Public Health career prospects for health professionals

In this article we will look at the various career paths that are open to those who choose to work in the field of public health. There are many roles to fill in this field, from those with have done a basic primary health care course and interact with patients, up to more senior and strategic roles in public health management. We also answer some common questions, such as what is public health and what different specialisations can be pursued.

Outline:

Public Health FAQs

Public Health Specialist – HIV Counselling & Testing Lead

South Africa has one of the highest prevalences of HIV in the world and as a result, we have a great need for many different roles related to this illness. HIV counselling and testing, also known as HCT, is a vital part of the battle against the disease.

The United Nations has set what is called the 95-95-95 target for 2030, which aims to have 95% of people with HIV aware of their status. Of those, the aim is to have 95% on treatment, and in turn, the last goal is that 95% of people on treatment have successfully suppressed their viral loads. This is a revised target from the 90-90-90 target set for 2020.

Statistics South Africa’s 2021 population study estimated that about 13.7% of the South African population is infected with HIV, totalling 8.2 million people. A study across sub-Saharan Africa estimated that 84% of infected people in the region knew their status in 2020, a massive jump from just 3.6% in 2000. This shows the great strides that have been taken thanks to public health interventions, but it shows there is still much yet to be done.

Health Duties and Responsibilities

The full duties and responsibilities for HIV counsellors and testers are likely to differ from job to job, but they all share some of the same basic health duties and responsibilities.

As the job title suggests, carrying out HIV testing is a large part of this job. Prior to testing, the job also requires that clients are educated and counselled on HIV treatments such as antiretrovirals and pre-exposure prophylaxis (PrEP). Counselling is required again after testing, especially in the case of a positive result. HCT practitioners also need to deal with follow-up administration, from capturing of data to following up with patients.

Some roles are more involved in research and require HCT practitioners to assist with recruiting study participants, carrying out surveys, tracking of participants and reporting on research findings and gathered data.

How to Become an HIV Counselling & Testing Lead

Here are the main requirements for a recently posted vacancy for HCT practitioners:

  • Grade 12 Certificate
  • HIV counselling and testing certificate (HCT)
  • Certificate of competence: Rapid finger-prick testing
  • Knowledge of Pre-exposure Prophylaxis (PrEP)

Applicants are also expected to have various other skills too, including computer literacy, strong communication skills, administrative skills and the ability to work well under pressure and in changing circumstances. HCT practitioners should be able to work independently as well as part of a team. The role can also require that applicants are able to work irregular hours and on weekends.

Academic Programmes, Certifications and Accreditation

The South African Qualification Authority (Saqa) has three listed certifications for HIV testing and counselling, all of which are at national qualification level 4.

You could also complete a Postgraduate Diploma in Public Health, which is a level 8 NQF qualification. Unlike a primary health care course, completing postgraduate courses in health management would qualify you for far more senior roles than just carrying out counselling and testing.

Global Organisations and their Initiatives for HIV Outbreaks

There are many organisations involved in tackling HIV across the world, from small NGOs servicing a specific local community all the way up to vast groups with a presence that spans the globe. The following are the world’s four largest global organisations with HIV initiatives.

The Global Fund

The Global Fund was set up in 2002 as an international movement that invests $4 billion a year in programmes to combat HIV, tuberculosis and malaria. More than 80 countries have pledged to contribute to the fund, but it claims that it’s largest income source is from private donations. According to a recent report, it provides 30% of international funding for HIV programmes across the globe. The fund is active in about 100 countries and it works with local governments, civil society, the private sector and the public to ensure that money is spent effectively.

International Aids Society

The International Aids Society stated aim is to “convene, educate and advocate for a world in which HIV no longer presents a threat to public health and individual well-being”. More specifically, it has a membership of more than 13,000 HIV professionals from over 170 countries and it is behind some of the largest global conferences that bring together scientists, civil society, governments and the private sector to work together to battle the pandemic

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UNAids

The Joint United Nations Programme on HIV/AIDS (UNAids) is the organisation behind the 95-95-95 targets that were mentioned earlier. UNAids is focused on achieving this goal worldwide by 2030, as part of the United Nations’ broader sustainable development goals for the same year. UNAids claims the credit for the strategic response to HIV, saying that it “provides the strategic direction, advocacy, coordination and technical support needed to catalyse and connect leadership from governments, the private sector and communities to deliver life-saving HIV services”. Interestingly, it is the only United Nations department with civil society represented in its governing body.

The World Health Organisation

The World Health Organisation (WHO) is also a United Nations entity and it is a cosponsor of UNAids, but it also does much to battle the HIV pandemic itself. The WHO’s Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes leads the development and implementation of the global health sector strategy for the elimination of HIV as a public health threat.

New Technology and Innovation in HIV

Medical research and advances are obvious candidates for supporting the battle against HIV, but the battle is also being helped thanks to other advances in technology, such as artificial intelligence and machine learning.

A 2020 joint study by a group of researchers entitled “Artificial Intelligence and Machine Learning for HIV Prevention: Emerging approaches to ending the epidemic” looked at practical applications of machine learning, artificial intelligence and big data in the prevention of HIV. It found that machine learning had shown promise in trials in Denmark and the US to identify potential candidates for PreP.

Noting that other applications were still in the proof of concept stage, the research paper also details other projects to use machine learning to process social media data and other information gathered through smartphones to promote real-time HIV risk reduction. Other potential technological applications include the use of virtual reality for the facilitation of serodisclosure, which is the sharing of one’s HIV status with others, and the use of chatbots for HIV education.

Public Health Specialist – Disease Control & Prevention

The National Institute for Communicable Diseases (NICD) is a public health institution that works with South African healthcare workers, policymakers and the general public to provide science-based, up-to-date information and articles related to communicable diseases. The NICD’s primary goal is disease control and prevention and it was put in the spotlight with the Covid outbreak.

Epidemiology is the study of diseases, but it is a highly specialised field requiring many years of study at a master’s level. For every epidemiologist, there are several other less qualified public health workers helping to control and prevent diseases.

Health Duties and Responsibilities

As a disease control and prevention specialist, your work will involve a mix of planning for outbreaks as well as dealing with outbreaks as they occur. This ranges from on-the-ground monitoring of outbreaks, reporting on their spread and advising on policies to manage and control outbreaks.

A job posting on Africa CDC for a technical officer for disease control and prevention lists a variety of technical support services that include workforce capacity development, health promotion, epidemiology assessments, monitoring and surveillance, public health research, and strengthening of health information systems.

How to Become a Disease Control & Prevention Specialist?

Disease control and prevention specialists are often also called infection control practitioners (ICPs) or infection control specialists.

The recruitment site Ziprecruiter suggests two broad paths to becoming an infection control specialist. You can go the strictly academic route and complete a bachelor’s degree in public health, biology, epidemiology or a related field. The other route entry point is for those who have qualified as a nurse and who have had some work experience in infection control.

Academic Programmes, Certifications and Accreditation

For nurses taking the work experience route, they would first need a primary health care course in nursing.

For those taking the route of academic health courses, options include public health courses and courses in health management. These can be completed through distance learning courses or in a face-to-face setting.

Global Organisations and Their Initiatives for Recent Disease Outbreaks

The World Health Organisation (WHO) is the world’s largest organisation dealing with international health and disease issues. With Covid having had such a vast global impact recently, this is likely the first that comes to mind when thinking of disease outbreaks and initiatives. You might be surprised at the number of other disease outbreaks that occur around the world every month.

According to the WHO’s disease outbreak newsfeed, there were several other outbreaks around the world in the month prior to writing this article. For July 2022, there were the following outbreaks: A Marburg virus outbreak in Ghana, a cholera outbreak in Somalia and a multicountry outbreak of severe acute hepatitis across 35 countries, mostly in Europe, North and South America and the Pacific. Also reported in July was the containment of an earlier outbreak of Ebola in the Democratic Republic of Congo.

Each outbreak is unique, but there are common elements in terms of the response to them. The WHO also works to help countries better prepare for outbreaks by strengthening their own capacity to deal with emergencies. In each case, the first step is to identify the outbreak through constant monitoring. Once an outbreak is identified, the WHO follows a standard set of procedures that it carries out within 48 hours of the initial discovery:

  • grade the severity of the event
  • activate the incident management system and designate response teams at its headquarters in Geneva and in the regional and country offices
  • release funds from WHO’s Contingency Fund for Emergencies
  • deploy field teams and activate global stockpiles of essential supplies
  • establish network communication systems and base camps, where needed
  • communicate the risk to the community and neighbouring countries
  • activate the Global Health Cluster, the Global Outbreak Alert and Response Network (GOARN), emergency medical teams and standby partners

New Technology and Innovation in Disease Control / Prevention

The WHO also develops new technologies to be able to detect and track new health events, such as the Early Warning, Alert and Response System (Ewars). The WHO is able to deploy this system in remote regions without reliable internet or electricity through its “Ewars in a box” solution.

The box contains 60 cell phones, laptops and a local server to collect, report and manage disease data. It also includes a solar generator and chargers to power the devices. One box is able to provide surveillance for 50 clinics serving about 500,000 people.

This is just one example of technological innovation being used by one organisation, but technological advances are ongoing throughout the medical field. You can read more about how new technologies are being adopted in our previous article on the impact of technology on public health and community health.

Family Planning / Reproductive Health Specialist

Family planning specialists or reproductive health specialists help people maintain good reproductive health, which also includes educating people on things such as the different methods of contraception that are available to avoid unwanted or unplanned pregnancies.

To see some jobs related to this field that are currently on offer in South Arica, you can have a look at the following job posting sites:

  • careerjunction.co.za | reproductive health jobs
  • careerjet.co.za | reproductive health jobs
  • za.recruit.net | reproductive health jobs
  • pnet.co.za | reproductive health jobs
  • za.indeed.com | reproductive health jobs

For some international opportunities, here are the current job vacancies at the United Nations Population Fund. These are the vacancies across the entire agency, but it is heavily involved with reproductive health and as such many of the positions relate to this field in some way, even if not directly as a family planning or reproductive health specialist.

  • untalent.org | Jobs at UNPFA

The UN careers website also offers some interesting information on the career path for those with a science or medical background, which you can view here.

Child Health Specialist / Paediatrician

Child health specialists are called paediatricians and they are responsible for monitoring the health and the development of infants and children. Paediatricians monitor health, growth and development several times a year from birth until two years of age, after which checkups are done once a year. As children grow older, a family GP will be able to deal with the majority of health issues, but they may still refer patients to a child health specialist in some cases.

Becoming a paediatrician first requires the same qualification as for a doctor – a Bachelor of Medicine and Bachelor of Surgery (MBChB) degree – as well as further specialisation and registration as a paediatrician. You can find out more about the University of Pretoria’s paediatric and child health care department here.

According to HW Careers, it takes about 10 years of study to become a paediatrician in South Africa. It takes six years to complete a Bachelor of Medicine and Bachelor of Surgery and another four years to obtain a Master of Medicine in Paediatrics degree. In addition to the years of study, South African doctors also need to do a one-year student internship and one year of community service.

Public Health Specialist – Epidemiologist

Epidemiologists play a crucial role within the greater public health system. These public health specialists focus on studying diseases and how they spread. They work towards containing disease outbreaks with the ultimate goal of eradicating a disease entirely.

We’ve covered some common questions in our FAQ section below and you can click these links to jump to the answers to those questions:

Public Health Specialist – Health Policy Analyst

So far we’ve focussed mainly on the more medical aspects of public health, but an effective public health system also requires the work of many other people with expertise in other fields. All the work done by public health workers to address health issues and problems, whether it be in the field or in a laboratory, is carried out as part of a wider public health policy framework. This policy framework is in turn shaped and guided by public health policy analysts.

It is their job to look at the effects of public health policies to determine whether or not they are successful in achieving their aims. Policymakers in turn base their decisions on the findings and suggestions provided by these analysts. Good public health policy should therefore be able to adapt and evolve to changing circumstances while also constantly improving the public health outcomes of the community it serves.

Please click on the links below to jump to the answers to some common questions relating to public health policy: