ENVIRONMENTAL HEALTH PROJECT

SLOVAKIA: Environmental Health Curriculum Development

WORK PLAN

July 2, 1997

SUMMARY

Project Name: Slovakia: Environmental Health Curriculum Development

Country/Region: Slovakia

Provider Name: Environmental Health Project

Duration: June 1997 - September 1998

Overall Objectives:

1. Develop a course in environmental health for at least two target audiences -- students of the Faculty of Health Economy and students of the Faculty of Natural Sciences at Matej Bell University in Banska Bystrica.

2. Achieve sustainability of the course at Matej Bell University.

3. Stimulate communication and collaboration across Faculties, Universities, and other institutions to enhance the teaching of environmental health.

USAID SO: 3.3 -- Reduced Environmental Risks to Public Health

• Background

In 1995, the Bureau for Europe and New Independent States (ENI) requested the Environmental Health Project (EHP) to help address the health consequences of environmental health in Eastern Europe. From 1995-1997, under the Promotion of Private Health markets Project, EHP conducted three simultaneous activities in Slovakia, Poland, and Romania. The focus of the activity in Slovakia was on strengthening outreach capacity and risk communication methods used by state health agencies and municipal governments to address pollution problems affecting human health, as well as establishing health promotion activities at the municipal level. In Banska Bystrica, the Municipal Environmental Office identified three environmental priorities and undertook a health promotion campaign that has already resulted in supportive action by the City Council. The SSZU in Banska Bystrica also developed and implemented a radon program aimed at homeowners. In Trnava, EHP assistance led to the establishment of a Health and Environmental Office and the formation of a broad-based committee to develop a health and environment action plan. In Martin, the SZU developed a community-based action plan aimed at reducing children's ingestion of heavy metals from the local heavy machinery plant.

In Poland and Romania, the focus of the activities was on the development and reform of pre- and post-graduate level university teaching programs in environmental health. The School of Public Health at the Jagiellonian University in Krakow, Poland established a 22-hour module in environmental health for students in their health promotion certificate program and a 200 hour post-graduate environmental health course leading to a degree in environmental health. The University of Medicine and Pharmacy in Cluj, Romania revised its hygiene curriculum for medical students, developed the capacity to teach environmental health in its family practice residency program, and developed a continuing education module in environmental health for practicing general physicians in the local area.

At a result of the EHP activities in Slovakia, three universities in the partner cities expressed interest in developing curricula in environmental health. These included:

• University of Matej Bell in Banska Bystrica (Faculty of Public Economy)

• School of Nursing and Social Work in Trnava University

• Jesenius University in Martin (Faculty of Medicine)

At the conclusion of the health promotion activity, EHP did not think that sufficient funds remained to undertake a curriculum development activity. However, a closer examination of remaining funds showed that adequate resources are available to carry out a one-year curriculum development activity, and USAID agreed that the funds should be used for this purpose. After consultation between the EHP local coordinator and USAID, a decision was made to focus the activity on the University of Matej Bell in Banska Bystrica, although EHP should design the activity so that faculty from other universities could also participate.

The activity supports USAID Strategic Objective (SO) 3.3 -- the reduction of environmental risks to public health. The activity will be based primarily on the provision of technical assistance to support the design and development of curricula and educational materials in environmental health. The Universities will retain responsibility for the implementation and delivery of curricula, courses, and/or lectures to the respective students.

Activities to Date:

A 5-day planning visit was conducted in June 1997 by Kathleen Rest, Janusz Pokorski, and Martin Rusnak . The visit had several purposes, including to:

• Meet with representatives from USAID and Harvard Institute for International Development (HIID) to ensure that EHP and HIID activities are well coordinated (HIID is also involved in developing a training course, but focused primarily on occupational health targeted primarily towards physicians).
• Identify and work with relevant faculty members at Matej Bell University in order to clarify expectations, roles, responsibilities and likely activities for the project.
• Identify other local resources that may assist or participate in the activity.
• Gather the data and information needed to develop this workplan.
• 
  
  
• Purpose and Objectives

Purpose

The overall purpose of the project is to enhance the knowledge, skills, and abilities of people in public service to recognize how local environmental conditions can affect community health and to effectively manage interventions designed to reduce environmental risks to public health.

Objectives

EHP has established several objectives to help accomplish the purpose noted above. Specifically, the activity will:

1. Develop a course in environmental health to be delivered for the first time in September 1998 for at least two target audiences -- students of the Faculty of Health Economy and students of the Faculty of Natural Sciences at Matej Bell University in Banska Bystrica. This will involve:

• 
  
  

  a) Defining the parameters of the course, e.g., number of hours, where in the existing curriculum, type of course, etc.

  b) Identifying and facilitating the interaction of key people to participate in course development and delivery.

  c) Developing educational materials.

  d) Training the trainers in new methods of teaching and evaluation.

  e) Disseminating the curricula and materials for use by other Universities.

  2. Achieve sustainability of the course at Matej Bell University by working with faculty members to:

  a) Develop and submit a proposal and budget for the course for approval by the University.

  b) Identify other resources and sources of continued support for the course, e.g., materials, computer resources, possibilities for grants, etc.

  c) Consider whether or not a market exists to develop a full specialization in environmental health at the University.

  3. Stimulate communication and collaboration across Faculties, Universities, and other institutions to enhance the teaching of environmental health.

  Participants and Target Audience

  The course will be developed for several target groups of students. The primary target group is master's level students in the Department of Public Economics in the Faculty of Economics who are specializing in the economics and management of regional, municipal, and administrative areas. Upon graduation, these students will work for regional, municipal, and other local governments and will move into positions with budgetary and other decision-making responsibilities. The course will be a required part of their curriculum.

  Secondary targets include:

  • •Other students in the Department of Public Economics, e.g., students specializing in the economics and management of health care;
  • •Students in the Department of Ecology and Environmental Education in the Faculty of Natural Sciences (upon graduation, these students may teach environmental education in secondary schools or through NGOs and government agencies);
  • •Individuals who enroll in the distance learning and continuing education programs offered by the Department of Public Economics and the Department of Ecology and Environmental Education; and
  • •Students from other Universities who choose to participate in the project. These may include the Jesenius University in Martin (Faculty of Medicine); Trnava University (School of Nursing and Social Work); University of Bratislava; and Zvolen University (Faculty of Environmental Sciences).

  With these targets in mind, participants in the activity will be key faculty members from the Faculties, Departments, and Universities listed above, as well as environmental health experts from the Specialized State Health Institute in Banska Bystrica.

  • Approach

  The project will primarily involve the provision of technical assistance by environmental health and curriculum development experts in the form of workshops, seminars, and focused technical assistance visits. The project will also have other components.

  • Planning Visit. As described above, a planning visit was conducted in June 1997 to more fully assess the interest of key faculty members at Matej Bell University and to begin mapping the existing EH resources and abilities at or available to the University.
  • Needs Assessment. An assessment of needs, knowledge, and interest in EH will be done for two groups: public officers in regions and villages and selected students at Matej Bell University. The assessment will involve interviews with key informants and, possibly, a questionnaire. This assessment will help the EHP team and its partners design a course and materials that most appropriately address the real-world needs of those who provide public service in Slovakia's regions, municipalities, and villages.
  • Curriculum Development and Skill-building Workshops. Four workshops (2 days each) will be held during the project period. They will focus on the following:

  - developing a common understanding of the scope and framework of environmental health;

  - sharing information and materials in EH;

  - developing a curriculum in EH;

  - exploring new methods for teaching; and providing methods for evaluating curricula and courses.

  • Special Presentations. At the suggestion of faculty members from the University, EHP team members will make special presentations on relevant EH topics for students and faculty members during their visits. These presentations will help publicize and promote interest in the project, as well as provide the latest information on technical areas within environmental health.
  • Technical Assistance. The EHP team will provide advice and assistance to partners during the project period to help ensure successful completion of the activity. This may involve ongoing assessment of progress and problems; assistance in preparing a business plan or funding proposal for implementation of the course; development of specific educational materials; facilitating networking among participants; identifying resource material; etc.
  • Study Tour. During the project, a one-week study tour will be arranged and provided to 3-4 active participants to further enhance their knowledge and experience in EH education, research, and practice. This tour may be to Krakow, Poland where EHP team member Janusz Pokorski has already coordinated the development and delivery of an EH course or to an appropriate site in Western Europe, such as the WHO European Centre for Environment and Health in Bilthoven, Netherlands.

  A schedule of activities and a tentative time table is shown in Table 1.

  • Major Tasks

  TABLE 1. Project Activities and Tentative Time Table
  DATE	Tech Assis(TA) Workshop (W)	EHP TEAM MEMBERS	CONTENT OF ACTIVITY
  Activity: ASSESSMENT of KNOWLEDGE, PRACTICES and NEEDS
  July-September, 1997	TA	M.Rusnak	* Conduct needs assessment with target groups: municipalities, teachers and students from participating universities
  Activity: 1st VISIT
  Last Week of October 1997 (Mon,Tue,Fri)	TA	K. Rest/L.Pepper, B.Hollister, M.Rusnak	* Review Changes/Progress SinceJune Visit * Discuss Project Plans & Any Ongoing Education * Special EH Presentation (Tentative)
  Last Week of October 1997 (Wed,Thu)	W	K. Rest/L.Pepper, B.Hollister, J. Pokorski, M.Rusnak	* Presentation of EHP Workplan * Define the Framework of EH * EH Problems in Slovakia (E.Fabianova) * Map Existing Abilities * Create Workgroups and Define Tasks * Create a Task Force * Networking
  Activity: 2nd VISIT
  Early December or Early January (Mon,Tue,Fri)	TA	K. Rest/L.Pepper, B.Hollister, M.Rusnak	* Assess Progress * Discuss Needs and Requirements * Identify Barriers and Problems * Special EH Presentation (Tentative)
  Early December or Early January (Wed,Thu)	W	K. Rest/L.Pepper, B.Hollister, J. Pokorski, M.Rusnak	* Framework for Curriculum Development * Review Workgroup Activities/Progress * Cover Technical Topics, such as: - Pathways of Exposure - Health Effects - Risk Assessment * Review WHO EH Textbook
  Activity: 3rd VISIT
  February (Tue, Wed, Thu, Fri)	TA	J. Pokorski, M.Rusnak	* Assess Progress * Discuss Needs and Requirements * Identify Barriers and Problems * Special EH Presentation (Tentative)
  Activity: 4th VISIT
  March (Mon,Tue,Fri)	TA	K. Rest/L.Pepper, B.Hollister, M.Rusnak	* Assess Progress * Discuss Needs and Requirements * Identify Barriers and Problems * Special EH Presentation (Tentative)
  March (Wed,Thu)	W	K. Rest/L.Pepper, B.Hollister, J. Pokorski, M.Rusnak	* Finalize Curriculum and Prepare Proposal for Course * Report of Workgroups * Teaching Methods * Planning Interventions in EH
  Activity: STUDY TOUR
  April (1 week)		3-5 participants, M.Rusnak	* Study EH education and/or research and/or practice in Cracow or Western Europe * Establish contacts and learn about resources
  Activity: 5th VISIT
  April (Tue, Wed, Thu, Fri)	TA	J. Pokorski, M.Rusnak	* Assess Progress * Discuss Needs and Requirements * Identify Barriers and Problems * Special EH Presentation (Tentative)
  Activity: 6th VISIT
  May/June (Mon,Tue,Fri)	TA	K. Rest/L.Pepper, B.Hollister, M.Rusnak	* Assess Progress * Discuss Needs and Requirements * Identify Barriers and Problems * Special EH Presentation (Tentative)
  May/June (Wed,Thu)	W	K. Rest/L/Pepper, B.Hollister, J. Pokorski, M.Rusnak	* Finalize Curriculum * Methods of Evaluation * Develop Teaching Materials
  Activity: 7th VISIT
  September (Tue, Wed)	TA	J. Pokorski, M.Rusnak	* Observe Startup of the Course

  • 
    
    
    
    

    TABLE 2. Tentative Level of Effort and Personnel by Visit
    Labour Category	Visits						Tour	Other	Total PD
    	1	2	3	4	5	6
    K.Rest or L.Pepper EH specialist	15	15		15		15		15	75
    B. Hollister trainer	10	10		10		10		5	45
    J. Pokorski occupational health specialist	4	4	6	4	6	4	14	8	50
    M. Rusnak public health specialist and project manager	10	10	10	10	10	10	20	20	100
    TOTAL Person Days (PD)									270

    
    
    

    • Expected Results

    The project expects to achieve following outcomes. It will:

    
    
    

    • Environmental health curriculum in place and taught for te first time at Matej Bell University in September 1998.
    • Students better prepared to recognized, manage, and make decisions around environmental health issues when they take positions in local governments;
    • Improved capacity of Matej Bell University to teach environmental health to its students;
    • Determination if there is a need and market for developing a specialization in the economics and management of environmental health issues within the Faculty of Economics.
    • Indicators:

    This activity is designed to address USAID SO 3.3 -- reduced environmental risks to public health -- through the education of students who will work in public service in Slovakia's regions, towns, and villages, as well as those who may work for government agencies, NGOs, schools, and health care facilities. These individuals will be in positions to affect EH risk reduction through planning and funding interventions, providing public education, and promoting policies aimed at risk reduction. Curriculum and course development is the first step in this process. Indicators of success for the project thus focus only on this first, but fundamental, step. They are listed here.

    • 2-3 faculty members from participating institutions attend and actively participate in all four workshops.
    • A cross-Faculty task force or workgroup is established to develop the curriculum and plan for implementation at the University of Matej Bell.
    • A course in EH is developed, including goals and objectives; elaborated topics; educational materials; and an evaluation strategy.
    • A budgetary proposal for implementing the course in the September 1998 is prepared and submitted to the University by the end of 1997.
    • Persons from different universities, institutions, and agencies are identified as possible teachers for the new EH course at Matej Bell University.
    • Other Universities adapt the EH curriculum developed through the project for use in their own courses or curricula.
    • Monitoring and Evaluation Plan

    EHP will monitor the progress of the project throughout its one-year duration. Specifically, it will:

    • Track progress on the indicators listed above;
    • Monitor the accomplishment of the activity and milestones listed in Table 1; and
    • Monitor the accomplishment of the project's critical success factors, which are:
    • identification of individuals who are able and willing to participate in teaching the course;
    • Institutional support for implementing the curriculum and delivering the course.
    • EHP Deliverables

    EHP will deliver following materials during the course of this project:

    • Short trip reports following each workshop and technical assistance visit;
    • A written curriculum in environmental health; and
    • A final report which summarizes the overall project activity and accomplishments.
    •  
      • PROPOSED BUDGET

      Workshops And Technical Assistance Visits

      4 workshops (2 days), with a 3-day technical assistance component (to be done by 2 U.S. team members, J. Pokorski, and M Rusnak).

      3 separate technical assistance visits, for 4 days each (to be done by Martin Rusnak and Janusz Pokorski)

      Travel

      4 trips for each of 2 U.S. team members -- to do workshops and TA visits

      6 trips for Janusz Pokorski from Krakow-- to do 4 workshops and 3 additional TA visits

      
      

      Needs Assessment

      1 day of U.S. EHP team member time to review questionnaire or interview questions

      Duplication costs

      Commodities

      approximately $11,000

      Purchase, translation, and duplication of 50 copies of WHO publication -- Environmental Health Text Book by A. Yassi (translation costs are approximately $6 per page) -- approx $4000

      Support of development and delivery of materials for use in the course

      Teaching Aides -- transparencies, videotapes

      Journal subscriptions and/or books