Global Health Education Training and Services at US Universities

Global health education is booming, as evidenced by the number of students seeking these opportunities and by the proliferation of new centers, institutes and initiatives in US universities. But a critical analysis of these programmes reveals significant power asymmetries that should be addressed.

Community-based global health education programs embed participants in existing health systems and elevate local health professionals as global health experts. They also promote solidarity between communities and expand worldviews.

CFHI

CFHI is an internationally recognized, United Nations-recognized nongovernmental organization that provides global health education programs. Their approach emphasizes ethical and authentic community engagement while leveraging local assets to create sustainable global health interventions that challenge rather than reinforce historical power imbalances. They also prioritize student safety and health concerns, with 60% of their program fees reinvested in host communities.

Founded in 1992, CFHI is the world’s leading international nonprofit organization placing health science students on global health immersion field experiences (GHELP). They provide undergraduate and graduate/professional level students with immersive, community-based opportunities that combine instruction, experience, service and reflection to prepare them for a career in global healthcare. They are committed to fostering the next generation of health leaders, while challenging and disrupting the status quo in global healthcare.

They offer field experiences to medical, nursing, public health, social work, pre-health, and other allied health students. These are often called global health internships, clinical electives, away rotations or service-learning. They allow students to learn about the complex interplay between disease processes, poverty and resiliency, geopolitical realities and historical contexts, and the broader social determinants of health.

In addition to offering a variety of programs, CFHI offers faculty development workshops and consultations. These sessions help teachers and administrators develop their knowledge of how to best integrate experiential learning into their classrooms.

GHeL

In addition to offering global health electives, GHeL also works with broader initiatives within the university to help students get involved in research and internships. For example, the office supports the Global Health Initiative at Children’s National Hospital. The Initiative offers fellowships for pediatric residents interested in incorporating international work into their curriculum.

GHeL is a community-based education and training program that aims to build a more equitable world through global health. Rather than simply transferring knowledge from the North to the South, GHeL programs engage with local communities and empower them to tell their own stories and perspectives. These programmes are praised locally because they provide solidarity between host communities and participants, expand worldviews in local communities, and promote the presence of global health experts in their communities.

Admission eligibility into many global health graduate programmes inherently privileges White, middle and upper class North American and European citizens. This is largely due to the high cost of tuition and other programme-related fees, as well as requirements that include multi-year volunteer programmes like the Peace Corps, which have been critiqued for their roots in white saviorism and imperialism. This feedback loop can be interrupted by reimagining the purpose of global health programmes and shifting away from a colonial position towards one that recognises strengths and experiences beyond HICs.

GHEC

The Global Health Education Consortium (GHEC) provides students with international exchanges and study opportunities, creates curriculum devoted to global health, and advocates for policies that support global health. The organization also offers a variety of resources, including webinars and training workshops, and fellowship and job opportunities.

GHEC’s mission is to advance the health and welfare of people worldwide by supporting global learning in medicine. It provides start-up grants to local training institutions and technical help to develop and improve programs that prepare and support medical, nursing and allied health workers. The organization also helps to overcome barriers that prevent people from accessing healthcare.

In the past, many global health education experiences were conducted under the auspices of a university and involved a short-term volunteer assignment to a remote country. This type of experience, called “duffle bag medicine,” may have been valuable in fostering awareness, but it has serious limitations. These limits include the risk that incoming students might not be properly trained to work in low-resource settings and the fact that they may take up high-demand clinical training slots that could have been filled by local residents.

SUNY Downstate’s Global Health pathway is designed to integrate student-centered research and global health education with an emphasis on collaboration across disciplines, communities, and cultures throughout the four-year curriculum. It also encourages students to think critically about their responsibilities as physicians and as citizens.

GHeTs

As global health continues to evolve as its own academic and clinical discipline, medical schools across the country are positioning themselves by establishing or strengthening programs, centers, and institutes dedicated to global health. They are also identifying competencies to prepare 21st century global health professionals. [12] The Consortium of Universities for Global Health is an important source of guidance in this area.

A major goal of GHeTs is to offer students an opportunity to engage with the global health community. These efforts include providing students with a number of educational opportunities such as webinars, global health internships and fellowships, and membership in professional associations. Additionally, GHeTs offers weekly live global health shows on which students and professionals discuss various topics in global health.

In addition to these educational initiatives, GHeTs is working with partners in Rwanda to provide medical services for the local population. The goal is to reduce the burden of malnutrition and communicable diseases in this region. Students can participate in this initiative by joining one of the many short-term study abroad programs offered at COHS.

The level of participation varies depending on the student’s level of training. For example, pre-health students can observe health professionals in the field while med and nursing students may assist with examinations and treatments to the extent permitted by local ministry of health standards. Regardless of the level of involvement, students are encouraged to develop a critical perspective and display cultural humility.