Developing global health strategies: integrating health education and action.

Globalization, war, terrorism, social instability, disease, poverty and environmental degradation are among the key challenges facing the world today. In the health arena, individuals, institutions and Governments are taking action to address issues of global significance, such as the HIV/AIDS pandemic and severe acute respiratory syndrome (SARS), as well as bio-terrorism preparedness. To optimize these actions, there is a need for developing clear strategies for global health capacity-building at the national level. Envisioning adequate training for public health professionals is illusionary unless concerted action is taken to build their capacity.

The development, testing and validation of global health training and action are therefore necessary in integrating theory, practice and policy domains. The outcomes of such initiatives have the potential for facilitating learning and teaching on critical health challenges in the twenty-first century. Given the breadth of global health, it is imperative that academic and field practitioners recognize as strategies the intersections of information and communication technologies (ICTs), advocacy and social capital (networks, norms, mutual goals).

The activities of some UN agencies, such as the United Nations Educational, Scientific and Cultural Organization (UNESCO), the United Nations Development Programme, the World Health Organization and the United Nations Population Fund, reveal the need for integrating training and action. The attainment of their goals requires knowledge and skills, including networking and advocacy. It is noteworthy that the UNESCO "Education for All" and the United Nations Literacy Decade have included health education activities as strategies for goal attainment and involved schools as academic partners and venues for service delivery, thereby illustrating such synergy.

Situated cognition (1) requires linking global health education to definitions and methods of measurement of concepts, such as human security. Freedom from pervasive threats to people's rights, safety or even their lives, sustainable development and health are clear when the role of health promotion is considered as a focus area of the UN Decade of Education for Sustainable Development (2005-2014). The Decade emerged out of General Assembly resolution 57/254, which was adopted in 2002. The possibility of assessing its implementation bodes well for research exploring components of theory, practice and policy.

Assuming that social capital and ICTs are the principal sources for learning and action, teachers can develop lessons linked to available technologies, processes and outcomes, as well as existing strategies. These can, in turn, be linked to new ideas for piloting, controls aimed at enhancing the quality of evaluations, and collective impact on implementation. These processes and related activities are amenable to enactment when dealing with a given health concern in a given context. The prevailing paradigm, funding source and/or availability, networks, advocacy and associated methods and indicators in turn shape these concepts.

As Mary Bassett notes, "... what people see, hear and experience is often what drives passionate commitment to changing the public's health. The basis for advocacy is not limited to what we count and the statistics we derive." (2) ICTs allow us to transcend limitations of space and place and can enhance students' ability to feel connected and act on issues that may otherwise seem far from everyday reality. They have also been advocated as a tool for enhancing research in resource-poor settings. (3) Lesley Doyal's commentary further illustrates the need for advocacy by pointing out that an estimated 10 per cent of health resources are used for research into 90 per cent of the world's health problems, called "the 10/90 gap". (4)

Although there are many more examples that can be used to illustrate the need for using ICTs and social capital in global health education and action, as indicated above, further exploration into best practices, key strategies and emerging trends is the next logical step.

Notes

1 Moore, Joyce L.; Lin, Xiaodong; Schwartz, Daniel L.; Petrosino, Anthony; Hickey, Daniel T.; Campbell, Olin; and Hmelo, Cindy (1994). "The Relationship Between Situated Cognition and Anchored Instruction: A Response to Tripp." Educational Technology, October, 1994.

2 Bassett, M. T. (2003) "Public Health Advocacy": American Journal of Public Health, August 2003; 93:1204

3 Momen, Hooman (2004). The role of journals in enhancing health research in developing countries. Bulletin of the World Health Organization, Vol. 82, No. 3, p. 163. See also Commission on Health Research for Development. Health Research: Essential Link to Equity in Development. Oxford: Oxford University Press; 1990.

4 Doyal, Lesley (2004). Gender and the 10/90 gap in health research. Bulletin of the World Health Organization, Vol. 82, No. 3, p. 162.

Alex Otieno is an instructor in the Department of Sociology and Anthropology and the MA Program in International Peace and Conflict Resolution at Arcadia University, United States.

[ILLUSTRATION OMITTED]