When I first saw the potential to help create a Global Health Center at the University of Baltimore in Maryland (UMB) back in 2004/2005, I had to stop and ask myself: What was I hoping to accomplish and why? My first thought was to help students and faculty understand that we live in an interconnected world. I wanted to look at shared global problems and build bridges between the US and low-income countries (LIC) or middle-income countries (MIC) so we can help and learn from each other. The grant asked to invite at least three schools together. I chose to bring all 5 UMB schools together and our public health/epidemiology department. I could not have foreseen the level of interest that this center would generate nor how it also helped build bridges between the various schools at UMB. Since then the Global Health Center, now called the Center for Global Engagement, is still going strong under its new leadership.
In this blog, I want to highlight why global health training is crucial, the benefits it offers to individuals and communities, and how to design and implement effective global health training programs.
Understanding Global Health Training
There are many similarities between global and international health. However the latter primarily focuses on health issues that cross international borders and often involve the collaboration between countries to address shared health concerns. It deals with health aspects related to international relations, including disease surveillance, health diplomacy, and the management of health emergencies that may affect multiple countries. International health typically concentrates on the exchange of information, expertise, and resources to tackle health challenges that have a transnational impact.
Global health, by contrast, refers to the study, practice, and promotion of health and well-being on a worldwide scale. It encompasses a broad and holistic view of health that goes beyond borders and addresses health issues and determinants that affect populations across countries and regions. Global health efforts often focus on addressing health disparities, promoting health equity, and addressing global health challenges, including infectious diseases, non-communicable diseases, environmental health, and health system strengthening. It extends beyond conventional healthcare boundaries, taking into account the social, economic, cultural, and environmental factors that influence health. Typical global health topics include climate change, refugees, food security, HIV, Malaria, and COVID-19 to name a few. Interventions in these areas tend to look not only at mitigation or disease prevention and treatment, but also at governance, health system strengthening, access, and other factors impacting population health.
- Global Health Challenges
As already stated, global health can help address many global challenges. Training in this field enables individuals to critically analyze these problems and develop innovative, context-sensitive solutions. These solutions are not only relevant to issues in low- and middle-income countries but can be also relevant to similar issues faced here at home.
For example, for years international health researchers have worked in countries to study malaria and develop a vaccine. We now have a malaria vaccine and interestingly the Washington DC area recently reported its first case of endemic malaria. Hence work to help other nations combat their health problems is going to be also aiding countries like the U.S. which are now having to grapple with old and new diseases. Another example relates to rural communities whether in the U.S., a LIC, or a MIC. All face healthcare access and health disparity issues. Successful solutions that can work in both countries are research and data collection to better understand the barriers and opportunities for the deployment of mobile clinics and the role of NGOs in serving remote or hard-to-reach communities.
- Interconnectedness
Global health practitioners have long known that we are all closely interconnected and that what happens in one country can affect us all. Indeed diseases and health crises can swiftly traverse borders. Today the whole world understands this truth at a deep level after our experience with COVID-19. What we do here at home affects the world and vice-versa. Training in this area not only fosters a sense of global citizenship and encourages collaboration among nations, but mostly it prepares organizations, and professionals to respond effectively to these challenges.
- Cultural Competency
Cultural competency is essential in healthcare, as it promotes understanding and respect for diverse cultures and beliefs. Global health training emphasizes the development of these skills, enabling healthcare professionals to provide compassionate and effective care in diverse settings. One course I have developed for the Moffitt Cancer Center-led GRACE program in Ghana focuses on clearly showcasing the difference in communication and work styles between countries to help promote better collaboration and outcomes. These differences were not just between the U.S. and Ghana, but some examples applied between rural and urban cultures in both countries. In other words, cultural competency training allows individuals to not only be better global citizens but also be better citizens at home.
Benefits of Global Health Training
The advantages of global health training extend to individuals, academic institutions, and the communities they serve.
- Enhanced Career Opportunities
Professionals with global health training can be in high demand depending on their field of expertise and skills. One advantage of building a global health center at UMB was to provide students the opportunity to conduct research or support an existing program overseas thus gaining the much-needed experience to be competitive in the job market. They can then find opportunities with NGOs, government agencies, and international organizations in academia, where their expertise is valued.
- Improved Healthcare Systems
Academic institutions offering global health training contribute to the strengthening of healthcare systems. By producing graduates who can address both local and global health disparities, these institutions play a vital role in advancing public health.
By understanding the role of culture in healthcare access, health professionals will acquire an additional dimension to their interactions with patients and communities here back home as well as overseas.
- Research and Innovation
Global health training stimulates research and innovation to combat emerging health threats. Students and faculty collaborate on projects with real-world impact, contributing to the knowledge and solutions needed to address pressing global health issues.
Designing Effective Global Health Training Programs
To create successful global health training programs, meticulous planning and execution are essential. Here are the key steps:
- Identify Objectives
Begin by clearly defining the program’s goals. Specify the skills and knowledge participants should acquire during their training. In my case, these included didactic and practical hands-on skills focused on the current projects and research UMB had.
- Interdisciplinary Curriculum Development
Develop a comprehensive curriculum that covers relevant topics, ranging from epidemiology and health policy to cultural sensitivity and ethics.
Based on my experience, a global health program training should include basic epidemiology, a qualitative and quantitative method course, multicultural communication, and monitoring and evaluation. In the global health course, participants would be exposed to key concepts and topics such as healthcare systems, policy, and, social determinants of health. They could then specialize in specific topics that are relevant to their interest such as infectious diseases, policy and advocacy, health systems strengthening, or health communication, to name a few.
Research is a critical component of global health. Training programs should equip learners with some basic research skills, including study design, data collection and analysis, and the ability to conduct ethical research in diverse settings.
When I was at UMB I helped create an interdisciplinary global training program and global health course that physicians, nurses, public health professionals, lawyers, social workers, pharmacists, and dentists would take. I worked with colleagues from different disciplines to make sure I addressed aspects I had not thought of. The advantage of interdisciplinary global health training is that it provides different perspectives on a problem and allows the students to see a more holistic solution with input from various disciplines.
Interdisciplinary activities should not be limited to the classroom. One of the challenges of sending students without sufficient research or public health background may be the lack of their ability to conduct simple activities such as on-the-ground assessments or surveys. Whereas researchers may be limited by their field of expertise. Sending a multidisciplinary team to conduct a healthcare system survey can, for example, include public health professionals with research skills along with a pharmacist who can explore drug availability, social workers who can explore community access and patients’ experiences in the healthcare systems, physicians and nurses who can explore medical care, and law students who can explore the healthcare and any insurance laws of the country.
- Faculty Expertise
Ensure that your program is staffed with experienced instructors who possess a deep understanding of global health and can provide valuable guidance to students.
In other words, such a course should have invited speakers with expertise in the areas being covered. It’s important and very helpful to have in-house expertise. But beyond the expertise that was found at UMB, one thing I did when teaching my course was to invite speakers who worked in NGOs, USAID, and the World Bank to give the students a well-rounded exposure to the different types of players in the field.
- Experiential Learning
Incorporate practical experiences, such as researching and writing a paper covering some of the basic principles acquired in class. Provide where possible internships or fieldwork, to allow students to apply their knowledge in real-world settings. This hands-on approach enhances their understanding and problem-solving abilities.
Experienced mentors and faculty members with expertise in global health are instrumental in guiding learners. They provide mentorship, share insights from their fieldwork, and help students navigate the challenges of global health practice and research.
Collaboration with international partners is essential in global health training. Building relationships with institutions and professionals in low- and middle-income countries ensures mutual learning and sustainable impact. Such partnerships enhance the relevance and cultural appropriateness of training programs. That was one of the goals of the Global Health Center I helped create at UMB. It provided a one-stop shop for both faculty and students interested in global health projects.
- Evaluation and Improvement
Continuously assess the effectiveness of your program and be prepared to make necessary improvements. Solicit feedback from participants and stakeholders to refine the training experience.
One important feedback from the students when we first launched the Global Health Center was to better connect them with existing projects on the ground with a defined project to tackle. This required mentorship commitment from our principal investigators as well as a rigorous matching program.
However, another important evaluation criterion is to look at how well your trainees are doing after they graduate. At the time I was conducting the program, not all were interested in an international experience. Most were just looking to broaden their learning and incorporate it into their practice. In that case, did the global health training help them do a better job? I would say yes because it equiped them with a solid understanding of common issues faced both in the U.S. and abroad. Their global health training whether as social worker, public health professional or other health professionals gave them a deeper undersanding and awareness in how to help underserved communities for example.
For those who were truly interested in a global health career, the measuring stick is whether they were able to land a job in the field of their choice. Conducting a short field activity helps, but having a year’s worth of international experience is important to land jobs with USAID or large NGOs. At the time that I left, our program was working towards building such an opportunity.
Conclusion
Based on the benefits I saw in the students that I trained, I firmly believe that global health training in academic centers is not merely an option—it is a necessity. However, academic centers tackling global health training should ensure they have the right infrastructure to deliver such training and target the training needs to their academic and on-the-ground strengths. Year-long projects that include considerable field experiences should be provided. When done correctly, global health training creates a new generation of public health professionals better equipped to tackle global and local challenges.
Resources
Khan, O. A., Daulaire, N., Sullivan, T. M., & Walker, D. K. (2012). Ensuring a Trained Health Workforce for Global Health. The Lancet, 380(9857), 957-958.
Koplan, J. P., Dusenbury, C., Jousimi, M., Somers, M. A., & Solon, O. (2014). Preparing the Public Health Workforce for Global Health Challenges. Public Health Reports, 129(2), 147-151.
Mendes IAC, Ventura CAA, Queiroz AAFLN, de Sousa ÁFL. (2020) Global Health Education Programs in the Americas: A Scoping Review. Ann Glob Health, 21;86(1):42.
Did you study global health in a US academic center? What was your experience like?