Harvard Business Publishing and the Global Health Delivery Project a collaboration between Harvard Business School, Harvard Medical School and Brigham and Women's Hospital released 21 case studies assessing the standards of health care delivery in under-resourced communities from 13 countries on Thursday. Aiming to standardize the study of health care delivery and efficiently distribute the information to medical practitioners, College President Jim Yong Kim began the initiative with Harvard University professors Paul Farmer and Michael Porter four years ago, according to a news release by PR Newswire.
The project aims to promote case-based instruction in which students learn to make decisions from real-life scenarios and build a global network of health care delivery instructors, according to the release.
"It dramatically expands the raw material for teaching [global health care delivery] because there isn't a lot of good stuff out there, whether didactic or [from a] case approach," Eric Wadsworth said in an interview with The Dartmouth. Wadsworth is the leader of the faculty from the Dartmouth Institute for Health Policy and Clinical Practice who also teaches in the Dartmouth Center for Health Care Delivery Science's new master's program.
In order for the new curriculum to be effective, leaders in the health care delivery field must understand that health care delivery to areas of the world with limited resources is an important topic area, Wadsworth said.
"This is a terrific addition to the literature, but we also have to get faculty interested in using it to make a difference," he said. "In our program, we focus on the United States' system because that's what we know. President Kim is teaching us to think more broadly."
Wadsworth said the current system of health care delivery in the United States is "broken," and students can learn how to improve the country's health care system from low-cost health delivery programs in poor areas.
"I think that the key is that President Kim is challenging us in the master's of health care delivery science [program] to be thoughtful about broadening the curriculum, and I think that's the critical piece to getting teaching faculty interested in thinking about a broader definition of health care delivery that has a global orientation," Wadsworth said.
The case studies describe public and private programs that distribute preventions and treatments for a number of diseases to developing countries, including Botswana, Thailand and India, according to the release. The studies are available to public health professionals and students at no cost.
The programs include the 100-percent Condom Program, implemented in Thailand in 1981 to prevent the spread and reduce the harm of human immunodeficiency virus. It involved handing out free condoms to commercial sex workers in an attempt to guarantee that all sexual encounters with the workers were protected by condom use.
One case study details a program designed to treat malnutrition in Haiti, while another describes a tobacco control program in South Africa.
"The publication of these cases online, and freely accessible to the practitioners, students and educators who will benefit most from them is an important step toward closing the know-do gap in global health," Farmer said in the release. "Increasingly, our feedback loop of research, teaching and service is directly strengthening the care we deliver on the ground and our ability to replicate and scale successes."
The case studies include instructional materials to help educators engage their students in dialogue. Using the collection of case studies as a reference, global health students adopt the role of decision-makers in the medical field, which helps them analyze health care strategy, management and delivery, according to the release.
In each case, they must consider the politics, economics and geography of the under-served region, which in turn teaches them to understand the intricacies of program implementation and sustainability, according to the release.
"I think of the [teaching] cases on a regular basis remembering what others have done, relating that to the options available to me and trying to use their lessons to inform my own decisions," Dan Schwarz, executive director of Nyaya Health a health care organization in rural Nepal said in the release. "To be able to share in [other leaders'] experiences and lessons has been, and continues to be, of profound benefit to my work."
The difficulty of studying health care delivery creates a significant bottleneck in improving health in underdeveloped regions, Porter said, adding that he hopes the newly-released collection of documents will motivate further research in the field.
"These cases capture the richness and complexity of actually delivering care in a variety of settings to help practitioners understand the principles of delivering high value care tailored to the medical condition and the populations served," Porter said in the release.
