Final Report on March 10-11 2014 Puducherry Public Health Retreat
“Transforming Public Health Education in India”
A Collaboration Between the Ministry of Health & Family Welfare (MoHFW), Indian Public Health Institutions, and the Harvard School of Public Health
The objectives of the retreat were to discuss the current issues and priorities in public health education and practice in India, examine capacity building for Indian Schools of Public Health, and develop actionable recommendations.
The two day deliberation ended with 14 recommendations for MoHFW, Indian Public Health Institutions and HSPH. The conclave concluded with the expectation of initiating collaboration between MoHFW, HSPH and all Public Health Institutions in India at a deeper level.
The MoHFW is very interested in the outcome of this meeting in the form of actionable recommendations. The recommendations are expected to provide a platform for brainstorming and generating new ideas for public health education in India.
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New diabetes prevention website launched to stop growing epidemic in Asia
March 12, 2014–The Asian Diabetes Prevention Initiative, a joint effort between Harvard School of Public Health and the National University of Singapore Saw Swee Hock School of Public Health, provides science-based evidence for policy makers and public to reverse spread of type 2 diabetes in Asia
Boston, MA – The rapidly emerging diabetes epidemic in Asia has the potential to overwhelm health care systems, undermine economic growth, and inflict unprecedented levels of disability on the world’s most populous continent. A new website—the Asian Diabetes Prevention Initiative—aims to put a stop to this deadly epidemic by offering Asian countries authoritative, science-based information to stop the spread of type 2 diabetes.
The website—www.asiandiabetesprevention.org—a joint initiative between the Department of Nutrition at Harvard School of Public Health (HSPH) and Saw Swee Hock School of Public Health (SSHSPH) at the National University of Singapore (NUS), gives the public, health professionals, and public health practitioners quick and easy access to information about the causes of type 2 diabetes, its dire consequences, and what can and must be done to decrease the prevalence of this disease in Asia.
“Asia has become the epicenter of the global diabetes epidemic,” says Frank Hu, professor of nutrition and epidemiology at HSPH and co-editorial director of the new website. “By providing the latest advances in research on epidemiology and state-of-the-art practices for diabetes prevention through lifestyle and environmental changes, this website will raise the public’s awareness about this ‘silent’ epidemic and spur urgent actions to address it.”
Created by nutrition experts at HSPH and SSHSPH, including those behind the popular and authoritative websites, The Nutrition Source and The Obesity Prevention Source, The Asian Diabetes Prevention Initiative website accepts no subsidies or commercial support from any industry, so that it can deliver an unbiased perspective on diabetes prevention.
The website offers several key features:
- a thorough, awareness-raising introduction to diabetes in Asia—from which countries have the highest prevalence to why Asians are at higher risk.
- concise summaries on the causes of type 2 diabetes—giving people the information they need to monitor their risk for diabetes and maintain a healthy diet and lifestyle.
- strategies for diabetes prevention in key settings—giving families and community leaders roadmaps to help prevent diabetes in their homes and communities.
- a quick and convenient diabetes risk calculator—giving individuals a personal estimate of their risk of developing type 2 diabetes, so those who are most at risk can start changing their habits before it’s too late.
Diabetes is an important health concern in Asia, especially because Asian populations are more vulnerable to developing type 2 diabetes at lower body mass indexes (BMIs) than people of European ancestry. However, much of the information on diabetes prevention on the internet focuses on Western settings, for example, foods commonly eaten in Western countries, says Rob van Dam, associate professor at SSHSPH and co-editorial director of the new website. “Our website takes into account risk profiles and dietary and lifestyle habits that are common in Asia and can thus provide more relevant information.”
The large majority of cases of type 2 diabetes are preventable through changes on the individual and societal level. Scientific evidence shows that facilitating a handful of key behaviors could help prevent many cases of type 2 diabetes:
- choosing healthier foods (whole grains, fruits and vegetables, healthy protein sources);
- limiting unhealthy foods (refined grains, red and processed meats) and sugary beverages;
- using healthy oils for cooking instead of unhealthy oils and fats (palm oil, lard, butter);
- increasing physical activity; quitting smoking; and getting the right amount of sleep.
The Asian Diabetes Prevention Initiative website conveys to individuals and communities ways to make better dietary and lifestyle choices and reduce the risk of getting the disease.
“We need to dispel the prevailing myth that type 2 diabetes is inevitable if it runs in the family. The scientific evidence is compelling that type 2 diabetes can be prevented. We need to get the message out loud and clear now before the diabetes storm in Asia worsens,” says Lilian Cheung, director of health promotion & communication in the Department of Nutrition at HSPH and co-editorial director of the new website.
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HSPH Professors Attend Public Health Retreat: Transforming Public Health Education in India–A Collaboration Between the Indian Ministry of Health and Family Welfare and the Harvard School of Public Health
On March 10 and 11, David Hunter, Peter Berman, Richard Cash, and Ian Lapp traveled to Pondicherry in the state of Tamil Nadu to participate in this workshop. It is the continuation of the collaboration between HSPH and the Indian Ministry of Health and Family Welfare. It follows closely on the heels of two schools of public health in India opening in the cities of Raipur and Pondicherry.
HSPH-IPH Coordinator Peter Berman in Delhi, January 2014
On a recent trip to India, GHP Professor Berman met with a number of colleagues and partners on different activities. These include the Ministry of Health and Family Welfare (MOHFW), the Bill and Melinda Gates Foundation, and others. Regarding the Strengthening Health Resource Tracking for Improved Delivery of Primary Care in India and Ethiopia Project (RTM), Professor Berman reviewed project objectives and activities with Mrs. Anuradha Gupta in the MOHFW. Mrs. Gupta is also the Mission Director of National Rural Health Mission, the flagship program of Government of India.
The goal of the RTM project is to develop better evidence and promote its use to increase the efficiency, effectiveness and equity of primary care delivery in India. This will be accomplished through research and analysis on health RTM, working with in-country partners in government and elsewhere. The project will also contribute to global learning on the effective use of resource tracking for improved primary care outcomes. RTM is conceptualized in the project framework as including resource mobilization, allocation, utilization, productivity, and targeting. Professor Berman also met with other senior officials at the MOHFW to discuss HSPH’s Memorandum of Understanding with the Ministry and joined Harvard Vice Provost for International Affairs Professor Jorge Dominguez for an information reception with HSPH alumni.
HSPH has signed a Memorandum of Understanding with Ministry of Health and Family Welfare, Government of India (MOHFW)
Strengthening public health education One area of work under the Ministry of Health includes collaboration to develop new masters of public health programs in several leading medical education institutions in different states in India. The model being developed for this collaboration will be an innovative combination taking advantage of Harvard’s new EdX offerings of online courses, the first of which was equivalent to HSPH’s introductory courses in Biostatistics and Epidemiology, an MPH requirement. HSPH expects to be able to offer the full MPH core curriculum in an online form in the next 1-2 years. The MOHFW program would include faculty development for Indian faculty, classroom-based teaching to accompany online instruction, and advice and support for advanced course development. HSPH will assist JIPMER (the Jawaharlal Institute of Postgraduate Medical Education) to establish a School of Public Health as part of a memorandum of understanding executed between the Ministry of Health and Family Welfare (MOHFW) and HSPH. See link for article.
Strengthening health systems performance for better and more efficient hospital and primary care Apex institutions in India which have started implementing a program to systematically measure and improve the quality, safety, and effectiveness of the healthcare it provides in the hospital setting. Work closely with them to develop a core set of metrics that provide key date on the clinical, administrative, and financial performance of these hospitals. As these Indian entities choose and implement their information systems, there is an opportunity to assist in ways that make assessing and improving quality of care easier.
In addition, work with Indian health care institutes to identify important areas where clinical practice guidelines and standard operating procedures are made part of a facility level quality management system. At the primary care level, India is carrying out a study of district level health needs, resources, and program costs. Collaborate in the current analysis of rural district-level budgeting, total health spending, needs and delivery. Participate in expansion of baseline data collection to new districts. Explore applications in urban areas. In addition, participate in the design, implementation, and evaluation of Universal Health Coverage demonstrations in selected districts. Develop methods and analytics on the factors affecting primary care performance, evaluation of new program strategies, and translation of knowledge into effective programs.
Leadership development and technical support for states’ policy leaders and advisors In India, many states are larger than most other countries. States command most of the government health resources and have an underused potential to develop policies and strategies for health system transformation. HSPH, in collaboration with Harvard Kennedy School, recently launched the Ministerial Leadership in Health (MLIH) Program to strengthen the skills of health system leaders at the national level with a strong focus on Africa. HSPH will collaborate with India’s Ministry of Health and Family Welfare to develop a similar initiative for India’s state-level health ministers. Beyond the ministers, global investigation has shown that top state leaders need the support of skilled and knowledgeable advisors. Senior advisors often lack well-designed opportunities to build up their capacities. HSPH has recently proposed two strategies to address this opportunity – a “senior policy advisors” capacity building program and a repository of user friendly health systems evidence. An India-specific partnership with India-based institutions will help by strengthening documentation and dissemination of India-specific health system innovations which would be of value both within India and in other countries, and developing a cohort of state-level advisors with advanced knowledge and skills in support of health system reform efforts at the state level.
The Jawaharlal Institute of Postgraduate Medical Education (JIPMER) Opens First Masters in Public Health Program
India’s premier medical school, JIPMER, which is based in Puducherry (formerly known as Pondicherry), has launched a school of public health with a specialized two-year post-graduate degree on the subject. JIPMER’s link with HSPH is part of the larger MoU between the American medical school and the Indian ministry of health and family welfare. “As part of that understanding, we would help and collaborate with JIPMER and other All India Institutes of Medical Science through a bilateral exchange of ideas, educational tools, research, data and faculty,” said Dr David Hunter, dean of academic affairs, Harvard School of Public Health (excerpts from Puducherry’s edition of Jan 22, 2014 The Times of India).
HSPH edX courses help train workers in India
Workers at Piramal Life Sciences—a Mumbai, India-based company that develops pharmaceuticals and medical devices—are among the first as a corporation to sign up for Harvard School of Public Health (HSPH) courses offered through edX, the online course platform founded by Harvard University and the Massachusetts Institute of Technology. HSPH courses in Health in Numbers: Quantitative Methods in Clinical and Public Health Research and in Fundamentals of Clinical Trials (offered jointly with Harvard Medical School) are being used to train medical staff at the company, according to Dr. Swati Piramal (MPH ’92), Vice-Chairperson of the Piramal Group.
“We trained our whole medical staff,” Piramal said in a January 1, 2014 article in The Hindu Business Line. “The edX courses work very well.” Piramal, who serves on the HSPH Dean’s Advisory Board and is a member of Harvard’s Board of Overseers, noted that India is an important market for edX and is home to the largest population of edX learners outside the U.S. Since HSPH began offering online courses through edX in fall 2012, hundreds of thousands around the world have signed up to learn about topics including biostatistics, epidemiology, environmental health, health policy, and genomics. The edX consortium currently includes 30 colleges and universities around the world, and countries and companies have also begun to partner with the online learning venture. Read The Hindu Business Line article.
Harvard India Nutrition Initiative receives Obama-Singh Award
The Obama-Singh 21st Century Knowledge Initiative awards are given to strengthen collaboration between American and Indian institutions of higher education. The HSPH Harvard India Nutrition Initiative, in collaboration with St. Johns Research Institute in Bangalore, was recently awarded funding through the Obama-Singh awards.
This initiative will aim to substantially contribute to the establishment of sustainable public health research and education capacity in India through mutually beneficial exchanges of faculty and students between Bangalore and Boston, the expansion of an existing and very successful short course in nutrition research methods (the Bangalore-Boston Nutrition Collaborative) co-taught by SJRI, HSPH and Tufts faculty, the development of new nutrition epidemiology courses by SJRI and HSPH faculty, and the expansion of access to a website for distance learning via the newly launched edX initiative.
More details can be found in the press release on the US Embassy’s website.