Theodore Herzl Tulchinsky

In the original publication of this article [1] Table 1 contained an error in 1 cell entry. In this correction the correct and incorrect cell are shown. The full table is available in the original article [1].

Public health has been an enormously effective instrument for improving life expectancy and quality of life. Historically a sphere of governmental activity led by physicians and staffed by sanitarians and nurses, public health has evolved to become a multi-facetted field of societal activity. It engages many agencies and community action in reducing infectious and non-communicable diseases as well as many aspects of lifestyle and health equity. Education for an adequate professional workforce is one of its key functions. Schools of public health have fulfilled this role only partly even in developed countries, but in countries in transition and in low-income countries the problem is much more acute. We discuss the role of mentoring of new schools calling for strong public and private donor support for this as a key issue in global health.

With its independence secured on 9th July 2011, the Republic of South Sudan faces a daunting task to improve public health and primary care in one of the poorest countries in the world. Very high maternal and child mortality rates must be a major concern for the new national government and for the many international agencies working in the country. Poor maternal health outcomes are primarily due to poor prenatal, delivery and post natal care services in health facilities, coupled with low literacy, widespread poverty, and poor nutrition among the general population. Child mortality is the result of widespread malnutrition, pneumonia, malaria, vaccine preventable diseases and diarrheal diseases. National responses to HIV and AIDS with international assistance have been encouraging with relatively low rates of infection. This paper explores barriers and identifies opportunities available to work toward achieving the targets for Millennium Development Goals (MDGs) 5 and 4 to reduce maternal mortality from its current rate of 2,054 deaths per 100,000 live births, and child mortality (currently 135 deaths per 1,000 live births) respectively in the new nation. National and international organizations have a social responsibility to mobilize efforts to focus on maternal, child health and nutrition issues targeting the worst affected regions for improving access to primary care and obstetrical services. Initiatives are needed to build up community access to primary care with a well supervised community health workers program, as well as training mid level management capacity with higher levels of funding from national and international sources to promote public health than current in the new republic.

I congratulate Gillam and Maudsley on a wide-ranging review of the topic, and I appreciate being asked to provide a commentary as someone from outside the UK with a different experience and point of view on public health and training in public health for medical students.

Countries of Eastern Europe and the Commonwealth of Independent States are facing a combination of difficulties in health including high rates of mortality from preventable diseases, and pressures for reform of their health care systems. The development of schools of public health is an important priority for international aid and for national government attention. This provides a challenge of integrating experience from many countries in the industrialized world and academic centers of excellence in the field of public health. Traditional departments of social hygiene within medical academies need to evolve to educate new generations of doctors to cope with challenges facing the health systems in these countries. Development of post-graduate centers of training will also be needed as independent schools of public health within single or multi-faculty universities to train health workers in a New Public Health. This paper outlines the mission of a school of public health (SPH), and the steps needed to achieve its objectives, with examples of several schools at relatively advanced and moderate levels of development. The purpose is to provide guidelines for those SPHs under development that are seeking international support and resources.