Evaluation of the Pacific Public Health Fellowship Program: An Innovative Model for Public Health Workforce...

The US-Affiliated Pacific Islands (USAPIs) face chronic public health workforce shortages, impacting sustainable health systems. In response, the Pacific Island Health Officers' Association (PIHOA) health leadership called for the establishment of a regional public health workforce training program. The Pacific Public Health Fellowship Program (PPHFP) was developed through a partnership between PIHOA and the US Centers for Disease Control and Prevention. PPHFP is the first regional cross-cutting public health fellowship model implemented across the USAPIs, aiming to create a sustainable and competent local public health workforce pipeline. PPHFP is a 2-year, mentorship and competency-based model providing full-time experiential training and placement in local health departments, combined with structured mentorship, comprehensive curriculum, and an individualized work plan mapped against 45 public health core competencies. In 2025, an independent mixed-methods impact evaluation was conducted for PPHFP Fellows in the first 5 cohorts. Results indicate strong satisfaction and local workforce retention rates. Overall program satisfaction was 100% among all Fellows (n=43) and host site supervisors (n=35). Among graduates (n=27), 81% secured local USAPI public health positions, and a further 11% enrolled in health-related university-led education in the Pacific region. Fellows addressed health priorities, through the delivery of 27 projects establishing new health registries, dashboards, standard operating procedures, and other interventions influencing data-driven decisions. Evaluation findings demonstrate PPHFP as an effective model for strengthening a local public health workforce pipeline in resource-limited Pacific Islands. Additionally, strengthening transition planning to the workforce, expanding mentorship structures, and introducing a dual-track model may support long-term workforce sustainability.