A strong public health workforce is crucial for a robust health system. India, with a high burden of COVID-19 cases and a need for universal health coverage (UHC), requires a strengthened public health workforce. While public health programs have expanded in recent years, including at the master's and doctoral levels, curricula lack standardization and there's an over-reliance on medical backgrounds. A supply-side forecast estimates an additional 45,000 public health workers are needed by 2026. This study aims to understand the current capacity for public health education and training in India, identifying opportunities and challenges to enhance the impact of its health workforce.

The introduction cites several studies highlighting the importance of a strong health workforce, the specific roles of public health professionals, and the challenges faced by India's health system, particularly in light of the COVID-19 pandemic. It also references previous work that identifies the lack of standardization in MPH curriculums and underrepresentation of non-medical backgrounds in public health training programs.

This study used a sequential explanatory mixed-methods approach. First, a desk review identified 59 institutions offering public health training in India through extensive internet searches, literature reviews, and expert consultations. Data on program types, geographic distribution, student numbers, faculty, tuition, and collaborations were collected. Second, 13 in-depth interviews with faculty representatives from purposively selected institutions explored barriers and opportunities in public health training. Thematic analysis was used for the qualitative data, combining deductive and inductive coding. The study was reviewed and deemed not to be human subject research by relevant IRBs.

The desk review revealed 59 institutions, mostly offering graduate-level degrees (MPH and MS). Key themes from the desk review and interviews included: * **Collaborations:** Hands-on experience through partnerships was valued but varied in quality and geographic reach, with more emphasis on international collaborations than local ones. * **Mentorship:** Mentorship was crucial but faced challenges due to mentor time constraints and a lack of formal structure and incentives. * **Curriculum:** Curricula lacked standardization, but offered flexibility and innovation. There was a noted overemphasis on medical perspectives. * **Funding:** Public sector programs were affordable, but private institutions often necessitated student loans. * **Student Demand:** Career pathways were unclear, especially for non-medical backgrounds. Students with existing health system positions often had defined career trajectories, while those without prior experience faced challenges identifying appropriate job opportunities. The lack of publicly available student intake data posed a challenge. Geographic distribution showed clustering in certain areas, leaving others underserved. Core competencies varied across programs, with Public Health Sciences being most commonly covered and others such as leadership, communication and financial management less represented. Post-graduate outcomes often reflected pre-existing educational and career paths. There was an identified lack of public health job postings within the government.

This study highlights the substantial capacity of public health education in India while underscoring critical areas for improvement. The lack of career pathway clarity and the over-reliance on medical backgrounds hinder the development of a multidisciplinary workforce. The need for curriculum standardization and stronger mentorship programs is crucial. Additionally, the study's findings suggest a need for increased advocacy for public health careers, greater integration of non-medical perspectives, better alignment of training with real-world needs, and ensuring that credentials are recognized by employers.

Public health education and training in India have a strong foundation but require strategic enhancements. Multidisciplinary training, career pathway development, curriculum standardization, mentorship support, and broader recognition of public health credentials are essential steps toward achieving India's UHC goals and fostering a robust public health workforce. Future research should focus on student and mentor perspectives and the impact of these recommendations.

The desk review might have missed institutions without an online presence. Challenges in contacting institutions due to COVID-19 limited data collection. The study lacked direct perspectives from students and workforce mentors. The exclusion of community medicine programs limits the scope of analysis, although the authors acknowledge its significance within the Indian context.