Expanding Academic Engagement in Global Health

TPHA Annual MeetingFranklin, TennesseeSeptember 11, 2014

Cathy R. Taylor, DrPH, MSN, RNDean and Professor

Gordon E. Inman College of Health Sciences and NursingBelmont University

cathy.taylor@belmont.edu

Objectives• Describe successful expansion of global health

and service learning efforts in one University• Discuss facilitators and challenges to global health

education, practice and research• Discuss next steps and new

opportunities for global health education, practice and research

Health Sciences Enrollment

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 20130

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400

600

800

1000

Total CHSTotal UndergradTotal Grad

Health Sciences at Belmont• Undergraduate

– Nursing – Social Work– Other

• Graduate– Nursing – Occupational Therapy

• Doctorate– Nursing– Occupational Therapy– Pharmacy– Physical Therapy

• Historic faith-based missions

• Applied, translational research Youth sports-related concussion Veterans with TBI Compassionate care of the older adult Safe transportation for seniors Ballet-related injury

Safe, effective team-based care Scholarship of teaching Student transition to practice

Faculty Scholarship

The Future of Health Sciences and Nursing at Belmont

• Interprofessional teams• Global health focus• Sustainable academic, practice and research partnerships• BU – Live Beyond Partnership in Thomazeau, Haiti

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Republic of Haiti• Occupies the western portion of the island of Hispaniola, in the Greater Antillean

archipelago. Borders the Dominican Republic.• Language

– French & French Creole• Religion

– 80% Catholic sometimes combined with voudou– 16% Protestant

• Population*– 80% of the population below the poverty line – 54% in “abject poverty”– 75% of the population lives on $2 or less per day– Ineffective reforms and aid because of widespread corruption and the inefficient judicial

framework. Source: The World Factbook. https://www.cia.gov/library/publications/the-world-factbook/geos/ha.html

HaitiPopulation 10.3 million ̴�

• 35% of the population is < 15 years old• Median age – 22 years• Adult literacy rate – about 50% adults • Professionally attended births – 25%• Use of modern contraceptive methods – 25%• Infant mortality rate 52/1000 live births• Birth – 5 years death rate 76/1000• Life expectancy – 61 female/64 maleSource: WHO Global Health Observatory. http://apps.who.int/gho/data/node.country.country-HTI Accessed 2/12/14.

Notice anything about these kids?

Community-based Health Impact Programs

• Clean Water Project• Mother & Infant Care• Special Needs Care• Mobile Medical Clinics• Sustainable Agriculture • Education• Vocational Training • Orphan Care

Staff and Volunteers

Sleeping Quarters

The Maternal Care Team

Visiting in the Villages - Annette

The Med Box

Singing with friends.

Facilitators: Education• Faculty/administration

“buy in” and support• Incorporating global

engagement in strategic plans

• Faculty/student interest• Accessible & reliable

internet resources• Compatible expectations

Challenges: Education• Time constraints and overloaded

curricula• Faculty workload• International travel costs• Varied time zones and schedules

make it hard to schedule interprofessional educational experiences

• Increasing scope of existing global activities

• Safety– Infectious disease – Civil unrest

Facilitators: Research

• Administrative support and funding

• Institutional Review Board support

• Engaged faculty champions• Measurement, data

collection and research staff expertise and capacity

Challenges: Research

• IRB and research ethics review differences

• Authorship issues • Data ownership• Cultural differences

and expectations• Indirect costs

Dr. Ruby Dunlap conducts research on adaptingnursing standards in austere conditions in Uganda.

Dunlap, R.K. (2013). Nursing Theory and the Clinical Gaze: Discovery in Teaching Theory Across a Cultural Divide. Nursing Science Quarterly, 26, 176-180.

Facilitators: Practice

• Administrative support

• Local partnerships• Cultural

competence• Standardized

practice and competencies

Challenges: Practice• Infrastructure

– Differences in practice standards– Quality oversight– Language/translation– Access to information– Currency & transfer of funds

• Competition and challenges with partners and governmental and NGOs working in the same country.

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References• Ablah E, Biberman DA, Weist EM, et. al., (2014). Improving Global Health Education:

Development of a Global Health Competency Model. American Journal of Tropical Medicine and Hygiene. [Epub ahead of print].

• Calhoun JG, Spencer HC, Buekens P. (2011). Competencies for global health graduate education. Infectious Disease Clinics of North America. 25(3):575-92. viii. doi: 10.1016/j.idc.2011.02.015.

• Dunlap, R.K. (2013). Nursing Theory and the Clinical Gaze: Discovery in Teaching Theory Across a Cultural Divide. Nursing Science Quarterly, 26, 176-180.

• Fitzpatrick J, Shultz C, Aiken T. eds. (2010). Giving through teaching: how nurse educators are changing the world. NY: Springer.

• Harless N. (2010). Nurses beyond borders: true stories of heroism and healing around the world. NY: Kaplan.

• Peluso MJ, Hafler JP, Sipsma H, Cherlin E. (2104). Global health education programming as a model for inter-institutional collaboration in interprofessional health education. Journal of Interprofessional Care. [Epub ahead of print]

• Reisch R, Boggis TL, Shaffer K, Brown S, Black A. (2011). Description of a model of interprofessional global education for allied health students. Health and Interprofessional Practice 1(1):eP1001.

Questions

• What’s missing from this discussion of critical challenges and facilitators to academic engagement in global health education, research and practice?

• What are the most critical global health competencies?

“From here to anywhere”

Thank You!