Public Health Capacity Building Research Articles

Artificial intelligence – NPHIs’ role in utilizing its opportunities and addressing the risks

Abstract Issue & Problem National Public Health Institutes (NPHIs) in many countries are at the forefront of action to mitigate the impact of current and future threats to health as well as improving population health and wellbeing. Through research, collaboration, and support, NPHIs can approach these new realities together. One of the many emerging realities that NPHIs will need to engage in is how NPHIs best can utilise the powers of artificial intelligence and deal with the ethical and legal issues that come with it. Methods In preparation of IANPHI’s (International Association of National Public Health Institutes) Europe Regional network meeting in April 2024 a survey was conducted among the 42 members. 16 countries replied to questions, around e.g., 1) current applications of (generative) artificial intelligence (AI) in the work of institutes, 2) which experiences were made and 3) which measures NPHIs take to best utilize the possibilities and overcome challenges of AI technologies. Within four weeks 16 replies were shared. Lessons & Conclusions Some institutes have not yet adopted AI, while others report multiple applications but the primary areas of application vary considerably among Europe. Applications include summarizing and reformatting text; translation; transcribing and documenting meetings; search information in documents or databases; coding; creating visuals; literature review; surveillance of infectious diseases; disease forecasting; analysis of transmission dynamics; vaccine efficacy assessment and development; image recognition; diagnosis and prediction of diseases from medical datasets; text mining; symptom extraction; social listening; prediction of nitrate concentration in groundwater; drug analysis and measuring psychological resilience in social crisis. Key messages • AI poses opportunities and risks for public health and work of national public health institutes and capacity building initiatives are essential. • IANPHI decided to develop a joint framework for the use of AI in its member organisations with a focus on research and responsible use.

Current status of public health system in Guangdong-Hong Kong-Macao Greater Bay Area and improvement suggestion

Guangdong-Hong Kong-Macao Greater Bay Area (GBA) has three public health systems under different systems, which plays an important role in the construction of the public health system in China. Further strengthening the construction of the public health system in the GBA will play an important reference role in the optimization and upgrade of China's public health system in the future. Based on the key consulting project of "research on the strategy of the modern public health system and capacity building in China" by Chinese Academy of Engineering, this paper deeply analyzes the current status and existing problems of public health system construction in GBA and suggests to improve and innovate the mechanisms of collaborative prevention and control of public health risks, resource coordination and joint research and result sharing, information sharing and exchange, personnel training and team building in order to comprehensively improve the capacity of public health system in GBA, and promote the construction of Healthy China.

Key Learning Statements for Persistent Pain Education: An Iterative Analysis of Consumer, Clinician and Researcher Perspectives and Development of Public Messaging

Over the last decade, the content, delivery and media of pain education have been adjusted in line with scientific discovery in pain and educational sciences, and in line with consumer perspectives. This paper describes a decade-long process of exploring consumer perspectives on pain science education concepts to inform clinician-derived educational updates (undertaken by the authors). Data were collected as part of a quality audit via a series of online surveys in which consent (non-specific) was obtained from consumers for their data to be used in published research. Consumers who presented for care for a persistent pain condition and were treated with a pain science education informed approach were invited to provide anonymous feedback about their current health status and pain journey experience 6, 12 or 18 months after initial assessment. Two-hundred eighteen consumers reported improvement in health status at follow-up. Results of the surveys from 3 cohorts of consumers that reported improvement were used to generate iterative versions of ‘Key Learning Statements’. Early iteration of these Key Learning Statements was used to inform the development of Target Concepts and associated community-targeted pain education resources for use in public health and health professional workforce capacity building initiatives. PerspectiveThis paper reflects an explicit interest in the insights of people who have been challenged by persistent pain and then recovered, to improve pain care. Identifying pain science concepts that consumers valued learning provided valuable information to inform resources for clinical interactions and community-targeted pain education campaigns.

Enhancing Partner Nation Security: A Mixed-Methods Evaluation of A Peacekeeping Public Health Capacity Building Initiative.

One way the U.S. Department of Defense (DoD) works to achieve national security is through security cooperation, by way of building and enhancing partner nation capacity. This study evaluated a health-related security cooperation training initiative delivered by the DoD to military peacekeepers. The study specifically examined outcomes of change, including the beginning phase of sustainability. The U.S. DoD employed a train-the-trainer model in Ghana, Rwanda, Senegal, and Uganda to support the African Peacekeeping Rapid Response Partnership program. U.S. instructors trained 192 peacekeepers through 11 training iterations between December 2016 and March 2020. A mixed-method explanatory sequential design was used to explore training outcomes. Quantitatively, three hypotheses were tested using nonparametric statistical analysis. Qualitative analysis of documents was used to inform and contextually understand the quantitative results. This study was submitted to the George Washington University Institutional Review Board and was fully approved (NCR202918). Quantitative and qualitative results indicated improved short-term public health knowledge and upskill among partner nation participants. There was the beginning of a cascade effect of the partner nations' ability to autonomously teach tasks and skills to their military to sustain the initiative. Differences in achieving and maintaining change outcomes were related to student characteristics, the training course, and the partner nation. This research serves as the first published study to empirically examine health-related security cooperation train-the-trainer initiative change outcomes. This research is an essential building block to empirically evaluate and capture change outcomes from security cooperation capacity building training initiatives. The findings and recommendations inform security cooperation policy and associated investments.

National public health institutes: A scoping review

ABSTRACT During the last century, national public health institutes emerged to address enduring and emergency public health challenges. Previous outbreaks often compelled countries to establish national institutes of public health. Despite historic legacies and contributions to public health, no review of this literature has been published. The aim of this scoping review is to provide an overview of this literature and map characteristics including format, authorship, geographic focus, methods, language, focal topic and public health capacity building domains. The scoping review was guided the Arksey and O’Malley methodological framework and utilised the PRISMA-ScR checklist. A systematic search of Medline OVID and Scopus databases yielded 5731 records. In total, 43 articles met the eligibility criteria. Articles were published in English, Spanish, French and Russian and included perspectives from over 20 countries in Africa, Europe, North America and South America. Three reported methods or collected primary data. Findings reveal a longstanding international interest in leveraging national institutes to address complex public health challenges. Lack of studies reporting methods reveals the need for future research utilising robust methodology. Several articles recommend investment in national public health institutes as a strategy to respond to crises and strengthen countries’ public health systems.

Mental health essentials for future healthcare professionals. A public health capacity building initiative

IntroductionMental disorders in Europe represent the leading cause of disability and the third leading cause of overall disease burden, following cardiovascular disease and cancers. As future healthcare professionals, with an imminent role in tackling this global health issue, we acknowledge that Mental Health is not adequately included in the medical curriculum. To address this gap, this workshop was created to equip medical students with the knowledge and skills that will empower them to lead a pioneering role in advocating for mental health for their patients, peers, and communities.ObjectivesBy the end of the workshop, all participants should have: - Increased their knowledge in the field of Mental Health disorders - Increased their skills in the field of Mental Health (preventive practices, intervention strategies towards others, etc.) - Explored the relations between stigma, vulnerability, and Mental Health - Strengthened the international perspective and global understanding concerning mental health issuesMethodsThis workshop utilized principles of non-formal education and was planned according to the 4MAT system to meet all four learning styles through theory blocks, space for reflection, practical application of knowledge, and future opportunities for application of content. This was achieved through various methodologies including presentations, self-discovery activities and exercises, roundtable debates, simulations, and role-playing.ResultsobtainedConclusionsThis workshop highlighted the importance of building the capacity of medical students to tackle the burden of Mental Health globally and within the region, and how similar student-led initiatives can further empower them to be change agents and impactful advocates for better Mental Health in their own communities.

Emergency preparedness for public health threats, surveillance, modelling & forecasting.

In the interconnected world, safeguarding global health security is vital for maintaining public health and economic upliftment of any nation. Emergency preparedness is considered as the key to control the emerging public health challenges at both national as well as international levels. Further, the predictive information systems based on routine surveillance, disease modelling and forecasting play a pivotal role in both policy building and community participation to detect, prevent and respond to potential health threats. Therefore, reliable and timely forecasts of these untoward events could mobilize swift and effective public health responses and mitigation efforts. The present review focuses on the various aspects of emergency preparedness with special emphasis on public health surveillance, epidemiological modelling and capacity building approaches. Global coordination and capacity building, funding and commitment at the national and international levels, under the One Health framework, are crucial in combating global public health threats in a holistic manner.

Piloting a city health adaptation typology with data from climate-engaged cities: Toward identification of an urban health adaptation gap

Climate change has important population health impacts, and cities are often on the frontlines. However, health is reported to be less active in climate adaptation than other sectors. To contribute to better understanding urban health adaptation efforts and identifying gaps we developed a City Climate Health Adaptation Typology and tested it with adaptation actions of 106 large world cities (population > 1 million) reported to a major publicly-available adaptation database. We found two-thirds of actions of these ‘active adapter’ cities were health-associated. Half were health information activities (e.g., hazard mapping, early warnings); and nearly one-third addressed climate-relevant health determinants in the urban built environment (e.g., green space). Forty percent of cities were in low- or middle-income countries. Our proposed typology provides a systematic framework for monitoring and comparing city health adaptation actions. Reported city actions are suggestive of increasing depth and breadth of urban health-associated adaptation. However, even among these adaptation-engaged cities, a health adaptation gap was apparent in key climate health services (e.g., mental health), and in climate-related public health governance and capacity building. The COVID-19 pandemic has demonstrated pressing need for strong public health institutions. We recommend better integration of public health agencies into local climate action planning, enhanced modes of collaboration between health and non-health agencies and with non-governmental actors, and strengthening of city public health adaptive capacity including through networking.

Building Public Health Capacity through a Sustainable South-South-North Training Program.

.Capacity building in public health is an urgent global priority. Recently, there has been an increasing emphasis on South–South and triangular cooperation. We describe our experience with a public health training collaboration between Peru and Bolivia, with Peru providing capacity building and expertise to Bolivia, while receiving supportive funding and training from the United States. This collaboration has led to a groundswell of research on clinically significant diseases, outreach to more than 800 scientists, several dozen publications, and the start of four institutional review boards. South–South and South–South–North collaborations should publish their experiences, and Northern funding organizations should consider funding such collaborations.

8.G. Workshop: Public health systems leadership and capacity building in changing Times

Abstract Objectives There is clear need for a diverse public health work force with the training, skills and expertise to provide leadership across health systems. The purpose of the proposed workshop is to share experience and learning on system leadership and capacity building in public health, using the work of the UK Faculty of Public Health as a case study. The workshop will cover: the nature, key role and the distinguishing features of system leadership in public health;capacity building through competency-based training, adaptive public health curriculum, systematic educational and training activities; and development of multidisciplinary workforce;generation and transfer of knowledge; andthe case for value-driven workforce, systems and leadership. The Faculty of Public Health is the UK's professional standards body for public health specialists and practitioners, with over 4000 members working around the world. As the professional membership body for public health it has played a leading role in education, training, and assuring an internationally respected public health workforce and development of robust public health systems; promoted public health knowledge; and been powerful advocate for the reduction of inequalities and the very best conditions for health and wellbeing to flourish. The roundtable workshop will include experienced senior public health practitioners, academics, and leaders who will briefly present from their different perspectives. This will include consideration of the historical perspective and conceptual frameworks around system leadership; the journey towards development of multidisciplinary workforce and recognition of the diversity of the wider workforce; evolution of public health curriculum and education and training activities; knowledge transfer in leadership, advocacy and analysis; and why ethics matters and what can be done about them. There will be opportunity for reflection and discussion with participants and the panel on system leadership and capacity building, including on the merits and risks of different approaches and implications for policy research and practice. Key messages System leadership and capacity building need to be adaptive and shaped by the needs of the times and based on moral mandate of public health. Development of multidisciplinary workforce; effective generation and transfer of knowledge; and value-driven workforce, systems and leadership are key to improving and protecting the public’s health.

Value-driven workforce, systems and leadership

Abstract Background Our norms and values are key to decision making, policy and practice. Some commentators have highlighted need for greater courage and purpose in public health leaders and systems. There is need for greater appreciation of moral mandate of public health and implications for public health system leadership and capacity building activities and practice Objectives Demonstrate the case for value-driven workforce, systems and leadership Share key findings and learning from research by the Faculty of public health around the public health values, and activities to build capacity and competency around the issue. Body of the session Surveys of the public health workforce and schools of public health have consistently highlighted need for education and training in public health ethics and law for some time and their key role for effective public health policy and practice. In this presentation there will be demonstration of the key findings of the surveys and their consequences, including moral distress for the workforce and potential failings of public health systems Some key activities and initiatives in building competency and capacity in public health ethics and law will be described. This will include activities to develop organisational values and professional values and the important distinctions between them, and development of public health code of ethics and professional conduct as part of efforts for professionalisation of the public health workforce. Conclusions Value-driven workforce, systems and leadership are key in meeting complex public health challenges. Building competency and capacity of the workforce and public health institutions are important part of the agenda.

Strengthening health promotion practice

Abstract Health services in most developed countries were developed to meet the needs of a demand-led health care, and focus mostly on treatment, cure and care. This system is challenged by the growing burden of non-communicable diseases, increased multi-morbidity, newly emerging communicable diseases, and increasing anti-microbial resistance. At the same time, widening health inequalities pose an additional threat to health systems that do not give enough attention to the factors that produce health. To address these challenges, it is necessary to reorient health services towards more preventive, people-centred and community-based approaches, with a more prominent role for health promotion, integrated within the wider health system. This shift of focus requires the strengthening of health workforce capacities to effectively implement health promotion. Whereas a competent health workforce has always been considered a key condition for the delivery of effective health services, the nature of the necessary 'competencies' is being redefined in the light of the current changes of the health system. Within the diversifying primary care and public health workforce, new skills and tasks must be added to existing professional roles, new professional profiles emerge, and collaborations between professions become more important. This presentation will consider the place of health promotion workforce development within the broader context of public health and health promotion capacity building systems targeting a diversifying primary care and public health workforce. Drawing on recent reviews it will provide an overview of existing capacity development systems in primary and secondary prevention and health promotion, and consider possibilities for integration and implementation of capacity systems within and across disciplinary boundaries.

30.K. Round table: What is and what is not HIA; expectations and realities

Abstract Health impact assessment as a public health tool to contribute to development of healthy public policy and later health in all policies approach entered public health practice, research, education and policy at the end of 1990'. During last 20 years the methodology spread around the globe, tools and guidelines have been developed, potential collaboration with other impact assessments discussed or even legally mandated. A quick search in PubMed using a MESH keyword “Health impact assessment” conducted in January 21, 2020 yielded 628 publications in time period of 2010-2019. Reading the abstract of last 100 from 2019 and partially 2018 based on first authors, manuscripts came from 31 countries of all five continents, USA being the most frequent contributor. This quick search revealed also substantial heterogeneity of the use of term; epidemiological studies, often environmental epidemiological ones, health care intervention evaluation studies, methodological development studies, general evaluation studies are often using health impact assessment label. Out of 100 abstracts, 14 seemed to be in-line with description of HIA by Gothenburg consensus paper, the basic document of HIA. On one hand, this is very positive showing the wide possibilities of use of HIA. On other hand however, it is hazardous as it could lead to misunderstandings and consequently to decreased interest for the methodology. With this regard it shall be noted that after a plateau in number of publications between 2014-2017, there seems to be a consistent decline of new research papers addressing using HIA. Looking at one database only can be a limitation of course. The aim of this round table workshop is to discuss where to go with HIA during coming years, identify potential facilitators for broader implementation and use of the methodology. After introductory presentation by workshop coordinators, five presentations will discuss potential facilitators such as common language and expectations, implementation and place of HIA within public health toolkit, capacity building and recent opportunities such as health in EIA and the SDG's. The final part of the round table will be as general discussion with involvement of the audience facilitated by workshop organizer. Key messages HIA is used for different purposes, not only the one described by Gothenburg consensus paper. There is a substantial heterogeneity in use of HIA influenced by language, implementation method, available capacities and motivation.

Workshop: Capacity building in public health in Northern Africa. A common effort to develop training programmes

Abstract Background In the years that have followed the overthrow of the former autocratic regime and the democratization of the country, the CONFIDE partner country, Tunisia, has experienced positive political and economic changes. These changes have driven important reforms in the field of public health, yet this country is facing important challenges in building a modern health system and finding an integrate approach to the main national public health problems. In terms of health research system, in Tunisia there is little coordination between stakeholders and the institutions in charge of public health. Moreover, there is no specific mechanism for informing the Ministry of Health about the progress of research in Tunisia and overall there is no structure responsible for the dissemination of research results to the public. To this end, the European and Tunisian members of this consortium have designed together the present capacity building project which aims to inform public health policies in Tunisia based on evidence and contribute to the development of public health research. The CONFIDE project is contributing to the development of the public health field in Tunisia and provides knowhow and tools to the Tunisian public health professions to better collaborate with the local stakeholders. Aim of the workshop The aim of this workshop is to share the experience of the capacity building process in the public health field in Northern Africa. The workshop will discuss and analyse the structure of opportunities for change and reform and the local needs of the public health domain in Tunisia and will identify the main challenges. We will present the processes used and challenges faced, but also the ways to overcome these challenges. This workshop will contribute to the European Public Health field by increasing the visibility at European level of the efforts directed to capacity building interventions and at transferring knowhow outside Europe, specifically Northern Africa. Program The introduction to the workshop will be made by Prof. Razvan Chereches MD, PhD, Professor of Public Health and coordinator of the CONFIDE project. He will describe the methodology used for the capacity building in public health trainings programme in Tunisia. The development of the Centre for Evidence Based Public Health in Tunisia and their impact on the Tunisian local and regional levels will be presented by Prof. Fatma Cheikhrouhou. The link between the knowledge transferred to the young professionals and the policy decision makers will be described by the Tunisian coordinator of the dissemination activities, Prof. Kalthoum Kallel. MScPH Maria Palianopoulou will follow with presenting the evaluation results of the capacity building process and lessons learnt. Last but not least, the sustainability of the trainings and the local effort to integrate the knowledge into the Medical University curricula will be presented by Assistant Prof. Mohamed ben Rejeb. Key messages Discussing lessons learnt can contribute to better tools for the development of public health. Partners` perspective and culturally adapted tools are important for high quality learning process.

Round table: International capacity building to boost public health: Can we join forces and share know-how?

Abstract Background European Universities are increasingly running or participating in capacity building in higher education in non-EU countries. These projects are funded by EC, US National Institutes of Health (NIH), governments, universities or private sector. Capacity building provides a way to build global bridges between public health communities; it increases cultural understanding, develops resources in the neighboring countries and prevents public health problems spreading to Europe. For the collaborating countries it empowers communities and enhances equity and solidarity. To pool together the expertise and lessons learnt by the universities delivering this kind of education, a roundtable discussion at EUPHA offers a good forum. Aim To create a forum where public health academics, adult pedagogic experts, policymakers and practitioners gather to share experiences, interests and ideas for potential collaboration to facilitate the export of public health training across countries and cultures. Based on this, the round table will increase sharing knowledge and transparency of results of international capacity building interventions and will contribute to the transcultural fertilization of the interventions, with a special focus on solidarity in health. We will present specific ways of how to do knowhow transfer from EU countries to some other parts of the world (Northern Africa, Arabian Peninsula and the Caucasus region). Program An introduction to the roundtable is given by Professor of Public Health Arja R Aro (SDU, Denmark). She will describe recent developments and multiple lines of funding options for international capacity building projects. Professor Razvan Chereches (BBU, Romania) will talk on the lessons learned in an ongoing public health capacity building project among medical faculty staff funded by EC Erasmus+ program in Tunisia. Dr Diana Dulf will present the lessons learned in capacity building projects funded by NIH in Armenia and Georgia in the area of injury prevention. Arja R Aro will tell about the recent and ongoing knowledge transfer and education export projects among undergraduates and health professionals in Saudi Arabia funded by local universities. Pedagogical expert Anne Leena Ikonen will reflect on the pedagogic challenges in capacity building across cultures, using the Saudi Arabian context as an example. After that the panel will discuss the main lessons learnt and challenges encountered, and the audience is invited to ask questions, to share their experiences and interests. The roundtable will finish by discussing options to get organized as a network or interest group around international capacity building in public health, potentially under EUPHA. Key messages Pooling lessons learnt will help towards better and cost-effective planning of the future training. Network or interest group can offer a platform for collaboration and enhancement of European public health training and export.

Capacity building in public health with two Saudi universities: Challenges of knowledge transfer

Abstract Introduction Collaboration between SDU and two Saudi Arabian (KSA) Universities started in 2012. Case 1 was a new public university for women; the contract (until spring 2017) aimed at knowledge transfer from SDU to two Bachelor of Science curricula (Epidemiology, and Health Education and Promotion). The aim was to train the trainers by teaching the 1st student cohort 100% by the SDU staff and for later cohorts to increase the teaching by local staff gradually. The SDU teams travelled to KSA to run 1-month courses at a time. In Case 2 (ongoing since 2017), 1-week courses for health professionals are offered in an established mixed-gender university; the courses are for a fee. Lessons learnt In case 1, knowledge transfer was challenging, since the local staff was busy ‘with their own courses’ and had low interest to learn from SDU. The SDU and the local group were working as separate teams. The local staff saw knowledge transfer as receiving the slides and other material from SDU. Only in the 5th contract year, interaction started mainly via staff capacity building workshops organized by SDU. The students appreciated the SDU teaching, and on the administrative level collaboration worked very well. Due to the lack of ownership among local teachers and deficits in cultural adaptation on- site, knowledge transfer was not successful. In case 2, different cultural approaches seem to clash; SDU prefers to market the courses early and e tailor them for the target groups; the Saudi cultural tradition relies less on organized marketing and is flexible with the registration deadlines. For the 1st course, this meant that the SDU team travelled to KSA without knowing who and how many participants had signed up. Learning the background of the participants only when the course started meant that the teaching was finalized from day-to-day while running the course. In the end, based on the course evaluation, the 9 participants were very satisfied with the course.

Undergraduate public health degree courses in India: selected overview

Background: Building the public health workforce in India along with strengthening the public health systems across the Nation are essential components necessary to achieve the sustainable development goals for India. In the Indian context, there is limited information available for undergraduate public health education. The central aim of this brief study is to elucidate the undergraduate public health education landscape at selected institutions in India.Methods: A mixed methods approach was used in this brief study. First, cross-sectional, scoping review was used. Then, to describe student perceptions and attitude towards undergraduate public health curriculum, primary data were collected by using a questionnaire. A self-administered questionnaire was developed after extensive literature search. Descriptive statistics were used to summarize questionnaire results. Chi-square tests were used to help identify factors that may influence student perceptions and attitudes.Results: Through scoping rapid review and internet search, eight institutions were identified that are offering undergraduate public health courses in India. Most institutes in India have 3 years duration for the undergraduate public health degree courses. Most of students (89%) believed that the undergraduate public health course increased their knowledge in the field of public health. We found an association between student perceptions about community benefits from trained undergraduate public health workforce.Conclusions: The undergraduate public health education initiatives should be promoted and envisioned as a new strategy for public health capacity-building in public health in India.

Nuclear power and uranium mining: current global perspectives and emerging public health risks.

Despite the Fukushima power plant accident (2011), development of next-generation nuclear reactors and rapid expansion of uranium mining in low-income countries are likely to improve prospects for the nuclear industry. Trends in the nuclear energy industry have given rise to new public health challenges. Driven by high power demands, electricity production from nuclear plants has continually risen. Africa and Asia have emerged as major sources of uranium due in part to the poorly enforced labor laws resulting in low operating costs, plus less stringent regulatory frameworks. There is ample evidence of the industry transgressing environmental regulations as well as unethical practices that pose serious threats to public health. Anticipated safety issues associated with new reactors need to be addressed before promoting them as a viable alternative. This article provides recommendations for multilateral institutional collaboration on public health surveillance plus capacity building for young researchers.

Online Education for Public Health Capacity Building in Low- to Middle-Income Countries: The Peoples-Uni Experience.

People’s Open Access Education Initiative (Peoples-uni, http://peoples-uni.org) aims to contribute to improvements in the health of populations in low- to middle-income countries by building public health capacity via e-learning at affordable cost. We describe experience over nine years of the initiative, including the development and delivery of a Master of Public Health (MPH) programme in public health and collaboration with a UK University. Courses rely on Open Educational Resources and volunteer tutors from over 50 countries to date. During 18 semesters since 2008, 1619 students from 92 countries (71% from Africa) enrolled. Of 128 students accepted on an MPH programme accredited by a UK University, 94 earned an MPH (73%) and a further 18 (14%) achieved a postgraduate diploma or certificate. Other developments include continuing involvement with Alumni, and a sister site for Open Online Courses to include topics not often found in MPH courses. We offer insights for further development of this and similar online capacity building programmes within low-resource environments. Our experience shows the feasibility of affordable, high quality online education and that there is scope for accelerating capacity building programmes through partnerships with higher education institutions and health(care) organisations.

Online Education for Public Health Capacity Building in Low- to Middle-Income Countries

People’s Open Access Education Initiative (Peoples-uni, http://peoples-uni.org) aims to contribute to improvements in the health of populations in low- to middle-income countries by building public health capacity via e-learning at affordable cost. We describe experience over nine years of the initiative, including the development and delivery of a Master of Public Health (MPH) programme in public health and collaboration with a UK University. Courses rely on Open Educational Resources and volunteer tutors from over 50 countries to date. During 18 semesters since 2008, 1619 students from 92 countries (71% from Africa) enrolled. Of 128 students accepted on an MPH programme accredited by a UK University, 94 earned an MPH (73%) and a further 18 (14%) achieved a postgraduate diploma or certificate. Other developments include continuing involvement with Alumni, and a sister site for Open Online Courses to include topics not often found in MPH courses. We offer insights for further development of this and similar online capacity building programmes within low-resource environments. Our experience shows the feasibility of affordable, high quality online education and that there is scope for accelerating capacity building programmes through partnerships with higher education institutions and health(care) organisations.