Training, employment and performance of public health workers in Latin America and the Caribbean

Health system reforms in Latin America and the Caribbean have been responding since the 1990s to problems concerning to the lack of universal access to services, inequities in the allocation of scarce resources, and low efficiency and quality of services. The participation of public health personnel in these reforms is crucial to guarantee responsiveness to current needs in the region while making prevention and promotion two core functions of health systems’ performance; thus, the study of public health workers has become a high priority. This report identifies the characteristics of academic and training programs in public health, evaluates their relevance to current health system needs in the region, analyzes labor market conditions, and offers recommendations for improving the capacity of health human resources to participate in system reforms. The study is based on secondary and primary sources, including documents, online search, and direct telephone interviews to institutional representatives. Thirteen Latin America and Caribbean countries were included in the study. Findings show that there is an important change from traditional teaching programs to a new generation of programs including doctoral programs, the use of on-line technology, competency-based models based on Essential Public Health Functions and educational innovations encompassing the use of active and collaborative learning, Problem-Based Learning (PBL), and case studies. Furthermore, many institutions have broadened access to professionals to fields such as social, administrative, and environmental sciences. On the other hand, few institutions in the region report having systematic continuing education programs that meet the needs outlined by ministries of health. Public health professionals however are still not highly demanded by the labor market as in many countries high levels of unemployment and low salaries are present. Their role in public institutions is still marginal despite the fact that health systems are moving ahead to prioritize public health interventions