In response to Mozambique’s specific health challenges, ICAP at Columbia University, Mozambique’s Ministry of Health, the Instituto Superior de Ciências de Saúde (ISCISA) and the Mailman School’s department of health policy and management have established a partnership centered on a new 37-course curriculum and a series of practica as part of a new four-year bachelor’s degree program in health management and administration at the Instituto Superior de Ciências de Saúde (ISCISA). Funded by USAID, the project has remodeled ISCISA’s curriculum to create a degree program where students work directly in hospitals to receive hands-on experience and produce graduates whose skills are more aligned with Mozambique’s national health needs. Over the course of four years, graduates have the opportunity to work closely with hospital staff to create safe and efficient systems, while freeing clinicians to provide essential health care.
[Photo: Dr. Paul Thurman]
Health management students are assigned to hospitals across Maputo. While most of the students have only recently finished high school, their practica placements could represent a sea change in hospital management in Mozambique, where despite a severe shortage of physicians, doctors often work as administrators instead of focusing directly on patient care.
According to Professor Paul Thurman of the Mailman School, learning to manage health facilities is a key factor in the fight against major health threats such as HIV, because it makes health systems stronger and more efficient. “If you free up doctors’ time that’s a good thing,” he said. Professor Thurman leads the project, along with Dr. Miriam Rabkin, ICAP’s director for health systems strategies.
“If the goal is to improve health services, you have to improve some very basic systems and infrastructure as well. Otherwise it doesn’t matter how much surveillance and information we have,” Thurman explains.
Central to the curriculum are eight practica, covering a range of topics from financial management to work scheduling, where students have the opportunity to develop solutions to real life challenges. Before the new curriculum, health management students did not begin practicing in hospitals until their final year. Now students are placed directly in facilities from the outset of the program, which allows them to experience challenges and troubleshoot solutions on location from the very beginning.
Infection prevention and control — one of the cornerstones of an effective hospital — has emerged as an especially important practica. Where hospital acquired infections affect between three and 12 percent of patients in developed countries, the World Health Organization estimates this number to be significantly higher in sub-Saharan Africa. In Mozambique, where some health facilities lack soap and running water and infectious waste is often disposed improperly, patients and staff are particularly at risk. In addition to completing rigorous coursework, students learn about specific sanitation needs, such as how to manage temporary interruptions of water supply in hospitals and how to avoid cross contamination when laundry facilities are limited.
Students in the program have been instrumental in establishing measures to protect staff as well as patients from hospital-acquired infections and other hazards. Even though many students have only completed two of the eight practica, some are already showing they have the skills to manage and administer hospitals.