The Association Of Schools Of Public Health In The European Region Public Health Workforce Capacity Building Lessons Learned from “Quality Development of Public Health Teaching Programmes in Central and Eastern Europe” Julien Goodman Judith Overall Theodore Tulchinsky A Joint ASPHER OSI Program 2000—2005 ASPHER Publication No. 3 April 2008 Authors GOODMAN, Julien. M.Phil (Cantab). Program Manager, ASPHER OSI Program OVERALL, Judith W. J.D., M.S. in Health Admin, M.Ed. Meta-evaluation Team, ASPHER OSI Program and Consultant to OSI Public Health Program Former Department Chair and Director of International Programs, Health Systems Management, Tulane University School of Public Health and Tropical Medicine, New Orleans, USA TULCHINSKY, Theodore. MD, MPH. ASPHER Executive Board Member and Faculty Consultant in ASPHER OSI Program Professor, Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem, Israel The Association of Schools of Public Health in the European Region (ASPHER) Founded in 1966, ASPHER is an association with over seventy-two institutional members throughout the European region,1 dedicated to strengthening the role of public health through the training of public health professionals for both practice and research. In fulfilment of its mission, ASPHER directs its activities toward: • Assisting schools and university departments of Public Health to achieve their missions of professional and graduate education, research and service. • Building coalitions with other programs and public health organisations to increase public awareness, appreciation and support of public health.2 The Open Society Institute (OSI) Public Health Program The Open Society Institute's Public Health Program aims to promote health policies based on social inclusion, human rights, justice and scientific evidence. The Program works with civil society organisations within two fields: • Promoting the participation and interests of socially marginalised groups in public health policy; and • Fostering greater government accountability and transparency through civil society monitoring and advocacy, with a particular emphasis on HIV and AIDS Program areas focus on addressing the human rights and health needs of marginalised persons, facilitating access to health information, and advocating for a strong civil society role in public health policy and practice. Copyright © ASPHER 2008 1 Located throughout the Member States of the European Union (EU), the Council of Europe (CE) and the European Region of the World Health Organisation (WHO). 2 Derived from the ASPHER statutes available at www.aspher.org Table of Contents Foreword 7 Preface 9 Acknowledgements 10 Introduction 11 Chapter 1 Specific Contextual Issues 14 Chapter 2 The ASPHER OSI program Overview 36 Chapter 3 The Development and Mission of the SPH 42 Chapter 4 External Environment 66 Chapter 5 Internal Environment 86 Chapter 6 Teaching Staff 94 Chapter 7 Students and Graduates 109 Chapter 8 Training Programmes 126 Chapter 9 Teaching / Learning Facilities 157 Research Institutional Quality Management System Chapter 10. Priorities and Practical Steps 169 Chapter 11. Summary 179 Chapter 12. Conclusion 192 Bibliography 193 Appendix. Program Participants 195 List of Tables and Figures Table 1. Training Workshops provided by ASPHER 37 Table 2. ASPHER OSI Projects in Post Graduate Education in Public Health in 39 CEE, CIS, NIS Countries Table 3. Other OSI Projects outside of the Joint ASPHER OSI Program 41 Table 4. Composition of external faculty in one PEER reviewed school 77 Table 5. Stream 2 - Establishing Schools and Programmes – Priorities 170 Table 6. Stream 1 - Developing Schools – Priorities 170 Figure 1. Geographical locations of Projects in ASPHER OSI Program 39 Figure 2. Geographical locations of OSI Projects outside of the Joint Program 40 Figure 3. Example of Organisation Chart from Albania 50 Figure 4. M.Sc. in Public Health at Debrecen School of Public Health 56 Figure 5. M.Sc. in Environmental Health at Debrecen School of Public Health 56 Figure 6. Diversity of Student Admission from one PEER Reviewed School 58 Figure 7. Student Educational Backgrounds in one PEER Reviewed School 112 List of Abbreviations and Acronyms used in this book AEA Albanian Epidemiological Association AFPH Albanian Forum for Public Health AIHA American International Health Alliance ASPHER Association of Schools of Public Health in the European Region AUA American University of Armenia BISPH Baltic International School of Public Health BPH Bachelor of Public Health BRIMHEALTH Baltic Rim Partnership in Public Health CEE Central and Eastern Europe CEPH Council on Education for Public Health CPH Center of Public Health ECTS European Credit Transfer System EHEA European Higher Education Area EMPH European Master of Public Health EU European Union EUPHA European Public Health Association FOM Faculty of Medicine FOSIM Foundation OSI Macedonia FPH Faculty of Public Health FPH-SEE Forum for Public Health in South Eastern Europe FSU Former Soviet Union IHSM Institute of Health Services Management IPH Institute of Public Health IRF International Renaissance Foundation (Kiev) KMAPE Kiev Medical Academy of Post-Graduate Education KMU Kaunas Medical University LCQAHE Lithuanian Center for Quality Assessment in Higher Education MA Master of Arts MAPS Medical Academy for Postgraduate Study MBA Master of Business Administration MD Medical Doctor MHA Master of Health Administration MoE Ministry of Education MoF Ministry of Finance MoH Ministry of Health MoL Ministry of Labour MPH Master of Public Health MPHM Master of Public Health Management MSc Master of Science MScPH, Master of Science in Public Health MU Maastricht University MUV Medical University of Varna NaUKMA National University “Kiev-Mohyla Academy” NGO Non-Governmental Organisation NIRDH National Institute for Research and Development NIS Newly Independent States NPHS National Public Health Service NSPH National School of Public Health OSI Open Society Institute OSI-NY Open Society Institute - New York PBL Problem Based Learning PEER Public Health Education European Review PH Public Health PhD Philosophiae Doctor (Doctorate of Philosophy) PHW Public Health Workforce PHWD Public Health Workforce Development QA Quality assurance RSU Riga Stradins University SAN-EPID Sanitary Epidemiological SEE South Eastern Europe SPH School of Public Health WASC Western Association of Schools and Colleges in the US WHO World Health Organisation Foreword A professional, qualified and multidisciplinary workforce, in sufficient numbers, is vital to the organisation and management of effective Public Health systems in Europe and around the world. Such a workforce is essential to evaluate and respond to growing threats to population health, to address health inequalities between and within countries, and to develop and implement scientifically- based interventions in a timely and appropriate manner within the limits of available resources. Ensuring that such a workforce exists and functions effectively requires the development and/or expansion of Public Health training programmes and educational systems in each country, based on the country’s own needs but incorporating international best practices and norms. Yet some European countries still do not have Schools of Public Health, or have Public Health training programmes that do not incorporate many of the more modern tools of Public Health education and practice. This shortage of training capacity was felt particularly acutely in Central and Eastern European (CEE) countries at the end of the 20th century, when population health deteriorated and the need for disease prevention and health promotion grew exponentially. The wide-reaching program funded by OSI and implemented by ASPHER described in this publication was a major developmental activity designed to respond to the region’s need for Public Health training capacity. This book documents the experiences and lessons from the thirteen-country project put forward by ASPHER and implemented by its members through twinning projects, on-site consultations, PEER Reviews, and faculty training and development. It includes information from parallel projects in other CEE and Central Asia countries funded by OSI in consultation with faculty from ASPHER member schools. It describes both new and sustainable institutions that continue to function, and it explains why other projects were less successful. Curricula and programme descriptions of individual projects are included. The OSI ASPHER program was implemented during the ASPHER presidencies of Professors Jose Martin Moreno, Roza Adany, and Charles Normand. The book was written during the presidency of Professor Anders Foldspang. Continuous monitoring and coordination was provided by Julien Goodman as Program Manager, with support by ASPHER Executive Director, Thierry Louvet. Representing OSI, Professor Judith Overall contributed continuously with evaluative advice. We share these program experiences in the belief that the documentation will prove useful not only to those who participated in the past, but also to those who take this path in the future. Françoise Girard Stojgniew J. Stiko Director, Public Health Program President, Association of Schools of Public Open Society Institute, New York Health in the European Region (ASPHER) Addendum: On a Personal Note I feel personally very attached to the enterprise of this book representing the experience gained in the establishment and development of programmes