The Department of Community Medicine, University of Zimbabwe, Zimbabwe
Background
The Zimbabwe two-year NTH program is embarking on its fourth year. The program is a partnership between the University of Zimbabwe (Department of Community Medicine), the Ministry of Health and Child Welfare (MoI-I/CW) at the central and provincial levels and the City Health Departments of Harare and Bulawayo. The goal of the program is to train "a continuing supply of public health leaders and workers who can apply the principles and methods of public health to assess and address Zimbabwe's public health challenges into the 21st Century."
Trainees are sponsored by the MOIVCW and are selected jointly by the MOIVCW and the University of Zimbabwe. Although both medical and non-medical health workers are eligible to apply for the NDH program, the first priority is to train physicians who can assume the posts of Medical Officer of Health (MOH) which are currently either vacant or filled by expatriate staff. A second priority is to train District Medical Officers (DMO) who can assume greater planning and managerial responsibilities as the health system in Zimbabwe becomes decentralized. The annual intake of new trainees has increased from five each in 1993, 1994 and 1995, to eight this year (1996), and the program has produced two cohorts of graduates, four in 1994 (one trainee withdrew voluntarily from the program) and five in 1995 (one of the five trainees will graduate pending resubmission of his NUH thesis paper). Among the nine potential graduates, five are physicians.
Course structure and content:
The course is 40 percent classroom and 60 percent field-based. The academic component is organized into the following five academic modules:
Module One: Computer skills, descriptive epidemiology, biostatistics & demography.
Module Two: Health promotion; communication skills.
Module Three: Analytic epidemiology & biostatistics; maternal &child health (MCH)- family planning (FP)- communicable diseases.
Module Four: Environmental & occupational health.
Module Five: Health service planning & management and health economics.
Until recently, the course schedule was organized into nine alternating academic and field blocks. This year, based on recommendations made at a midterm review meeting held in Darwendale in May 1995, which included representatives from the other PHSWOW programs, the number of course blocks was reduced to three. According to the new "three-block" schedule, students will spend the first seven-month block in the classroom except for short field trips amounting to a month, the second 12-month block in a supervised field setting, and the third and final four-month block back at the university to write up their NDH thesis project, attend review courses and take their final examinations. It is anticipated that this new schedule will enable students to be better prepared for their field attachments, allow more continuity in the field experience, reduce housing costs and allow for an increase in class size without affecting the total number of trainees the field sites can accommodate at any one time. At present only one trainee can be accommodated per field site.
MPH:
As in Uganda, the thesis project in the Zimbabwe program is developed based on one of the field investigations undertaken during the field attachment and usually as an extension of one of the field write-up requirements. The thesis topic must be approved by the field supervisor as well as the Academic Review Board. The findings can be published in a newsletter, a local journal or as a report to the government. PHSWOW presentations at the national conference in Zimbabwe have won awards. The MPH thesis requirement is intended to demonstrate the student's ability to independently identify, analyze and solve problems in the field. The NDH thesis carries 25% of the final course grade.