Challenges of Public Health Education in the former Soviet Union: Example of Ukraine

Authors

  • Anna Piekkala WHO Country Office, Ukraine, Finland

Keywords:

public health, preventive medicine, epidemiology, soviet approach to prevention, former Soviet Union countries, Ukraine

Abstract

BACKGROUND: Many former Soviet Union (fSU) countries face a high burden of disease and a much lower life expectancy compared to western countries. Many of the underlying causes are amenable to public health interventions, but the prevailing Soviet approach to prevention has largely failed to address the new and more complex public health issues these countries face. This study looks at public health challenges in Ukraine, in particular at those related to public health education.
METHODS: The research is based on a small-scale, qualitative analysis of information collected through i) review of literature related to public health and public health education in the former Soviet Union and Ukraine, as well as curricula and training material for epidemiology students in Ukrainian medical schools, ii) observations during workshops for epidemiology students and teachers from Ukrainian medical schools and iii) semi-structured interviews with epidemiology students and teachers from Ukrainian medical schools. The collected data was interpreted using the method of thematic discourse analysis, which allowed identifying major areas challenging public health education in the country.
RESULTS: The main challenges identified were seen in the outdated conceptual understanding of public health, particularly in epidemiology. These challenges underlie further problems including limited hours and narrow content of epidemiology training, lack of training in research skills, inadequate training material and conservative attitudes among teachers and students towards prevailing ideas and development.
DISCUSSION AND CONCLUSION: There is urgent need for a wider definition of public health, moving towards the “New Public Health” approach and subsequently a series of changes to education curricula and materials. Curricula reform should provide additional hours for covering non-communicable diseases, non-medical topics such as health policy and health promotion and ensure linkage between training and research. Critical evaluation of current approaches, their impact and performance is essential for reforming public health education programmes and strengthening health systems.

References

Adany, A., Villerusa, A., Bislimovska, J. & Kulzhanov, M. (2011). Public Health Education in Central and Eastern Europe, and Central Asia. Public Health Reviews. 33. 1. 105-133. URL: http://www.publichealthreviews.eu/

Chenet, L. & Telishevska, M. (2000): Epidemiology, medical demography and data quality issues in the former Soviet Union. Journal of Epidemiology & Community Health 2000.54.722-723. doi:10.1136/jech.54.10.722

Djibuti, M., Gotsadze, G., Mataradze, M. & Menabde, G. (2010): Human resources for health challenges of public health system in Georgia. Human Resources for Health. 2008; 6.8.1-7. doi:10.1186/1478-4491-6-8

Goodman, J., Overall, J. & Tulchinsky, T. (2008): Public Health Workforce Capacity Building. Lessons Learned from “Quality Development of Public Health Teaching Programmes in Central and Eastern Europe”. ASPHER Publication No.3. URL: http://2011.aspher.org

Gotsadze, G., Chikovani, I., Goguadze, K., Balabanova, D. & McKee, M. (2010). Reforming sanitary-epidemiological service in Central and Eastern Europe and the Former Soviet Union: an exploratory study. BMC Public Health. 10.440. 1-10. doi:10.1186/1471-2458-10-440

Lekhan, V., Rudiy, V. & Richardson, E. (2010). Ukraine: Health System Review. Health Systems in Transition. 12(9). Copenhagen, Denmark: WHO Press. URL: http://www.euro.who.int

Maier, C. & Martin-Moreno, J (2011). Quo vadis SANEPID? A cross-country analysis of public health reforms in 10 post-soviet states. Health Policy. 102. 18-25. doi:10.1016/j.healthpol.2010.08.025

Müller-Nordhorn, J., Holmberg, C., Dokova, K.G., Milevska-Kostova, K., Chicin, G., Ulrichs, T., Rechel, B., Willich, S.N., Powles, J. & Tinnemann, P. (2012). Perceived challenges to public health in Central and Eastern Europe: a qualitative analysis. BMC Public Health. 12.311.1-8. doi:10.1186/1471-2458-12-311

Powles, J., Zatonksi., Vandeer Hoorn, S. & Ezzati, M.(2005). The contribution of leading diseases and risk factors to excess losses of healthy life in eastern Europe: burden of disease study. BMC Public Health. 5.116.1-6. doi:10.1186/1471-2458-5-116

Tarantino, L., Chankova, S., Preble, E., Rosenfeld, J. &

Routh, S. (2011). Ukraine Health System Assessment 2011. Health Systems 20/20 Project. Bethesda, MD, US: Abt Associates

Tillinghast, J.S. & Tchernjavskii, V.E. (1996). Building health promotion into health care reform in Russia. Journal of Public Health Medicine. 18.4.473-477. doi:10.1093/oxfordjournals.pubmed.a024547

Tulchinsky, T.H. & Varavikova, E.A. (1996): Addressing the epidemiologic transition in the former Soviet Union: strategies for health system and public health reform in Russia. American Journal of Public Health.86.313-20. doi:10.2105/AJPH.86.3.313

Tulchinsky TH, Varavikova EA (2009): The New Public Health.2nd Edition. Burlington, MA, US: Elsevier Academic Press.

Tulchinsky TH, Varavikova EA (2010): What is the “New Public Health”? Public Health Reviews. 32.1.25-53. URL: http://www.publichealthreviews.eu/

Paccaud, F., Weihofen, A., & Nocera, S. (2011): Public Health Education in Europe: Old and New Challenges. Public Health Reviews. 33.1.66-86. http://www.publichealthreviews.eu/

WHO (2006). World Health Report 2006. Working Together for Health. Geneva, Switzerland: WHO Press. URL: http://www.who.int

WHO/UNAIDS/UNDP (2010): A systematic review of operational research into HIV, AIDS and STIs conducted in Ukraine in 1998-2006 and development of an operational research strategy in the context of implementation of national goals towards Universal Access to Prevention, Treatment, Care and Support by 2010. (unpublished)

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Published

2012-10-10