Transformative Education
for Health Professionals

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Looking beyond health: broadening perspectives

Looking beyond health: broadening perspectives

World Health Organisation recently announced the creation of an expanded Department for Public Health, Environmental and Social Determinants of Health.

Dr Maria Neira, Director of this new department and Professor Sir Michael Marmot, UCL, London are keynote speakers in the WHO co-hosted parallel session ‘Looking beyond health: broadening perspectives’ at the Prince Mahidol Award Conference due to start in Bangkok, Thailand next week (27 - 31 January 2014).

Dr Neira will present key elements of WHO’s expanded strategy for Public Health, Environmental and Social Determinants of Health and Professor Sir Michael Marmot on his report ‘Working for Health Equity; the Role of the Health Professional’.

-see session abstract below.

Other speakers will include; Margaret Mungherera, President, The World Medical Association, France; David Williams, Professor of Global Oral Heath, Barts and The London School of Medicine and Dentistry, United Kingdom; Mary Mauldin, Professor and Executive Director, Office of Instructional Technology and Faculty Resources, Medical University of South Carolina, USA.

At the meeting Dr Neira will be presenting WHO's expanded remit, particularly how it synergises with another WHO initiative for transforming and scaling up of health professionals' edcuation and training. "Education for health professionals in the environmental and social determinants of health is a critical aspect of “transformative learning. Such training can prepare health workers to prevent and treat root causes of disease in their day-to-day clinical practice -- as well as positioning future health sector leaders to interact with other sectors, in support of sustainable development strategies that benefit health".

This echos the call by Sir Professor Michael Marmot, who in his recent report 'Working for heath equity; the role of the health professionals' makes a recommendation for a “greater focus on information about the social determinants of health, and information on what works to tackle health inequities, should be included as a mandatory, assessed element of undergraduate and postgraduate education”.

WHO has recently published guidelines for transforming and scaling up of health professionals' education and training. With the 2013 WHO World Health Assembly resolution 'Transforming the health workforce in support of universal health coverage' it is likely that a modified version of the guidelines might be used to inform and guide policy development and implementation for the education and training of mid-level providers and community health workers. 

In terms of the social determinants of health, the guidelines provides the policy basis for the incorporation of more knowledge of the environmental and social determinants of health into programmes at all levels.  The rationale for such training is threefold:

1. Education in the root environmental and social causes of ill health can help prepare and empower future health sector leaders to interact with other sectors in the formulation of strategies that reduce a critical disease burden;

2. Health professionals  also need to learn more about how to address environmental and social risks to health encountered in their own clinical practices;   

3. Finally, the health sector must also be prepared to engage in the process of multilateral dialogue on  regional and international agreements and conventions that protect health, equity and the environment.

It is also important that these aspects are viewed as part of an education continuum; how we might look to integrate teaching on PH; E & SDH in pre- and in-service education / what should be pre-service, what in-service ?

Looking at broadening transformative education and training to encompass the health workforce with an inter-sectoral lens speaks to the recommendations for instructional and instituional reforms made in the Global Indepdendent Commission, specifically the idea of 'Academic systems' to improve both education and service delivery.

There is considerable momnetum from many health workforce stakeholders attending PMAC - we will be posting regular updates, reports and interviews from the conference - follow us on facebook and twitter

PMAC PS 2.3 Session abstract; Background / Overview

The World Conference on Social Determinants of Health in 2011 identified that the social determinants and equity agenda must be addressed at a global governance level through the leadership of the United Nations and its various agencies.

In linking the social determinants of health with environment and sustainable development agendas, the United Nations conference on sustainable development (Rio +20) set out a common vision, seeking to mainstream sustainable development at all levels, integrating economic, social and environmental aspects and recognizing their interlinkages. One of the main health specific development goals being considered in the post 2015 development agenda is reducing the burden of the major noncommunicable diseases.

The WHO global action plan for the prevention and control of noncommunicable diseases sets out overarching principles and approaches, including the need for multi-sectoral action, the goal of universal health coverage and in particular the adoption of a life course approach. Social determinants impact all phases of the life course and as such, are key drivers of health inequity.

The Report “Working for Health Equity: The Role of Health Professionals” recognizes that the health workforce is well placed to initiate and develop services that take into account and attempt to improve the social context in which people live and work, however they are often under-utilized for this purpose. Health professionals, while predominantly employed within health systems, very often have positions and responsibilities that are linked to other sectors (e.g. education, social welfare and housing).

Transformative health professional education must;

- encompass the social determinants of health to address health care delivery in a holistic manner. The training and education of all cadres of health professionals should include ways to address the impact of social determinants of health on their clients, so that health professionals are prepared with the knowledge to diagnose the social causes that underlie ill health and the unfair distribution of health;

- provide the health workforce with the knowledge and practical approaches on how to work with sectors that lie outside health, yet significantly impact health, will facilitate health workers to drive multi sectoral action for health.

2. Objectives

1. Describe how UN post 2015 development agenda could provide the required global governance and leadership framework to enable consistency and coherence on the social determinants of health across all sectors;

2. Discuss the role of health professionals as multi-sector actors in advocating, communicating and developing partnerships to address social determinants of health as a strategy for decreasing inequities in health;

3. Identify ways to reduce health inequities through transformative education and training of health professionals with a particular emphasis on mid level providers and the community health workforce;

4. Discuss strategies that can be undertaken by the health sector as the employer of HRH to address SDH (incentives for working across sectors, use of employment and distribution of HRH to reduce inequities in health).