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 International Health and Development

INHL 604 HEALTH AND ECONOMIC DEVELOPMENT (3)
This course provides an introduction to social and economic development issues. The political and economic characteristics of developing countries; the process of and obstacles to economic growth are also explored. The relationships among health, nutrition and development are analyzed to illustrate the need for an intersectoral approach in development and health planning. Other important development issues including population problems, health care financing, food production and distribution, and international flow of capital are also discussed.

INHL 605 PRINCIPLES FOR POLICIES AND PROGRAMS IN POPULATION, HEALTH, AND NUTRITION IN DEVELOPING COUNTRIES (2)
This course provides an integrated introduction to the principles of designing large-scale programs in the fields of population, health, and nutrition in developing countries. The problems to be solved are first outlined, with the changing context of international collaboration. Then nine sessions, three each for nutrition, health, and population, systematically address problems, causes, strategies, and policy debates; program components in different contexts; and assessment, analysis, and design of actions in specific circumstances. Finally, common factors, contrasts, and synergies in programs in population, health, and nutrition are discussed. Case studies are used and discussed throughout to illustrate these points. The course aims to give an introduction useful for more detailed study of one or more of the health, population, and nutrition fields in other courses, as well as enough familiarity with basic ideas and language to allow effective interaction with those working in the other related fields.

INHL 607 THE SOCIAL IMPACT OF HIV/AIDS: AN INTRODUCTION TO THE EPIDEMIC (1)
This course provides an introduction to HIV/AIDS diagnosis, prevention, and treatment, and the social, political, and economic impact of the disease. The course begins with a brief introduction to HIV epidemiology, virology, and developments in drugs and vaccines. The course also discusses public health responses to the epidemic, including counseling and testing, prevention/education, and behavioral research. The course concludes with a discussion of the public reaction and responses in domestic and international contexts, and future directions.

INHL 611 HEALTH ECONOMICS FOR DEVELOPING COUNTRIES (3)
The course is intended to familiarize students with the tools that economists use to analyze health care systems and to apply these tools to current policy issues in developing countries. The course concentrates on the methodological issues of estimating demand and supply of health services, pricing policy in the health sector, financing methods for health services, increasing productivity of health resources, analyzing problems and prospects of private health insurance schemes in developing countries, alternative methods of estimating costs, and benefits of health programs and projects. To illustrate the issues, case studies from different developing countries are used.

INHL 615 PUBLIC NUTRITION AND HEALTH IN COMPLEX EMERGENCIES (2)
Complex emergencies involving conflict, destitution, and often environmental crises, leading to large-scale population movements, are causing widespread malnutrition, disease, and high mortality among millions of people, especially in Sub-Saharan Africa and parts of Asia. Some of this suffering can be prevented through more effective programs when the refugee and displaced populations become accessible to outside help. This course is designed to familiarize students with methods and approaches for coping with public nutrition and health problems in complex emergencies. It addresses the control of malnutrition (general and micronutrient) through general ration distribution and selective feeding programs, emergency public health measures, and key policy issues. Outside speakers with recent experience in this field contribute to specific topics and with illustrative case studies.

INHL 622 PROGRAM SKILLS IN CRISIS AND TRANSITION SETTINGS (3)
This course is designed to equip students with a set of skills related to the assessment and analysis of the social, economic, and policy aspects of complex political emergencies, as well as post-conflict/transitional settings. The course covers selected topics in preparedness, response, and transition in complex political emergencies, and their effects upon the civilian populations and the agencies that seek to assist them. Students develop skills in the following areas: information management, program operations management, and policy and context analysis. In terms of information management, students develop the capacity to adapt surveys to conflict-affected settings and utilize a series of rapid assessment approaches and participatory rural appraisal techniques for data collection. Students also learn to identify and utilize the principal components of crisis prevention and early warning information systems. In terms of program operations management, students develop skills in the construction of a logistics management system appropriate for emergency settings, and learn how to develop key programs of particular importance in post-conflict and transitional settings. In terms of policy and context analysis, students are equipped with analytical skills related to assessing potential harmful effects of humanitarian assistance, international political aspects of humanitarian work, international humanitarian law, and opportunities for promoting conflict resolution, capacity building, and development through humanitarian assistance.

INHL 624 MONITORING AND EVALUATION IN INTERNATIONAL HEALTH (2)
This course provides the student with the basic concepts and methodologies needed to undertake evaluation research. Major applications of evaluation research are covered: program planning, monitoring, impact and efficiency assessment. The focus of the course is on the practical issues in undertaking evaluation in developing country settings.

INHL 626 FORMAL QUALITATIVE METHODS (3)
This course will provide hands-on experience in qualitative methods useful for health research. Formal and non-formal ethnographic methods useful for health research will be examined, including key informant interviewing, direct structured observation, free lists, pile sorts, ranking, social network analysis, and the management and analysis of qualitative data in general. Students are required to learn and use the software program ANTHROPAC.

INHL 631 VIOLENT CONFLICT AND CONFLICT RESOLUTION WITH APPLICATIONS TO HEALTH AND DEVELOPMENT (3)
In the post-Cold War world, ethnic conflict has emerged as a major factor leading to political instability, violence, and displacement of populations in almost every part of the world, creating serious implications for public health. The course will address this major issue from an interdisciplinary, cross-cultural perspective. The primary goal will be to equip the students with a better understanding of such conflicts and a deeper appreciation of strategies needed in order to assist in the nation-building projects of these societies. Such an understanding will help the public health and development practitioner to factor in the ethnic element into health and development strategies, policies, and programs.

INHL 636 THE OTHER DRUG WAR: ESSENTIAL DRUGS, CONTRACEPTIVES, VACCINES & HEALTH COMMODITIES (2)
Within the health sector, the pharmaceutical sector most clearly spotlights the contradictions between health care service provision as an economic engine worldwide and access to health care (as a human right) threatened by worldwide socio-economic inequities. Next to personnel, pharmaceuticals (including contraceptives and vaccines) represent the largest cost item in most health budgets. Their manufacture is generally controlled by multinationals and their importation requires foreign exchange that is too often scarce. Their procurement is a tempting entryway for lucrative under-the-table arrangements at every level of the health system. These factors make them a primary target for cost containment. Consumers are more willing to pay for pharmaceuticals than for any other component of health services. This makes them a primary target for user fees and revenue generation. If pharmaceuticals and contraceptives are not available, health service providers are not effective, and client confidence in the system erodes. Yet, supplies systems frequently function in haphazard and irrational ways, with overstocks that result in spoilage or expiration, stock-outs that result in health system failures, and poor prescribing combined with poor patient compliance that sabotage the positive impact pharmaceuticals can have on health status.

In addition to lecture-discussions, this course will rely heavily on detailed teaching case studies from Bangladesh, Botswana, Haiti, Jamaica, Nigeria, and other African countries that cover the private sector, the public sector  and private-public sector programs.

INHL 637 GRANT WRITING (3)
This course is an intensive workshop-style class designed to teach students how to identify, research, and prepare grant proposals in the fields of international public health, population and nutrition, and development.  Specific emphasis is given to the idiosyncrasies of developing proposals for the United States Agency for International Development, the European Union, and the British Department for International Development.  By the end of the course students will know how to identify prospective funders, conduct pre-proposal research, and develop and write a full proposal, including writing clear and attainable goals and objectives, coherent methodologies, meaningful evaluations, devising budgets, and providing supplementary material.  The first week of the course combines lectures with in-class exercises, daily writing assignments, and an oral presentation.  The second week of the course is a required distance-learning component, during which the students are required to develop a full proposal and budget along with supplementary material to achieve the objectives of this course. 

INHL 638 PSYCHOSOCIAL EFFECTS OF COMPLEX EMERGENCIES (2)
In today's world, complex humanitarian emergencies are one of the root causes of social rupture and forced migration affecting nearly 1% of the world's population.  Increasingly, the strategy of modern war and low-intensity conflicts targets civilian populations, creating a state of terror that penetrates the very fabric of social relations and the subjective mental life of the community.  This course will examine the impacts of trauma on populations affected by complex emergencies, and the role and importance of psychosocial interventions in the recovery of traumatized communities.  A theoretical framework for effective culturally-sensitive psychosocial work will be discussed, as well as guiding principles for effective and relevant psychosocial assessment and program design.  Students will have hands-on experience in developing a psychosocial program through all of its elements, assessments of psychosocial needs in various settings, program design, staffing, budgeting, implementation and program evaluation.  Students will become familiar with the components of a formal psychosocial proposal.

INHL 645 SURVEY MEASUREMENT IN THE INTERNATIONAL HEALTH, POPULATION, AND NUTRITION SECTORS (3)
Prerequisite BIOS 603.
The use of sample surveys to satisfy program-related information needs has become increasingly common in recent years in the international health, population and nutrition sectors. In order to take full advantage of recent developments in survey methodologies, professionals working in these sectors need to have a solid understanding of the intended uses and limitations of various standard protocols, as well as of the underlying principles of survey measurement. Accordingly, the purposes of this course are twofold: to establish a solid understanding of the basic principles of survey measurement, and to review the state-of-the-art in survey measurement in the health, population and nutrition sectors, with primary attention to the methodological basis of the protocols considered, and the strengths and weaknesses of the various approaches in actual practice.

INHL 650 FIELD METHODS FOR NUTRITION PROGRAMS IN POOR COMMUNITIES IN JAMAICA (2)
Improving health and nutrition in developing countries results largely form local programs, based in communities and health facilities.  Students have learned about such programs in class, and this course is aimed at giving experience of their reality in one developing country, Jamaica, which while relatively nearby has many features widely relevant.  The course is run in collaboration with the Caribbean Food and Nutrition Institute (CFNI:PAHO/WHO regional institute), Kingston, Jamaica, for 2 weeks in the May intersession period, approx. May 16 to May 29.  Preliminary reading plus participation in a one day preparatory session earlier in May are expected.  The activities emphasize field visits, interacting with people in community programs, health centers, food plants, official and NGO projects, labs, etc.  Topics include: area and community assessments (of extent, characteristics, and causes of malnutrition problems); community- and facility-based programs (including growth monitoring); micronutrient, ante-natal, and fortification programs.  Students (in groups) research a priority problem (e.g. child malnutrition, anemia, diet related chronic disease including obesity) covering causes, extent, consequences, current programs, intervention needs and gaps, planning new interventions - similar to a rapid assessment while on a mission - and report back in a final workshop.

INHL 653 HEALTH AND DEVELOPMENT IN KENYA IN THE AGE OF HIV/AIDS (3)
A field course for public health students to explore a range of health, development and environmental issues that interact in the Sub-Saharan African context today.  Kenya offers a laboratory to investigate aid agency, government and non-governmental projects tackling inter-related problems of HIV and AIDS, poverty, and endemic disease, compounded by rapid urbanization and globalization.  Students spend time in lectures, talking to VCT clinic staff, observing farming and water harvesting in rural Machakos, attending mobile health clinic serving the Samburu, a pastoral population in Northern Kenya, and visiting parasitological and other laboratories in the Kenya Medical Research Institute (KEMRI) on the coast.  Presentations from local and international experts, researchers and practitioners complement site visits and field trips.  Academic coursework includes reading and discussing background texts and course-pack articles, individual essays, and group field exercises.  Conditions are demanding, including long stretches of travel on unpaved roads, hiking, and rough camping.

INHL 655 HEALTH AND DEVELOPMENT ISSUES IN PERU (2)
This course will be an introduction to health and development issues in a developing country.  Peru, like many other Latin American countries, is in the midst of an epidemiologic transition, characterized by a shift in the principal causes of morbidity and mortality in the population, from being predominantly infectious diseases to chronic diseases.  Thus, we will discuss some of the prevalent infectious diseases affecting the population, as well as the chronic diseases thar are increasingly apparent in Lima, the capital.  We will discuss other issues relevant to health in Peru, such as the interaction between geography and health, and development and health.  Peru experienced terrorism in the 1980s and early 1990s from two terrorist groups - Shining Path and the Movimiento Revolucionario Tupac Amaru, and we will discuss the impact of terrorism on migration, development issues, mental health, as well as overall violence in the country.  The course will take place in Lima, Iquitos, and Cusco - and will consist of a combination of lectures, facilitated discussions and field trips.
Peru is an interesting country for this course because we will visit each of the three main geographic regions: the barren, desert coast (Lima); the high Andes (Cusco); and the rainforest (Iquitos).  Each region has unique health problems related to its terrain, and yet there are also many commonalities.

INHL 656 INTRODUCTION TO OPERATIONS RESEARCH IN INTERNATIONAL SETTINGS (2)
This course is designed for students planning international careers in public health administration and policy or health systems research.  The focus is on one of the major aspects of contemporary operations research - intervention research in health care systems in developing countries.  The course offers an introduction to the use of experimental designs in field settings and examines the importance of the program manager/researcher collaboration in conducting program research.  As part of the course, students will complete research design exercises, review case studies and critique intervention studies and proposals.  Most examples are drawn from international reproductive health programs and research.

INHL 675 ADOLESCENT HEALTH POLICIES AND PROGRAMS (3)
Prerequisites: BIOS 603, BIOS 604, or permission of instructor.
This course provides students with an understanding of the context, design and effectiveness of the main interventions to prevent and reduce adolescent health risk-taking and develops students' professional skills in the use of quantitative methodologies to determine the health needs and problems of adolescents in developing countries and the formulation of workable strategies for responding to identified needs. The course begins with a discussion of major policy issues and controversies surrounding specific program approaches to reducing adolescent health risk-taking. Students will compare interventions for addressing common health problems in adolescence as well as services for meeting the needs of special youth populations in emerging and developed countries. The key components of successful and unsuccessful programs in specific health areas will be addressed.

INHL 680 INTRODUCTION TO POPULATION STUDIES (3)
This course is an introduction to world population growth and its determinants at the individual, familial and societal levels. Readings and lectures will cover population theory, basic demographic methods, current patterns of population growth, and programs designed to influence demographic trends. Tulane undergraduate students may enroll with permission of their dean, faculty advisor and instructor in the SPHTM.

INHL 681 DESIGN AND IMPLEMENTATION OF REPRODUCTIVE HEALTH PROGRAMS IN DEVELOPING COUNTRIES (2)
This course provides students with an in-depth perspective into the design and implementation of reproductive health programs in developing countries. We begin with presentations on the trends, policy issues, and programs designs used to address the major areas of reproductive health. We cover abortion, safe motherhood, men, adolescents, HIV/AIDS, and family planning. The second part of the course focuses on specific program designs used by reproductive health programs including mass media and social marketing, community-based programs, facility-based programs, and school-based programs. Influential persons from the field of reproductive health will be brought in to share their expertise on program design and implementation issues.

INHL 683 INTERNATIONAL HEALTH POLICY (3)
This course examines the process of designing and implementing health policy, mainly focusing on developing countries. The diversities of health policies will be illustrated using case studies, group discussions and in-class lectures. Constraints such as lack of resources, multiple stakeholders, corruption and historical conditions will be discussed with both the practical and ethical considerations of how the policy process operates in difference cultures, and why it so often fails to operate as planned.

INHL 685 POPULATION-ENVIRONMENT THEORY AND EVIDENCE (3)
This course entails a critical examination of major social science approaches (demography, anthropology, economics) to the understanding of relationships between population dynamics, environmental change, and development policies; and a broad survey of global environmental concerns (and their relationship to population dynamics) and proposed solutions. The main approaches which influence social science research and policy today are surveyed: Malthusian theories, Boserupian population-induced intensification, and mediated modes such as policies, structural constraints, and environmental change. Students survey conceptual models and seek evidence from empirical research on major concerns: food, forests, and biological diversity, urban and industrial issues, and climate change. Projects which integrate reproductive health and conservation concerns into practical, community-based interventions are examined. Techniques and data needs for researching population-environment interactions are briefly surveyed. A final segment focuses on Guatemala and the interrelated impacts on land, forests, biological diversity, and urban infrastructure of population dynamics, development policies, and historical inequities. INHL 685 is recommended for students interested in working in developing countries in reproductive health, environmental health, population policy, or development.

INHL 701 SOUTHEAST ASIA'S RESPONSE TO THE AIDS EPIDEMIC (2)
The objectives of the course are to provide an intense overview of the progression of HIV and AIDS in southeast Asia and the response to the countries in the region, inlcuding responses from government and nongovernment agencies, at the national and local levels. We will focus on the following dimensions of the epidemic and the response: basic epidemiological features (trends and differentials); social and economic impacts; programs directed at reducing incidence; treatment programs; and programs directed at mitigating the impact of AIDS on those infected and their families.

INHL 702 COMMUNICATIONS RESEARCH FOR FAMILY PLANNING AND HEALTH (3)
Prerequisites: BIOS 621 or a working knowledge of SPSS.
This course constitutes a practical introduction to the research methodologies used in planning a communication program for promoting desirable health behavior, designing appropriate messages, pre-testing communications and evaluating program effectiveness. Most examples and data sets will involve international family planning, but will be applicable to other areas of public health. Lectures will be combined with exercises in which students carry out communication pretests, conduct and analyze the results of focus groups and do secondary analysis of existing communication data sets using statistical software. These skills are basic to the systematic approach in designing, implementing, and evaluating a health communication program.

INHL 705 DOCTORAL SEMINAR IN INTERNATIONAL HEALTH (1)
Students in this course will select individual papers published from peer-reviewed journals on topics of interest to them, and lead a summary, critique, and group discussion of the research methodology and general science underlying the article; develop critical thinking skills related to issues of research design, methodology, implementation, presentation, and discussion of results; develop critical and presentation skills through guided mentoring and close and structured interaction with their peers and the faculty.

INHL 709 PUBLIC NUTRITION: ASSESSMENT AND ADVANCED ANALYSIS (3)
Planning policies and programs to improve nutrition in populations requires appropriate assessment and analysis. This course covers the process of acquiring, handling, and analyzing data, from a conceptual through to a practical hands on approach, for decisions at different levels of organization for policy and program planning, with particular emphasis on community based programs in poor countries. Outcome data (general and micronutrient malnutrition), program data (coverage, targeting, etc.), differentials and trends, and advanced analytical techniques addressing confounding, interactions, and causality are included in relation to decisions on action.

INHL 712 MONITORING AND EVALUATION OF MATERNAL AND CHILD HEALTH (3)
This course is designed to serve the purpose of (1) providing students with an understanding of the context and design of the main interventions to improve maternal and child health in developing countries, (2) developing professional skills in the use of quantitative analytical tools and technologies to appropriately monitor and evaluate maternal and child health programs in developing countries, and (3) increasing students; abilities to use monitoring and evaluation results to improve the planning and delivery of maternal and child health services in developing countries.

INHL 792 BEHAVIORAL SURVEILLANCE IN DEVELOPING COUNTRIES (2)
HIV surveillance systems are increasingly being used in countries across the globe to provide an understanding of the underlying dynamics driving the spread of HIV.  Epidemics are diverse and no two countries are alike.  Designing surveillance systems that respond to the unique data needs of a country while still contributing to a global understanding of the epidemic is one of the most challenging endeavors in public health.  The endeavor is complicated by the political nature of the pandemic, but the need for honest and accurate assessments of the spread of HIV is critical if countries are to avoid epidemics, or reverse the rampant spread of the disease in those countries most severely affected.  This course will provide an overview of theoretical and methodological issues of HIV epidemiological and behavioral surveillance with case studies from Asia and Africa.  Students with a desire to work internationally on the epidemiology of HIV will benefit from this highly "hands-on" and participatory seminar.

INHL 796 PREVENTIVE MEDICINE RESIDENCY (0)
Third year/practicum.

SPHL 799 INDEPENDENT STUDY (1-3)
Topics of individual research and study to be conducted with the guidance of a faculty member are identified by the student and advisor and approved by the department chair. Groups of students together with faculty may also arrange special seminars on relevant topics not presented in the other courses. Permission of instructor required prior to registration.

INHL 997 DISSERTATION (0)

INHL 998 CAPSTONE (0)
The Capstone experience is designed to allow students to synthesize the knowledge and skills developed during the academic portion of their program at the university. All students are required to register in and successfully complete the Capstone experience. A 300-hour practice experience is designed to expose the student to the real-world public health practice. This offers an opportunity to integrate and apply the theories and concepts learned in the program to various settings and services internationally. Plans for such experiences are to be developed jointly between the student and the academic advisor.

INHL 999 DISSERTATION RESEARCH (1-15)

SPHL 603 SOCIAL AND BEHAVIORAL ASPECTS OF GLOBAL HEALTH (3)
This core course covers the behavioral, social, and cultural aspects of health and disease in both developed and developing countries.  students learn how behavioral and social theories are relevant to health promotion and disease prevention efforts.  They also learn how factors that protect or erode health operate at multiple levels (including individual, community, societal, and global levels), and how interventions are developed to improve health by addressing critical factors at each of these levels.  The course also addresses the roles of culture, race, and ethnicity in the conceptualization of health and illness, and reviews various research approaches to understanding behavioral and social aspects of health and disease.  Case studies will be used to apply the concepts learned to relevant health problems domestically and abroad.

SPHL 617 FIELD METHODS IN COMPLEX EMERGENCIES (2)
This course provides an overview of the basic requirements of displaced populations.  Students are equipped with skills to quantify populations and their level of access to basic services, for the purpose of emergency response and program planning.  Additionally, the course provides an overview of methods of documenting health crises among displaced and conflict-affected populations.  Students should be able to advocate effectively for the needs of displaced and conflict-affected populations based on a sound understanding of population requirements and methodologies of needs assessment.