CASE STUDIES IN PRIMARY HEALTH CARE Syllabus

221.635.01 | AY 2013-2014 - 3rd Term | 4 Credit(s)
TTh 1:30:00 PM
  • Contact Information
    Faculty
    Henry Perry
    Henry Taylor
  • Course Learning Objectives

    Upon successfully completing this course, students will be able to:

    • Describe the key concepts of the SEED-SCALE and illustrate their use in a description of a plan for implementing Community Based Primary Health Care
    • Demonstrate practical methods of promoting participatory activities in communities and action groups
    • Comprehend the methods for examining the conditions and practical techniques for developing partnerships to improve bottom-up participation of communities, top-down support by officials and outside-in stimulation by experts
    • Explore in depth and be able to describe concepts of equity, justice, sustainability, scaling up, the tilting point in community empowerment and challenges in promoting changes in behaviors and social norms
    • Describe strategies of multisectoral collaboration and integration within health services and demonstrate the methods for analysis of these strategies
    • Identify successes and failures or weaknesses of each case study and describe the lessons learned from them
    • Overall objectives of this course are: 1) to help students clarify their own values and attitudes in developing partnership relationships with communities and colleagues
    • To facilitate students' ability to Discuss participatory methods in building community capacity to solve priority problems in varied health care settings
    • To build on students' prior experiences and help them develop skills in learning how to use case studies in their own work and teaching
    • To facilitate students' ability to scale up community-based succeses from a local situation to general extension
  • Course Description

    Introduces students to the origins, concepts and development of community-based primary health care through case studies from both developing and developed countries. Like clinical bedside teaching, the course uses real cases to help students develop problem-solving skills in practical situations. Participatory approaches in the organization and management of health services and other factors such as equity, socio-cultural change and environmental protection are discussed.

    Additional Faculty Notes:

    Class Time

    Duration: 16 sessions; Third Term, 21 January to 14 March 2014

    Time: Tuesday and Thursday: 1:30 pm to 3:20 pm

    Room: W2017

  • Intended Audience
    Those who have an interest in the practical issues of implementing primary health care programs in developing countries.

    Additional Faculty Notes:

    This course is designed for students who expect to promote and participate in community-based programs. It is not appropriate for those whose interest is in basic research dealing with numbers rather than people, or patients rather than communities.

    This course is an elective for the Certificate in Community Based Public Health.

  • Methods of Assessment

    Student evaluation based on discussion, participation and a final paper.

    Additional Faculty Notes:

     

    Expectations and Evaluation

    This course is designed for students who expect to promote and participate in community-based programs. It is not appropriate for those interested in basic research dealing with numbers rather than people.

     Active participation is essential. Almost half of the class time is experiential. Small groups discuss issues raised by the readings and lectures. Group work culminates in a final presentation to the class.

    The lectures assume the required readings have been done in advance. There will be one to two hours of preparation for each hour of class. There is more reading in the first half of the course, and more group work later on. Pay close attention to the CoursePlus syllabus for more detailed guidance.

    The class will review at least 16 cases demonstrating important concepts of Community-Based Primary Health Care. Each case will be described in documents on the course website, or PDF files with accompanying MP3 audio, also in the course website. Required readings are, indeed, required. For most cases, additional background documentation is available on the course website. We encourage students be creative in identifying additional sources that can be added to our archive for future classes.

    Grading

    This class has always sought to:

    • Engage students as active learners
    • Respect each student’s unique experiences, perspectives and contributions
    • Synthesize what has been learned so it can be applied

    ·         Enable each student to make a real difference at the community level.

    Therefore, we will evaluate performance based upon how well assignments reflect each student’s understanding of: the cases presented, the key concepts of Primary Health Care, and the student’s ability to apply the concepts to other real-world situations.

     

    The student’s final grade will be based on three types of assignments:

    1.      Daily Class Assignments (30%),

    2.      Group work (including class participation) and presentation (40%), and a

    3.      Referenced paper (30%).

     

    Assignment I: Daily Class Assignments and Bulletin Board Participation

    At the beginning of each day of class, we require students to submit a paper no more than one page in length that has AT LEAST ONE QUESTION to help shape the discussion that day. They should reflect your understanding of the homework for that particular class. Homework will be assigned at the end of each class for the subsequent class. In general, students will be asked to submit questions of several types:

    1.      Clarification of some point in the readings and/or on-line materials

    2.      Question about study design and methods

    3.      Criticism of some aspect of the case

    Format

    ·         Submission: At the beginning of class, a hard copy of the one-page paper will be handed to the faculty responsible for the class that day.

    ·         Identification: Header or footer on every page with:

    o   Date

    o   Name

    o   E-mail address

    ·         Length: less than one page (but at least one question)

    ·         Font: Calibri, Arial or Times New Roman

    ·         Font size: 12 points (12 pt)

    ·         Spacing: 1.15 spacing

     

    Bulletin Board

    Students will be expected to participate in CoursePlus Bulletin Board discussions. By the end of the first week of class, students should post a paragraph introducing themselves and what they hope to achieve while taking the course. The teaching assistant is available to provide assistance if necessary. The quality of work for the Daily Class Assignments and the on-line discussions will constitute 20% of the final grade.

    Assignment II. Paper (due midnight 9, March 2014)

    Forty percent of the grade will be based on a referenced paper. This will be due on Sunday, 9 March 2014 at Midnight. The paper will be a more detailed study of one of the course’s cases or one that you select in conjunction with the faculty. The paper will analyze one or more of the main topics, issues or questions discussed in the course, but from the standpoint of a specific case. We also want you to analyze the case from the perspective of one or more of the Primary Health Care frameworks we present in the first class session.


    Your analysis should demonstrate relevant insights and judgments about what happened and how the problems that arose could have been handled better. Your writing should be concise, with focused brevity. We expect you to show that you have done more extensive reading beyond that provided to the entire class, and extra credit will be given for bringing into your paper information from references that reflect a thoughtful understanding. These may be from the reference materials for the course that have been posted on CoursePlus or material you have identified yourself as relevant – either from peer-reviewed journal articles, from the “grey” literature (technical documents not published in peer-reviewed journals), from materials available on the internet, or from personal experience – either your own or someone else’s.  (Do be careful that Internet material is valid – the Welch librarians are a tremendous resource!)

    We expect you to state how you might improve on the methods used in the case study or resolve problems that were unsolved at the end of the case study. We are particularly interested in your thoughts regarding how health impact, equity and sustainability could have been improved. Submissions after the deadline without permission will be penalized.

    Format

    ·        Length: At least 8 and not more than 10 pages

    ·        Submission: Via CoursePlus Drop Box

    ·        Identification:  Header or footer on every page with:

    o   Date

    o   Name

    o   E-mail address

    o   Page Number

    ·        Font: Calibri, Arial or Times New Roman

    ·        Font size: 12 points (12 pt)

    ·        Spacing: Double-spaced

     

    Referencing Guidelines

    We expect your submitted paper to have an adequate balance of articles from peer-reviewed scientific journals, from books, and from Internet sources. Particular attention will be paid to the quality of the sources cited. We do not recommend that you base your arguments on Internet sources exclusively. Much of the relevant work in CBPHC is, however, in the “grey literature.” Do be careful that the Internet material is valid.

    We strongly recommend using the Welch librarians to assist your literature search! Talk to one of the librarians at the Welch Main desk. Peggy Gross (mgross21@jhmi.edu) is most helpful if you take specific questions to her or several articles similar to additional ones you are looking for. She is an expert at finding information.

    Proper referencing is essential. All quotes should be identified with quotation marks, and authorship should be acknowledged. Do not paraphrase text. Either quote it exactly as it is written or include the ideas in your own words. Follow a consistent format for all your references.


    Two commonly used referencing formats in public health and health allied sciences journals are those proposed by the American Psychological Association (APA) and the International Committee of Medical Journal Editors (ICMJE):

    ·               APA (American Psychological Association): A summary of rules from the APA Publication Manual is available online at: http://www.psywww.com/resource/apacrib.htm

     

    ·               ICMJE (International Committee of Medical Journal Editors): General guidelines are available online at: http://www.icmje.org/manuscript_1prepare.html

    For references from the internet follow the guidelines recommended by APA available on-line:  http://www.apastyle.org/manual/related/electronic-sources.pdf

     

    Assignment III. Group Project (including Class Participation)

    The group project and participation in the group and class sessions will amount to 40% of the final grade. Groups will consist of 5-6 students, and they will begin their work during the third week of the course.

    Following discussions with faculty, each group will select a primary health care project or program for which there is written documentation – either a case from the Case Archive on CoursePlus, one presented in class (for which additional documentation is available, possibly on the course website), or one selected by the group in consultation with faculty.

    The groups will then analyze the case based on what they have learned from the course, from their life experience and from each other, and from other sources.

    The group will make a presentation to the entire class summarizing the findings of their analysis. This can be conveyed in any type of traditional or non-traditional format (such as role play, drama, or a group exercise). The presentations will be judged on how well they have conveyed key concepts and principles of Community-Based Primary Health Care. Innovative approaches are encouraged.

    Academic Integrity

    Students are expected to demonstrate professionalism and ethical behavior as detailed in the Academic Ethics Code. When in doubt, please ask for guidance. We remind you that in science, ideas are property. Plagiarism is taking credit for the thoughts, ideas, or words of someone else. Always cite material that is not yours. Violations of the Academic Ethics Code can have serious consequences.

    https://my.jhsph.edu/Resources/PoliciesProcedures/ppm/PolicyProcedureMemoranda/Students_01_Academic_Ethics.pdf


    The teaching assistant for this course is Meike Schleiff (mschleif@jhsph.edu)

     

  • Prerequisites
    220.601

    Additional Faculty Notes:

    We routinely waive the requirement for 220.621 the Introduction to International Health. However, students are expected to understand and apply the basic concepts of public health, conduct a literature search on PubMed (surprise - Google Scholar is not enough - lol) and read public health journals.

  • Required Text(s)

    Additional Faculty Notes:

    Reference Materials

    Required

    Taylor-Ide, D and Taylor, C.E. 2002. Just and Lasting Change: When Communities Own Their Futures. Baltimore: Johns Hopkins University Press.

     

    Additional required readings will be presented on a weekly basis.

     

    Recommended

    Arole, M. and Arole, R. 1994. Jamkhed: A Comprehensive Rural Health Project. London: The MacMillan Press.

     

    Lankester, T. 2009. Setting Up Community Health Programmes: A Practical Manual for Use in Developing Countries. Berkeley, CA: Hesperian Press.

     

     

    Additional Reference Materials

    Copies of the syllabus, discussion guides and readings are available on the CoursePlus  website. The URL for this is http://coursePlus.jhsph.edu/. If you have any problem in accessing the website please contact one of the teaching assistants.

  • Course Schedule

    Please see the course Session for a full list of dates and items for this course.

    Additional Faculty Notes:

    Case Studies in Primary Health Care Third Term 2012 (221.635)

    21 January – 14 March 2014

    Schedule

     

     

     

    Week/ Date

     

    Leader(s)

    Week 1
    Tues 21 Jan

    Lessons from the Previous Century in the Development of Primary Health Care

     

    1:30-1:50

    Course Overview

    Henry Taylor/Henry Perry/Archie Golden/Bob Parker

    1:50-2:20

    Video – Carl Taylor

     

    2:30-3:20

     

    Bob Parker

     

    Evolution of Carl Taylor’s thinking about Primary Health Care

    Henry Taylor

     

    What have we learned from pioneers of primary health care?

    Henry Taylor

     

    Orientation and homework for next class session

    Bob Parker/Henry Perry

    Thurs 23 Jan

    Orientation to Primary Health Care

     

    1:30-2:20 Primary Health Care Frameworks-1

    Henry Perry/Henry Taylor

    2:30-3:20

    Primary Health Care Frameworks-2

    Henry Perry/Henry Taylor

     

    Orientation and homework for next class session

    Bob Parker/Henry Perry

    Week 2

    Tues 28 Jan

    Two Classic Examples of Primary Health Care

     

    1:30-2:20

    The Narangwal Project

    Bob Parker

    2:30-3:20

    The Jamkhed Project

    Henry Perry/Meike Schleiff

     

    Orientation and homework for next class session

     

    Thurs 30 Jan

    Innovations in Primary Health Care Research and Scaling Up

     

    1:30-2:20

    SEARCH

    Bob Parker

    2:30-3:20

    BRAC and Bangladesh

    Henry Perry

     

    Orientation and homework for next class session

     

    Week 3

    Tues 4 Feb

     

     

     

    Taking Primary Health Care to Sclae in China and Mozambique

     

    1:30-2:20

    The China Model Counties Project

    Bob Parker

    2:30-3:20

    Mozambique Care Group Project (Food for the Hungry)

    Henry Perry

      Orientation and homework for the next class session

     

    Thurs 6 Feb

    Examples of Primary Health Care in Urban Baltimore and Rural West Virginia

     

    1:30-2:20

    East Baltimore, primary health care, and Johns Hopkins

    Archie Golden and Lee Bone

    2:30-3:20

    Community-Oriented Primary Care (COPC) Implementation in the United States

    Henry Taylor

     

    Orientation and homework for next class session

     

    Week 4

    Tues 11 Feb

    Examples of Primary Health Care from the Western Hemisphere

     

    1:30-2:20

    Cases from Latin America and the Caribbean (Bolivia, Peru, Guatelama, and Haiti)

    Henry Perry

    2:30-3:20

    Primary Health Care in Brazil: A Natonal Case Study

    Henry Perry

     

    Orientation and homework for next class session

    Henry Taylor

    Thurs 13 Feb

    Examples of Primary Health Care in Africa

     

    1:30-2:20

    The Origins of the Care Group Model in Mozambique

    Anbrasi Edward

    2:30-3:20

    The Navrongo Project/Ghana

    Henry Perry and Jim Phillips

     

    Orientation and homework for next class session

    Henry Perry

    Week 5

    Tues 18 Feb

    Examples of Primary Health Care for the Underserved in the United States

     

    1:30-2:20

    Roots of COPC in the United States

    Bob Lawrence

    2:30-3:20

    A Century of Community Health Centers

    Henry Taylor

     

    Orientation and homework for next class session

    Henry Taylor

    Thurs 20 Feb

    Facilitated Group Work and Discussion: Community Participation

     

    1:30-2:20

    Group work

    Faculty and students

    2:30-3:20

    Discussion

    Faculty and Students

     

    Orientation and homework for next class session

    Henry Perry

      Part 1 of the final assignment is due  
    Sunday 23 Feb Take home exam due (11:59pm)  

    Week 6

    Tues 26 Feb

    Facilitated Group Work and Discussion: Equity

     

    1:30-2:20

    Group Work

    Faculty and students

    2:30-3:20

    Dicsussion

    Faculty and students

     

    Orientation and homework for next class session

    Henry Perry

    Thurs 28 feb

    Facilitated Group Work and Discussion: Intersectoral Collaboration

     

    1:30-2:20

    Group Work

    Faculty and students

    2:30-3:20

    Discussion

    Faculty and students

     

    Orientation and homework for next class session

     

    Week 7

    Tues 4 Mar

    Other Recent Advances

     

    1:30-2:20

    Group Work

    Faculty and students

    2:30-3:20

    Discussion

    Faculty and Students

     

    Orientation and homework for next class session

     

    Thurs 6 Mar

    Group presentations

     

    1:30-2:20

    Student presentations

    Faculty

    2:30-3:20

    Student presentations

    Faculty

    Sunday 9 Mar Final Assignment due in dropbox (11:59pm)  

    Week 8

    Tues Mar 11

    Group presentations

     

    1:30-2:20

    Student presentations

    Faculty

    2:30-3:20

    Student presentations

    Faculty

    Thurs Mar 13

    Reflection and  Bringing Primary Health Care back in the the Mainstream

     

    1:30-2:20

    Bringing Primary Health Care back into the mainstream

    Faculty

    2:30-3:20

    How do we disseminate these ideas? 

    Faculty and students

     

  • Academic Ethics Code

    Students enrolled in the Bloomberg School of Public Health of The Johns Hopkins University assume an obligation to conduct themselves in a manner appropriate to the University's mission as an institution of higher education. A student is obligated to refrain from acts which he or she knows, or under the circumstances has reason to know, impair the academic integrity of the University. Violations of academic integrity include, but are not limited to: cheating; plagiarism; knowingly furnishing false information to any agent of the University for inclusion in the academic record; violation of the rights and welfare of animal or human subjects in research; and misconduct as a member of either School or University committees or recognized groups or organizations.

  • Welcome Message

    "... the minds of the educated now soar in the realm of thought, like clouds in the sky, far away from the earth. The two could be brought together in fruitful union only if they (the clouds) were to melt and descend in the shape of rain. The new monsoon of this new age will have come in vain, if all this imposing preparation roams on in the sky only in wind and vapour. Not that there has been no shower, but the fields have not been ploughed. Nobody yet pays any attention to those places which alone, if properly irrigated by ideas, can grow a rich crop." (Sen. Sundhir. Rabindranath Tagore on Rural Reconstruction, Calcutta, Visva-Bharati, 1943, pp. 40-41)

  • Course topics

     

    Active class participation is essential. Almost half of the class time is experiential. Small groups discuss issues raised by the readings and lectures. Group work culminates in a final presentation to the class. Auditors are only allowed under highly unusual circumstances.
    The lectures assume the required readings have been done in advance. There will be one to two hours of preparation for each hour of class. There is more reading in the first half of the course, and more out-of-class group work later on. Pay close attention to the CoursePlus syllabus for more detailed guidance.
    The class will review at least 16 cases demonstrating important concepts of Community-Based Primary Health Care. For most cases, additional background documentation is available on the course website. We encourage students be creative in identifying additional sources that can be added to our archive for future classes.
  • Academic Integrity

    Students are expected to demonstrate professionalism and ethical behavior as detailed in the Academic Ethics Code (click here).

  • Contact Information(from old syllabus)

    Henry Perry, MD MPH PhD
    Email: heperry@jhsph.edu
    Office: E8008
    Tel: 410-377-0421

    Henry .Taylor, MD, MPH
    Email: hgtaylor@jhsph.edu
    Tel: 304-610-1139
    Home Page: http://faculty.jhsph.edu/default.cfm?faculty_id=1703

    Robert Parker, MD MPH

    Email: bcparker2@verizon.net

    Archie Golden, MD MPH

    Email: agolden77@comcast.net
     

  • Course Objectives(from old syllabus)

     

    SPECIFIC LEARNING OBJECTIVES

    1)     To learn practical methods of promoting participatory activities in communities and action groups.

    2)     To understand the principles of Community-Based Primary Health Care.

    3)     To critically identify successes, failures, strengths, and weaknesses in a variety of case studies in Primary Health Care; to be able to transfer these “lessons learned” to other situations.

    4)     To apply a systematic paradigm for implementing Community-Based Primary Health Care, such as SEED-SCALE, Alma Ata, CBIO, COPC, or Care Groups, to a real-life situation.

    5)     To critically examine the conditions and practical techniques for developing three-way partnerships which maximize the bottom-up participation of communities, top-down support by officials, and outside-in stimulation by change agents.

    6)     To explore challenges in promoting changes in behaviors and social norms with in-depth key concepts such as equity, justice, sustainability, scaling up, and the ‘tilting point’ in community empowerment.

    7)     To analyze and apply process strategies which enhance multi-sectoral collaboration and integration within health services

     

  • Disability Support Services
    If you are a student with a documented disability who requires an academic accommodation, please contact the Office of Student Life Services at 410-955-3034 or via email at dss@jhsph.edu.