Specialization in Health, Nutrition and Development for MA Development Program Concept Note I. Introduction 1. Health and Nutrition constitute a vast domain of theory and practice: both state and non-state actors have been profoundly engaged in developing policies, plans and programs to achieve a minimum set of goals. Global, national and local initiatives have proliferated over the last several decades, emphasizing the importance of both health and adequate nutrition as pre-requisites for a life of dignity and well-being, even a basic human right. In the last few decades, India has made substantial progress in key indicators of health system performance, reducing infant and maternal mortality and increasing life expectancy at birth significantly. Despite this, we still have a way to go; and flagship national programs such as the National Rural Health Mission (NRHM) and Integrated Child Development Services (ICDS) need support in order to achieve their mandated outcomes. 1 The system has been constrained due to poor governance, manpower shortages and ineffective service delivery. 2 In order to catalyze a change, it is recognized that human resource capacity needs to be increased for: (i) more grounded research on factors that can enhance the capacity of the system to deliver services to those most in need; (ii) better management and monitoring of health and nutrition programs; and (iii) systematic assessment of progress towards agreed health and nutrition goals, as well as /sound recommendations for effective mid-course corrections. 3 II. Rationale and Approach 2. Given the extensive canvas of possibilities, it is important to prioritize a few areas where the Azim Premji University (APU) could make a meaningful difference. The academic program at APU is not the vehicle to develop and deliver a traditional Public Health program, which would be more appropriate for the institutions where such a specialization is currently offered: medical colleges (within Departments of Community Medicine) or institutes devoted to the study of epidemiological and biomedical approaches to health. 4 3. In keeping with the overall objectives of the MA Development program at APU, the proposed Health and Nutrition specialization will approach the topic from the 1 National Family Health Survey, Rounds 1, 2 and 3; District Level Household Survey, Round 3. 2 National Rural Health Mission mohfw.nic.in/.../nrhm_paradisgm_shift_by_dr_sundar_raman.ppt 3 Potter C and Brough R. Systemic Capacity Building: A Hierarchy of Needs. Health Policy and Planning; 19(5), 336-345; 2004. 4 Annex 8 to this note places the APU Health and Nutrition Program in the context of programs being offered at other universities.
perspective of vulnerable communities and households attempting to address their multiple health needs in the face of myriad constraints: financial, social, locational and of gender. The approach recognizes that such communities need to be provided protection against risk in a changing environment, and will examine various prominent paradigms in the sector which attempt to provide answers to this challenge. 4. The curriculum is built around two axes: (i) the overarching developmental themes of public health, which are equity, access and efficiency; and (ii) the major actors in the public health domain, namely the state, the system and the community. All courses will ensure that syllabi actively engage with equity, access and efficiency issues as they apply to the specific content they cover. III. Professional Opportunities for Students 5. What will the students choosing the Health and Nutrition specialization be equipped for after their course is done? There are several possibilities: Doing policy analysis in government and non-government think tanks such as the National/State Health Systems Resource Centers (set up under the NRHM), the National/State Institutes of Health and Family Welfare, Center for Enquiry into Health and Allied Themes, Community Health Cell, others. Managing health and nutrition programs in government, donor agency and NGO/I-NGO health and nutrition projects either as program officers or field officers. Possibilities are the ICDS program managers, as District Project Managers of the NRHM, CARE, USAID, or other field operations, among others. As part of project monitoring and evaluation teams, for consulting firms such as ORG- MARG, Ma Foi and so on, or even government programs. As the pre-requisite for an M.Phil/Ph.D. program in public health. IV. Curriculum 6. The curriculum of the Health and Nutrition program at APU ensures an effective mix of theory, practical skills, analytics and data use, exposure to global experience/lessons learned and their translation to the local context. The specialization particularly seeks to: Draw upon the theoretical foundation provided in the core courses in the M.A. Development program; and use them to trace the theoretical provenance of the dominant discourses in public health: for example, Social Determinants of Health draws consciously
upon concepts covered in Sociology of Development and Politics and Political Philosophy etc. Provide students with the knowledge and analytical skills needed to understand major health and nutrition policies, programs and transitions, and their impact on regional, national, state and local outcomes Provide also an understanding of the structures, systems and roles within the health and nutrition sectors, with a particular focus on the Health Systems Approach - the dominant analytical paradigm in the health sector today, its strengths and challenges Enable an understanding of health systems from a medical pluralism perspective Explore the challenges, constraints, opportunities and dilemmas associated with providing equitable access to quality health care and nutritional services Teach skills and tools, including basic quantitative and qualitative analytical techniques, to understand achievements and trends in the health and nutrition sectors, and conduct program assessments and impact evaluations Build the links between health, nutrition, education and other important development domains Courses Credits Faculty/Resource Persons Semester III Courses (12 Credits - required) Health and Development 4 Credits Harilal Madhavan/Benson Issac Public Health: Policy, Planning, Programs 4 Credits Shreelata Seshadri and Arima Mishra Measuring Development (cross-listed with MA Ed) 4 Credits Kalyani Subbiah and Prashanth, N.S. Semester IV (8 Credits) Health, Nutrition and Education (cross-listed with MA Ed) 4 Credits Shreelata Seshadri Health Education and Communication 4 Credits Kalyani Subbiah Social Determinants of Health 4 Credits Arima Mishra Health systems organization and financing 4 Credits Harilal Madhavan
Period of assignments in various fields of Health domain The field engagements are integrated in the curriculum and are planned at various level of the course. This includes: Six weeks internship (Mid-May to Mid- July) - This activity is to enhance the understanding of the students regarding various organizations in the domain of health and support them to get engaged with a project implemented by the organization. They are expected to work closely with an organization, get associate with a project/program, involve in the implementation and experience the dynamics, challenges, output etc. This is planned at the end of the 2nd semester. 8 weeks Independent field project (November to Mid- January), where the students can choose either a research study, work out a business plan, prepare a training module or associate with an organization/community for developing and/or implementing a plan of action. Semester long Independent Study, which is planned as an elective in the 4 th Semester (Mid January to Mid-May) where the students need to conduct a research study, in a topic as per their interest. This need to be in Bangalore as the regular activities of the University will be also ongoing simultaneously. Mentoring process A two fold mentoring- by the University and by the organization - is adopted to enable the best learning opportunity to the students. Overall role of organizational mentor is supporting the students to get optimum exposure to field realities and to maintain constant relationship with the students and the University. The specific roles differ as per the difference in the expectations from each field assignment.
In the six week internship, the mentor s role also include setting up ideal target to the student in coordination with the University mentor and also playing a key role in evaluation and grading of the student. In the 8week Independent field project, it is supporting the students in designing, structuring and conducting a study, or providing them an enabling environment for preparation of training module or implementing a plan of action, as jointly designed by the University, Organization and the student. The semester long independent study requires constant input and feedback to the students in respect to the field realities, supporting them to build up relation with the study populace etc.