information resources needed by public health professionals Results public health professionals usually prepare informational and analytical reports and reviews for decision-makers. Therefore, it is important to understand what issues this group of information consumers is interested in, as well as what information resources they may need. To address this purpose, the authors have surveyed this group of specialists and analyzed their requests for information submitted to WHO Documentation Center in the Russian Federation. The results obtained made it possible to define major information needs of Russian public health professionals. By topics, they are arranged as follows: analysis and trends in mortality by age and cause of death; analysis and trends in fertility; analysis of information resources on healthy lifestyles, physical activity, healthy diet an risk factors, as well as analysis of international experience and comparisons. Distribution by information resources used by the public health professionals: Russian collections of statistical data, National report on health; articles from Russian journals on public health and nutrition; statistical databases of the World Health Organization; Eurostat; WHO reports on different public health issues (tobacco control, excessive alcohol consumption, obesity and unhealthy diet, etc.); WHO/Europe reports on health and well-being; WHO evidence reports on public health problems; PubMed - articles on public health questions; Cochrane library, etc. Key messages This poster presents the results of a study of the information needs of public health professionals. The study was conducted by interviewing these specialists at conferences and seminars.

Background: There is a lack of synthesis in the existing literature concerning Professional Identity Formation (PIF) in public health professionals. The community of practitioners in public health may lack an understanding of opportunities for supporting PIF in public health education and practice. Hence, the purpose of the present Qualitative Meta-Analysis (QMA) was to gain insight into situations and factors that facilitate and challenge PIF among public health professionals. Material and Methods: A QMA was conducted to address the study objectives. We retrieved articles on PIF using a systematic search strategy across Medline, Scopus, and Google Scholar. Inclusion criteria included original qualitative and mixed methods research on PIF among public health students or professionals from various backgrounds, grey literature such as thesis, and studies in English, or with English translations, published in peerreviewed journals. Narratives, participant quotes, categories, and themes from the results and discussion sections were used for thematic and content analysis. Reporting followed the PRISMAScR checklist. Results and Conclusion: We derived five main meta-categories: 1) nature of public health practice and professional identity; 2) professional identity formation in the context of public health, which had three meta-categories on the role of the university in PIF, requirement of reconciliation with various other identities, and influence of job profile on professional identity; 3) facilitators of PIF included meta-categories of facilitators related to curricular aspects and while at work; 4) barriers related to PIF included metacategory related to curricular aspects and while at work; and finally, 5) perspectives of self and stakeholders included factors related to self, employers, and society. The results will provide a framework for future research and curriculum development in public health courses aimed at supporting PIF among students.

Orientation: The public health sector in South Africa faces a number of human resource– related inundations. Solving these challenges requires the provision of empirically derived information on these matters.Research purpose: This study investigated the relationship between three work-related factors, person-environment fit, work-family balance and perceived job security, and employee satisfaction and organisational commitment. A conceptual framework that links these factors is proposed and tested.Motivation for the study: The prevalence of employee-related challenges involving public health professionals, as evidenced through industrial action and high labour turnover, amongst others, demands further research in order to generate appropriate solutions.Research approach, design and method: A quantitative design using the survey approach was adopted. A six-section questionnaire was administered to a stratified sample of 287 professionals in three public health institutions in Gauteng, South Africa. Data was analysed using descriptive statistics, exploratory factor analysis, Pearson’s correlation analysis and regression analysis.Main findings: Job security and person-environment fit both positively correlated with and predicted employee satisfaction. The association between work-family balance and employee satisfaction was weak and showed no significant predictive validity. Employee satisfaction was strongly correlated to and predicted organisational commitment.Practical/managerial implications: The findings of the current study may be used by managers in public health institutions to improve the level of organisational commitment amongst professionals in the sector, thus preventing further employee-related challenges that negatively affect the provision of outstanding public health services.Contribution: The study provides current evidence on how both work-related and humanrelated factors could contribute to the prosperity of the public health sector, both at micro and macro levels. The study also provides updated insights into the interplay between these factors in the context of South Africa, thereby addressing a research gap in this subject.

Ours is an age of unprecedented levels of environmental alteration and biodiversity loss. Beyond the exposure to environmental hazards, conditions such as environmental degradation, biotic impoverishment, climate change, and the loss of ecosystem services create important health threats by changing the ecology of many pathogens and increasing the incidence and/or severity of certain noncommunicable conditions. They also threaten health in the future by weakening the Earth's life support systems.Although physicians remain one of the most often accessed and most trusted sources of information about the environment, there is currently little emphasis on educating medical professionals about these environmental issues. This lack of training reduces the ability of most physicians to be efficient science-public interfaces and makes them ineffective at contributing to address the fundamental causes of environmental problems or participate in substantive environmental policy discussions. This is an important challenge facing medical education today.To turn medical students into effective physician-citizens, an already-overwhelmed medical school curriculum must make way for a thoughtful exploration of environmental stressors and their impacts on human health. The overarching question before medical educators is how to develop the competencies, standards, and curricula for this educational endeavor. To this end, the authors highlight some of the critical linkages between health and the environment and suggest a subset of key practical issues that need to be addressed in order to create environmental education standards for the physician of the future.

I read with great interest Dickens’s column about the challenges and opportunities of ethics.1 Dickens discussed the Belmont Report2 and the Public Health Code of Ethics3 and stated that these widely respected core principles offer guiding values for both research and epidemiological practice and that the challenge to public health practitioners is to apply these principles not just individually but at the collective “macroethical” level. I fully agree with Dickens’s point of view. Ethical behavior (i.e., behavior conforming to accepted principles of right and wrong that govern the conduct of a profession4) is very important in public health, not least because it helps maintain a positive relationship among public health professionals and between these professionals and society as a whole. The unique mission of public health is to protect, promote, and restore the health of the population. Public health could not function without ethics. An important question to answer is how can we as individuals and members of society identify the positive values that make up our belief system and ultimately guide our behavior. I think adopting core values from existing ethics codes is insufficient. We should identify our own values, discuss them with our colleagues, and then compare them with existing codes of ethics. I have recently come across several books that I would like to recommend to interested readers. The first, by Kenneth Majer, describes how to identify our own values and how to build values-based teams and organizations.5 The second, by Nancy J. Adler, describes the international dimensions of organizational behavior and includes discussions on the complexity of ethical decisionmaking in multicultural settings.6 The third, edited by Francis L. Macrina, is about scientific integrity as it relates to the responsible conduct of research.7 The development of ethical behavior requires introspection and continuous self-reflection. Written codes of ethics can be useful in this educational journey as guidelines and as means of correcting, collaboratively, behaviors that have ethical implications. Although we like to adhere to the highest standards of integrity, we may sometimes be confronted with situations in which we have to make trade-offs between competing positive values. Such situations (which can be defined as ethical dilemmas or defining moments) pose, I believe, the real challenges in human and organizational behavior.