Regional collaboration in public health training and research among countries of South Eastern Europe
Genc Burazeri1, Ulrich Laaser2, Vesna Bjegovic3, Lidia Georgieva4 on behalf of the: Consortium for Public Health Collaboration in South Eastern Europe5
1 Department of Public Health, Faculty of Medicine, Tirana University, Albania
2 Section of International Public Health, Faculty of Health Sciences, University of Bielefeld, Germany
3 Institute of Social Medicine, School of Medicine, University of Belgrade, FR Yugoslavia
4 Department of Preventive Medicine and Epidemiology, Faculty of Public Health, Medical University, Sofia, Bulgaria
5 See at: http://www.snz.hr/ph-see
Correspondence: Genc Burazeri MD, MPH, Department of Public Health, Faculty of Medicine, University of Tirana, Rr. "Dibres", N.371, Tirana, Albania, tel: +355682150535, fax: +3554232102, Email: gburazeri{at}yahoo.com
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Abstract |
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It is argued that each country of South Eastern Europe should have its own school of public health. However, a basic prerequisite of modern public health training is the comprehensiveness of the programme and a worldview approach. Most of the countries of South Eastern Europe face the same difficulties to adapt their inherited communist structures of public health training to Western standards. A regional collaboration would facilitate the process of establishing schools of public health in all countries of the region and support the training of public health professionals at all levels.
Key points
- South East Europe includes Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Greece, Macedonia, Moldavia, Romania, Serbia and Montenegro, and Slovenia.
- Public health institutions in South East Europe face similar difficulties to adapt their inherited teaching structures to Western standards.
- Public health institutions in South East Europe should make a joint effort towards establishing regional training programmes.
- A regional approach in public health training would enable an efficient use of resources in countries of South East Europe.
Keywords: public health, regional approach, school of public health, South Eastern Europe, training programme
Most countries of South Eastern Europe are going through difficult periods of transition following the collapse of the Soviet Union in 1991 and consequences of a long-lasting war in the region. The public health crisis these countries are experiencing reflects socio-economic upheavals succeeding the disintegration of the socialist economy.1 Furthermore, there is lack of well-trained public health specialists capable of managing the health problems the countries of South Eastern Europe are facing. Traditionally focused on sanitary engineering, most of public health specialists in these countries lack the capability to solve the emergent multi-factorial public health crisis.2 Therefore, this training deficit of at least one generation of public health specialists will engage many teaching institutions in countries of South Eastern Europe throughout the years to come with re-training of the public health workforce in line with a new task profile of a western societal type.3
However, a new public health training fashion is emerging in countries of South Eastern Europe. Since 2000, a collaborative network (Public Health Collaboration in South Eastern Europe, a project of the Stability Pact, which strives for social cohesion among countries of South Eastern Europe) is working on a common set of teaching materials and has developed a common database for public health in the region.4,5 Furthermore, a minimum indicator set for regional health monitoring has been developed.6 A joint project of the Open Society Institute and the Association of Schools of Public Health in the European Region is facilitating the establishment of schools of public health in selected countries of Eastern Europe,7 with a main focus on development of teaching curricula at Masters’ level.
Yet, most countries of South Eastern Europe are not prepared to face the broad spectrum of public health training.8 Most of the institutions involved in public health teaching in these countries still lack the expertise to train professionals in a modern context. In this paper we propose a regional training approach at different levels for countries of South Eastern Europe.
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The concept of regionality |
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Depending on the size of a country and its population, the geographical scope of a public health training institution may differ. Notwithstanding international even global collaboration, many hold the position that each state needs at least one school of public health. Larger territories within a country require even their own institutions. For South Eastern Europe such an example would be Bulgaria with its two main institutions (in Sofia and Varna). On the other hand, it is unlikely that a small country can or even should afford an expensive institution with the full spectrum of activities. The result in this situation very often is an institution being too small, understaffed and sub-standard in all respects, especially if a (small) country is in transition as it is the case of Albania, Monte Negro or Macedonia. For Europe, with the diminishing importance of the old national borders, a structured regional cooperation may offer the solution. Regionality in this context does not refer to regions within a country, but to collaboration with neighbouring countries in a geographical region such as South Eastern Europe, which includes: Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Greece, Macedonia, Moldavia, Romania, Serbia and Montenegro, and Slovenia. Other examples are the Nordic School of Public Health for the Nordic countries, or the Swiss consortium of Departments of Preventive Medicine.
Many institutions in South Eastern Europe involved in public health training are facing similar difficulties to adapt their inherited old teaching structures to Western standards. Progressed age and lack of modern training characterize the public health workforce. Moreover, specialists involved in fieldwork lack knowledge of foreign languages and Internet use, which assure accessibility to health information. To re-train this workforce short modules over a certain time-span are required. The consequence would be a sandwich training approach consisting of two-three days every two-three weeks for two-three years. This would be a realistic option for people who cannot leave their jobs for a full training programme for family and other reasons.
A regional approach, in this context, may be supportive of training mid-level people in field leadership positions (health managers, hospital directors) by developing short modules, which could be a joint contribution of all institutions involved in public health training in South Eastern Europe. This will assure standardization of training and an efficient use of resources within the region. A suitable start would be the implementation of key modules developed by the European Master of Public Health Program including five key areas of public health training.7
Furthermore, specific modules reflecting the needs of South Eastern Europe may be designed according to preferences and the heterogeneous lecturing faculty in these countries.
From this perspective, a regional collaboration opens the alternative to achieve excellence at least for a few health sciences in each local institution and to exchange lecturers and students to study specific subjects at the most renowned regional institutions.3 Certificates would be issued by the host institutions (offering the modules) to students upon successful completion of the courses. The mother institutions (sending the students) would acknowledge these certificates for their own degrees. Therefore, all the participatory institutions of the region would develop a mutual acknowledgement of certificates for complementary modules.
Successful implementation of these short modules may facilitate the development of a full Master of Public Health programme in English language for younger students who wish to pursue a career in public health. This would be a suitable start for development of a regional school of public health, though the fragility of regional identity is still an obstacle to overcome along with enhancement of collegiality and professional unity.
Development of a regional collaboration in public health training at Master's level would also be in line with Bologna Declaration9 and suits the current trends observed in Europe namely the strive for international compatibility, equal opportunities for all universities, a flexible organization of training programme, as well as modularization and credit-system (European Credit Transfer System).
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Advantages of a regional approach |
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TopAbstractThe concept of regionalityAdvantages of a regional...ConclusionsReferences |
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A regional collaboration in public health training has many advantages for countries of South Eastern Europe:
It would bridge professional relationships after a long period of violence and open war in the region. Tensions originating from unacceptable differences in chances for healthy living within populations, particularly so among minorities in South Eastern Europe can destroy the societal web and lead to violence and war.10 Therefore, a regional approach would rebuild trustiness and reciprocity within the region.
A regional collaboration would add an important dimension into training programme, namely the international problem-oriented perspective, which would enable training of specialists in a multidisciplinary fashion with a broader target-oriented framework according to international standards.
A regional approach would allow for an efficient use of resources. Each country of South Eastern Europe would contribute and share facilities, human resources and expertise with its regional counterparts.
Regional training programme in South Eastern Europe would be more attractive and also affordable for students because of local price-structure. Also, collaborative programme would help regional lecturers to develop their skills and competence. Involvement of regional professionals would prevent to some extent the brain drain of well-trained professionals in countries of South Eastern Europe.
Regional training collaboration would be a suitable start for development of research in South Eastern Europe. It would facilitate consortia research proposals as requested from different funding agencies.3
Development of regional programme would support the emergence of professional identity and collegiality among students and teachers in South Eastern Europe.
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Conclusions |
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TopAbstractThe concept of regionalityAdvantages of a regional...ConclusionsReferences |
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Notwithstanding differences, all public health training institutions in South Eastern Europe should make a joint effort towards establishing a regional training programme. A suitable start would be the development of short modules for public health specialists working in field leadership positions who cannot leave the job for a full time training programme. Regional collaboration in development of short training modules in English language would provide the means of excellence of the overall teaching programme provided by each national institution. Successful implementation of short training modules may facilitate the obtainment of Master of Public Health degrees in all countries of South Eastern Europe, especially for young students who have a good command of English and seek a career in public health.
The Public Health for South Eastern Europe and the joint project between Open Society Institute and the Association of Schools of Public Health in the European Region are mainly devoted to development of teaching curricula at postgraduate level. We believe that, besides the standardization of teaching programme, countries of South Eastern Europe should strive for joint modular training courses in English language.
In conclusion, regional training programme would give a chance to all countries of South Eastern Europe to participate and develop something within and for the region. Regional ownership is very important in view of the unique needs to be met in most countries of South Eastern Europe, where infectious diseases, environmental pollution and war consequences are still considered major public health challenges.
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References |
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2 Tulchinsky TH, Varavikova EA. The New Public Health: An Introduction for the 21st Century. San Diego: Academic Press, 2000:735–77.
3 Laaser U. The institutionalisation of public health training and health sciences. Proceedings of the international conference on developing new schools of public health. Public Health Rev 2002;30:71–95.
4 Public Health Collaboration in South Eastern Europe (PH-SEE): A project of the Stability Pact. Available from: www.snz.hr/ph-see. Accessed: 15 July (2002).
5 Kovacic L, Laaser U. Public health training and research collaboration in South Eastern Europe. Med Arh 2001;55:3–5.[Medline]
6 Bardehle D. Minimum Health Indicator Set for South Eastern Europe. Croat Med J 2002;43:170–3.[Medline]
7 Association of Schools of Public Health in the European Region (ASPHER). Available from: www.ensp.fr/aspher. Accessed: 15 July (2002).
8 Tulchinsky TH, Varavikova EA. The New Public Health: An Introduction for the 21st Century. San Diego: Academic Press, 2000:727.
9 European Ministers of Education: The Bologna Declaration on the European Higher Education Area. Bologna, June 19, 1999. Available from: http://www.med-net.nl/topics/news/bologna.htm. Accessed: 15 July (2002).
10 Laaser U, Donev D, Bjegovic V, Sarolli Y. Public Health and Peace (editorial). Croat Med J 2002;43:107–13.[Web of Science][Medline]
Received March 19, 2003, accepted October 14, 2003
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