Home Scholar Opinion | मेराे पनि भन्नु छ Introduction of Public Health Leadership and its challenges in Nepal | Sumina Maharjan

Introduction of Public Health Leadership and its challenges in Nepal | Sumina Maharjan

by Subin Shrestha
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According to C.I. Bernard –  ‘Leadership is the quality of behavior of the individuals whereby they guide people or their activities in organized efforts.’ Leadership is the ability to set the direction and direct a group of people towards achieving a common objective. Leaders create an instructive vision for the future and motivate people to engage with that vision. Good and effective leaders have vision, determination, morality and always look forward to planning strategically and encouraging cooperation among their team members. Regardless of any changes and development in the structure of the society, be it past, present or future, a leader has always been required for the betterment of the society.

“In the field of public health [leadership] relates to the ability of an individual to influence, motivate, and enable others to contribute toward the effectiveness and success of their community and/or the organization in which they work. It involves inspiring people to craft and achieve a vision and goals. Leaders provide mentoring, coaching, and recognition. They encourage empowerment, allowing other leaders to emerge.” PHAC (2007)

Public Health Leadership is the ability to influence, inspire and lead toward a healthy population. It originates vision and goals leading toward better public health. Public Health  Leadership aims to take on complex public health challenges by leading teams, managing projects, and designing solutions. It is essential to address complex public health issues/challenges and tackle them effectively. 

Definitely, Leadership is very crucial in public health but to become a good public health leader, one must have proper knowledge and ideas about public health itself, should be familiar with various determining factors of health, public health values and public health ethics, health inequalities and inequities.  Public Health Leaders should have abilities to address the complex and evolving demands of health care systems. Good  Public health leaders should be updated on the status of the health of the population. Leaders are provided with sufficient health information and health outcomes that can be used for effective decision making and strive to bring desired changes. Leaders should be able to evaluate the health status of the population and address health priorities. Good communication skills play an indispensable role to maintain a good interpersonal relationship between leader and team. Good Leaders should communicate and coordinate properly with the team to direct and motivate them to work efficiently and effectively to attain predetermined goals. Public Health Leaders must be familiar with public policy, strategic planning, information management and human resource management. Public health leadership skills such as interorganizational collaboration, networking abilities and advocacy contribute to the enhancement of the health sector. They should also work continuously to develop their leadership skills and should never stop learning.

The major objective of Public Health is to work with all groups in the community and improve the health of the overall population. Leadership is essential to deal with various social and political factors that impact the health of the population. Various roles of PH leaders can be highlighted below:

Public health Leaders:

  • emphasize disease prevention and health promotion for ensuring the health and well being of the people. They focus on providing promotive, preventive, curative and rehabilitative health services to flourish the overall health of the people.
  • play a vital role in developing health care policies, making effective decisions and imparting positive changes, collaborating with different sectors and building supportive environments conducive to health. Leadership in public health means taking a collaborative approach to issues in the community to best solve problems.
  • work as an important component to improve the efficiency and effectiveness of the health care system. They focus on creating a health system that addresses the needs of every person in the community.
  •  seek to take risks and find solutions to every health challenge. They are always prepared to tackle unforeseen health problems and health crises. The role of Public Health Leaders in helping to manage the sudden outbreak was very evident during CoViD-19 Pandemic. Public Health Leaders are more focused on proactive planning rather than reactive. Planning is done to prevent any kind of catastrophe beforehand rather than to plan and take action after it has occurred.
  • focus on managing increasing demands with limited resources. Public Health Leaders adopt the decisions that shape the future of public health. Public health leaders work to protect the health of all citizens.
  • set an inspiring vision for the future which also needs expansion of networks and partnership with stakeholders. Engaging community partners is also equally important to develop the local health system and improve community health. Public Health Leaders work collectively with community leaders to yield desired changes in the community. Sustainable development can only be ensured when community people themselves actively participate to improve their health.
  • are flexible and various leadership practices are used according to the circumstances.

Although Public Health Leaders operate intending to improve health, they face complex challenges which makes it quite complicated for them to accomplish the preset targets. Some of the challenges are identified below:

  • Insufficient human resources and their improper distribution seem to be major problems for Public Health Leaders in meeting health needs and demands. The public health workforce has major problems such as irrational distribution and inadequate knowledge and skills. Human resources management is crucial to any health care system. It is very necessary to achieve better outcomes from and access to health care and services.
  • Inadequate financial resources or limited budget allocation is also another major issue for Health Leaders to yield required health care and services. The health financing system has limited ability to address inequities and identify and protect the poor. Economic crisis has a direct impact on public health making it more complex to deal with the existing health problems.
  • Health system is facing major issues like population growth, aging populations and increased disease burden which results in an escalation of the cost of health care. These factors lead to increased demands for health care and such demands are difficult to be fulfilled with limited resources.
  • Various social issues like poverty, stigma and disasters are also responsible for creating hindrances in smooth functioning and operation of Public Health Leaders. Uneven distribution of resources, inaccessible health services, unaffordability of basic health needs, and geographical hyraces results in creating complex situations to achieve health targets.
  • Lack of a collaborative approach between different sectors has created a hurdle in improving health because health is interlinked with different sectors and cannot be enhanced solely. Collaboration with non health sectors seems to be lacking because of a lack of networking, advocacy and communication.
  • The major challenge in public health is the change in health policies and the way of anticipating and responding to those altered health policies.
  • Unclear organizational goals, structural weakness and shortage of resources are the barriers to effective public health leadership. Due to unmanaged organizational structure and poorly set goals, it becomes problematic for leaders to work for the betterment of the health system.

Conclusion:

The Health system requires competent public health leaders for its enhancement. Leadership in Public Health is indispensable to lead people in utilizing resources to the utmost level and assist to achieve all the health needs and demands.

For better functioning of Public Health Leaders, there should be a provision of sufficient numbers of health workforce and their proper utilization is very necessary. Our Country should have clear goals, financing policy and strict implementation plans for budget execution to minimize the major issue of insufficient financial resources and inadequate budget allocation.

Lack of effective leadership in Public Health makes it difficult in achieving health goals and targets. Adequate leadership and governance should be emphasized for the effectiveness and efficiency of health organizations. Leaders should focus on working collaboratively with health sectors as well as non health sectors for smooth planning and rigorous implementation. Equitable resource distribution should be promoted to make sure that resources are accessible whenever and wherever required.

Ensuring effective Public Health leadership must be included as an essential part of public health training. To sum up, strong and effective leadership in Public Health plays a significant role to speed up the development of public health.

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