BSc Global Health (intercalated)

After the broader context and strategic considerations of the Semester 1 module HCRI30021Introduction to Global Health, this module is intended to focus on a more operational and practical understanding of the differences and challenges facing health systems in Low /Middle-Income Countries (LMICs) when compared to more mature systems and explore some of the strategies for managing them.

Examples of current strategic health system challenges and disease burdens will be used to explore how the current systems are structured and consider how they might evolve and be better able to address the challenges faced. It is not intended that this be a programme to teach the management of tropical disease, or the health problems of poverty, rather to explore the constraints and challenges in delivering healthcare and consider ways of achieving better coverage. The module aims to provide students with an understanding of the problems that a lower level of health system development and maturity, together with capacity, have on the management of disease.

Please note HCRI20321 or HCRI30021 are pre-requisites for HCRI30042

Provide the students with an understanding of the differences that the level of health system development and maturity together with capacity have on the management of disease processes that are found in all communities.  

To introduce students to the practical challenges of delivering healthcare in a low-income setting

To develop an understanding of the demographic, logistic, human resource and economic difficulties experienced in developing health systems

To recognise and appreciate how to begin to resolve the healthcare challenges in the context of a range of diseases to be found in these settings

To encourage a critical analysis of the provision of quality health care in a resource challenged environment.

The intended learning outcomes of this course directly support students’ academic development, critical thinking, and practical application of global health concepts. By the end of the course, students will have gained the following skills and competencies:

Knowledge and Understanding

• Develop a strong understanding of health system constraints in low- and middle-income countries (LMICs), including economic, workforce, and infrastructure challenges.
• Gain insight into the burden of disease, covering infectious diseases, neglected tropical diseases (NTDs), non-communicable diseases, maternal and child health, and trauma care.
• Understand the impact of health economics, financing models, and policy approaches to improving healthcare access in resource-limited settings.
• Recognise the importance of vaccination programmes, workforce planning, and trauma system development in mitigating health challenges.

Intellectual Skills

• Critically evaluate how health system design impacts healthcare delivery and disease management in LMICs.
• Apply case study analysis to examine real-world global health challenges and propose solutions.
• Assess policy interventions aimed at improving healthcare access and service delivery.
• Reflect on the ethical considerations and challenges in providing healthcare in resource-limited environments.

Practical and Professional Skills

• Develop group collaboration and presentation skills through structured assignments, including a policy pitch to a simulated Minister of Health.
• Enhance analytical skills in evaluating health interventions, policies, and economic constraints.
• Apply knowledge in practical settings, such as conducting a clinical risk assessment or proposing health system reforms

Transferable Skills and Personal Development

• Strengthen research and analytical abilities to assess and propose evidence-based health solutions.
• Improve communication and persuasion skills, particularly in presenting complex health challenges and proposed solutions to a professional audience.
• Gain experience in teamwork and problem-solving, particularly in the context of global health policy.
• Build confidence in engaging with academic debates and practical health system evaluations. 

Lectures and seminars 
The module will be delivered using a series of lectures, with individual structured reading, group discussion and seminars.

Group presentations and seminars 
The group sessions and seminars provide a structured environment for students to explore their analysis and interpretation of specific disease care systems based on preparatory work.  

Session material including guided reading web links to information sources will be made available via Blackboard (accessed via the student system). Students will all make one seminar presentation during the course. These seminar presentations will be allocated to students at the beginning of the course.  

Students will work in small groups (of 2-3 people) to give a 10-minute presentation addressing a specific question for that week. The students will also be asked to prepare two discussion questions to kick-off the seminar group discussion.    

The purpose of this exercise is to support students to strengthen their presentation, teamwork, and leadership skills.  

• Appreciate the constraints in terms of scope of delivery in developing health systems.
• Understand the burden of and approach to infectious disease management in a developing country health system.
• Understand the burden of injury and trauma care in a developing system and outline the system requirements for a structured approach to service improvement.
• Understand the modifications required for the care of chronic disease in a resource constrained and immature health system.

• Explore and describe the realities of health care delivery in the global health environment through examination of illustrative case studies.
• Critically reflect and evaluate the impact of health system design on a health economy.
• Identify policy approaches to improving service delivery and critically appraise the approaches
• With reference to examples, be able to describe the possible implications from implementing system change and the difficulties of measuring this.
• Critically review the clinical risks of care provider diversification and describe options to mitigate this risk.

• Analyse and evaluate health policy and programme implementation
• Health profiling and analysis
• Critical appraisal of change process

Written feedback.

Mossialos E and others, ‘The Future of the NHS: No Longer the Envy of the World?’ (2018) 391 The Lancet (British edition) 1001

Kruk ME and Freedman LP, ‘Assessing Health System Performance in Developing Countries: A Review of the Literature’ (2008) 85 Health Policy 263

Coates, A., Fuad, A. O., Hodgson, A., & Bourgeault, I. L. (2021). Health workforce strategies in response to major health events: a rapid scoping review with lessons learned for the response to the COVID-19 pandemic. Human resources for health, 19, 1-18.

Serpil Ozcan, ‘Determining Hospital Workforce Requirements: A Case Study’ Human Resources for Health Development Journal (HRDJ) <http://pendidikankedokteran.net/images/file/Determinan%20Hospital%20workforce%20requirment.pdf>

Dussault G and Franceschini MC, ‘Not Enough There, Too Many Here: Understanding Geographical Imbalances in the Distribution of the Health Workforce’ (2006) 4 Human resources for health 12

Dovlo D, ‘The Brain Drain in Africa: An Emerging Challenge to Health Professionals’ Education’ (2004) 2 Journal of higher education in Africa 1

Yates R, ‘Universal Health Care and the Removal of User Fees’ (2009) 373 The Lancet 2078

Weatherly H and others, ‘Methods for Assessing the Cost-Effectiveness of Public Health Interventions: Key Challenges and Recommendations’ (2009) 93 Health policy (Amsterdam) 85

The Lancet, ‘Global Health: Time for Radical Change?’ (2020) 396 The Lancet (British edition) 1129

Luisa Frescura and others, ‘Achieving the 95 95 95 Targets for All: A Pathway to Ending AIDS’ (2022) 17 PloS one

Mitra AK and Mawson AR, ‘Neglected Tropical Diseases: Epidemiology and Global Burden’ (2017) 2 Tropical medicine and infectious disease 36

Konadu-Yeboah, Dominic, Kusi Kwasi, Peter Donkor, Senyo Gudugbe, Ossei Sampen, Augustus Okleme, Frank Nketiah Boakye, Maxwell Osei-Ampofo, Helena Okrah, and Charles Mock. “Preventable Trauma Deaths and Corrective Actions to Prevent Them: A 10-Year Comparative Study at the Komfo Anokye Teaching Hospital, Kumasi, Ghana.” World journal of surgery 44, no. 11 (2020): 3643–3650.

Ronsmans, Carine, and Wendy J Graham. “Maternal Mortality: Who, When, Where, and Why.” The Lancet 368, no. 9542 (September 2006): 1189–1200.

Garces, Ana, Elizabeth M McClure, Leopoldo Espinoza, Sarah Saleem, Lester Figueroa, Sherri Bucher, and Robert L Goldenberg. “Traditional Birth Attendants and Birth Outcomes in Low-Middle Income Countries: A Review.” Seminars in perinatology 43, no. 5 (2019): 247–251.

Palermo, Tia, Jennifer Bleck, and Amber Peterman. “Tip of the Iceberg: Reporting and Gender-Based Violence in Developing Countries.” American Journal of Epidemiology 179, no. 5 (2014): 602–612.

WHO. “Violence against Women Prevalence.” Last modified 2021. https://apps.who.int/iris/rest/bitstreams/1347689/retrieve. 

Zerhouni, Elias. “GAVI, the Vaccine Alliance.” Cell 179, no. 1 (2019): 13–17. http://dx.doi.org/10.1016/j.cell.2019.08.026. 

Glassman, Amanda. “Global Health and the New Bottom Billion: What Do Shifts in Global Poverty and the Global Disease Burden Mean for GAVI and the Global Fund?” Last modified 2011. https://www.files.ethz.ch/isn/133774/1425581_file_Glassman_Duran_Sumner_MIC_global_health_FINAL.pdf. 

Mendenhall, Emily, Brandon A Kohrt, Shane A Norris, David Ndetei, and Dorairaj Prabhakaran. “Non-Communicable Disease Syndemics: Poverty, Depression, and Diabetes among Low-Income Populations.” The Lancet 389, no. 10072 (March 2017): 951–963.

NCD Countdown 2030 collaborators. “NCD Countdown 2030: Efficient Pathways and Strategic Investments to Accelerate Progress towards the Sustainabl