Public health education and health system needs in Pakistan: a mixed methods study

Background: Pakistan has recently observed a significant growth in public health education programmes. Little is known about the structure of these programmes nor whether they are adequately responsive to national health system needs. Aims: We reviewed existing public health degree programmes in Pakistan along with an exploration of the national public health market and health system needs. Methods: A mixed-methods study was conducted between January 2015 and March 2016. Seventeen public health degree programmes were reviewed for programmatic and instructional attributes. Thirteen key-informant interviews were conducted to explore health system needs and challenges related to public health workforce. Results: We found substantial variation in public health academic programmes in terms of offered courses, credit hours, number of faculty and tuition costs. About 70% of public health degree programmes were generic (i.e. with no specific concentration track) and only 18% offered practicums. Overall median tuition cost in 2016 was US$ 10 350. During key-informant interviews, emerged themes for challenges included lack of practical public health skills, limited knowledge of latest theoretical principles, poor communication skills and insufficient IT orientation. Identified themes about knowledge and skills areas to address future public health challenges of Pakistan included system thinking mind set, healthcare IT skills, and leadership and management skills. Conclusions: Public health education in Pakistan falls short of meeting current national challenges. Pakistan needs a national public health accreditation body for regulating education, harmonizing global standards to local context and developing relevant career pathways.