Haile Debas: Building Capacity – Institution to Institution

As the future of global health and global health education is debated, Dr. Haile Debas, founding Executive Director of Global Health Sciences at the University of California, San Francisco, points to a five-year partnership between UCSF and the Muhimbili University of Health and Allied Sciences (MUHAS) as an example of how the future can look.  As Dr. Debas tells it:

“Our collaboration has focused on education and building the institutional capacity of MUHAS.  The first area of progress is in curriculum development. MUHAS is converting its curriculum from being traditional to competency-based.

We looked at what is needed if you are going to be a doctor in Dar es Salaam. UCSF and MUHAS students interviewed MUHAS graduates about how the program had prepared them for their work. What were the deficits? What competencies did they need?  So, instead of having vague lectures that deal with human health, the new curriculum deals with women’s health, maternal, neonatal and child health.  So when students finish school they are competent to deal with the main problems, prevention and treatment.  In the old way, you could learn all kinds of fancy things, but they may or may not have relevance. Other important areas of competency are infectious diseases and violence.  Violence is a big problem, both domestic and motor vehicle accidents.  Based on these kinds of findings, MUHAS has adjusted its curriculum.

The other area of collaboration has been a very big effort on faculty development. They don’t have enough faculty. The faculty they do have are poorly paid, overworked, and have no time to keep up their skills.  For 10 years, because of the requirements of World Bank and IMF loans, governments were told not to spend any money on higher education. So there was a hiring freeze for ten years. For the past four years, UCSF has sent post-doctoral fellows to teach basic science in students’ preclinical years. We are helping them develop masters programs in basic sciences like anatomy, physiology and biochemistry.

The third thing we are doing is constructing an education building — the Center for Health Professionals Education — that centralizes educational activity.  It has a curriculum innovation center, education technology center, clinical skills center, and surgical skills center where students learn to do life-saving procedures, like inserting chest tubes or performing difficult deliveries.  We are also working on information technology. Because the Internet and electricity are so unreliable, we have just developed with UC Berkeley a plan for using wireless technology to enable MUHAS to communicate with its satellite sites as far as 100 kilometers away.

Based on the UCSF work, which was funded by the Bill & Melinda Gates Foundation, the NIH and PEPFAR are now funding a similar partnership initiative, with the first awards to some 10 schools set to be announced later this fall. 

This really is the way to build capacity. U.S. faculty can go to African countries and do nice research, and when they are done, it’s finished. This way there is a long-term investment, and capacity building, institution to institution.”

Interview by Bee Wuethrich

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