MSc/PGDip/PGCert Humanitarian Practice

Those who are interested and involved in Global Health and in responding to humanitarian situations are often both strategic and visionary in their approach to large challenges, but also pragmatic, very practically minded, and even mission-focused people. They work on some of the world's greatest health challenges and under some of the most challenging circumstances. Addressing the social determinants of health, access to shelter, security, food, clean water and sanitation are essential but there is also a need address the health needs of the population. 

Whether at WHO and at an international strategic level, at Government-level intervention through a Ministry of Health, as an operator of vertical or horizontal system-level interventions by an NGO, or from local system design and development in response to an immediate need, the design and approach to the health system needs constant monitoring and adjusting rto deliver the best for people.  

The field is constantly evolving and the module will look at the challenges that arise and consider some of the potential solutions that might be considered. How systems structure themselves, understand the demand and need from their population, evolve and respond to the health problems faced at all levels constantly evolves. Of course recent specific difficulties such as COVID and Monkeypox have had an effect, but the global economy, the perceived health priorities and changing patient/public expectations have a longer, and arguably greater, influence and effect. 

Working through the content, the melting pot of diverse professional backgrounds in HCRI will bring their differing perspectives to the problems raised, be they understanding the operational health system challenges being faced, the human resource deficits or the issues raised in specific disease area such as infectious disease, maternal or child health, traumatic injury and chronic non-communicable diseases. 

Some of the most significant, unexpected and improbable learning can arise from sharing experiences and perspectives with diverse colleagues. As you travel together through the module, be receptive and open-minded to innovation and different ways of doing things. 

To strengthen knowledge and understanding about:  

• Understanding the variances and variables in health systems as they respond to their burden of disease  

• The challenges in managing health systems with changing disease, patient demand and resource challenges 

• Management strategies for the breadth of disease burden upon resource challenged health systems 

• The health system impact in trying to meet the Sustainable Development Goals 

• A range of public health crises and 'neglected epidemics' affecting populations 

• Appreciate the need for system integration and cooperation across the political and governm

Week 1: Health system drivers and approaches in developing countries 

Health systems need to be designed to meet the needs of their populations. There are a multitude of factors that drive the shape of a system, and the delivery of health care cannot be seen in isolation. The Director-General of WHO has set strategic international targets but how these are achieved depends upon politics, economics, education, infrastructure and the burden of disease. 

Most students have a country or region of personal interest and focus. This week will challenge you to consider the variables that drive these health systems. 

Week 2: Health workforce challenges in a resource-limited setting 

To deliver healthcare requires a workforce. Estimates suggest a 4-million-person deficit in the global healthcare workforce. What is the workforce need relative to the burden of disease? What are the benefits and risks of skill transfer? What role does the international community play and what might a human resource plan look like?  

Week 3: Communicable diseases – the traditional burden 

Infectious diseases have been a huge burden upon health systems in low-income settings historically. Some diseases have been defeated and others have come to the fore. Some were thought to be under control but have become resurgent. This week will consider some of the traditional Global Health disease challenges and try to place them in the context of the wider health burden facing populations. 

Week 4: Non-Communicable Diseases 

Heart disease, hypertension, reversible respiratory disease and diabetes, even obesity, might be regarded as the diseases of high-income countries. With a longer life expectancy, better management of infection, the nutritional transition from a traditional diet to a refined one, and a reduction in extreme poverty, an NCD tsunami for low-income settings has been predicted. The current epidemiological signs suggest this is a rapidly growing challenge for the near future. 

Week 5: Neglected diseases? 

There is an understandable focus on the big diseases, malaria, TB and HIV, ischaemic heart disease and diabetes; they bring the greatest burden to a challenged health system. There are however lots of diseases that can seriously debilitate populations and damage the economic prospects of communities. Vertical initiatives, environmental management and relatively simple treatments can have a big impact. These diseases remain important. 

Week 6: Mate

By the end of this course students will: 

• Have an understanding of health systems, health infrastructure, the burden and response to common diseases, maternal health, traumatic injury challenges in developing country systems 

• Understand the influence of economy, education, politics and the environment on health 

• Identify common issues and challenges surrounding meeting health provision need and access in developing countries 

By the end of this course students will be able to: 

• Critically reflect on strategic decision making according to context (low resource, political instability) supporting care pathways 

• Improve application of ethical thinking and decision making 

• Interpret and evaluate evidence in the healthcare context  

By the end of this course students will be able to: 

• Work cohesively as a diverse team from different professions and cultures 

• Undertake self-directed learning and tasks to achieve a defined outcome 

• Improve communication and diplomacy skills across different cultures  

• Deploy teamwork skills to secure positive outcomes in challenging environments 

By the end of this course students will be able to: 

• Undertake time efficient self-directed learning 

• Problem solve in complex contexts 

• Demonstrate decision-making and leadership skills 

• Demonstrate skills in negotiating challenging situations  

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Hone T, Macinko J, Millett C. Revisiting Alma-Ata: what is the role of primary health care in achieving the Sustainable Development Goals? The Lancet (British edition). 2018;392(10156):1461-1472. doi:10.1016/S0140-6736(18)31829-4 
 
Murray CJ. Five insights from the Global Burden of Disease Study 2019. The Lancet (British edition). 2020;396(10258):1135-1159. 
 
O’Connell T, Rasanathan K, Chopra M. What does universal health coverage mean? The Lancet (British edition). 2014;383(9913):277-279. doi:10.1016/S0140-6736(13)60955-1 
 
Varghese C, Nongkynrih B, Onakpoya I, McCall M, Barkley S, Collins TE. Better health and wellbeing for billion more people: Integrating non-communicable diseases in primary care. BMJ (Online). 2019;364:l327-l327. doi:10.1136/bmj.l327 
 
WHO. Thirteenth general programme of work (gpw13): Methods for impact measurement. Published 2020. https://cdn.who.int/media/docs/default-source/documents/about-us/thirteenth-general-programme/gpw13_methodology_nov9_online-version1b3170f8-98ea-4fcc-aa3a-059ede7e51ad.pdf?sfvrsn=12dfeb0d_1&download=true  
 
Santosa A, Wall S, Fottrell E, Högberg U, Byass P. The development and experience of epidemiological transition theory over four decades: a systematic review. Global health action. 2014;7(1):56-71. doi:10.3402/gha.v7.23574 
 
World Health Organization. The World Health Report. 2006, Working Together for Health. Vol 2006,. World Health Organization; 2006. https://www.who.int/whr/2006/whr06_en.pdf 
 
Berland A. Assessing the legacy of the global health workforce alliance through the lens of complex adaptive system. Published 2016. https://www.researchgate.net/publication/313037886_Assessing_the_legacy_of_the_Global_Health_Workforce_Alliance_through_the_lens_of_Complex_Adaptive_Systems  
 
Dovlo DY. Using mid-level cadres as substitutes for internationally mobile health professionals in Africa. A desk review. Human resources for health. 2004;2(1):7-7. doi:10.1186/1478-4491-2-7 
 

WHO. Global strategy on human resources for health: Workforce 2030. Published 2016. https://apps.who.int/iris/bitstream/handle/10665/250368/9789241511131-eng.pdf 
 
WHO. High burden to high impact: A targeted malaria response. Published 2018. https://www.who.int/publications/i/item/WHO-CDS-GMP-2018.25 
 
WHO. Global tuberculosis report. Published 2020. https://apps.who.int/iris/bitstream/handle/10665/336069/9789240013131-eng.pdf 
 
WHO. Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021. Published 2021. https://apps.who.int/iris/rest/bitstreams/1348210/retrieve  
 
WHO. Ending the neglect to attain the sustainable development goals  a road map for neglected tropical diseases 2021–2030. Published 2021. https://apps.who.int/iris/rest/bitstreams/1326801/retrieve 
 
NCD

Please note that these units are intensive 8-week short courses, predominately independent-study, with no face-to-face learning