Title:	Research Approaches and Challenges in International Health
Country:	Belgium
Institution:	Belgium - Antwerp Institute of Tropical Medicine
Course coordinator:	Ludwig Apers Deo Katsuva Sibongwere
Date start:	2024-09-02
Date end:	2024-12-20
About duration and dates:	16 weeks; Application deadline: 2024-07-15
Classification:	core course
Mode of delivery:	Face to face
Course location: Institute of Tropical Medicine (ITM) Nationalestraat 155 2000 Antwerpen Belgium
ECTS credit points:	20 ECTS credits
SIT: SIT: 575 hours ● Contact hours: 378 hours ● Self-study (individual or in group): 197 hours
Language:	French English
Description: Core courses introduce students to the fundamentals of international health as stated in the following aims. By the end of the core course students should be able to… ● critical reflection on the collection, analysis and appraisal of qualitative and quantitative data relevant for the improvement of health and health care equity. ● identify and analyse interrelated determinants of health and major health concerns of populations in a trans-disciplinary perspective in low- and middle-income settings and on global level. ● propose sustainable improvements of health systems addressing inequities and considering diverse intercultural settings as well as social, legal and ethical responsibilities. ● describe the role, decision-making process and impact of global health policy actors ● collaborate and clearly communicate in a multi-disciplinary and multi-cultural setting 1. Learning objectives related to the aim (tropEd) “critically reflect on the collection, analysis and appraisal of qualitative and quantitative data relevant for the improvement of health and health care equity.” By the end of the core course, students should be able to: ● Determine the scope of research in international health and the importance of evidence for decision-making ● Distinguish between the perspectives of different research disciplines and domains in international health: epidemiology, social sciences, and health policy and systems research   ● Critically appraise the study design and the quality of the evidence in a scientific article  ● Apply concepts and methods of epidemiology and statistics  using the “R” software ● Judge the value and good practices of qualitative and quantitative research approaches ● Clearly communicate the results of different research approaches    2. Learning objectives related to the aim (tropEd) “identify and analyse interrelated determinants of health and major health concerns of populations in a trans-disciplinary perspective in low- and middle-income settings and on global level.” By the end of the core course, students should be able to: ● Assess the importance and burden of a particular health problem in terms of frequency, severity, inequity, and socio-economic cost, in stable and outbreak settings ● Discuss the different risk factors and determinants (ecological, genetic, social, economic, behavioural, health system-related) of health and well-being of populations, with special focus on populations in vulnerable situations (such as migrants, children, adolescents, pregnant women, key populations, … ) ● Formulate evidence-based and context-specific health programmes/interventions in stable context and crisis situations with the available resources and the stakeholders' perspectives; ● Critically assess the set-up of a field laboratory and propose interventions to improve its organization ● Identify priority actions to assure the quality of a laboratory in terms of accuracy, reliability, and timeliness of the results. 3. Learning objectives related to the aim (tropEd) “propose sustainable improvements of health systems addressing inequities and considering diverse intercultural settings as well as social, legal and ethical responsibilities.” By the end of the core course, students should be able to: ● Define the main public health interventions, with their implementation challenges, to prevent and/or control a health problem with particular attention to screening, surveillance, outbreak investigation, control and elimination, emergency responses, reproductive and child health programmes and using multisectoral approaches ● Assess (local) health systems in terms of access, quality of care, organisation of service delivery, stewardship, and intersectoral interfaces and collaborations ● Critically appraise the crisis preparedness and responsiveness of health systems and health policies to current and emerging challenges ● Formulate evidence-based and context-specific health programmes/interventions in stable context and crisis situations with the available resources and the stakeholders' perspectives; 4. Learning objectives related to the aim (tropEd) “describe the role, decision-making process and impact of global health policy actors” By the end of the core course, students should be able to: ● Discuss the major issues in international/global health policy and the development agenda (SDGs) including the role and agency of health policy actors at all levels 5. Learning objectives related to the aim (tropEd) „collaborate and clearly communicate in a multi-disciplinary and multi-cultural setting“ By the end of the core course, students should be able to: ● Show evidence of a critical and value-based attitude ● Communicate and collaborate in a multi-disciplinary and multi-cultural setting ● Work independently ● Develop life-long learning skills ● Clearly communicate the results of different research approaches.
Focus or specific features: The ITM core course is made up of two parts. Part 1 “Research Approaches in International Health” takes 4 weeks and discusses different research approaches in Public Health. The four weeks include an introduction week. (merge). Part 2 “Challenges in International Health” takes 12 weeks and is structured in four course components. Each course component includes more modules: ● The first course component “Health Problems from Prevention to Control” discusses various health problems and their prevention and control. The link between epidemiological model, risk factors and intervention is analysed. ● The second course component, Health in Times of Crises, explores the tools and frameworks necessary for defining, analysing, and addressing health-related issues during times of crisis. ● The third course component, Health Systems and Policies for Universal Health Coverage, introduces public health and health systems concepts and tools. ● In the fourth course component, students choose between option A (clinical orientation) or B (biomedical orientation). “Health in Vulnerable Situations” for the clinical orientation includes three themes: sexual health, reproductive health, and child health; and, for the biomedical orientation, it deals with “Field Laboratory Preparedness.” The topics are mainly discussed using a public health approach. Group assignments allow students to work in an interdisciplinary way.
Assessment Procedures: More details can be found in table 3. In general: ● Participants are assessed through group assignments, essays, and tests for formative and summative assessments. The generic skills are cross-curricular and are assessed through individual or group work, plenary presentations, further reading and various social activities organised by the Institute.   Their assessment is mainly related to what is presented in table 3.   The weight of each block is proportional to the student investment time. See table 2. The total number of assessments is divided as follows: o Clinical track: regarding formative assessments, there are 11 individual assessments and 14 group assessments. For summative assessments, there are 4 individual open-book assessments, and 4 group assessments with oral presentations. o Biomedical track: for this track, there are 11 individual formative assessments, 14 group formative assessments, 5 individual summative assessments and 4 group assessments with oral presentation. ● For each group work, there is a plenary presentation during which peers and teachers make comments and ask questions. ● All the written assignments are individual, open book and made of essay questions. Their duration varies from 2 to 4 hours. ● For part 1: “Research approaches in Internation Health”, there is individual or group work for each topic as a formative assessment, and a final open book summative assessment which counts for 100% of grades. For part 2: “Challenges in International Health”, during the first course component, the summative assessment includes a group work on epidemiological model which counts for 20% of the total grade, and an open book written assessment for 80% of the grades. For the second course component, the assessment is made of a group work developed thoroughly during the course with support from coaches, and defended in a plenary session. This assessment counts for 100% of grades of the course component. For the CC3, there is one final open book assessment made of essay questions and it counts for 100% grades of the CC. The CC4 Health in vulnerable population has two summative assessments: the first one for STI and HIV is an open book essay questions and counts for 30%, and the second one is a group work on reproductive and child health with questions from a real case from a health district in Benin which counts for 70%. The CC4 Field Laboratory Preparedness for biomedical participants has three assessments: a personal written assignment which counts for 10%; an integrated exercise on a scenario in the simulated laboratory (60%), and a group work on designing a study for diagnostic test evaluation (30%). ● Two of the five course components are assessed via open book examination (around 40%): Research Methods in International Health, and Health Systems and Policies for Universal Health Coverage; two combine open book assessment and oral presentations (40%): which is Health Problems from Prevention to Control, and Health in Time of crisis; and one via peer-assessment of oral presentations (20%): Health in Times of Crises (see table 3 for more details). ● Students pass when they succeed in the first course “Research Methods in International Health” and all 4 Course Components of the second course “Challenges in International Health with at least 50% for each . ● Students who fail a test are entitled to a re-sit exam not later than two months after the end of the course. In the case of a failure in group work, the resit is organised before the end of the course. The group is given a new topic to discuss and present.
Content: Each core course, however, has its special emphasis (i.e. medical, social sciences, health systems, etc.). Please provide the specific content topics or sessions and relate them to the overall tropEd core course sections: ● Introduction and learning skills (minimum of 0.5 ECTS credits). ● Concepts, theory and methods for global health research (quantitative and qualitative) (minimum of 4.5 ECTS credits). ● Global health concerns (e.g. SDGs, health emergencies, communicable and non-communicable diseases, sexual and reproductive health and rights, environmental health, injury), and response strategies (minimum of 4.5 ECTS credits). ● Global health policies, health systems, their management, financing and strengthening (minimum of 4.5 ECTS credits).
Methods: ● The contact hours (66% of SIT) are a combination of state-of-the-art lectures, demonstrations, problem-based learning, and interactive classes often as discussions on cases and on articles or book chapters read during self-study time, group work ● Self-study, critical reading, group work, and assignments represent 34% of the SIT. Some examples of group assignments: ● Epidemiological model: systematic analysis of a health problem, with the identification of factors influencing the risk of going from one stage to another, and afterward identifying interventions to decrease the burden of the problem. This assignment counts for 20% of the total grades of CC1. The work is presented in a plenary session. ● General exercise on emergency settings, developing an action plan for an emergency situation in a conflict area and/or epidemic ● Discussing different strategies in prevention and treatment of HIV/AIDS (eMTCT cascade, timely HIV testing, …) ● Situational analysis and planning of reproductive and child health activities in a health district in LMIC
Prerequisites: Academic degree Applicants must be holders of a university degree of minimum 4 years equivalent to 240 ECTS (referred to as a Master’s degree in the European Union) in medicine or health sciences such as pharmacy, nursing, midwifery, health economics, medical sociology, medical anthropology and biomedical sciences. Applicants with a professional Bachelor’s degree in health, including nursing and midwifery (>= 180 ECTS) require two years of relevant professional experience to be admitted. Language proficiency The minimum language requirements are proof of a TOEFL iBT (internet-based test) score of 79-93, an IELTS score of 6.5 or other qualifying evidence of an English CEFR level of B2-C1 meaning a higher tier B2 or C1. A higher tier B2 will generally mean a B2 on all components of language proficiency and would have to be evidenced (ITM Toefl Code = 7727). Native English speakers are exempt from these language requirements. Applicants whose first language is not English are exempt if they have successfully completed a higher education programme of at least 60 ECTS credits taught in English or have a higher education diploma from a Flemish Community higher education institution. For French the language requirement has been set at: CEFR level C1 (DALF-C1 or equivalent) or high-B2 (DELF-B2 or equivalent)
Attendance: A maximum of 60 students is admitted, and the minimum for organising the course is 12. No limitation for tropEd students.
Selection: Admission on first come, first served basis. A selection process is only applicable for scholarship candidates (see below).
Fees: EU/EFTA 2020 Euro, non EU/EFTA 6100 Euro.
Scholarships: Because of continuing into the Master of Science in Tropical Medicine (MTM) or the Master of Science in Public Health, a number of scholarships from the Belgian Directorate General for Development (DGD) are available for core course participants from LMIC’s (see www.itg.be ). The scholarships are attributed following a selection organised in May of each year. Candidates have to introduce a motivation: why they wish to do the course (as part of the MTM or MPH-HSDC), how they envisage it will help them in fulfilling their future career objectives, indicating academic experience relevant to the content of the course and specific elements of the programme that appeals to them, and proposing a provisional study plan for the MTM or MPH-HSDC with selected advanced courses and a thesis topic.
Major changes since initial accreditation: Structure Since 2023, the course has been organised in two parts: Part 1: Research Approaches in International Health which takes 4 weeks; and part 2: Challenges in International Health which takes 12 weeks. Part 2 is made of 4 interrelated course components. The fourth course component offers a choice in function of the clinical or biomedical background or interest of the participants. Content There are some changes in the new course programme. The contents of two parts of the course have been reassessed and readapted to the evolution of public health agendas and field needs. The current contents include realities of both the Global North and Global South. In part 1, Research Approaches in International Health: this was formerly called Epidemiology and statistics, mainly including quantitative, qualitative, and health systems research. Additional topics are research ethics and integrity, review and appraisal of evidence, research proposal, introduction to implementation science, and to monitoring & evaluation. In part 2, four new course components have been created: ● Course component 1: Health Problems from Prevention to Control: it includes three big themes: health problem analyses, prevention and control strategies; and outbreak investigation. ● Course component 2: Health in times of crises: this course component discusses migration and health; the impact of climate change, and antimicrobial resistance. ● Course component 3: Health systems and policies for Universal Health Coverage: focuses at organisation of care and health service delivery at local level and the strategic management of local health system in its context. ● Course component 4: Health in vulnerable situations (for clinicians) discusses sexual health and risk groups, reproductive health and child health; and Field Laboratory Preparedness (for biomedics) which discusses logistics in lab, stock management, equipment calibration, chemicals, cold chain and shipment of infectious samples, sampling and labeling, and quality assessment. Learning Methods Personal work, online teaching and hybrid teaching are being reinforced by the use of different teaching/learning methods and new digital tools such as Rise-Articulate, Claro… Assessment The courses use individual and group assignments alternating from one course component to another. The assignment feedback is planned in the schedule beforehand. Individual feedback is provided to participants who fail to get 50%in the assessment, or to any participant who wants to get details on his answers. Assessments take place or are submitted and discussed at the end of each course component. Learning support The Moodle learning management system includes an activated calendar indicating to participants when they have an important task such as a preparatory work before the in class session, a group work, an assignment, or a social event. It is also organised in a user-friendly way that helps participants finding different tasks to be done before, during and after the lecture.
Student evaluation: The course is being evaluated in 3 ways: ● a feedback at the end of each course component ● an overall evaluation through an anonymous written questionnaire at the end of the course ● a final oral feedback with all participants to discuss global aspects Feedback is communicated to lecturers and analysed during the steering-group meetings which take place twice a year: after the English version organised from early September to end of December, and the French version which takes place from March to end of June. Adjustments of content, methods and teaching staff are made accordingly. Positive aspects: ● Participants are very satisfied with the course, which many of them feel exceeding their expectations. ● Participants say they appreciate the topics on migrant health, the discussions on climate change and its effects, and the alternating methods of summative assessment. ● They also say they find the s sequence of the course components. ● They add that the course helps develop group work skills. Remarks that need improvement: The following criticisms have been addressed to a large degree: ● The content on hand wash is not very pertinent and can be removed to gain time; ● The workload is high; ● Late feedback on assessments, and now feedback timeslots are planned from the beginning of the course. ● Overlap in content between lecturers has been discussed and addressed.
Lessons learned: Some participants are taking only part 1 or part 2 (see point 13) or the two parts in different academic years according to their learning needs and their availability. This flexibility is an innovation in the new course programme.
tropEd accreditation: Accredited in Valencia 2001. Re-accredited in Bergen May 2006, and was reaccredited at the Barcelona meeting in 2011 and in Amsterdam in October 2016. Re-accreditation Bagamoyo, June 2022.Re-accreditation EC Telco, Nov.2024. This accreditation is valid until Nov. 2029
Remarks: This course can be considered as a stand-alone short course or a core course of ITM’s Master in Tropical Medicine (MTM) or Master in Public Health orientation Health Systems and Disease Control. Both masters are in the broad field of International / Global Health and integrate mobility in the tropEd network and thus welcome tropEd students. After successfully completing this core course, participants can be selected for the whole master programme. The core course certificate is valid for application to the master programme during 5 years. Note: this course is also part of a postgraduate certificate programme for medical doctors, leading to a postgraduate certificate in tropical medicine & international health. The second part (10 ECTS) of this postgraduate certificate programme focusses on tropical medicine and clinical decision-making.
Email Address:	bbroucker@itg.be
Date Of Record Creation:	2012-01-19 22:28:22 (W3C-DTF)
Date Of Record Release:	2012-01-20 04:52:21 (W3C-DTF)
Date Record Checked:	2016-11-03 (W3C-DTF)
Date Last Modified:	2024-12-05 09:53:13 (W3C-DTF)