Challenges of Public Health Education in the former Soviet Union: Example of Ukraine
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RESULTS: The main challenges identified were seen in the outdated conceptual understanding of public health, particularly in epidemiology.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.
KEYWORDS: public health; preventive medicine; epidemiology; soviet approach to prevention; former Soviet Union countries; Ukraine
Full text (pdf)