Jones & Bartlett Learning Health Blog

    Now that you are done with GH 101, what do you do for an encore?

    Posted by Cassie Peterson on Dec 4, 2012 9:04:46 AM

    Richard Skolnik – Author of Global Health 101

    A quick scan of the internet suggests that the number of colleges with Global Health majors, minors, and concentrations is continuing to increase. It also appears that colleges and universities are offering an increasing array of courses that relate to global health.

    Many colleges and universities now offer an introductory course in Global Health and community colleges are beginning to do the same. However, an important question for those institutions that are new to Global Health is what courses they can offer in Global Health beyond their introductory courses and beyond traditional courses in public health or medical anthropology. This will be an especially important issue for community colleges and for colleges and universities that are relatively small and not linked to strong programs in public health or economic development.

    Following an approach that many institutions use, one could offer courses that build on an introductory course but explore a critical area in Global Health in greater depth than the introductory course could do. In some respects, these courses would still be “introductory,” “broad,” and cover fundamental topics in Global Health. Courses like this might include, for example:

    • The History of Global Health
    • Ethics in Global Health
    • Demography and Global Health
    • Comparative Health Systems
    • Poverty, Equity and Global Health
    • Maternal and Child Health – A Global Perspective
    • Women’s Health in the Global Context
    • Global Mental Health
    • Infectious Diseases and Global Health
    • Non-communicable Diseases and Global Health
    • Global Health Programs and Projects
    • International Organizations and Global Health

    There is a substantial literature in each of these areas and many faculty have experience in them. There are also a large number of courses in these areas from which one can learn.

    Another of the many options for courses beyond an introductory course would be “Case Studies” courses. Case Studies courses can also serve as the basis for capstone or synthesis courses that are increasingly being used by colleges as part of general education or as the culminating component of a major.

    One can imagine, for example, a number of interesting Case Studies courses that could be built around the themes noted above. These could include:

    Case Studies in Comparative Health Systems – One could focus such a course, for example, on the quest for “Universal Coverage” in low- and middle-income countries. One could begin with the conceptual frameworks for such a review and then move on to the examination of countries that offer instructive lessons. In Latin America, the countries of special interest might be Argentina, Brazil, Chile, Colombia, Costa Rica and Cuba. In East and Southeast Asia, the quest for broadening insurance in China, the Philippines, Taiwan, and Viet Nam has been instructive, as has been the Health Equity Fund approach in Cambodia. There is also much discussion and writing these days about social insurance in Ghana and community-based insurance in Rwanda. The Sri Lankan experience has much to say about trying to achieve high levels of health status, even as the country was relatively poor. In addition, many people are carefully watching India’s efforts at expanding access and coverage of health services to its poor people. The Lancet has had a series on a number of countries, including Brazil, China, and India and a recent series on Universal Health Coverage that are wonderful resources for this type of course. Health Affairs had an excellent series on Taiwan that my students and I found very instructive. The Results for Development Institute manages the Joint Learning Network for Universal Health Coverage, which also provides access to many valuable resources:
    http://www.resultsfordevelopment.org/focus-areas/joint-learning-network-universal-health-coverage-jln

    Case Studies in Disease Control – Many colleges and universities review disease control cases as a part of their introductory courses or as an additional and separate course. Case Studies in Global Health – Millions Saved is frequently used as a text for courses that cover this material. There is an extensive literature on the concepts of disease control, elimination, and eradication. Once you set the foundation for the course on those concepts, almost everyone turns to Smallpox, of course, as their first case study. There is considerable literature, as well, on Onchocerciasis, Guinea Worm, Malaria, Polio, Trachoma, Schistosomiasis, and the “wormy diseases” – the soil transmitted helminths, such as hookworm. You will also be able to find good cases and literature on tobacco control. There are also new books that I found very useful on the history of efforts to eradicate disease and on smallpox, including Eradication by Stepan and books on smallpox by Henderson and Foege, two giants of the smallpox eradication program. My students thoroughly enjoyed Oshinky’s book on Polio – American Story and found it an excellent backdrop to our look at the polio campaign globally.

    Health Disparities – My own preference would be to ensure that the students have a good foundation in global health, in comparative health systems, and in issues of health equity and inequality in low- and middle-income countries before exploring health disparities in depth. Otherwise, I find students have a hard time looking at the health and health systems of countries through an “equity lens.” I am just finishing teaching the last part of an upper level undergraduate case studies seminar at Yale, the last module of which focuses on “The Quest for Equity and Equality” in health in low- and middle-income countries. There is a good literature on the conceptual underpinnings for an examination of inequality in health in these countries. There is extensive literature on health inequalities in high-income countries, such as Australia, Canada, and the US that can be an interesting jumping off point for cases about low- and middle-income countries. There are also good materials on health disparities in some of the largest and best studied of the low- and middle-income countries, such as Brazil, China, and India. However, one has to stretch to find the literature one would like on countries in sub-Saharan Africa, for example, outside of South Africa. Despite the challenges of trying to develop this module for a new course this year, now that it is done I must say that I have found this part of the course extremely interesting, very thought provoking, and enjoyable, as well.

    Finally, I should note that advanced global health courses can also be excellent courses for "writing in the discipline," which is becoming an important part of many undergraduate efforts to improve writing above and beyond freshman writing courses.

    Thanks to Professor Richard Riegelman and Jared Bernstein for their exceptionally helpful comments and suggestions on this blog.

    Richard Skolnik is a Lecturer at the Yale School of Public Health, where he teaches global health courses at the undergraduate and graduate levels. Richard was previously an Instructor in Global Health at The George Washington University, the Vice President for International Programs at the Population Reference Bureau, and the Executive Director of the Harvard School of Public Health PEPFAR program. Richard worked at the World Bank from 1976 to 2001, last serving as the Director for Health and Education for South Asia. Richard is the author of Global Health 101 a comprehensive, introductory text on global health.

    Topics: Global health, Richard Skolnik

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