The International Health Program
A Focal Point for International Activities Through Teaching,
Research, and ServiceTatiana Masters
Stephen GloydEnthusiasm for international activities and collaboration has always been strong within the University of Washington School of Public Health and Community Medicine (SPHCM). At the School's founding in 1970, international health was an integral part of the Department of Epidemiology, which had research sites in Taiwan and other countries. From 1981 through 1985, the SPHCM and the School of Medicine jointly ran the Center for International Health, which encouraged interactions among a variety of disciplines including public health, anthropology, medicine, and geography The center also developed a funded exchange program with the People's Republic of China.
The International Health Program (IHP), established in 1986 as a graduate curricular program, is now the focal point for international health activities in the SPHCM. The curricular track is designed for health professionals, administrators, and policy analysts who intend to devote a significant part of their careers to improving health in developing countries. Its goal is to contribute to the advancement of world health through teaching, research, and service. The international clearinghouse activities include coordinating international health research and training, fostering collaborative relationships with foreign institutions, developing international opportunities for students, faculty, and staff of the UW, and directly carrying out research, teaching, and service overseas. The IHP also supports international health activities in all other health sciences schools.
Students are encouraged to pursue practica in an international setting and theses using international data, and to do their thesis research abroad when possible. Foreign students usually return to their home countries for thesis work during their course of study U.S. students work with their own overseas contacts and those of faculty to find placements and funding opportunities. When pursuing thesis work abroad is not feasible, students often work in crosscultural settings or with a local international population to obtain relevant thesis opportunities in Washington State.
The IHP curriculum stresses the importance of socioeconomic determinants of health, the most important of which is basic education. This is a typical primary school classroom now found in many parts of rural Mozambique, where war has ravaged the networth of schools and health posts. Access to primary school education throughout Africa has significantly decreased over the pastfive to 10 years, mostly due to financial austerity programs mandated by the International Monetary
Fund to repay debts.
IHP Curriculum
The IHP focuses on community health and primary health care systems in the developing world. Students learn not only the basic principles of public health, but also to identify the social, political, and economic determinants of illness. A particular strength of the program is providing a historical context for health issues throughout the world. Study of the planning, management, and evaluation of health care systems is also an integral part of the academic program. Both the Department of Health Services and the Department of Epidemiology have an IHP curriculum leading to the MPH degree. in addition, PhD-track Epidemiology students and students from Biostatistics and Environmental Health have participated in the program. The IHP also offers a concurrent Master of Public Health-Master of Arts in International Studies (MPH-MAIS) degree in cooperation with the Henry M. Jackson School of international Studies.IHP students complete core MPH courses, departmental requirements, a public health practicum, specialized international health courses, and a thesis on a topic relevant to health issues in developing countries.
Students
The program enrolls 10 to 15 students annually, with a fairly equal division between the departments of Epidemiology and Health Services. Foreign students, on average about 45% of the group, have commonly been leaders with considerable responsibilities in their countries, including national program directors, medical school deans, and nongovernmental organization directors. They have come from Kenya, Zaire, Ethiopia, Central African Republic, Mozambique, South Africa, Zimbabwe, Cameroon, Cote d'Ivoire, Senegal, Thailand, China, Mexico, Honduras, Peru, Haiti, and Romania. Many have been participants in the International AIDS Research and Training Program. Domestic students usually have a minimum of two years of international health experience. Cooperative learning is thus a strength of the program. More than 100 students have graduated from the IHP since 1986. Nearly all foreign students return home, usually to increased responsibility in the health systems of their countries. Domestic students work both internationally and in the United States after graduation (Table 1). Examples include teaching nursing in Zimbabwe, program management in Thailand, research in Nicaragua, and refugee care throughout the world. Some domestic graduates combine work in the United States and abroad. For example, one former student divides her time between the Seattle-King County Department of Health and the Peace Corps as a trainer in Senegal and Cote d'Ivoire. Others have reported that the crosscultural skills and awareness of the social and economic determinants of health that they learned in the IHP are essential to the work they do in the United States.
IHP Partnerships
Another function of the IHP is to act as a clearinghouse for international research opportunities, internships, information, and contacts for the SPHCM. More than 50 faculty members within the School are involved in international work of some kind. The IHP also sponsors school and university-wide events on topics of international health interest such as annual World Health Day programs.Partnerships with academic institutions in other countries encourage student and faculty exchanges and collaborative research. The International Health Program is involved in partnerships with the University of Zimbabwe University of Nairobi, Kenya; University 4 Guadalajara, Mexico University of Eduardo Mondlane, Mozambique; Mahidol and Chiang Mai universities in Thailand and Shanghai Medical University and West China University Faculty and students have done research and clinical clerkships in more than 20 additional countries in Latin America, Asia, and Africa.
Faculty work with numerous partners in their research activities abroad. Among them is Health Alliance International (HAI), an independent nonprofit organization founded in 1987 to assist faculty and students to develop public health projects overseas. Current and recently completed projects are in Mozambique, Central African Republic, Cote d'Ivoire, Nepal, and Washington State. Faculty also work with organizations and institutions such as AIDS Impact and Program for Appropriate Technology in Health (PATH), both headquartered in Seattle, and the World Health Organization.
Future of the IHP
The International Health Program continues to develop new ways to provide the core context for training and research in less developed countries. The program intends to address the challenges of increasing the international focus of the University of Washington by exploring innovative approaches to provide public health skills to health workers abroad, including distance learning options using the Internet and other new technologies. Initiatives to link the IHP with the Graduate School of Public Affairs and the Department of Geography are in progress. The program is also playing a major role in MPH curriculum changes in the SPHCM.Authors
Tatiana Masters was coordinator of the International Health Program at the UW School of Public Health and Community Medicine from 1995-1997. She is now a graduate student in the UW School of Social Work.
Stephen Gloyd, M.D., MPH., is director of the International Health Program and associate professor of health services at the UW School of Public Health and Community Medicine. He is also executive director of Health Alliance International. He recently returned from nine months in Cote d'Ivoire on a Fulbright Fellowship.
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Created: 4/14/98 Updated: 7/15/99
