The complex challenges of improving global health delivery require practitioners with a diverse set of tools and the flexibility and creativity necessary to use them in the most challenging settings imaginable.
A global health worker might be a physician trying to provide a full suite of medical services to a population that lives with limited access to clean water, healthy food or secure shelter. She might be a program director who needs to manage relationships with local community health workers, international aid groups and supply chains stretched to their limits, or a researcher hoping to use evidence-based methods to improve care delivery in a politically, culturally and socially complex environment.
To help provide the skills needed to do this work, the Harvard Medical School Department of Global Health and Social Medicine (GHSM) launched a new Master of Medical Sciences in Global Health Deliveryin July of 2012.
“We felt there was a need for advanced training in some of the practical skills necessary to study, analyze and improve the delivery of health care,” said Program Director Joia Mukherjee, HMS associate professor of medicine.
The program’s inaugural class includes a fourth-year HMS student and three physicians from resource-poor setting who have significant experience providing health care and managing projects in resource-limited environments at the local, regional and national level. Shruthi Rajashekara, an HMS student, will study food access issues in the Navajo Nation. Joining her are Melino Ndayizigiye, a Burundian physician who is the medical director of the non-governmental organization Village Health Works and will be researching the delivery of care of non-communicable diseases; Kobel Dubique, a Haitian physician who managed the delivery of health care post-earthquake in Parc Jean Marie Vincent, the largest camp for displaced people in Port-au-Prince. Kobel will be studying the best practices for care delivery in a post-disaster environment. Last is Fernet Leandre, Co-Executive Director of Zanmi Lasante (“Partners In Health” in Haitian Creole) and one of the pioneers of initiating antiretroviral therapy in resource poor settings. He will be studying the social and economic impact of long-term treatment for HIV on the rural poor.
Initially, Rajashekara felt intimidated that her colleagues had already worked so extensively in the field. “But it's been great learning from their experiences,” she said. “They have such a strong understanding of the needs of their communities.”
The theme of collaboration is woven throughout the design of the program. Faculty from GHSM worked with colleagues at the business school to develop a case-based course to study and discuss the successes and failures of existing health equity programs. Coursework includes social science, management, methods and ethics classes from HMS, Harvard Business School and Harvard School of Public Health.
“In these times, and especially in the environments in which our students work, no highly successful project can exist that isn’t collaborative,” Mukherjee said.
The core of the program is a mentored field project, where students work with an experienced colleague to create a project that both makes a real contribution to the scholarship of global health delivery and advances efforts to improve health care in a resource-poor environment.
For Kobel Dubique, who helped build a community health delivery system for tens of thousands of displaced earthquake survivors before joining the first class of students, the practical aspects of the field project are crucial.
“With this program, students can turn their new knowledge into something that has a concrete impact in the community,” Dubique said. “The way I see it, if, after my studies, I didn’t do something to alleviate the suffering in my community, what good were the studies?”
Mukherjee, who is also the chief medical officer of Partners In Health, said that HMS is a particularly good place for a program like this because there are so many faculty at the School, including but not limited to those affiliated with Partners In Health who have experience delivering care and working with health care networks in a variety of resource-poor settings, including Bangladesh, Chile, Haiti, India, Liberia, the Navajo Nation, Peru, Rwanda, Tanzania and Uganda.
The two-year program is open to residents and fellows as well mid-career clinicians and professionals seeking to study the delivery of health care using an interdisciplinary approach. For HMS students, the program can be completed with one additional year of training.
For more information, visit Master of Medical Sciences in Global Health Deliveryor contact Christina Lively.
