NEWS
Public health schools: six portraits
The James P Grant School of Public Health was established in Dhaka, Bangladesh, in 2004 by the world's largest development nongovernmental organization, BRAC (formerly the Bangladesh Rural Advancement Committee), to train future public health managers and leaders.
The idea of setting up the school grew out of BRAC's work alleviating poverty in disadvantaged parts of the world, says the school's dean, Professor A Mushtaque R Chowdhury. He says that the school's goal is to "improve the health of the population by training future leaders in public health".
BRAC collaborated with prestigious public health schools in developed countries, such as Johns Hopkins and Columbia universities to determine the curriculum. Guest professors from those schools also teach on the school's courses. "We wanted to make it a centre of excellence, so we talked to different schools of public health in different parts of the world and launched the [MPH] programme with their help," Chowdhury says.
The master's of public health (MPH) programme was launched in February 2005. The course covers diverse topics, including public health management, health financing, communicable and noncommunicable diseases, and runs for 12 months. Students spend half of that time learning about the health challenges faced by rural communities in field locations in Bangladesh. This experience also gives students themes and material for their dissertations. Chowdhury says: "We feel that it is very important that the students are given exposure to real life."
Among public health schools in Latin America, the Sergio Arouca National School of Public Health in Rio de Janeiro, stands out. It is part of Brazil's most prominent science and technology health institution, the Oswaldo Cruz Foundation (FIOCRUZ) and is Brazil's national school of public health. The director, Professor Antônio Ivo de Carvalho, says the school attracts students from all over the country, as well as other parts of Latin America and Portuguese-speaking African countries.
Established in 1954, the school was inspired by the need to train professionals in public health but it soon evolved into a cornerstone of the Brazilian government's strategy to modernize the country's economy and society, Carvalho says. The school is also key to "the process of change of strategies for public action in the context of developmental policy".
Even today, the school plays a leadership role in Brazil's public health system. It helped establish the country's network of schools of public health, which trains the managers of the public health system and health services on both the national and local level.
The school offers two MPH programmes, one of which requires students to write about their fieldwork in their dissertation. The subjects covered by the school include: epidemiology; information and communications technology; health communications; health policy and management of health systems; research methodology in health and health surveillance.
The High Institute of Public Health in Alexandria is "the centre for progress in health development throughout Egypt and in many other countries in the region", says its director Dr Moustafa Ibrahim Mourad, referring to the Eastern Mediterranean Region of the World Health Organization (WHO). The 21-country region extends from Morocco across north Africa and the Middle East to Afghanistan and Pakistan.
Founded in 1956, the school became part of the University of Alexandria in 1963. Most of its students are sponsored by Egyptian ministries, the governments of other countries in the WHO region and international organizations, such as WHO and the United Nations Children's Fund (UNICEF).
The institute has nine academic departments offering 23 public health specializations. These include epidemiology, biostatistics, tropical health, microbiology, nutrition, family health, health administration and behavioural science, environmental health, and occupational health and hygiene.
It offers master's degrees, diplomas and training programmes for health providers. These include the Leadership in International Health course, and health quality management programmes.
The University of Ghana School of Public Health in Accra was created to meet "the urgent need for health personnel to man several newly created administrative districts and municipalities to address emerging health issues", says the school's dean, Isabella Quakyi. "The School of Public Health continues to play a crucial role in the health of the nation, providing essential health training for academia, research, policy and community mobilization for health improvement."
Students on the Master's of Public Health course come from across Africa, Canada and the United States of America, though the majority are Ghanaian, Quakyi says. Most of the Ghanaian students are sponsored by the country's health ministry and international organizations, including the United Nations Population Fund, the United Nations Children's Fund (UNICEF) and WHO. Many students also come from disciplines and fields other than health, creating a diverse mix that is especially attractive for students with a special interest in the developing world.
"Upon returning to Canada, it's very interesting to see how people respond to your CV [curriculum vitae] with an MPH from a school in a developing country," says recent graduate, Ian Wagg, from Canada. "How does that compare to [the] Johns Hopkins [University] or the London School of Hygiene and Tropical Medicine? In many ways it is much better than those schools, and in some ways it is not."
Wagg's story is an example of advantages to be gained from attending school outside the developed world. He initially chose the school to be close to research into antimalarial bednets at the Navrongo Health Research Centre in northern Ghana. But it also brought him into contact with top researchers in Africa, which he says was "the best thing for me aside from the educational experience" and gave him a unique perspective as the only Westerner in his class.
MPH students study biological and environmental occupational health sciences, biostatistics, epidemiology and disease control, health policy planning and management, and population and reproductive health planning, as well as social and behavioural sciences.
"We cover all issues of developed nations," Quakyi says. This ranges from communicable diseases such as malaria, HIV/AIDS and tuberculosis, to noncommunicable diseases like diabetes, stroke and cancer. Graduates go on to become district or regional directors of health in their own countries or to hold positions in various international health organizations, she says.
The Arkhangelsk International School of Public Health is establishing a new type of public health education in the Russian Federation.
"Public health, as it is seen and perceived abroad, is not well developed in the Russian Federation," says project coordinator Alexander Kudryavtsev. "So our programme is one of the first attempts in the Russian Federation to establish public health education in accordance with international standards."
The school was founded in September 2006 at the country's Northern State Medical University with support from the Department of Health Care of the Administration of Arkhangelsk Region in collaboration with several north European universities, Kudryavtsev says. The school is partly funded by the Barents Euro-Arctic Council (BEAC), a forum for intergovernmental cooperation in the Barents Region, and it admitted its first students in January 2007.
Currently, 24 students are enrolled on MPH programme and a further 29 will be admitted in January 2008. They come from diverse backgrounds and include medical doctors, social workers, psychologists, university teachers and health administrators.
A school was needed for many reasons. Kudryavtsev says public health has deteriorated since the 1991 collapse of the Soviet Union, with life expectancy, infant mortality, cardiovascular and infectious diseases, alcoholism, accident rates and drug abuse going "from bad to worse in all instances".
Kudryavtsev says: "There's a need for new quality of specialists trained to deal with public health, and we are training such specialists".
The Swiss School of Public Health + (SSPH+) was founded on 7 July 2005 by merging the public health schools of six universities: Basel, Berne, Geneva, Lausanne, Lugano and Zurich. The new school combines studies in public health and health financing, and is geared primarily towards health administrators and policy-makers in Switzerland.
The schools were merged to avoid duplicating one another's efforts. "We realized that each faculty is fundamentally too small to organize all the master's programmes," says Executive Director Gilles de Weck.
The institute offers several postgraduate degree courses covering public health, international health, and health economics and management. It offers courses to health professionals who need medical knowledge but not a medical degree.
The school offers several master's degrees in French, German and Italian - the country's three main national languages - in diverse aspects of public health. Its MPH programme covers epidemiology and biostatistics, sociology and psychology of health, prevention and health promotion, health and the environment, health economics, and health-care management and policy.
Research and report by Theresa Braine