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HPSR Teaching Blogs

CHEPSAA supports curriculum development in Bangladesh: exploring health systems complexity, student consciousness…and cricket

CHEPSAA support for HPSR courses

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On celebrating its 10th anniversary in 2015, the James P. Grant School of Public Health (JPGSPH) in Bangladesh conducted an extensive internal curriculum review of its Masters in Public Health (MPH) degree, recognising that the field of public health and the country context is changing. In February this year, Dr Vera Scott of the University of the Western Cape in South Africa represented CHEPSAA at a workshop that sought to take forward the recommendations of the curriculum review. In this blog, Vera writes about the curriculum review, the workshop to further develop the curriculum and other experiences and lessons from her journey.

It was a great privilege to represent CHEPSAA and to share some of the learning that has been generated within our collective.

The JPGSPH curriculum review was followed by two workshops. The first, held in August 2015, saw key international and national stakeholders discuss the results of the review, and develop and consolidate the best practices, strengths and competencies of the MPH programme. This workshop advised on technical content and pedagogic approaches. The second workshop, in which I participated, gave faculty the opportunity to work with the review recommendations in four working groups, considering their practical implications for some core modules, as well as the inter-modular connections. Our team worked on strenghtening the Health Systems Management module.

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I was impressed with the thoroughness of the JPGSPH curriculum review processes and the commitment of the JPGSPH faculty to grappling with how to apply the recommendations. The programme already has many strengths, but faculty were keen to improve it even further, recognising the need to equip MPH graduates to be adaptive and responsive to an ever-changing regional context.

I found CHEPSAA’s Introduction to Complex Health Systems to be a very helpful resource in providing support to the team of faculty seeking to introduce systems thinking into the management module, as it considers what is required of leadership and management within complex settings and systems, and seeks to build critical thinking (which our team identified as a core MPH competency). We found the notion of complexity to be useful in situating health within the context of social determinants and for exploring the influence of local and global actors.

The module has the possibility of capitalizing on JPGSPH’s unique institutional setting, with ample opportunities for field exposure through trips or an internship programme to observe and experience the practice of leadership and management within BRAC’s administrative structure. We discussed options for moving some of the teaching from the classroom to the organisational workplace and how to introduce a flipped-classroom, where students use face-to-face contact time for discussion of workplace experience and the pre-set readings. The module also has access to hugely innovative health programmes such as the Manoshi Project that works with community health workers to improve maternal and neonatal care in urban slums, demonstrating features of complexity.

I was very excited to see the Manoshi Project in action. I accompanied a community health worker on her rounds in Gulshan slum, saw the households that she was responsible for, watched her conduct a home antenatal visit and walked with her to the local delivery centre where women are encouraged to give birth with skilled birth attendance and have access to referral should an emergency arise. A local project manager is responsible for building relationships with community organisations and setting up a health committee which works through community networks to advocate for facility-delivery.

There are plans to develop a case study based on the Manoshi Project that will support applied learning within modules as well as act as a bridge between various MPH modules such as Introduction to Public Health, Anthropological Approaches to Public Health and Qualitative Research Methods, Epidemiology and Biostatistics.

The workshop coincided with the start of the new academic year and the orientation programme for the 2016 intake of MPH students. The MPH programme has positioned itself to support the development of public health skills in developing country contexts, and draws students from a number of different countries, which enriches the opportunity for peer learning.

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Two evenings were spent with the students, hearing about their diverse disciplinary and country backgrounds. I spoke to a young Yemeni oncologist, a Nepalese development worker, a Myanma dentist and a Bangladeshi doctor about their various challenges, motivations and personal journeys to studying public health. A cultural evening gave me a taste of regional dance forms and folk music, as well and the opportunity to hear students talk about the importance of their cultural and political heritage. These contextual understandings are highly relevant to an understanding and practice of public health in the region.

Beautiful Dhaka

I also used the opportunity to take in some of the impressive sights of Dhaka. The parliamentary buildings are surrounded by a moat - the architecture spoke to me of strength, peace and balance. Bangladesh is on a delta, river navigation feeds communication and transport across the country and the bustling port is a hive of activity with a score of triple-decker steam boats waiting to ferry passengers. Fort Lalbagh is a fortified palace dating back to the Mughal Empire and there are a number of monuments in Dhaka commemorating the 1971 War of Liberation. Art is valued and celebrated in this city. There are some exquisite mosques – the Star Mosque can only be accessed on foot or by rickshaw and has examples of intricate mosaic tiling.

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Did people in the streets know anything about my home country South Africa? Of course…we share a common love for cricket! One lasting effect of my trip is that the children in my family are now huge supporters of the Tigers.

Author: Vera Scott, senior researcher, University of the Western Cape