Institutional Responses to Ethical Challenges within Global Health Programs Shawna O'Hearn Director, Global Health Office, Dalhousie University Dr Jennifer Hatfield Associate Dean, Global Health and International Partnerships, University of Calgary’s Faculty of Medicine Canadian Conference for Global Health October 2012
Objectives ✓
Identify challenges in global health for universities
✓
Outline strategies to address challenges
✓
Highlight the principles of effective engagement
University Priorities • Education (all levels) - discussions must focus on curriculum and accreditation
• Research - Priority? • Community Engagement - foundation?
Education
Student Movement
• Medical to Determinants of Health
• Interprofessional is the future (local & global) Continuum of Learning • Mentoring (CSIH, CCGHR, CFMS) **
• Career Paths (short, medium & long term) Competency Development
Research • Gap analysis in our current work • e.g. Research with partners (ethics, engagement)
• Enhanced graduate training • Health System Strengthening
• Example: MicroResearch Training
Engagement Partnership Interactive
Adaptive Process Active Listening
Continuum of Engagement (International Association of Public Participation)
Participation Spectrum • •
• • •
Inform: give information to public Consult: get feedback Involve: work with you & let you know how your input helped final decision Collaborate: incorporate input into decision Empower: decision with public (IAP2)
Calgary: Defining and expanding partner engagement
Engagement …….. Three equally important processes 1. Sharing Information 2. Encouraging exploration of choices and option 3. Closing the feedback loop http://www.scdc.org.uk/national-standardscommunity-engagement/10-national-standards/
Encouraging Exploration of Choices and Options What has been learned about the problem? what are the options? • what are the benefits with each? • what are the risks with each? • how should the decision be made ? • by whom? • what are the barriers to implementation? •
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Closing the Feedback Loop •
• • • • •
Putting agreed to option into action Providing support for those carrying out the action Testing and modifying action if needed Assessing impact of action over time Dialogue with community over learnings and outcomes Evaluation
Principles of Engagement •
Begin by listening
•
Attend to people’s leading concerns
•
Reach and listen beyond usual community leaders
•
Frame issues for deliberation
•
Provide the right type and amount of information
Modified from Source: Public Agenda – Centre for the Advancement of Public Engagement (www. publicagenda.org)
Principles of Engagement •
Help people move beyond wishful thinking
•
Expect obstacles and resistances
•
Create multiple, varied opportunities for dialogue
and deliberation •
Respond respectfully and conscientiously to
people’s involvement •
Build long-term capacity
Engagement & Univ • Balance learning needs of students & organizations capacity
• Consider levels of engagement for faculty, partners, students • Develop mutually agreed TOR/MOUs with timelines and feedback loops • Dialogue with partners
Next Steps •
Education - Integrate GH into curriculum - Accreditation Changes - Policy Development and Implementation
•
Research - Local Training Capacity - Mentorship
•
Engagement - Feedback is essential - Understand the Continuum - Defining Ethics with Partners
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References •
Abelson, Julia & Gauvin, François-Pierre Gauvin, Assessing the Impacts of Public Participation: Concepts, Evidence, and Policy Implications. CPRN (2006). http://www.cprn.org/doc.cfm?doc=1405&l=en
•
Pinto A, Upshur, R. Global Health Ethics for Students. Dev World Bioeth 2009:9(1):1-10.
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Ethics of International Engagement & Service Learning Global Praxis: Exploring the Ethics of Engagement Abroad An Educational Resource Kit http://blogs.ubc.ca/ethicsofisl/
•
Hayes, E. (2003). Community Service-Learning in Canada: A Scan of the Field, Canadian Association for Community Service Learning www.communityservicelearning.ca/en/documents/ScanofCSLinCanada_000.pdf
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Shah, S. & Wu, T. (2008). The medical student global health experience: Professionalism and ethical implications. Journal of Medical Ethics, 34, 375 – 378.
•
Working Group on Ethics Guidelines for Global Health Training (WEIGHT), Ethics and Best Practice Guidelines for Training Experiences in Global Health. Am J Trop Med Hyg 2010 83: 1178-1182.
Merci
Asante Sana Nakurmik Thank You 17
