Historically, healthcare workforce education has been inadequate in addressing complex health system challenges. This is particularly true in India, where understaffed health systems, workforce shortages, and inadequate worker distribution exacerbate problems. The significance of public health education in India has grown due to projected human resource gaps. Even defining public health education is challenging, as it encompasses various disciplines. Recent efforts toward standardization, such as the Ministry of Health and Family Welfare Model Curriculum Handbook for Master of Public Health (MPH), aim to improve training. Despite increased training programs, demand for trained personnel remains low, and graduates often face uncertain career paths. This study aimed to analyze the landscape of public health training in India and identify challenges and opportunities to optimize the approach to public health training.

The introduction cites several existing studies highlighting the global inefficiency of healthcare workforce education in solving complex health challenges (Frenk et al., 2010). It references research on the Indian context, noting understaffed systems, workforce shortages, and inadequate distribution of qualified workers (Tiwari et al., 2018; Sharma & Zodpey, 2013; Zodpey et al., 2014). The introduction also mentions the need to standardize public health education and the challenges of defining the field clearly, referencing the Ministry of Health and Family Welfare's Model Curriculum Handbook (2017). Finally, it discusses the traditional medicalized lens of public health in India and the need for a multidisciplinary approach (Garg & Gupta, 2011; Negandhi et al., 2010).

The study employed a mixed-methods approach. First, a web-based desk review cataloged public health training programs in India by key descriptors (location, qualifications offered, core competencies, etc.). This review excluded community medicine programs with a more clinical focus. Second, 13 in-depth interviews were conducted with representatives from a purposive sample of institutions identified in the desk review. Interviews used semi-structured guides based on competency-based education literature, focusing on departments, research areas, courses, mentorship models, and collaborations. Interviews, conducted remotely via Zoom due to the COVID-19 pandemic, were transcribed and analyzed using Dedoose software. A thematic analysis identified key themes, which were then used to develop a SWOT analysis. The SWOT analysis categorized themes as internal/external and positive/negative factors influencing public health education in India.

The desk review identified 59 institutions offering various public health training programs (MPH, MS, diplomas, PhDs, certificates, executive trainings, workshops) across diverse settings. The SWOT analysis revealed key strengths: affordable tuition, particularly at publicly funded institutions; faculty-driven innovation, especially evident in the COVID-19 response; and strong research capacities. Key weaknesses included insufficient collaboration between institutions, a lack of clear career pathways and incentives for graduates, misalignment between supply and demand for public health professionals, bureaucratic challenges (“officialism”), and a perceived lack of urgency in preparing for future public health challenges. Opportunities included the increased public awareness and interest in public health due to COVID-19, the potential for greater community engagement in education and research, and the utilization of technological advancements for both training and collaboration. Threats included the mismatch between the supply of trained professionals and the actual demand for their skills, bureaucratic hurdles hindering institutional flexibility, and the lack of a sense of urgency in addressing future challenges.

The study's findings highlight the need for a more coordinated and strategic approach to public health education in India. The identified strengths, particularly affordability and research capacity, provide a strong foundation for improvement. Addressing weaknesses, such as fostering collaboration and creating clear career paths, is crucial for attracting and retaining talent. The increased public awareness and technological opportunities presented by COVID-19 should be leveraged to bolster public health training. The study emphasizes the importance of aligning supply and demand for public health professionals, taking into account health system needs. It suggests that competency-based education, integration of One Health approaches, and national accreditation systems could enhance the quality and relevance of public health education.

The study underscores the critical need for reform in public health education in India. The country's unique combination of needs and potential positions it to serve as a global model for rapid and intentional reform. Future efforts should focus on optimizing collaborations, creating clear career pathways, leveraging technological advances, and aligning training with evolving real-world challenges. Embracing transdisciplinary approaches and incorporating frameworks such as planetary health and One Health are essential for preparing the next generation of public health leaders. While limitations exist regarding the scope of the study, its findings provide valuable insights into strengthening public health education in India and beyond.

The study's limitations include relying on an internet-based search for the desk review, potentially excluding institutions without an online presence. The review also did not capture medical public health education or institutions using languages other than English. Data from institution websites varied, affecting data uniformity. The generalizability of interview findings is limited to the specific institutions sampled. Despite these limitations, the study offers valuable insights into the current state of public health education in India and potential pathways for improvement.