Working group #1

TRAINING FOR PUBLIC HEALTH "COMPETENCIES", PRIORITY AREAS FOR THEIR APPLICATION AND STRUCTURE OF THE PROGRAMME

The first task of the small group sessions of the Workshop was to refine a set of public health "competencies" which should characterise the graduates of this programme. It was agreed that overall the training programme should aim to produce public health practitioners who are skilled and competent in assuming leadership roles within the public health system of Zimbabwe. Leadership in this context encompasses knowledge, skills and a set of attitudes that place public health issues in the context of the contributions of other sectors to health and the role of public health in overall community and national development.

Appropriate attitudes include sensitivity to cultural and class differences; capacity to listen as well as speak; patience and persistence in working toward long-term goals; commitment to continuing education and the habit of self-learning; and having an appreciation of the role of public health in development.

The Workshop participants agreed that the MPH curriculum would best be presented in terms of both the desired competencies and priority application areas. The competencies represent tasks to be performed, and the priority application areas represent the major health problems to which the competencies are applied. It was recognised that these two reflect different dimensions of the MPH curriculum, and the two therefore could be developed as a matrix.

1. Competencies

A. Epidemiology

• Design, implement, analyse and interpret community surveys (including use of qualitative methods) and use and evaluate routinely collected data.
• Design, use, evaluate and improve surveillance systems
• Recognise, investigate and control outbreaks and disasters (including chronic diseases and non- communicable conditions as well as classic infectious disease epidemics).
  

B. Biostatistics

• Use appropriate statistical methods to interpret public health data.

C. Research Methodology

• Design, implement, analyse and report on research projects based on essential health needs
• Utilise rapid community assessment techniques

D. Health Informatics, Computer Skills

• Use simple data management, word processing and statistical packages, including EPI-INFO.
  

E. Health Services Planning and Management

• Make a community diagnosis, establish priorities, set targets, design, implement and evaluate programmes for community health action.
• Manage personnel and material resources.
• Draw up budgets and manage financial resources.
• Utilise and promote the team approach.
• Work effectively with other sectors and non- governmental organisations.
• Utilise demographic data to project populations and calculate demographic indices.
• Evaluate public health programmes, including ability to describe the organization, the process and outcome indicators to measure success, and make recommendations for improvement.

F. Communication Skills and Health Education

• Listen to and assess community opinion regarding health issues, and identify community leaders.
• Promote behaviour change of community and individuals. (This requires an understanding of the effect of culture and social organisation on perceptions of health and behaviour).
• Utilise mass media.
• Present scientific findings at the levels of colleagues, decision-makers, and the lay public.
• Teach other students, peers and colleagues within the public health system.

2. Priority Application Areas

A. Maternal and Child Health

1. Family Planning
2. Nutrition
3. Expanded Programme on Immunisation
4. Childhood Diarrhoeal Disease
5. Acute Respiratory Infection
6. Maternal diseases

B. Communicable Diseases

1. AIDS and other Sexually Transmitted Diseases
2. Tuberculosis
3. Malaria

C. Environmental and Occupational Health

1. Housing
2. Hazard evaluation
3. Waste disposal
4. Water supply
5. Food hygiene

Structure of MPH Programme

The following were agreed with regard to the structure of the programme:

A. TEACHING TIMETABLE

1. Approximately 25% in classroom; 75% in field work

2. Schedule: Take into account practical constraints, eg, plan University class work during holidays when campus housing is available weeks of classroom teaching blocks over 2 years divided into 3 blocks per year; remainder in field assignments.

3. Classroom Blocks:
(The following is a summary of the recommendations made on which there was broad consensus.)

Block 1: First week will be spent in team building, orientation to student-centered learning and review of training needs. Then 5-6 weeks focussed on core disciplines of epidemiology, biostatistics, computer skills and demography, and situating public health in the broader context of development.

Block 2: Planning, management, communication.

Block 3: Operational research methodology, biostatistics, communicable and non- communicable diseases. (year 2)

Block 4: Advanced epidemiology, health informatics. Overlap with 1st year for teaching. Non-communicable diseases, maternal and child health. Management.

Block 5: Environmental and occupational health. Write up dissertation.

Block 6: Revision, leading into exams.

4. Problem-based teaching and learning
Goal: emphasise problem-based teaching, integration of class work and field work.
Constraint: limited manpower and preparation time.
Assign students responsibility for individual learning.
5. Flexibility of field work Opportunities for outbreak investigation may take precedence over other field assignments. Case material from field assignments will be used in class work. Students will be assigned to a primary field site, but may be transferred to pursue training goals. Objectives for each block in the field should not be narrow, but a guide to what should covered in each year is needed.

B. ADDITIONAL SEMINAR SESSIONS

1. Throughout the programme, including during field assignments, seminar sessions will be scheduled to report on work in progress, with oral presentations by students.
   
2. Individualised teaching and supervision during field
   assignments.