Competencies should take into account the needs of the professionals for whom they are developed. However, there is a need to think beyond the needs of local trainees and reflect on broader implications in different settings when developing global health competencies. Future work also needs to take into consideration implementation and evaluation aspects of these competencies.
Background: importance of global health competencies
- Diseases and health-related issues no longer confined within national boundaries
- A global increase in population movement and in ethnic minority populations
- Increasingly globalized and interconnected world
- Clear perceived needs for global health competencies by different health professionals
- Lack of consensus in different settings including Norway regarding competencies in global health
Mandate
- Review international initiatives and literature related to establishing national or discipline specific recommendations for Global Health Competencies.
- Review UNESCO’s 2030 framework for education and SDG education initiatives ensuring congruency.
- Establish and conduct a process for soliciting broad input in the development of Norwegian Global Health competencies
- Ensure that the proposed competencies comply with National Guidelines for higher education and training.
Process
A working group that consisted of seven members representing different institutions was established by Global Health Norway (GHN). Multiple workgroup meetings were held. Relevant literature was identified. In addition to relevant literature in the area of global health competencies, other general frameworks of relevance to the group’s work were presented and discussed during these meetings. Workgroup members read different publications, and afterwards presented a summary and their reflections to the whole group during different meetings. Afterwards, the key outputs from the workgroup were summarized.
However, the workgroup believes that validation of the suggested competencies is required in different settings including Norway. The workgroup believes this is best achieved by asking members of the academic community from different disciplines related to global health to indicate to what extent they agree with the suggested competencies and whether they have suggestions for changes and for other competencies that need to be covered.
Key considerations
The following definition of global health and the following target group for the competencies explored were first agreed upon by the workgroup:
Definition of global health:
“an area for study, research, and practice that places a priority on improving health, and achieving equity in health for all people worldwide” (1).
Target group:
The group agreed that the target group should include all students at postsecondary level in health-related fields for whom global health education is relevant. Recognizing the need now more than ever for an inter- and cross-disciplinary approach to understand and solve complex global health challenges, workgroup members also agreed on the need to focus on interprofessional competencies and not discipline-specific ones. The competencies would be relevant for organizations engaged in research and teaching in global health.
UNESCO’s 2030 framework for education and SDG education initiatives:
The workgroup also reviewed initiatives and frameworks focusing on education for sustainable development, in order to explore to what extent competencies in global health address/encompass competencies deemed relevant for attaining global sustainable development. The crosscutting key competencies for sustainability identified in the literature were particularly taken into consideration when working to identify global health competencies: systems thinking competency, anticipatory competency, normative competency, strategic competency, collaboration competency, critical thinking competency, self-awareness competency and integrated problem-solving competencies (2).
Table 1: List of proposed global health competencies classified by domain1
DOMAIN: 1. Global epidemiology of disease2
Encompasses basic understandings of major causes and drivers of morbidity and mortality and their variations between high-, middle- and low-income regions, and changes over time, and major public health efforts to reduce health disparities globally3.
- Describe the major causes of morbidity and mortality around the world, and how the risk for disease varies with regions (K)
- Describe major public health efforts to improve global health and reduce disparities (K)
- Describe how cultural context influences perceptions of health and disease (K)
- List major social, economic, commercial and political determinants of health and their effects on the access to and quality of health services and on differences in morbidity and mortality between and within countries3 (K)
- Describe the global interconnection between people, animals, plants, and their shared ecosystem, including climate4 (K)
DOMAIN: 2. Social and Environmental Determinants of Health
Focuses on an understanding that social, economic, and environmental factors are important determinants of health, and that health is more than the absence of disease
DOMAIN: 3. Globalization of Health and Health Care
Focuses on understanding how globalization affects health, health systems, and the delivery of health care.
- Describe how global trends in health care practice, commerce and culture, multinational agreements and organizations contribute to the quality and availability of health care locally and internationally5 (K)
- Describe how travel and trade contribute to the spread of communicable and chronic diseases (K)
DOMAIN: 4. Collaboration, Partnering, and Communication
“Collaborating and partnering is the ability to select, recruit, and work with a diverse range of interdisciplinary stakeholders to advance global health research, policy, and practice goals, and to foster open dialogue and effective communication” with partners, communities and within a team3.
- Exhibit interprofessional values and communication skills that demonstrate respect for, and awareness of, the unique cultures, values, roles/responsibilities and expertise represented by all professionals and groups working in global health (S)
- Acknowledge one’s limitations in skills, knowledge, and abilities (S, A)
- Demonstrate an understanding of different ways to use innovations in technology and communication to advance global networking opportunities4 (K, S, A)
DOMAIN: 5. Ethics
Encompasses the application of basic principles of ethics to global health issues and settings.
- Demonstrate an understanding of and an ability to resolve common ethical issues and challenges that arise when working within diverse economic, political, and cultural contexts as well as when working with vulnerable populations and in low-resource settings to address global health issues (K, S, A)
- Exhibit an awareness of local and national codes of ethics relevant to one’s working environment3 (K)
DOMAIN: 6: Professional Practice
Refers to activities related to the specific profession or discipline of the global health practitioner.
- Demonstrate integrity, regard, and respect for others in all aspects of professional practice5 (S, A)
- Articulate barriers and enablers to health and health care in low-resource settings locally and internationally3 (K, S)
DOMAIN: 7. Health Equity and Social Justice
"Health equity and social justice is the framework for analyzing strategies to address health disparities across socially, demographically, or geographically defined populations."
- Demonstrate a basic understanding of the relationships between health, human rights, and global inequities, including marginalized groups3 (K)
- Demonstrate a commitment to global equity, social justice and sustainable development3 (A)
DOMAIN: 8. Sociocultural and Political Awareness
“Sociocultural and political awareness is the conceptual basis with which to work effectively within diverse cultural settings and across local, regional, national, and international political landscapes.”
- Describe the roles and relationships of the major entities influencing global health and development (K)
- Demonstrate an understanding of the importance of power and context in various aspects related to global health4 (K)
1 Adapted from Jogerst et al.7
2Global Burden of Disease in the original reference
3Modified from original reference
4Not included in the original reference
5Not included at the Global Citizen level in the original reference but at other levels
A=attitude, K=knowledge, S=skills
Key reflections
Competencies should take into account the needs of the professionals for whom they are developed. However, there is a need to think beyond the needs of local trainees and reflect on broader implications in different settings when developing global health competencies. The GHN workgroup also acknowledges the need to eventually tailor these competencies to align them with the requirements of different disciplines and facilitate incorporation into curricula. Furthermore, future work also needs to take into consideration implementation and evaluation aspects of these competencies, as suggested in existing literature (15). The format in which these competencies will be implemented could benefit from innovations in information technology and communication, and account for issues related to climate change and sustainability of global resources.
Find the full summary here: GH Competencies By GHN Working Group