by improving education and training
of public health professionals
for both practice and research
EUROPEAN PUBLIC HEALTH REFERENCE FRAMEWORK (EPHRF)
Started in 2006, ASPHER’s European Programme on Public Health Core Competences has involved more than hundred European public health teachers, scientists and practitioners in the development of lists of competences for public health professionals. In the first round, all ASPHER member schools were asked to contribute to six workgroups, which lead to the first list of competences (1). Thereafter, European ministries of health were invited to participate, among other things in a conference, where, in the end, 27 European countries were represented, by decision makers and by teachers and scientists. At the same time the first two in a series of national practitioner-teacher workshops were performed, in Slovenia and Scotland, respectively (2). This all led to the second – and now enlarged – list of competences (3), which was presented at a second European conference. ASPHER’s workgroup on competences represented four parts of Europe, making easier the implementation of the lists in various population health and health systems frameworks. ‘Master classes’ were organised with high-level decision makers. The lists were further developed to crystalize concepts and terms and to avoid overlaps – and to demonstrate the whole spectrum of competences expected in public heath professionals at large (4) as well as the shorter lists for master of public health (MPH) education (5). The 2011 edition (4, 5, 6) was printed, sent to all ministries of health in Europe, and finally, in September 2012, was endorsed by all European WHO member states as the basis for public heath education, as expressed in WHO’s European Action Plan for Strengthening Public Heath Capacities and Services (7, p. 18):
"National governments should make efforts to ensure that the core competences for public health, recently revised by the Association of Schools of Public Health in the European Region (ASPHER), are being taken into account in national and subnational educational and training programmes for the public health workforce".
The wider process related to the development of the competences lists has been described in reference (6), and a review of broader perspectives related to the development and use of lists of competences have been analysed and commented in reference (8). Moreover, as the lists are intended to play crucial roles in the development of the European public health workforce, as aimed at in WHO Europe’s Health 2020 Strategy, ASPHER has also commented on the wider policy aspects of the future development of the European public health workforce and systems of public health services, including the crucial role of lists of competences (9).
The fundamental chain: Challenges in population health < > Interventions to improve population health - EPHOs < > Competences - forms the basis for the analysis and illustration of the role of defined competences and their related performances in public health and, furthermore, in the end not only (1) defines the public health profession but also (2) makes possible the identification of the components of public health to be taken care of by various health professionals – doctors, nurses, midwives, dentists, other - and (3) by persons outside the health sector, as well, like, e.g., teachers, policemen, architects.
The main structure of the European lists of competences is:
- Methods in public health – quantitative and qualitative methods
- Population health and its social and economic determinants
- Population health and its material – physical, radiological, chemical and biological – environmental determinants
- Heath policy; economics; organisational theory and management
- Health promotion: heath education, health protection and disease prevention
ASPHER is grateful to the extensive efforts made by its members – who have repeatedly rated the development and implementation of the lists of competences a top priority – and for the collaboration provided by a series of important European public health partners. This is acknowledged in the volume on Philosophy, Process and Vision (6). Since its start in 2006 the programmes has been chaired by Professor Anders Foldspang, Aarhus University, Past President of ASPHER, during 2008-2012 co-chaired by Dr. Chris Birt, Liverpool University, then member of ASPHER’s executive board, and since 2012 co-chaired by Professor Helmut Brand, Maastricht University, President of ASPHER. Since 2008 the administrative part of the programme has been managed by ASPHERs Director, Robert Otok.
At present, some major aspects of the competences programme are:
- Organising meetings with schools of public health in European countries in order to: (i) Identify strengths in their individual competences profiles, and: (ii) Promote collaboration in networks to support full implementation of the lists and thus further continued quality development of education and training programmes;
- Promoting public health education by meeting with high-level decision makers in selected countries, including ministers of health and ministers of labour, establishing ‘country cases’ of development;
- Planning the development of a repository for individual career planning for public health professionals and for planning of systems of public health services, linking public health competences, EPHOs and population health challenges;
- Planning the development of a European council for the continued development and quality assurance of European lists of public health competences;
- Developing methods and organisations for testing of competences at school level and at national and European level;
- Collaborating with a series of important partners in the public health field: WHO Europe, EU, EUPHA, EPHA, EHMA, EuroHealthNet, ...
- Foldspang A (Ed.). Provisional Lists of Public Helth Core Competencies. European Public Health Core Competencies Programme (EPHCC) for Public Health Education. Phase 1. ASPHER Series No. 2. Brussels: ASPHER, 2007.
- Whittaker PJ, Pegorie M, Read D, Birt C, Foldspang A. Do academic competences relate to ‘real public health practice’? A report from two exploratory workshops. Eur J Public Health 2010;20:8-9.
- Foldspang A (Ed.). Provisional lists of public health core comeptecirs. European Public Heath Core Competencies Programme (EPHCC) for Public Health Education. Phase 2. ASPHER Series No. 4. Brussels: ASPHER, 2008.
- Birt C, Foldspang A. European Core Competences for Public Health Professionals (ECCPHP). ASPHER’s European Public Health Core Competences Programme. ASPHER Publication No. 5. Brussels: ASPHER, 2011.
- Birt C, Foldspang A. European Core Competences for MPH Education (ECCMPHE). ASPHER’s European Public Health Core Competences Programme. ASPHER Publication No. 6. Brussels: ASPHER, 2011.
- Birt C, Foldspang A. Philosophy, Process, and Vision. ASPHER’s European Public Health Core Competences Programme. ASPHER Publication No. 7. Brussels: ASPHER, 2011.
- Action Plan for Strengthening Public Health Capacities and Services. Copenhagen: WHO Europe, 2012.
- Birt C, Foldspang A. The Developing Role of Systems of Competences in Public Health Education and Practice. Public Health Rev 2011;33:134-47.
- Foldspang A, Otok R. ASPHER’s position paper concerning: The new European policy for health – Health 2020 (Draft 2), and The European Action Plan for Strengthening Public Health Capacities and Services (17.02.2012). Brussels: ASPHER, 2012.
To strengthen the development and maintenance of a sufficient and competent public healthworkforce and in parallel to the developments in many other disciplines during the last two decades,also the planning of public health education and training programmes has increased the focus on the outcome of education and training in terms of the competences achieved and the relationship of thesecompetences to the performance in relevant job functions. ASPHER started its European PublicHealth Core Competences Programme in 2006, involving in the first place about 100 European publichealth researchers and teachers and, later, ministries of health and public health practitioners, in thediscussion of the selection and definition of competences, their practical implementation at systemslevel as well as for individual career planning, and the establishment of an organisational structure, acouncil, to ensure the future development of the lists (1,2). As indicated in WHO’s European ActionPlan for Strengthening Public Health Capacities and Services (EAP) (3) – part of the Health 2020Strategy – the third edition (2011) of ASPHER’s lists of competences (4,5,6) was endorsed in 2012,by WHO Europe’s member states, to be included in the planning of public health education in Europe.Moreover, in 2013 WHO Europe delegated the responsibility to ASPHER for leading its workinggroup concerning assuring a sufficient and competent Public Health workforce (Essential PublicHealth Operation (EPHO) No. 7) (7). Balancing with these trends and supported by EU PHPoperating grants (ASPHER FY2011, ASPHER FY2012, ASPHER FY2014), ASPHER in 2013 initiated its ShapePH programme, aiming at shaping the public health profession across Europe andsustaining comprehensive and coherent systems for public health services delivery. Accordingly, an important part of the ShapePH programme is the creation of the Council and the Repository under theEuropean Public Health Reference Framework (EPHRF). The EPHRF including its Council and Repository is intended to play an important role in ASPHER’spolicies, and the following text clarifies the background and context as well as the structure andcontent of this role. The text is in balance with but naturally intends to further develop ASPHER’spolicy in general, and with ASPHER’s position paper concerning the EAP (8).
A Foldspang, R Otok, K Czabanowska, V Bjegovic-Mikanovic. Developing the Public Health Workforce in Europe. THE EUROPEAN PUBLIC HEALTH REFERENCE FRAMEWORK (EPHRF): IT'S COUNCIL AND ONLINE REPOSITORY. Concept and Policy Brief. References Foldspang A (Ed.).
Provisional Lists of Public Health Core Competences. European Public Health Core Competences Programme (EPHCC) for Public Health Education. Phase 1. ASPHER Series No. 2. Brussels: ASPHER, 2007.
Foldspang A (Ed.). Provisional Lists of Public Health Core Competences. European Public Health Core Competences Programme (EPHCC) for Public Health Education. Phase 2. ASPHER Series No. 4. Brussels: ASPHER, 2008.
European Action Plan for Strengthening Public Health Capacities and Services. Copenhagen: WHO Europe, 2012. Birt C, Foldspang A. European Core Competences for Public Health Professionals (ECCPHP). ASPHER’s European Public Health Core Competences Programme. Brussels: ASPHER, Publication No. 5, 2011.
Birt C, Foldspang A. European Core Competences for MPH Education (ECCMPHE). ASPHER’s European Public Health Core Competences Programme. Brussels: ASPHER, Publication No. 6, 2011.
Birt C, Foldspang A. Philosophy, Process and Vision. ASPHER’s European Public Health Core Competences Programme. Brussels: ASPHER, Publication No. 7, 2011.
Terms of Reference for the Working Group on Public Health Workforce as Part of the Implementation of the European Action plan. Copenhagen: WHO, 2013.
Foldspang A, Otok R. ASPHER’s position paper concerning the new European policy for health – Health 2020 (Draft 2), and the European Action Plan for Strengthening Public Health Capacities and Services (17.02.2012). Brussels: ASPHER, 2012.