Sustainable Health Workforce Development through Applied Learning Methods: An Evaluation Case Study of One Health Field Attachments in Kenya and Rwanda

• In Event: Public health

Proposal

Recent and ongoing infectious disease threats have showcased a critical need for educating and training health workers that not only have the technical skills and competencies to work within their own discipline/sector, but also possess the skills to work across sectors to manage an infectious disease outbreak on a global scale (Errecaborde et al., 2018). One way to train this type of workforce is by utilizing a transdisciplinary approach known as One Health. One Health brings together disciplines such as [human] medicine, veterinary medicine, public health, nursing, and ecology to work together to effectively address emerging challenges at the interface of animals, humans, and the environment.

In the first 4 years of the USAID One Health Workforce (OHW) project (2014-2019), a number of partner higher education institutions have developed and implemented training programs centered around the One Health Core Competencies (OHCC). To satisfy the competency domain areas of collaboration & partnership, culture, values, and leadership (Frankson et al., 2016), the OHW project, in collaboration with the One Health Central and Eastern Africa (OHCEA) university network, has implemented multidisciplinary Field Attachments in 7 countries. Field Attachments are field-based applied learning experiences that bring together students from various health disciplines to work with communities to develop and implement community-based interventions that are informed by a community assessment of health priorities.

This paper looks at a comparative evaluation case study of two One Health Field Attachment programs in Kenya and Rwanda. The OHW project, in collaboration with the OHCEA university network and partner evaluators at the University of Minnesota and Tufts University, commissioned a program evaluation that endeavored to answer the following questions: Does the One Health Field Attachment program contribute to the creation of a One Health workforce (particularly in the areas of fostering multisectoral collaboration and the creation of an enabling environment for One Health professionals)? What has been the immediate and longer term experience for program participants (faculty, students, and the communities in which they work)? How do program participants view the project’s sustainability, and have university partners created sustainability plans to continue the One Health Field Attachment program absent funding from the OHW project?

An evaluation team conducted individual semi-structured interviews with faculty and community supervisors who have participated in the program, and led semi-structured group interviews with past student participants and with the communities in which they work. The team then conducted a deductive thematic analysis of participant responses and also surveyed content such as past reports, surveys, and publications related to the program.

In evaluating and comparing the One Health Field Attachment programs in Rwanda and Kenya, the team found a large difference in the programs’ structures, instructional methods, learning outcomes, and plans for sustainability. In Rwanda, while the program accepts a wider range of disciplines from across the health and social sciences, students and faculty expressed different ideas of what One Health looks like in practice. While this approach proved less effective at breaking down discipline “silos,” the looser structure allowed for it to be adaptable to change, which included the incorporation of an active response effort to an outbreak of Rift Valley Fever that occurred in the community site. In Kenya, despite being a newer program, the structure was informed by the long history of field attachment programs in the country’s schools of public health and veterinary medicine. Faculty exhibited a strong appreciation for One Health, which participants expressed had contributed to an increase in multisectoral collaboration both amongst students and community partners. In addition, past student participants described ways that the program has helped them incorporate a One Health perspective into their current careers and projects. On the issue of sustainability, partner universities in Kenya have begun efforts to incorporate a One Health approach into their current university field attachment programs, which they expressed will help ensure the continuation of the program absent funding from the OHW project. This process of integration into the existing university curriculum can inform other countries’ programs as they begin exploring sustainable ways to continue the One Health Field Attachment programs.

The results and recommendations of this evaluation are important not only for internal program development, but also for the larger field of international and comparative education. While there is a growing international interest in integrating One Health into higher education curricula, there exists a lack of standardization across formal and informal sector specific and cross-sectoral training programs. This paper helps to satisfy a need for increased research that can inform educators on best practices for implementing multidisciplinary experiential learning programs to prepare multidisciplinary workforces that are better equipped to prevent, detect, and respond to infectious disease threats.

Author

• Ian Kenneth Allen, University of Minnesota