Best Practices for Global Health Programs

Identifying interesting approaches to global health education

Sustainability and Scale

Topic Status: 

Identify UCSF programs which appear to demonstrate sustainability over a period of time.

Such programs are likely to have broad campus support and a commitment beyond an individual person.

 

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IGOT has grown steadily since it's inception (2006) considering limited funding & administrative/organizational infrastructure. IGOT has 4 programmatic pillars: Global Research Initiative, Global Knowledge Exchange, Global Surgical Education & Global Advocacy & Leadership. Within each pillar there are "gems" that are scalable such as the SMART Course SF & in-country with an interest for IGOT to co-host the SMART Course in at least 4 additional countries in the coming year (pending financial support). Research initiatives are sustained by our fellow & annually IGOT is approached by learners within & outside of UCSF interested in suporting these efforts. The Exchange Program is popular with housing & travel expenses being the limiting factor for expanding the program.

In general terms the greater UCSF "Global Surgical" community is strong with longstanding faculty support across the subspecialties. Some efforts overlap in country (such as Uganda & Tanzania) across the groups. Offering resident global electives, research support, exchange programs & education are common interests. As a collective we offer a unique strength compared to other universities.

Collective fundraising, communication tools (such as registries, open source portal to discuss/consult on cases from our partners abroad) & administartive support are common needs to ensure further scalability & sustainability.  

Twelve years of productivity attests to the Roatan Program’s sustainability and growth. Expansion through new research initiatives is already underway. Since its founding by UCSF faculty in 2003, the Program has provided over 35,000 patient-visits. The Program hosts one of the largest Pediatric Residency International Electives available to US trainees (>100 pediatric residents); the undergraduate Health Education and Advocacy Liaisons (HEAL) internship, developed with Stanford (>80 students) and a local Pediatric “Fellowship” to train a Honduran physician in Pediatrics (5 fellows).  Several student alumni have pursued advanced training in global health and several Pediatric “Fellowship” graduates have assumed healthcare leadership positions in Roatán. Importantly, local leadership remains strongly supportive of the UCSF-Roatán Program.  Both Drs. Omar Brito (current Ministry of Health Bay Islands Director) and Dr. Raymond Cherington (former Roatán program fellow and current PHR Medical Director) continue to advocate for growth in the UCSF partnership, including expansion of training and research.   The Roatán projects have accelerated interprofessional collaboration at UCSF with nearly 200 clinical trainees hosted to date. The Program hosted two Clinical Scholars (SOM, SOD) in 2012-2013 and five Clinical Scholars (SOM, SOP, SOD), three Pathways students (SON), and one MS student (GHS) in 2013-2014.

Since the Student Training Education Program (STEP) is based out of the Family AIDS Care and Education Services (FACES) project in western Kenya, STEP has enjoyed relatively steady participation since 2006, with over 200 electives conducted during the 2006-2014 period. Furthermore, multiple participants in the program have continued on to mentor students in the program in research, thus reinvesting in the sustainability of the program.

Global Partners in Anesthesia & Surgery (GPAS - www.globalsurgery.org)

For the past 8 years this initiative has focused on building local capacity for surgery and anesthesia research, education and clinical service. Most of the program is run by partners based in Uganda, and plans are moving forward to scale our initiatives to a rural hospital in Uganda and an additional training hospital in Tanzania. These efforts are being led by faculty who have graduated from the training program with GPAS support. 

MU-UCSF collaborators in Uganda started studying malaria in 1998 and today, also includes research in the areas of TB, HIV, pulmonary disease, non-communicable diseases, immunology, parasite and drug resistance with over 20 collaborating principal investigators primarily in Uganda and at UCSF (www.muucsf.org). The goals of this collaboration are: 1) conduct high-quality research in infectious diseases; 2) build capacity through training; and 3) strengthen infrastructure to help integrate research into policy by linking researchers and policy makers. Infectious Diseases Research Collaboration (IDRC), an NGO, formed in May 2008 with the support of MU-UCSF collaborating investigators and founder members of Ugandan health scientists from MU and Ministry of Health (www.idrc-uganda.org). A Collaboration Executive Committee with members from MU, UCSF, IDRC, and LSHTM to direct and monitor goals for the scientific direction of the research collaboration. To date the collaboration accomplishments include: malaria and TB surveillance of over 750,000 patients throughout Uganda; enrolling ~230,000 persons in research studies; contribution of 250-300 publications; carrying out annual MOH dissemination meetings on malaria and HIV findings to policy makers; maintaining two high functioning research laboratories in Kampala and Tororo; and support for internal and external training programs and research symposiums for U.S. and Uganda students.