Richard Skolnik – Author of Global Health 101
Since 2001, I have taught two to four introductory Global Health courses each year to undergraduates. In the last two years, I have taught an introductory Global Health course to graduate students, as well. In addition to teaching these courses, I have given numerous “Global Health 101” talks both to students and professional groups.
Recently, however, I was asked to teach a course in the fall for a Yale School of Management program intended for healthcare executives. The program is called MBA for Executives: Leadership in Healthcare. Those responsible for the program had been planning for some time to “globalize” the course curriculum, and they asked me to help them do this.
The intensive program takes place largely on alternate weekends for 22 months. The course members are seasoned healthcare executives. There are about 25 participants in the course, averaging roughly 40 years of age - substantially older than my undergrads or grad students. Almost all of the students are from the United States. I understand that, despite the substantial talents of the students, many of them have had relatively little exposure to health systems outside of the US or to the health problems faced by the poor in low- and middle-income countries and what can be done to address them.
Developing the course syllabus was both interesting and challenging. First, I spoke with those who manage the program about their aims for the course. Second, I looked at the overall curriculum for the program to see how my course might fit in. Next, I examined syllabi from other courses in the program to see how my course could complement theirs and to avoid unintentional overlap. This was the easy part.
The harder part was deciding what topics to cover in a 12-hour course that would be divided into four biweekly sessions of three hours each. This was especially difficult since my main focus has always been on comprehensive courses that, in many ways, are like old-fashioned “survey courses”.
Given the nature of the students, their knowledge gaps, and the overall curriculum, we decided to focus the course on:
- The burden of disease, risk factors, and social determinants of health – What do people get sick and die from, how does that vary across income location, age, and gender, and why do people get sick and die of these things? Linked to the burden of disease, we will also cover demography and health - How will population aging and continued population growth affect the burden of disease and health care costs?
- Comparative health systems and health system reform – What health systems are performing “best” and what can the US learn from them? What are the key issues facing health systems in low-, middle-, and high-income countries and how are countries seeking to address them? What are the focuses of efforts aimed at improving health systems in low- and middle-income countries, such as results-based financing and the quest for universal health coverage?
- Women and children, and communicable and non-communicable diseases – I will focus on critical issues in the health of women and children, as well as on HIV, TB, and malaria, and what we know and don’t know about how to address them in cost-effective ways.
- Future challenges in global health – The last of the four modules will focus on some of the critical challenges we will face in Global Health and the “innovations” and approaches that countries are taking, often collectively, to address them. We will cover, among other things, health market innovations, research and development for the health problems of the poor in poor countries, and financial innovation to fund development assistance for health.
Given both the short duration of the course and the intensive work in the students’ core courses, I also had to carefully focus the course readings. This required repeatedly asking myself questions like: “If the students could only read 50 pages to introduce them to the concept of the burden of disease and set a foundation for pursuing the topic further in the future, what should they read?” “If the students could read just one article on demography and health, what should that article be?” (I certainly hope that I have chosen wisely, since there is not much room for error when you are assigning only a reading or two per topic…)
Finally, I had to narrow down the assignments. As some of you will have read in my earlier blogs, I usually make learning how to write policy briefs a specific objective of my courses. I decided to do the same for this course. However, since all readings and assignments have to be done over about an 8-week period and since I have to respect the intensity of the core courses and their respective assignments, I will assign only two five-page policy briefs, instead of the usual three. The first will be on a health system of the student’s choice, which will give the students a chance to pursue the topics we cover in the second module of the course. For this assignment, the student will briefly describe the basic organization of the system. Then, they will examine key issues facing the health system, how the country has tried to resolve them, and how successful they have been in doing so. The students will end the brief by suggesting some measures they might take to address the most important health system issues and then outline what lessons for other countries can be taken from the experience of the country on which they write.
The second brief will largely follow what I have my other students do. However, I will give these students a wider choice of topics since I am assigning just two briefs. I will ask the students to write on a country of their choice, in a region different from the country about which they wrote their first brief, so they can expand their geographic horizons. I will ask them to write either about women’s health, children’s health, communicable diseases, or non-communicable diseases. They will have to answer the following questions: What is the nature and magnitude of the problem? Who does it affect? Why does it affect them? Why should the Minister of Finance and the President care about this problem? What can be done at least cost to address the problem?
Although I have taught healthcare executives before, it has usually been through my one-session “Global Health 101” talk. This new course should be both fun and challenging. At some stage in the fall, I will let you know how it went and what lessons we can all take away from it.
Ms. Lauren Tronick provided valuable comments on the draft of the 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.