Access to Health in Emergency Contexts: New Models of International Curriculum Development to Address Global Challenges
Summary, in English
These dynamics are also at work in the area of curriculum development. Fundamentally, there is an assumption that both knowledge and professional competence are universal, and that excellence can be judged according to shared criteria. Among other consequences, the assumption leads to the notion that universal knowledge and competence can then be applied or adapted to local conditions (Robson & Wihlborg, in press). The assumptions underlying this paradigm have been contested by several scholars (see Singh, 2011; Ndofirepi & Gwaravanda, 2018), pointing to the fact that knowledge and competence are necessarily embedded in particular historical, geographical, institutional, social and cultural contexts. A paradigm of transmission in international collaboration for curriculum development will consequently lead to a centring of practices based in high-income countries with English language HEIs, and a corresponding de-centring of HEIs in the global south. Recognising the need for alternative models (cf. Goddard & Hazelkorn, 2016), various initiatives are emerging, such as the People’s Uni (WHO Bulletin).
The study is drawn from an international collaboration project for equitable access to health, involving HEIs in Lebanon, Jordan, Yemen and Sweden. Travelling is currently restricted for Yemeni academics, due to visa requirements and cost. Networked forms of internationalisation, such as this project, can therefore provide access to some of the advantages otherwise offered by student and staff mobility. The Yemeni part of the project focuses on curriculum development for the health professions. Due to the war in Syria, Lebanon and Jordan have received large numbers of refugees, while in Yemen, many people are internally displaced. The region of Hadhramout has been relatively peaceful throughout the conflict and has therefore received people fleeing from other parts of the country where fighting has been intense. Local structures and humanitarian relief have been insufficient to address the needs of the displaced people, and available resources are likely to remain limited.
The Yemeni partner of the project, the Community Health department at Hadhramout university has a focus on approaches relevant to equitable access to health, but the overall organisation of the university and the programmes for the health professions are conventional. An additional challenge for this context is that international models for community health often presuppose the existence of relatively cohesive and stable communities, while the ongoing conflict and situation of displacement has led to a situation of conflicting interests and low trust.
Methodology, Methods, Research Instruments or Sources Used
As a first stage of the ongoing project, a survey including open questions and scales to prioritise concerns will be developed and given to various types of practitioners and health professionals working in the Hadhramout region, to gain a comprehensive picture both of working conditions and needs of the concerned communities. Descriptive statistics are used to describe the basic features of the data in a study. In addition, a qualitative approach (Mayring, 2000) is used to analyse the content of the survey and identify main concerns. Contextual information and descriptions of practices will be summarised in narrative form (cf. Hansen, 2006), and survey excerpts used to illustrate typical situations and practices. The aim of this step is to have a sufficiently detailed understanding of existing challenges to discuss implications for training, in terms of competences and content, but also for how work can be organised across professions with available resources. In a second stage, results from this mapping will be used to develop the curriculum (Leask, 2015) in collaborative workshops both locally and jointly in the international network of partners for the project.
Conclusions, Expected Outcomes or Findings
Many qualified Yemenis have received their training in other countries, oriented towards quite different conditions. An additional challenge are the different types of professions that need to cooperate in this context, and the generally low level of education of the displaced. Curricular development can in this case not be limited to a particular section of the university, or to academic actors, but needs to involve various kinds of practitioners as well as the concerned populations.
Several of the characteristics of the situation observed in Hadhramout can be found also in Lebanon and Jordan (Sim et al., 2018; Al-Rousan et al., 2018). Although availability of resources and infrastructure is greater in Europe, and the number of refugees is comparatively small, Sweden like other European countries experiences similar structural tensions (cf. WHO, 2018). International collaboration on curriculum development therefore holds potential benefits for all partner HEIs.
Implications of mismatches between local needs and the orientation of the curricula of professional programmes are serious. Programmes and curricular content in HEIs from the global south will tend to be organised to suit the needs of the global north, which at country levels can encourage brain drain of qualified professionals. Similar disparities between regions exist in Europe both within and across countries. Developing more collaborative models for international cooperation between HEIs in the area of curriculum development to better match local needs is therefore an important concern, not only to address the global challenges of Agenda 2030, but for the future of Europe, to reduce disparities and promote social justice (McAllister-Grande, 2018; Rumbley & Proctor, 2018; de Wit et al., 2017; Proctor, 2016; Altbach, 2004).
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Intent of Publication
EERJ or European Journal of Higher Education
- Centre for Advanced Middle Eastern Studies
- MECW: The Middle East in the Contemporary World
- Integrative Health Research
- LUCSUS (Lund University Centre for Sustainability Studies)
Conference paper: abstract
- Public Health, Global Health, Social Medicine and Epidemiology
- Educational Sciences
- higher education
- global health
- access to health care
- social justice
2019-09-02 - 2019-11-06
- Integrative Health Research