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Western Public Health Casebook 2015 Western Public Health Casebook 2015 Cases from the Schulich Interfaculty Program in Public Health Editors Mark Speechley, PhD Professor Department of Epidemiology & Biostatistics Schulich Interfaculty Program in Public Health Western University London Canada Amanda Terry, PhD Assistant Professor Department of Family Medicine Department of Epidemiology & Biostatistics Schulich Interfaculty Program in Public Health Western University London Canada Public Health Casebook Publishing Western University London ON 2015 Public Health Casebook Publishing Western University London ON Western Public Health Casebook 2015 ISBN 978-0-7714-3103-6 Copyright © 2015 Public Health Casebook Publishing The cases in this book may be copied, stored, disseminated, and used free of charge without permission for any educational uses by an accredited educational institution. No parts of this book may be changed without prior written permission of the publisher. Any other uses including commercial uses are expressly forbidden. Suggested citation – cite individual cases as book chapters: [author1, author2, author3.] (2015). [title of case.] in: Speechley, M., & Terry, A.L. [eds] Western Public Health Casebook 2015. London, ON: Public Health Casebook Publishing. Printed in London, Ontario, by Wonderland Printing Ltd. DEDICATION To the memory of Dr. M. Abdur Rab December 22, 1949 - August 8, 2015 Dr. Mohammad Abdur Rab MBBS, DTM&H, DMP, MPH, PhD Founding Director of the Schulich Interfaculty Program in Public Health TABLE OF CONTENTS Foreword .................................................................................................................................... vii Acknowledgements .................................................................................................................... ix INTRODUCTION What is Case Teaching in Public Health? .............................................................................. 1 CASES Case 1: Deciding Value for Money: Improving Prenatal Genetic Screening in Ontario .... 11 Case 2: Understanding and Developing Conceptual Frameworks and Causal Models in Maternal and Child Health Programming ............................................................. 27 Case 3: Hospitals Don’t Burn: Caribbean Island Regional Hospital .................................. 47 Case 4: Returning to Our Roots: Building Capacity in Public Health for Action on the Social Determinants of Health ........................................................................................ 60 Case 5: Let’s Agree To Agree: Management Techniques in Calibrating Oral Health Screening Systems .............................................................................................. 73 Case 6: Reducing Poverty in Canada: Public Policies & Population Health ..................... 87 Case 7: Integration of FP-MNCH Services to Accelerate Reduction of Maternal & Child Deaths: Bangladesh Experience ....................................................................... 117 Case 8: Mentor Mothers Preventing Mother-To-Child Transmission of HIV/AIDS in Jinja ........................................................................................... 140 Case 9: Combating Food Borne Illnesses through Safe Food Handling Practices in the United Nations/African Union Mission in Darfur (UNAMID) ................................ 156 Case 10: Youth as Change Agents ................................................................................... 180 Case 11 Knowledge Dissemination and Private Well Water Testing in Middlesex County, Ontario ............................................................................................................... 197 Case 12: Health Operations in Emergencies (HOPE) ....................................................... 211 Case 13: Chikungunya in the Americas: Estimating the Burden of Disease and the Cost of Illness ................................................................................................................. 227 INTEGRATED WORKSHOPS Integrating a Curriculum at the Program Level .................................................................. 239 v FOREWORD In 2010, the Schulich School of Medicine & Dentistry set out to establish a new Interfaculty Master of Public Health program at Western University. In the fall of 2013 we were able to open a wonderful new facility that is purpose-built for the innovative case method that is used by faculty and students from across our campus. This book represents cases written by students in the inaugural Class of 2014. We are very pleased to offer it as a resource to the educational community with the goal of broadening the reach of public health case teaching into classrooms around the world. – Dr. Amit Chakma, President, Western University Public health is inherently multi-disciplinary. The Schulich Interfaculty Program in Public Health is innovative in three major ways. First, it brings together dedicated teachers from the many faculties whose work touches on public health – health studies, law, medicine and dentistry, science, and social science. Second, it uses the case method of learning instead of the more traditional lecture method. And finally, the Western MPH program empowers the students themselves to author public health cases based on their practicum placements. The cases in this book cover some key topics in public health including food-borne illnesses, healthy mothers and children, and the determinants of health that we as health professionals can to some extent control. – Michael Strong, MD, FRCPC, Dean, Schulich School of Medicine & Dentistry The Schulich Interfaculty Program in Public Health is radically innovative in many dimensions; this case book exemplifies our commitment to case based pedagogy. We firmly believe that cases are an essential tool in the public health educator’s armamentarium, but more importantly, are a public good. Sharing of knowledge should have no barriers, and it is to that end we make our cases freely available. We will be publishing our case book annually in the future, and encourage you to widely share the cases and your experience of using them. Please send us your feedback at [email protected]. We look forward to hearing from you on how we can together train tomorrow’s public health professionals. – Amardeep Thind, MD, PhD, Director, Schulich Interfaculty Program in Public Health Teaching with cases is one of those things that looks easier than it is. It requires going beyond the effort required of the traditional lecture. It requires extensive planning, yet often looks spontaneous. While the lecturer has considerable control over the order in which concepts will be covered in a session, the case teacher has to face the unpredictability of not knowing beforehand exactly how the class will unfold. But, when teaching with cases, you see furrowed brows replaced by looks of enlightenment; you see students demonstrate their abilities in leadership and develop their self-confidence, and you see complex concepts covered at a depth that is seldom matched in a lecture. We believe that this is the way to teach and to learn the complexities of public health, and are honored to serve as the editors of our first casebook. – Mark Speechley, PhD, Amanda Terry, PhD, Editors vii ACKNOWLEDGEMENTS This book would not have been possible without the participation of the following organizations: Association of Ontario Midwives, Centre for Global Child Health (Hospital for Sick Children), Institute of Public Health, Lambton Public Health, Makerere University School of Public Health, Middlesex-London Health Unit, National Collaborating Centre for Health Public Policy, Pan American Health Organization (with special thanks to Farida Kerouani), the United Nations- African Union Mission in Dafur (UNAMID), and United States Agency for International Development (USAID). We are grateful for the sustained contributions, guidance and wise counsel of Dr. Murray Bryant, Professor Emeritus, Richard Ivey School of Business at Western. As well as the preceptors and other staff who welcomed our students and helped them build their skills and confidence, we would also like to thank the many members of the public health community who have contributed to our program as guest teachers and subject matter experts during our integrated workshops. This book would not have been possible without the dedication of our staff: Diana Lee, Courtney Hambides, Lisa Metselaar, Judith Thomas, Brandy McIntee, and Jennifer Nangreave. Finally, our heartfelt thank you to the entire MPH Class of 2014. Mark Speechley Amanda Terry London, Ontario July, 2015 ix INTRODUCTION WHAT IS CASE TEACHING IN PUBLIC HEALTH? Schulich Interfaculty Program in Public Health WHAT IS CASE TEACHING IN PUBLIC HEALTH? Mark Speechley, PhD, Amanda Terry, PhD, Marlene Janzen Le Ber, PhD, Ava John-Baptiste, PhD, Gerald P. McKinley, PhD, Shannon L. Sibbald, PhD, Amardeep Thind, MD, PhD, Lloy Wylie, PhD1 BACKGROUND Planning for our new case-based interfaculty Master of Public Health program began in July 2010, with our first cohort of 32 students enrolled in September, 2013. Our original view of ‘cases’ was based on those used in professional programs such as those at Harvard. Harvard is credited for introducing the case method in the law school in 1870, and then in business administration in 1920 (Shugan, 2006). Part of our initial enthusiasm was practical: Western University’s business school, the Richard Ivey School of Business, had adopted the Harvard approach in 1922 (Richard
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