Distance learning

In South Asia, you can count the number of schools of public health on one hand, despite a population of 1.5 billion. Compare that with about 30 schools of public health for a nation of more than 300 million in the United States, and the opportunities for growth become glaring.

At yesterday’s World Federation of Public Health Associations panel discussion on establishing schools of public health in developing nations, Richard Cash, MD, MPH, of the Harvard School of Public Health, and Gregory Pappas, MD, PhD, of Aga Khan University in Pakistan, stressed the importance of increasing recognition of the public health profession and training more faculty to institute and expand master’s of public health programs.

Training public health practitioners in their own countries while simultaneously creating a demand for public health degrees is the goal, as is tailoring the programs to prepare graduates to face the specific challenges of their communities. The benefits of training public health practitioners in their home country include drastically less expensive tuition than in the United States, and the opportunity to do in-person field studies, Cash told attendees.

Of the graduates at the Achutha Menon Center for Health Science Studies — the first Indian university to offer an MPH degree — only 8 percent of graduates migrated elsewhere to work. The statistic leads credence to the notion that more schools of public health are necessary to develop a local work force and improve health outcomes.

“It is my belief that if you really want to improve the public health…[in South Asia], you are going to have to train locally, for a whole variety of reasons,” Cash said.

At the James P. Grant School of Public Health at BRAC University in Bangladesh, students take part in field work and training that will hopefully improve the quality of life for local populations, including projects on water and sanitation, family planning, immunization, malaria, HIV/AIDS, nutrition and tuberculosis, just to name a few.

One challenge in furthering public health programs abroad is the difficulty of procuring trained faculty. However, increased funding for exchange programs among U.S. universities would help, Cash said. Other challenges include creating a demand for public health education in the work force and equating the importance of public health graduate work with other medical-related degrees. Currently, public health workers without a medical background can find it difficult to find work in their home country, Pappas said. At India’s Achutha Menon Center, students must first have a medical or other post-graduate degree to even get into public health school.

In Pakistan, the focus on traditional medicine should be shifted to include more preventive and health promotion measures, Pappas said. The country is facing the “double burden” of afflictions commonly found in developing countries as well as high rates of chronic disease. Pakistan’s rates of hypertension are similar to that of the United States, Pappas said.

Shortages of doctors and a lack of public health infrastructure are serious concerns in the developing world, and new structures are needed to unite efforts working to solve both problems. Partnerships with U.S. schools of public health and local research projects are also vital, Pappas said.

“Research is essential to the vibrancy of the program,” he said. “Research leads to new programs and informs the coursework.”

A webcast of this session, “International Public Health Education: The Experience from MPH Programs in Developing Settings Worldwide,” will be available via the Alabama Public Health Training Network on Wednesday, Jan. 16, 2008. Visit the Web site for more information.

— P.T.