Title: Analysing Disrupted Health Systems (ADHS)
Keywords: Management/leadership
International / global
Health systems
Health information
Health in emergencies
Country: Netherlands
Institution: The Netherlands - Royal Tropical Institute (KIT), Amsterdam
Course coordinator: Fernando Maldonado
Date start: 2021-08-16
Date end: 2021-08-27
About duration and dates: 2,5 weeks including 0,5 prereading
Classification: advanced optional
Mode of delivery: Face to face
Course location:
Amsterdam (spring) – Addis Ababa, Ethiopia (winter)
ECTS credit points: 4 ECTS credits
112 student investment hours
Contact hours: 68 hours, of which 16 hours guided group work
Self-study hours: 20 hours of pre-course reading, 24 hours of in-course reading
Language: English
At the end of the module the participants should be able to:
• Use adequate tools for health system analysis in countries in crises and adapt them to the local context;
• Assess the structure and features of disrupted health systems;
• Identify the type of adaptation process that health systems undergo during crises and formulate measures to develop effective strategies and plans;
• Distinguish key health sector actors agendas and propose a plan of action to influence decision making;
• Present findings of health systems analysis through the use of a case study.
Assessment Procedures:
30% of mark will come from the presentation of the country case study (group mark)
70% of mark will come from an individual 3 hour written open-book exam
Protracted crises, mainly those labelled complex emergencies, have a severe impact on health systems, in all their sub-components such as policy development, planning, human resource development, financing, management, infrastructure, and support systems. Unreliable and incomplete information hampers sound decision making, while fast evolving conditions increase uncertainty. Health professionals often have limited experience analysing the major features and distortions of disrupted health systems. Learning from successes and failures in health sectors of countries in crises is particularly difficult because lessons that could be relevant to different contexts are not always well documented.

The following subjects are covered during the course:
- Analysing disrupted health systems
- Complex emergencies: trends, challenges and impact
- Humanitarian aid and its politics
- Data and information challenges in crises
- Challenges of complex emergencies to health systems
- Health policies, strategies and plans
- Key components of health systems in a crisis:
o health financing,
o the pharmaceutical sector,
o human resources,
o management systems etc.
- The recovery process of the health sector
Lectures, interactive discussions, exercises and case studies, group work, self-study:
- 41 hours: Introductory lectures, exercises and case studies as well as interactive group discussions, building on participant experiences
-16 hours: Group work will include critical analysis of a practical country case study
- 8 hours: Participant groups will present the results of the country case studies to their class colleagues, with subsequent plenary discussions
- 44 hours : Self-study. 20 hours pre-course reading; 24 hours: in-course reading to support lectures, group work
- 3 hours: written examination
The following criteria will be used for the selection of participants:
- a degree equivalent to Bachelor’s level in medicine, public health, social sciences or related disciplines;
- at least 5 years of work experience in humanitarian action or health systems development, preferably in contexts affected by crisis [tropEd students are exempted from this pre-requisite];
- proven proficiency in spoken and written English (TOEFL score of 5.5 or higher, or an IELTS score of 6.0 higher)
A minimum of 80% attendance (for the face-to-face component) is required

Maximum number of students: 30
Maximum number of tropEd students: 4
A selection panel consisting of representatives from KIT will review applications and select the strongest candidates based on the above criteria.
1.650€ for tropEd students
Early Bird Fee: 1.750€ (deadline: 1.05.2021)
Scholarships: For this course funding from the Orange Knowledge Programme (OKP, former NFP) is available for applicants from OKP countries. Additional information available at: https://www.kit.nl/health/study/okp-orange-knowledge-programme/
Major changes since initial accreditation:
Initially the course was conducted in collaboration with CDC, WHO, HAI, IRC and Merlin.

HAI and IRC are currently not participating. Merlin was absorbed by Save the Children.

Members from WHO, CDC and Save the Children give input about the course (relevance and contents)

A new course coordinator (Fernando Maldonado) was appointed on November 2015 replacing Annemarie ter Veen
Student evaluation:
During the ADHS participants complete evaluations at the end of each session and also at the end of the module.

- Overall the course and teaching methods (especially the in-class discussion, debate and role plays) are appreciated.
- Participants find that a strong point of the course is the rich mix of participants and their ample experience in the field.
- The contents of the course are felt to reflect “reality”
- Participants felt that the course helped them to expand their view about perspectives and opportunities while analysing health systems.

Challenges faced:
- During the course students perform the analysis of the health system of selected countries (e.g. DRC, Zimbabwe, South Sudan, Afghanistan, Sierra Leone). The analysis is largely based on reports and peer-reviewed articles and on other resources that students find on the internet and through personal contacts. At the end of the course participants present their analysis and identify and prioritize key problems
Both the facilitators as well as the participants agree that the exercise has limitations:
o Time is limited for an in-depth analysis (finding and organizing information, understanding the setting, performing the analysis)
o Information from selected countries is often incomplete, outdated and/or inaccurate
To address this situation the assignment has been reviewed. The focus has shifted from a full health system’s analysis to a “closer look” at only one of the 6 HS building blocks. Groups are still encouraged though to link their findings to the other building blocks and not to look at the components as isolated elements.

- Facilitators try to have interactive sessions. Still, participants have requested more interaction during some of the sessions. A new role play has been developed and tested

- Course participants have at least 5 years of field experience. On the other hand, tropEd students have less experience. This diversity within the group creates some challenges while facilitating a session. So far the approach has been to inform in advance all tropEd students about this situation and to offer support whenever possible. In general, participants with more experience tend to support their classmates. Still, this remains a challenging point for the course coordination.
Lessons learned:
See earlier point
tropEd accreditation:
Accredited in May 2012. Re-accredited in December 2016. This accreditation is valid until December 2021.
Course is conducted in collaboration with Centers for Disease Control and Prevention USA, Save the Children, WHO.
Email Address: F.Maldonado@kit.nl
Date Of Record Creation: 2012-06-26 14:28:15 (W3C-DTF)
Date Of Record Release: 2017-10-09 18:34:33 (W3C-DTF)
Date Record Checked: 2018-07-18 (W3C-DTF)
Date Last Modified: 2020-09-22 12:03:48 (W3C-DTF)

Report a Problem with this Resource Record

Log In: