THE DEVELOPMENT OF THE MPH PROGRAMME
Zimbabwe currently faces an acute need for
post-graduate level public health training. Most public health
posts are vacant or filled temporarily by expatriate doctors; the
attrition rate for physicians is high. Those Zimbabwean
physicians who do serve in public health posts and go overseas
for training, frequently find themselves ill-equipped to function
in local public health settings on return.
The challenges that face public health workers
are formidable. Although considerable progress has been made to
improve public health in Zimbabwe since Independence, largely
through the successful implementation of the Primary Health Care
approach and improved living standards, these advances are now
threatened with reversal. The combination of structural
adjustment, recession, drought and AIDS is likely to bring
serious adverse public health consequences in the mid-l990's.
The Department of Community Medicine of the
University of Zimbabwe and the Ministry of Health of the
Government of Zimbabwe have collaborated to design an MPH
programme aimed at training suitably qualified public health
practitioners to meet these challenges. Such cadres would possess
both knowledge of public health and the skills and experience
necessary to apply this knowledge in public health settings
within the Ministry of Health, local health authorities and the
private sector. This would be accomplished through an integrated
programme of formal class work and a large element of supervised
practice in actual public health settings.
In order to oversee the design and
implementation of the training programme, the Department of
Community Medicine and the Ministry of Health organized a Task
Force composed of representatives of the Ministry, the
University, municipal health authorities and Provincial Medical
Directors. Since its formation in February 1992, and with a
planning grant from the Rockefeller Foundation, the Task Force
accomplished two milestones in an ambitious drive toward an MPH
programme beginning January 1993:
1) A needs assessment survey was conducted among
the country's eight Provincial Medical Directors to identify
training needs for physicians who would qualify for that public
health post. The PMDs identified several areas in which they
recommended training, including: epidemiology; health services
management (particularly financial management); computer skills;
maternal and child health, and communicable diseases control.
Current District Medical Officers (DMOs) and Government Medical
Officers (GMOs), who are qualified medical graduates with some
field experience, would be likely candidates for the training
programme.
2) University of Zimbabwe Regulations were
drafted, submitted and approved by the necessary University
committees to authorize the post-graduate degree programme
beginning January 1993. The programme was approved as a two-year
Master's level course, offering an MPH degree, and open to both
physicians and non- physicians who carry qualified undergraduate
degrees and relevant health care experience.
The Task Force further determined that the
training programme would be practical and action-oriented,
emphasising the application of feasible solutions to public
health problems. Candidates on the programme will be required not
only to be able to demonstrate that they possess relevant
knowledge, but also that they can apply this knowledge
effectively in practice. Field training experience will consume
approximately three-quarters of each year of the programme;
classroom work will occur during the remainder. The following are
goals broad which graduates are expected to attain:
a) Identify, quantify and prioritise community
health problems and needs;
b) Design, implement, and evaluate programmes
aimed at countering these problems and meeting health needs;
c) Communicate effectively with individuals and
groups; and
d) Demonstrate leadership capacity within the
public health system of Zimbabwe.
The content of the curriculum, designed to
achieve these goals, would cover the following areas:
- epidemiology
- operational research methodology
- biostatistics
- communicable disease control
- maternal and child health and family
planning
- health services planning and management
(including demography)
- environmental and occupational health
- communication skills and health education
(including behavioural science)
- health informatics and computer skills.
The Nyanga workshop was held in order to refine
the curriculum design and content, and in particular to meet the
objectives given below.
Workshop Objectives
1. To inform all participants of the background
need for public health training in Zimbabwe, the development of
the MPH Programme, and the career opportunities available for
graduates of this programme within the public health sector.
2. To review and refine the MPH curriculum
developed thus far, with particular focus on:
a) Training for public health competencies and
teaching methods;
b) Field work environments and supervision, and
c) Assessment of candidates.
3. To consider recommendations for future growth
of the MPH Programme, including the introduction of
non-physicians.
4. To consider recommendations for evaluating
the MPH programme in meeting the public health training needs of
Zimbabwe.
