Font size:
Print
India’s Public Health Crisis Begins in the Classroom
Public health in India strained by flawed policy, weak training
Context:
World Health Day 2025’s theme, “Healthy Beginnings, Hopeful Future,” may resonate globally as a call to action, but for India, the future of public health remains tethered to deep-rooted structural flaws — especially in public health education.
More on News
- A critical, often overlooked fault line is the design and delivery of India’s Master of Public Health (MPH) programmes, which are failing to produce a competent, future-ready public health workforce.
Public Health Is Not Just About Hospitals and Doctors
- Misconception: A major misconception persists — that public health is merely a branch of medicine.
- Interdisciplinary: In reality, public health is an interdisciplinary field that blends medical science, engineering solutions, and social sciences.
- From water purification to sanitation infrastructure, from behaviour change communication to data-driven health policy — public health spans it all.
- Remains Siloed: Yet in India, public health remains siloed in policy and practice.
- Often relegated to a State Subject under the 7th Schedule of the Indian Constitution, the broader constitutional reality is more complex.
- Core public health responsibilities are distributed across the Union, State, and Concurrent Lists, leading to fragmented governance.
Why Public Health Governance in India Is Fragmented
- Colonial Inheritance: India inherited its public health architecture from colonial Britain — a unitary system — but adapted it poorly within its federal framework.
- Scattered Even Today: Even today, health responsibilities are scattered across Ministries and Departments: disease control under Health Ministries, water and sanitation under Public Works, and food safety under separate Commissionerates.
- Overlapping Mandates: This lack of synergy creates overlapping mandates, poor accountability, and policy contradictions — like subsidising tobacco while simultaneously fighting tobacco-related diseases.
State of MPH Education in India: Broken and Incoherent
India’s MPH education system mirrors this dysfunction. As the foundational degree for future epidemiologists, health economists, behavioural scientists, and public health engineers, MPH courses should be the backbone of India’s health preparedness. Yet:
- Admission criteria vary wildly, with some institutions accepting only medical graduates, while others are open to all.
- Curricula lack standardisation — some are heavily theoretical, others overly managerial, with little practical training.
- Key areas like public health engineering, behavioural science, food safety, and health technology assessment are either ignored or poorly taught.
- As a result, MPH graduates from different universities possess widely varying competencies, undermining the credibility and utility of the degree itself.
Lack of Practical Skills: A Major Concern
- Public health engineering, vital for disease prevention through clean water, waste management, and drainage systems, is scarcely covered.
- Food safety education is disconnected from food processing and handling — critical for preventing foodborne illnesses.
- Behavioural science training is minimal, despite its proven importance in shaping public health outcomes (e.g., vaccine uptake, sanitation).
- Health technology assessment (HTA) — essential for evidence-based policy — is taught in only a handful of elite institutes.
MPH Duration and Design: Unrealistic and Overloaded
- India’s current two-year MPH programme tries to cover epidemiology, health policy, communication, economics, and fieldwork — an ambitious load that often results in superficial training.
- There is a pressing need to redesign MPH courses to include modular, flexible formats with practical, skill-based components, tailored to India’s unique public health challenges.
Systemic Invisibility of MPH Graduates: No Career Path, No Cadre
- Despite being trained professionals, most MPH graduates face systemic neglect. There is no structured public health cadre in most Indian States.
- Graduates are often absorbed into NGOs, short-term consultancy projects, or data-entry roles, which grossly underutilise their capabilities.
- This disconnect between education and employment further weakens India’s public health system.
Why Reforming MPH Education Is a National Priority
If India hopes to tackle antimicrobial resistance, climate-induced diseases, future pandemics, and food safety threats, it must urgently invest in building a robust, interdisciplinary public health workforce. India Needs:
- A nationally coordinated MPH curriculum with minimum standards and regional flexibility.
- Core modules covering epidemiology, public health engineering, behavioural science, HTA, and data analysis.
- Institutional collaboration between medical colleges, engineering institutes, social science departments, and health policy think tanks.
- A clearly defined career pathway and public health cadre to absorb MPH graduates into meaningful roles.
