Title: Introduction to International Health
Country: Belgium
Institution: Belgium - Antwerp Institute of Tropical Medicine
Course coordinator: Prof. Bruno Marchal
Dr. Pol De Vos
Date start: 2021-09-06
Date end: 2021-12-23
About duration and dates: 16 weeks
Classification: core course
Mode of delivery: Face to face
Course location: Institute of Tropical Medicine
ECTS credit points: 20 ECTS credits
SIT: 596 hours SIT
Contact hours: 376 hours
Self-study (individual or in group): 220 hours
Language: English
By the end of the core course, students should be able to:

• identify and analyse interrelated determinants of health and major health problems of populations in a cross-disciplinary perspective in low- and middle income societies.
• critically collect, analyse and appraise qualitative and quantitative data relevant for the improvement of health and health care in low and middle income societies.
• plan sustainable improvements of health systems considering the diverse intercultural settings as well as social and ethical responsibilities.
• clearly communicate and work professionally in a multi-disciplinary team.

Specific objectives
By the end of the core course, students should be able to:

1. (tropEd) identify and analyse interrelated determinants of health and major health problems of populations in a cross-disciplinary perspective in low- and middle income societies

• discuss determinants of health in general and of health care seeking behaviour in particular
• explain the ‘Health in all Policies approach”, its cross-sectors organization and its possible impact

2. (tropEd) critically collect, analyse and appraise qualitative and quantitative data relevant for the improvement of health and health care in low and middle income societies

• analyse the main biomedical, clinical and epidemiological aspects of the major health problems in low and middle income countries in order to manage their prevention and control at population and individual level
• critically analyse disease control programmes, applying scientific tools and methods

3 (tropEd) plan sustainable improvements of health systems considering the diverse intercultural settings as well as social and ethical responsibilities

• organise primary health care services taking into account local priorities and resource availability as well as the perspective of communities and patients
• explain the major issues in international health policy and development cooperation

4 (tropEd) clearly communicate and work professionally in a multi-disciplinary team

• manage communication in a multi-disciplinary setting
• play a positive role in the strengthening of teamwork in sometimes stressful situations
Focus or specific features:
The ITM core course structure, consisting of 8 blocks, one introductory and 7 thematic, enhances integration of different disciplines central to international health. The introductory block introduces concepts and tools of public health, epidemiology and statistics. The first three thematic blocks focus on major health problems (vector-borne diseases, HIV/Aids, TB), the next three on important social groups (motherhood, childhood, emergencies). The last block makes the participants responsible for organising health care for a defined (health district) population.
In all blocks clinical aspects of major health problems are combined in a balanced way with a public health approach to disease control, health service organisation and management.
It thereby integrates quantitative and qualitative methods and highlights topical issues in international health.
Group assignments allow students to work in an interdisciplinary way.
Assessment Procedures:
Participants are assessed through 7 tests (2 hours /test) with equal weight for the final result
• 1 open-book test on Epidemiology and Statistics (in week 5)
• 6 closed-book tests related to 6 blocks: vector-borne diseases, TB, HIV/Aids, motherhood, childhood, health systems (in weeks 15 and 16)
Each closed-book test consists of 2 components: essay questions (60% of mark) and a set of multiple-choice questions (40% of mark)
Students pass when they succeed for all 7 tests with at least 50%
Students who fail a test are entitled to a re-sit exam
The four main categories of the MIH core course as defined by tropEd are:
1. Introduction and orientation
2. Concepts and research methods (4½ - 7½ ECTS)
3. Health problems and responses (4½ - 7½ ECTS)
4. Health systems, management and communication (4½ - 7½ ECTS)

• Introduction and orientation: 33 hrs SIT ≈ 1 ECTS
• Concepts and research methods: 126,5 hrs SIT ≈ 4 ECTS
• Health problems and responses: 213 hrs SIT ≈ 7 ECTS
• Health systems, management and communication: 223,5 hrs SIT ≈ 8 ECTS

Details please see here
- Contact hours (61% of SIT) are a combination of state of the art lectures and interactive classes often as discussions on cases and on articles or book chapters read during self-study time

- Group work / assignments are done outside formal contact hours in groups of 5-6 students (6,5% of SIT). Plenary sessions with presentations by students and comments by expert panels conclude these assignments

Examples of group assignments:
• Vertical analysis: systematic analysis of a disease problem, developing an epidemiological model and control interventions.
• General exercise on emergency settings, developing an action plan for an emergency situation in conflict area and/or epidemic
• Case study to illustrate the need of different perspectives of different actors and stakeholders in a health care delivery process

- Problem-based learning tasks: 2 cases are analysed individually and discussed in team, following different steps: define the problem, brainstorm on knowledge and ideas, discuss learning objectives and process, identify literature and sources, propose a strategy leading to solutions

- Critical reading skills are developed during discussion of scientific papers

- Laboratory skills are taught through practical sessions
A degree in medicine or a university (master) degree (min 240 ECTS credits) in health (e.g. biomedical or pharmaceutical) sciences. Other health professionals, such as health economists and sociologists, are welcome to apply on condition that they are holder of a university degree (min 240 ECTS credits) and have a minimum of 2 years relevant professional experience in international health in low or middle income countries. Nurses and midwives with a university (master) degree can also be admitted provided they have minimum 1 year of professional experience.
Students for whom English is not their first language must provide evidence of a 6.5 IELTS score (or 580 TOEFL score). Exemption from this requirement may be granted to those who successfully completed higher education in English.
A maximum of 60 students is admitted.
Admission on first come, first served basis.
A selection process is only applicable for scholarship candidates (see below).
EU/EFTA 1000 Euro, non EU/EFTA 2000 Euro.
In view of continuing into the Master in Public Health – Orientation International Health (equivalent to an MIH), a few scholarships from the Belgian Directorate General for Development (DGD) are available for core course participants from specific 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 MPH-IH), how they envisage it will help them in fulfilling their future career objectives, indicating academic experience relevant to the content of the module and specific elements of the programme that appeals to them, and proposing a provisional program for the MPH-IH courses and thesis topic.
Major changes since initial accreditation:
- Since 2015 the course is not organised in French anymore
- The course has since 2014 a new coordinator (Dr. Pol De Vos) and since 2016 a new course director (Prof. Bruno Marchal).
- The balance between epidemiological/clinical aspects and public health has been evaluated as adequate, and only underwent minimal refinements.
- The course on epidemiology and statistics has been extended, continuing with an exercise-based stepwise approach. Participants get introduced to the topic by way of exercises with increasing level of complexity. It enhances understanding of the relevance of a concept or tool and stimulates learning and communication.
- Specific lectures on Dengue and Ebola were added to the curriculum, respectively in the block on vector-borne diseases and emergencies.
- The topics of mental health and other non-communicable diseases were developed to 12 contact hours
- An introduction to literature review has been added.
Learning Methods
- Problem-based learning was introduced in the block on health systems allowing participants to analyse cases individually and in team following different steps: define the problem, brainstorm on knowledge and ideas, discuss objectives and process, recognise literature and sources, finally developing proposals leading to solutions.
- An interdisciplinary exchange session on health systems with students from the MPH health systems management and policy (HSMP) and disease control (DC) tracks (mostly experienced professionals from LMICs) has proven to be very positive and is now included in the curriculum.
- The use of group and individual assignments in the different blocks has been strengthened. Attention went to introducing more variation in assignments, to group composition and to provision of clear feedback at the end of group work.
- The assessment procedures will evolve towards more varied methods, including the scoring of group work and presentations.
Learning support
A comprehensive student handbook is updated every year.
All course material is placed on Moodle, and stays available to our alumni up to 3 years after the course. Paper printing is limited as much as possible.
Student evaluation:
The course is being evaluated in 3 ways:

- a feedback session with a small group of students at the end of each block
- 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: just after the course and again when starting the organisation of the next course. Adjustments of content, methods and teaching staff are made accordingly.

Positive aspects:
- the expertise, enthusiasm and accessibility/availability of lecturers, both ITM lecturers with extensive work and research experience as well as external consultants from international organisations, is well appreciated; it enhances motivation and interaction
- the structure of the core course is well appreciated; the integration of disciplines enhances students’ understanding and learning
- students consider there is a good balance between public health and clinical aspects in the blocks; they also acknowledge the wide disciplinary variety of information and the operational approach in the blocks.

The following criticisms have been addressed to a large degree:

- some lectures were too clinical for non-medical doctors: content was adapted
- overlaps and gaps in content: a better coordination between teaching staff has limited this to a minimum ; every year this point is taken up again
- lectures on international health policies (including health economics) have been added.

Negative remarks:
- the late distribution of hand-outs and lecture slides remains a (limited) problem, although lecturers have done a great effort.
- students request more time to prepare for the exams.
Lessons learned:
The block structure allows integration of different disciplines and in particular the integration and application of public health concepts. This has clearly enhanced students’ understanding of public health aspects and has broadened their vision on international health.

On suggestion of the students, the sessions on culture and development have been moved to a later moment in the course, to be able to ensure a more in depth debate, when they are more familiar with LMIC problems.
tropEd accreditation:
Accredited in Valencia 2001. Re-accredited in Bergen May 2006, November 2011 and October 2016. This accreditation is valid until October 2021.
This course can be considered as a stand-alone module or a core course of ITMs Master in Public Health – Orientation International Health. After successfully finishing this core course, participants can be selected for the whole master programme. The first selection for ITM’s Master in Public Health – Orientation International Health is in May of the year following the core course. The core course certificate is valid for application to the MPH-IH 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: gvheusden@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: 2021-06-30 10:29:53 (W3C-DTF)