Public Health Degree Programs with Global Focuses

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1 ACADEMIC AFFAIRS FORUM Public Health Degree Programs with Global Focuses Custom Research Brief Research Associate Anna Krenkel Research Manager Nalika Vasudevan March 2013

2 2 of 12

3 3 of 12 Table of Contents I. Research Methodology... 4 Project Challenge... 4 Project Sources... 4 Research Parameters... 4 II. Executive Overview... 5 Key Observations... 5 III. Program Curriculum and Structure... 6 Course Offerings... 6 Strategies to Provide Global Content... 8 Partnerships IV. Student Demand and Outcomes Applicants Outcomes... 11

4 I. Research Methodology Project Challenge Leadership at a member institution approached the Forum with the following questions: 4 of 12 What courses do other programs in comparative public health offer? How do they ensure the programs include comparative elements? How do course offerings reflect the connections between community health and public health and medical programs and public health? What is the delivery format for programs? What partnerships do programs maintain with international institutions? What demographic groups do programs target as potential applications? How many international students enroll in comparative health programs? What impact does their presence have on curriculum? What professions do program graduates enter? Project Sources The Forum consulted the following sources for this report: Institutional web sites National Center for Education Statistics. Accessed March 5 th, Research and Insights.. Accessed March 5 th, Research Parameters The Forum interviewed deans of schools of public health, directors of global health programs, and senior lecturers of global health courses. A Guide to Institutions Profiled in this Brief Institution Type Location Approximate Institutional Enrollment (Undergraduate/Total) Classification University A Public Canada 33,300 / 37,700 Medical Doctoral University B Private South 6,700 / 15,400 Research Universities (very high research activity) University C Public Western Canada 31,300 / 38,800 Medical Doctoral University D Public South Africa 19,900 / 27,900 Not Applicable Source: National Center for Education Statistics

5 II. Executive Overview Key Observations 5 of 12 Core curriculum for master s programs in global health emphasize a breadth of research skills to appeal to students varied professional and research-based backgrounds in global health. Content for core courses teach research methods such as health measurement, global health research, and health program evaluation. Students build regional or topical expertise in areas such as disease causation and prevention, environmental health, and health policy through electives. Global health curricula include case studies from across the globe and field research requirements to prepare graduates for positions that require relevant research experience with non-profits, intergovernmental organizations, and government agencies. Although some courses discuss health topics or policies of a specific country or region, others utilize case studies from around the world to illustrate trends, best practices, and challenges in global health. Fieldwork ensures students have practical knowledge of research practices in global health and demonstrates graduates independence and preparation to work overseas to potential employers. Partnerships with institutions abroad or other departments and colleges support student and faculty research and encourage interdisciplinary research and perspectives. Relationships with institutions abroad begin as partnerships between individual faculty members and expand to formalized agreements that include support for student research and student exchanges. Joint faculty appointments, shared research presentations, and dual degree programs create connections between students in global health programs and students of nursing, medicine, and dentistry. Most admitted students possess prior experience in global health and seek career advancement; however, programs may accept applicants without professional experience who conduct field research as an undergraduate. Most programs attract international students, although some contacts report international applicants express more interest in master of science and master of public health programs with other specializations such as biostatistics, rather than global health.

6 III. Program Curriculum and Structure Course Offerings 6 of 12 Students Enroll in Required Foundational and Research Courses and Specialize their Degree Through Electives and Fieldwork Rather than offer a master of science (MS) or master of public health (MPH) in global health, University A and the University D require students gain admittance to the MPH program and either indicate a specialization during their initial application process or apply for an emphasis program after admission. The University C offers several specializations in the MPH and MS programs, including global health. While all programs share core courses in epidemiology, students in the global health specialization must complete electives in global health. In contrast, the MS in global health program at University B requires students to complete no general MS or MPH courses. Instead, students in the MS in global health program complete only core courses and electives specific to global health. All institutions require students to complete fieldwork or a capstone project to receive a degree. Most students choose to complete this overseas; however, students at University A may work with a Canadian organization engaged in global health issues instead. Recommended Electives Focus Areas at University B 1 Disease Causation and Prevention (sample courses): Global Health Research: Epidemiologic Methods II Health Promotion and Disease Prevention Microbial Ecology and Evolution Global Environmental Health: Globalization and Governance Human Health and Ecological Risk Assessment Water, Cooperation, and Conflict Global Health Policy and Management: African Health Systems, NGOs, and Global Health Politics of International Aid in Low-Income Countries Statistics for Policy Makers Population Sciences: Advanced Demographic Methods Introduction to Population, Health, and Policy Population and Environmental Dynamics and Human Health At the University C, administrators design the MS program in global health to prepare students for PhD programs and the MPH program to prepare students who seek immediate entrance to the field as a practitioner. However, contacts fear students do not consider those differences when enrolling. 1 University B web site.

7 7 of 12 Global Health Programs at Profiled Institutions Program University A Global Health emphasis for master s students Host Unit and Required Core Global Health Courses Housed in the School of Public Health, students must enroll in a MPH program or a MS in Biostatistics degree program Global Public Health Schedule and Format Shortest Completion Time: Not available Delivery: In-person University A Collaborative Doctoral Program in Global Health 1 University B 2 MS in Global Health Sponsored by the School of Public Health and the Faculty of Medicine, students must gain admittance to other health-related colleges or departments prior to applying for program Comparative Politics of Health and Health Policy in a Globalizing World Three semesters of a half-credit global health research seminar Housed in the Global Health Institute Global Health Challenges Global Health Research: Design and Practice Global Health Research: Intro to Epidemiologic Methods Bioethics Health Systems in Developing Countries Shortest Completion Time: Not available Delivery: In-person Shortest Completion Time: 1.5 years Delivery: In-person University C 3 MS in Global Health and MPH in Global Health University D 4 MPH with specialization in Rural Health Housed in the School of Public Health Health Program Evaluation Introduction to Global Health Global Health Project Development Housed in the School of Public Health Health and Society Approaches to Population Health Health Measurement I Designing Effective Public Health Programs Shortest Completion Time: 16 months Delivery: In-person Shortest Completion Time: 2 years Delivery: Hybrid; for each course students attend a one week oncampus session and then complete a sixweek project related to the content off-campus 1 To apply to the collaborative doctoral program at University A, students must be accepted or admitted to specified PhD programs in related colleges or departments. Students graduate with a notation on their official transcript indicating completion of a collaborative program in global health. 2 University B web site. 3 University C web site. 4 University D web site.

8 8 of 12 Strategies to Provide Global Content Emphasize Skills over Content to Appeal to Varying Student Backgrounds To provide students with skills relevant across disciplines and industries, faculty and program directors at University B design foundational courses to emphasize skills rather than content. This ensures required courses relate to students goals regardless of their country of origin. However, contacts note equal difficulty developing courses relevant to students with different background experiences (e.g., years of employment, fellowship experiences, etc.). At the University D, students compare case studies from different African countries and the around the globe to highlight best practices and ensure relevancy of content to students from outside South Africa. Curriculum Changes Address the Impact of Transnational Topics on Health Faculty and administrators at the University C plan to amend the curriculum and place additional emphasis on the relations between transnational trade, economics, and politics on health. However, the degree already requires more coursework than other master s programs, and contacts express concern that the addition of foundational or theoretical coursework would come at the expense of practicums or case studies. Students Spend at Least Six Weeks Conducting Field Research Focused Outside the United States and Canada At all institutions, the majority of field research projects occur where faculty conduct research, although some students collaborate with nongovernmental organizations or intergovernmental organizations. At University B, students who do not directly collaborate with faculty on their research must enlist a faculty mentor to oversee the development of their research proposal and post-fieldwork analysis. Students at University A may conduct research domestically with a Program administrators admit students who demonstrate interest in health in the Global South in their applications. Administrators ensure student demand for courses or fieldwork related to this region through this admissions requirement. government agency, non-profit organization, or intergovernmental organization focused on global health.

9 9 of 12 Fieldwork Opportunities from Profiled Institutions Administrators consider safety and government travel restrictions. Students at the University C may not participate with faculty on research in Pakistan due to safety concerns Students at University B studied barriers to distributing salt-substitute dietary supplements and low cost anti-hypertensive drugs in rural China in efforts to improve cardiovascular health. 1 Students at University B coordinated with an existing non-profit in Haiti to assess family planning programs and identify culturally sensitive strategies to lower maternal and child mortality through contraception usage and birth spacing. 2 Students at the University C often conduct research in Uganda on topics such as community-based antiretroviral treatment for AIDS patients and increased reproductive knowledge of teenagers. 3 Students at the University C work in Columbia to improve access to malaria diagnoses. They also track the spread of drug resistant strains of malaria. 4 To fund fieldwork at most institutions, students apply for grants from the institution, government agencies, nongovernmental organizations, and intergovernmental organizations. At University B, student tuition covers the cost to conduct fieldwork, which typically occurs the summer between the first and second year in the program. Students at the University D Typically Conduct Research at their Place of Work The program at the University D is located in the Global South and many students live in the southern Africa region. Therefore, students have many opportunities to conduct relevant research without abandoning professional obligations. Instead, they complete a research capstone related to their professional interest which applies concepts and research methodologies learned in the program to their current employment. 1 University B web site. 2 Ibid. 3 University C web site. 4 Ibid.

10 10 of 12 Partnerships Faculty Researchers Develop Partnerships with Institutions Overseas to Support Student Fieldwork Collaborations with institutions of higher education abroad begin with faculty research partnerships. Faculty bring graduate students to their research site to assist with data collection and analysis. This expands informal partnerships to formal agreements that include student exchanges or prescribe a certain number of students may enroll in the institution overseas each semester. Similar agreements may also exist between the institution and regional non-profit organizations, government agencies, and intergovernmental organizations in the country where students conduct research. Contacts recommend that administrators send highly-skilled students to newly developed partnerships because these students are eager to gain new experiences and make a good impression on new partners. For example, first year medical students require additional training to diagnose patients at a rural clinic. However, graduate students who complete prior training in research methods can survey local populations to further data collection. After faculty and administrators establish the program, they send students who require additional training in fieldwork, but early cohorts should demonstrate the value of the partnership to the host organization. Dual Degree Programs and Joint Faculty Encourage Interactions Between Global Health and Medical Programs Medical school faculty and student health care practitioners who teach and enroll in global health courses offer their peers a unique perspective into the implementation of global health policies and the practices and theories discussed in class. However, contacts at the University D note that practitioners interest in collaboration varies by practice area. Specializations with high interest include family medicine; medical students in this area work with MPH students on research that examines health in local rural populations from birth to the age of twenty. Medical and public health students also form natural collaborations around epidemiology, especially public health students concentrating in disease causation and prevention. Strategies to Partner with Colleges Across the Institution Joint Faculty Appointments Presentation of Research Dual Degree Programs Global health programs at all institutions share faculty with the medical school. These relationships ensure that students receive a practitioner s perspective in the classroom and encourage public health students to consider implementation strategies such as medical supply delivery and personnel demands during program and policy evaluation. At University B, an interdisciplinary institute houses the global health program, and all faculty have appointments in other colleges, including the College of Medicine. At the University C, a faculty member or student in the school of public health or school of medicine presents monthly on global health topics. These sessions are well attended and foster community between the two colleges. University B offers a dual degree program for students interested in both an MD and an MPH in global health. Contacts note this program is relatively popular, although some students find the required fifth year and additional cost prohibitive to completion. At University A, students who enroll in the schools that teach future health care providers may enroll in the collaborative doctoral program in global health to receive a transcript notation for their participation.

11 IV. Student Demand and Outcomes Applicants Directors Admit Students with Prior Work or Research Experience 11 of 12 All contacts report high demand for their program; at the University D, directors receive 300 applications annually and only enroll 40 students. Program administrators at University D reject students without prior professional or research experience in the field of global health; therefore, applicants seeking to transition to a new field rarely gain admittance. University B and the University C evaluate applicants on similar criteria; for example, at the University C students must possess one year of experience working in global health. Due to these admissions standards, the majority of students in profiled programs do not enroll immediately after the completion of a bachelor s degree. International Student Enrollment Diversifies Student Perspectives and Enriches Classroom Discussions Contacts report varying success attracting international students to programs in global health; at the University C, they select other MS and MPH specializations such as biostatistics. However, contacts at University B estimate at least 20 percent of students in the program are from outside the United States. They recruit international students at institutions in the students countries of origin where the University has existing research or exchange partnerships. At the University D, all students come from Africa; 12 of 40 International students face greater barriers to obtain funding for field research as many government grants dictate that recipients have citizenship. total students live outside of South Africa and travel to Johannesburg for courses. Eight students country of origin is not South Africa but they currently work and reside within its borders. Outcomes At the University D, some students feel unprepared for their current position and enroll in the program to obtain relevant skills. They do not seek career advancement, rather preparation for their present job. Students Seek Advancement in their Current Profession Contacts track student outcomes anecdotally through s with former advisees and formally through institutional surveys students complete six months after degree completion. They consider graduates employment in the field of public health or acceptance into PhD programs as indicators of high program quality and curriculum strength. Students who enroll directly after completing their bachelor s degree or who transition from a different field typically find jobs at small non-profit organizations overseas or with municipalor state-level agencies. Students with prior experience may secure highly competitive positions in prominent intergovernmental organizations such as the World Health Organization or the United Nations, or federal agencies such as the Center for Disease Control or United States Agency for International Development. Although their degree is in global health, students may also work for government agencies on domestic health concerns at the local, state, or federal level. Strategies advisors, faculty, and program directors employ to help students secure job placements post-graduation include: Personalized Advising: At University A, students send career advisors copies of their resumes and a letter of interest prior to meetings so the advisors can prepare materials specific to the students interests and experiences to discuss. Small-group Discussions and Workshops with Employers: Advisors invite representatives from academic institutions, non-governmental organizations,

12 12 of 12 intergovernmental organizations, and local-, state-, and federal-level government agencies to discuss job opportunities with their employers. Alumni Panels: Program alumni return to campus for in-person panels or host online seminars to discuss their career trajectory and answer questions from current students seeking similar employment. Webinars are a popular delivery format as alumni abroad participate more easily.

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