TRAINING AND RESEARCH SUPPORT CENTRE and …

1 TRAINING AND RESEARCH SUPPORT CENTRE and UNIVERSITY OF zimbabwe department OF community medicine (DCM) PUBLIC HEALTH WINTER SCHOOL SHORT COURSE TRAINING REPORT OF THE PUBLIC HEALTH WINTER SCHOOL TRAINING July 9-14 2007 UZ Health Sciences Building, Harare, zimbabwe July 2007 Report produced by TARSC 8/07 1 Table of contents Executive Summary 1 Background 2. The course Introduction to the course Introduction to epidemiology and public health Epidemiology of HIV and AIDS: Current situation. HIV and AIDS Prevention, treatment and care. Epidemiology and management of TB and Malaria Nutrition and food security: issues and multisectoral responses Assignment one : On Public health zimbabwe s health services and district health systems Primary health care policies and practice Managing and retaining health workers at district level Essential drug supplies and rational drug use Health care financing in zimbabwe Financing of HIV and AIDS prevention, treatment and care Mechanisms for community participation in health Panel discussion: Non health sector roles in health: Assignment two: On community diagnosis to improve health Presentation skills 3.

2 The course evaluation, text and closing sessions Test of knowledge Course evaluation Follow up and other sources of TRAINING Course certificates and closing remarks Appendix 1: TRAINING programme Appendix 2 : Student list 2 Executive Summary The University of zimbabwe , department of community medicine (UZ-DCM) together with the TRAINING and RESEARCH SUPPORT CENTRE (TARSC), held for the third year the Public Health Winter School short course- TRAINING programme at UZ Health Sciences Building from the 9th-14th of July 2007. The structure and content of the course was based on the findings from a needs and capacity assessment carried out by the two institutions in 2005 and the feedback from the July 2005 and July 2006 Winter School courses. The programme was aimed at building capacities for people working particularly at district level in health-related work, but who may not have had the benefit of formal TRAINING in health.

3 The course included people from government, education, social welfare, from health related civil society, from researchers working at community level and parliament technical staff including reporters. The course aimed to build an understanding of public health and of health systems, particularly at district level. The course covered Principles of public health and epidemiology Major public health issues, including HIV and AIDS, TB, Malaria, nutrition Elements of health systems, health financing, essential drug supplies and human resources for health zimbabwe s health services at national, district and primary healthy care level community and non health sector roles in health An open invitation was made for applicants and of the pool of 50 applicants a total of 29 people were accepted and 27 participants attended the course, 20 women and 7 men. Participants included district level officers from various government ministries, non governmental organisations, civil society and RESEARCH organisations working on HIV and AIDS programmes and reporters from the parliament of zimbabwe .

4 Participants came from or worked in various districts across the country. There were enquiries from foreign students some from as far as Nigeria but these could not be taken on this year as they all needed sponsorship. The resource persons and facilitators for the course came from the University of zimbabwe , TRAINING and RESEARCH SUPPORT CENTRE , Ministry of Health and Child Welfare, National AIDS Council of zimbabwe , Food and Nutrition Council of zimbabwe , Non governmental organisations (CWGH, WAG) Parliament of zimbabwe and City of Harare Health department . Sessions were accompanied by handouts and course materials. Two assignments were done by the students in groups to test their public health and health systems knowledge. The second assignment also involved development and feedback on a community based project. This will be followed up on to SUPPORT community level RESEARCH skills. Students completed a course evaluation form at the end of the TRAINING to give feedback on the strengths and weaknesses of the TRAINING .

5 The evaluation indicated that students found the course relevant to their work and the course useful. Students rated trainers and materials as good. The majority of students understood the lectures, and found the handouts and assignments clear and appreciated the zimbabwe relevant content. For future courses students proposed the inclusion of various other topics not covered especially introduction to RESEARCH methods and grant proposal writing. The course included discussion on further TRAINING opportunities for these areas. Various subjects were also suggested for the proposed follow up advanced course. An end of course test was completed with all students passing. The Dean of the School of medicine Prof MM Chidzonga gave closing remarks and handed out Certificates of completion to students marking the end of the Course. 3 1 Background The University of zimbabwe , department of community medicine (UZ-DCM) together with the TRAINING and RESEARCH SUPPORT CENTRE (TARSC), held the third Public Health Winter School short course- TRAINING programme at UZ Health Sciences Building from the 9th-14th of July 2007.

6 The programme is aimed at building capacities for people working particularly at district level in health-related work, but who may not have had the benefit of formal TRAINING in health. The course thus aims to include people from local government, from health related services and sectors working in areas related to health at district level, from civil society and from community leaders with roles in health. The course aims to build an understanding of public health and of health systems, particularly at district level. The course covered Principles of public health and epidemiology Major public health issues, including HIV and AIDS, TB, Malaria, nutrition Elements of health systems, health financing and human resources for health zimbabwe s health services at national, district and primary health care level community and non health sector roles in health Participants were selected from 50 applicants who responded to an open call, and a total of 27 participants attended the course, 20 women and 7 men.

7 Participants included district level officers from various government ministries, non governmental organisations, civil and RESEARCH organisations working on HIV and AIDS programmes and the committee clerk and reporters from parliament of zimbabwe . The course involved teaching, presentations and mentored assignments. The course programme is shown in Appendix 1. Students carried out two mentored assignments during the course to consolidate their knowledge in areas of Public health, and Health systems. Handouts were provided for each session in the programme, and a list of reference materials and useful websites made available for follow up reading on subject areas. An end of course test was completed and certificates of completion were given at the end of the course. The course was jointly administered by UZ DCM and TARSC. Proceedings of the one week TRAINING course are briefly outlined below. A full set of handouts and reading materials is provided with the course.

8 The sessions provided time for questions and discussion. These discussions were very lively and gave time for delegates to raise issues arising from their work in the districts. They are not recorded here. 2. The course Introduction to the course The background, course overview, objectives and participant introduction was facilitated by Professor S Rusakaniko UZ-DCM and Dr Rene Loewenson TARSC. 4 An Introduction to public health Introduction to epidemiology and public health Dr Rene Loewenson TARSC, gave a general introduction to the principles of public health and key concepts in epidemiology and how they are used in public health. She defined public health, and outlined using examples from zimbabwe the basic elements of public health, the measures and concepts in epidemiology, how the data is collected and used and how it is applied to address public health. Epidemiology of HIV and AIDS: Current situation.

9 Dr A Mahomva (Elizabeth Glazier Pediatric HIV and AIDS Foundation ) gave an outline of the epidemic pattern of HIV and AIDS: the transmission mechanisms and natural history of AIDS and the trends globally and in zimbabwe of the epidemic. She informed delegates of the distribution and determinants of HIV, and the current levels and trends in the HIV and AIDS epidemic through prevalence, incidence and mortality data. She used the evidence to describe patterns of vulnerability and susceptibility in HIV and AIDS and the major public health challenges this raises and the opportunities for responses. HIV and AIDS Prevention, treatment and care. Dr T R Bwakura, a Specialist physician ( Ministry of Health OI Clinic) outlined the options for prevention, treatment and care for HIV and AIDS, as well as for opportunistic infections. He also outlined the current options for Antiretroviral treatment (ART) and the issues related to managing treatment and care in zimbabwe .

10 Epidemiology and management of TB and Malaria Dr C Duri (Harare City Health department ) outlined the current distribution of Tuberculosis (TB) in zimbabwe , its distribution and causes. His presentation explored that TB is, and what TB infection is, the major sources of TB infection and the progression from infection to disease. He outlined the current TB trends including the new XDR strains and how TB can be controlled and managed, making clear the roles of communities and health services. On Malaria, Dr J Chirenda UZ DCM provided information on the epidemiology of malaria, the burden of malaria, and its transmission in Africa, zimbabwe . He discussed with delegates the burden posed by malaria on health systems, on households and local economies and how these can be prevented and dealt with. Dr J Chirenda gave a practical presentation on experiences of managing malaria. Both sessions outlined and discussed the steps to establish a community approach to TB and Malaria management with participants.