SEMESTER AT SEA COURSE SYLLABUS. May Course Title: SEMS Building Maternal and Child Health in Central America

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1 SEMESTER AT SEA COURSE SYLLABUS May 2012 Discipline: Nursing/ Public Health Course Title: SEMS Building Maternal and Child Health in Central America Division: Upper Faculty Name: Barbara Parker, RN, PhD, FAAN Pre-requisites: None COURSE DESCRIPTION This course will focus on MDG 4, Reduce child mortality, and MDG 5, Improve maternal health. Central American and Caribbean nations have made progress in improving health care for their populations although poverty and poor maternal-child health are still issues in some countries. This course will expose students to the current status of health care in the countries that we will visit and within the region in general. This interactive course will include investigations of primary, secondary and tertiary care with a focus on maternal child health in each. Specific comparisons will be made to describe the effects of cultural and religious influences, the impacts of economy, national health policy and political stability on improvements in health. Issues relating to location (rural/ urban) environments and local traditions will also be investigated. This course will introduce learners to concepts of health and healthcare and to strategies for measuring these both quantitatively and qualitatively. Health care from the perspective of the patient, family, community and provider will be identified and compared to describe the strengths and limitations of each. Faculty Developed Practicum s will focus on agencies providing health care to women and children in the community. COURSE OBJECTIVES At the conclusion of this course, the student will be able to: 1. Identify and describe different definitions of health and health care at individual, family, community, and global levels. 2. Describe and apply assessment models of contributing components to the biosocial context of health. 3. Identify and apply basic epidemiological principles and tools. 4. Identify and describe health challenges ranging from microbial to environmental to social. 5. Examine and evaluate strategies to address health challenges, particularly to the Millennium Development Goals 4 and Examine women s health issues in developing countries including maternal mortality and 1

2 morbidity, AIDS and other sexually transmitted diseases, and infectious diseases of poverty. 7. Evaluate the pros and cons of various solutions including existing health care services, microfinancing, women s empowerment, education and technology. REQUIRED TEXTBOOKS Author: Richard Skolnik Title: Essentials of Global Health Publisher: Jones and Bartlett ISBN#: Date/Edition: 2007/ 1 st edition Cost: $39.23 (Amazon.com) Author: Ruth Levine Title: Case Studies in Global Health Publisher: Jones and Bartlett ISBN#: Date/Edition: 2007/ 1 st edition Cost: $ (Amazon.com) Authors: Kristof, ND, WuDunn, S. (2009). Publisher: Random House. Title: Half the sky: Turning oppression into opportunity for women worldwide. ISBN # Cost $27.95 Course Reading Packet (available through electronic course folder) TOPICAL OUTLINE OF COURSE Day 1 Introduction and Social Determinants of Global Health Introduction to the course and course requirements/evaluation Introduction to course-related FDPs (descriptions at the end of this syllabus) Introduction to the Millennium Development Goals (MDGs) Definitions of major health and health care terms and concepts o Health at the individual, familial, national, and global levels Overview of health statistics and trends in the Caribbean and Central America Introduction to Social determinants of global health o Discussion of social determinants of global health in the Caribbean and Central America Skolink; Introduction, Chapter 1 and 3 Marmot, Michael. "Social Determinants of Health Inequalities." Lancet. 2005: 365:

3 WHO Commission on the Social Determinants of Health: Towards a Conceptual Framework on Actions and Analysis of Health 2005 Kristof & WuDunn (2009) Chapter 1,2 &3 United Nations Millennium Development Goals Day 2 Epidemiology: The tools of the trade Historical context Epidemiological terms and methods of measurement o TEDTalks: Debunking third-world myths with the best stats you ve ever seen, by Hans Rosling Epidemiological trends in the Caribbean and Central America Data behind the MDGs o Using data to measure progress and change o Introduction of positive deviants Epidemiology Assignment. This assignment will ask you to work through the analysis of a disease outbreak and to present your findings. (Objective 3, due at the beginning of Class 3) Skolink: Chapter 2 Murray, CL and AD Lopez. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. The Lancet : Lopez A, Mathers C, Ezzati M, Jamison D, and CJ Murray. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. The Lancet : Intro to Epi: Day 3 Ethics, Human Rights, and Culture: The biosocial approach Assignment due Epidemiology assignment due today Discussion of biosocial context of health o Social determinants of health o Assessment Models used in Global Health o Health and Development Ethical issues: o Social justice and health care systems Accessing Care o Workforce issues, including brain-drain o Cross-cultural educational, practice, and research implications Assessment models o Community health assessment models in global health Spotlight on Panama : Skolink: Chapters 4 and 6. Kristof & WuDunn, chapters 5, & 6 3

4 Walton D, Farmer P, Dillingham R. Social and Cultural Factors in Tropical Disease: Reframing our Understanding of Disease In Tropical Infectious Diseases. ed. Guerrant, Walker, Weller. Kristof, N. How to change the world. New York Times, October 20, Day 4 Health Systems and NGOs: Delivering Health Care and Promoting Health Discussion of FDPs and student experiences Descriptions of health systems in the Caribbean and Central America Descriptions of workforce training Access to care for individuals and families Positive deviants Classification of NGOs TEDTalks: Melinda French Gates: What Non-profits can learn from Coca-Cola NGOs and health Health Promotion Population-based approaches Global Health Models for Education and Practice Focus on the health in Peru Skolink: Chapters 5, 14, and 15 Kristof & WuDunn, Chapter 8 Walton, D et al. Integrated HIV Prevention and Care Strengthens Primary Health Care: Lessons from Rural Haiti Journal of Public Health Policy Vol. 25, No. 2 April 2004 Day 5 The Health of Women and Children Gender inequality and social context o Issues of poverty and gender o Development and Health Microcredit o Education and gender o Intimate partner violence Kristof & WuDunn (2009) Chapter 7 & 8 Skolink Chapters 9 and 10 Day 6 Communicable and Non-Communicable Diseases: Defining the Priorities Disease and the MDGs Communicable vs. non-communicable diseases o Pathophysiology HIV/AIDS, Malaria, TB o Social Context HIV/AIDS, Malaria, TB Focus on health Ecuador Skolink: Chapters Sachs, J.and Malaney, P. "The economic and social burden of malaria." Nature February 2, 2002: 415,

5 Farmer, P., The consumption of the poor. Chapter 7 in Infections and Inequalities. Pps Day 7 Environmental Health and Nutrition Environment and health o Individual, family, National, and global levels Environment and development MDGs and environmental sustainability Nutrition and Health o Global Context of Food Distribution Focus on health Panama Skolink Chapter 7 and 8 Flake, D.F. & Forste, R. (2006). Fighting families: Family characteristics associated with domestic violence in five Latin American Countries. Journal of Family Violence, 21(1), Day 8 Mid-Term Examination Day 9 Presentations Day 1 Presentations of Case Studies (Assignment due) Day 10 Presentations Day 2 Discussion of FDPs and student experiences Presentations on country-level health policy (Assignment due) Spotlight on: Belize ( Day 11 Positive deviants, Lessons learned, and the future of the MDGs Discussion of FDPs and student experiences Charting continuing progress of the MDGs Positive deviants and lessons learned The future of the MDGs NURS 4501: Course Requirements and Evaluation: Daily readings done prior to class. Class attendance and participation (10% of total grade; may include pop quizzes on daily readings). (Objectives 1-5) FDP Assignment (20%). This assignment will consist of a journal of observations about health conditions at the site. It should be kept on all FDPs attended, and the journal must include, at a minimum: health issues identified; data needed to assess health issue; proposed strategy to collect data; social or cultural factors that may affect the issue; and relevant stakeholders. Specific descriptions of course required FDPs are listed at the end of this syllabus. (Objectives 2-4) Case Study Assignment (20%). Case studies will focus on health issues in Central and South America, selected from Levine s Case studies in Global Health Mid-term Examination (10%). This examination will take place on the 8 th class meeting. 5

6 Epidemiology Assignment (20%). This assignment will ask you to work through the analysis of a disease outbreak and to present your findings. Country-level Health Policy Assignment (20%). A group of students will represent each of the six countries visited. Each small group will research the health challenges and assets of the assigned country. The group will choose health interventions as case studies. The group must present a written report that describes the choices and the decision-making process with explicit reference to the MDGs. FIELD ASSIGNMENTS FDP Information: Ciudad del Saber (The City of Knowledge). Panama City. Academic Objectives: 1.Describe the health care system in Panama and compare patient access to care to that of the US. 2.Describe the most common health problems of women and children in Panama 3. Compare and contrast maternal care (labor, and delivery) between Panama and the US. IV. Field Lab Description: The City of Knowledge is an international complex for education, research, and innovation, and was developed to "promote and facilitate synergy between universities, scientific research centers, businesses, and international organizations." Centrally located on the banks of the Panama Canal, the City of Knowledge, located on the former Fort Clayton military base, has the facilities and support essential to foundation of programs of excellence in education, research, technological development and innovation, while encouraging and promoting integration of institutions, businesses, and programs. It is a goal of the City of Knowledge to become a place in which people from various backgrounds, students, professors, scholars, scientists, and business people alike, can come together for the sharing of ideas and the exchange of knowledge. This day long visit will include a lecture on the health care system in Panama, visits to clinics and schools and other observational experiences. RESERVE LIBRARY LIST Author: Dan Bortolotti Title: Hope in Hell: Inside the World of Doctors Without Borders Publisher: Firefly Books ISBN#: Date/Edition: 2010/ 3 rd revised edition Author: Tracy Kidder Title: Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World Publisher: Random House Trade Paperbacks 6

7 ISBN#: Date/Edition: 2004/ 1 st edition AUTHOR: Gbowee, Leymah BOOK TITLE: Mighty be our powers: How sisterhood, power and sex changed a nation at war. DATE: 2011 PUBLISHER:New York: Beast ISBN AUTHOR: Michael Marmot ARTICLE/CHAPTER TITLE: Social Determinants of Health Inequalities JOURNAL/BOOK TITLE: Lancet VOLUME: 365 DATE: 2005 PAGES: AUTHOR: WHO Commission on the Social Determinants of Health ARTICLE/CHAPTER TITLE: Towards a Conceptual Framework on Actions and Analysis of Health JOURNAL/BOOK TITLE: VOLUME: DATE: 2005 PAGES: AUTHOR: CL Murray and AD Lopez ARTICLE/CHAPTER TITLE: Global mortality, disability, and the contribution of risk factors: Global Burdern of Disease Study JOURNAL/BOOK TITLE: Lancet VOLUME: 349 DATE: 2007 PAGES: AUTHOR: A Lopez, C Mathers, M Ezzati, D Jamison, and CJ Murray ARTICLE/CHAPTER TITLE: Global and regional burden of disease and risk factors, 2001: Systematic analysis of population health data JOURNAL/BOOK TITLE: Lancet VOLUME: 367 DATE: 2006 PAGES: AUTHOR: D Walton, P Farmer, R Dillingham ARTICLE/CHAPTER TITLE: Social and cultural factors in tropical disease: Reframing our understanding of disease JOURNAL/BOOK TITLE: Tropical Infectious Diseases (editors Guerrant, Walker, Weller) VOLUME: Book chapter DATE: 2005 PAGES: 7

8 AUTHOR: J Mukherjee ARTICLE/CHAPTER TITLE: Basing treatment on rights rather than ability to pay: 3x5 JOURNAL/BOOK TITLE: Lancet VOLUME: 363 DATE: 2004 PAGES: AUTHOR: Jonathan Mann, et al. ARTICLE/CHAPTER TITLE: Introduction and Part I JOURNAL/BOOK TITLE: Health and Human Rights: A Reader (Routledge publishers) VOLUME: DATE: 1999 PAGES: Introduction and Part I p AUTHOR: D Walton, et al. ARTICLE/CHAPTER TITLE: Integrated HIV Prevention and Care Strengthens Primary Health Care: Lessons from Rural Haiti JOURNAL/BOOK TITLE: Journal of Public Health Policy VOLUME: 25, no. 2 DATE: 2004 PAGES: AUTHOR: J Sachs and P Malaney ARTICLE/CHAPTER TITLE: The economic and social burden of malaria JOURNAL/BOOK TITLE: Nature VOLUME: 415 DATE: February 2, 2002 PAGES: AUTHOR: P Farmer ARTICLE/CHAPTER TITLE: The Consumption of the Poor (Chapter 7) JOURNAL/BOOK TITLE: Infections and Inequalities VOLUME: DATE: PAGES: AUTHOR: DF Flake and R Forste ARTICLE/CHAPTER TITLE: Fighting families: Family characteristics associated with domestic violence in five Latin American Countries JOURNAL/BOOK TITLE: Journal of Family Violence VOLUME: 21(1) DATE: 2006 THE JOURNAL OF LAW, MEDICINE & ETHICS, 2010, VOLUME 38:3 Entire issue Author: Linda Pollman Title: The Crisis Caravan: What's Wrong with Humanitarian Aid? Publisher: Metropolitan Books 8

9 ISBN#: Date/Edition: 2010/ 1 st edition Author: William Easterly Title: The White Man s Burden Publisher: Penguin Books ISBN#: Date 2007/1 st edition 9