Prof Jovanka Karadzinska Bislimovska, MD PhD Prof Theodore H Tulchinsky MD MPH

1. Master of Public Health Program as a Basis of a New School of Public Health -Initial Macedonian Experience Prof Jovanka Karadzinska Bislimovska, MD PhD Prof Theodore H Tulchinsky MD MPH Medical Faculty, Skopje, Macedonia Braun School of Public Health, Jerusalem, Israel

2. Aim of the Study To describe the establishment and development of a Master of Public Health Program (MPH) as a basis of a new School of Public Health (SPH) within the Medical Faculty of the University “St. Cyrilus and Methodius”, Skopje.

3. Burden of high rates of mortality • and morbidity from preventable diseases • Inaccessibility to health services • Explosion of addictive drug abuse • Insufficiencies in education in this field • Poor capacity utilization • Excess emphasis on hospital care • Absence of cost-benefit, • cost-effectiveness analysis • Under-funding of the health care • High rates of poverty and • unemployment • Low motivation of health care • providers • Decline of medical and other aspects of ethics: • prostitution, corruption and profiteering • Need for international standards of PH • New public health challenges Macedonia Capacity for professional education in PH is a key to a health strategy

4. Elements of the New PH Teaching Program An organizational structure A stated mission with supporting goals and measurable objectives A curriculum plan Institutional commitment to the development of the school or program Policies and plans for recruitment and selection of faculty and students

5. Mission of the PH Teaching Program Preparing the critical mass of PH professionals competent in the PH content and methodological approach to problem solving Teaching, research, service Ensuring the academic development of modern public health ideas Providing the proper level of training in health science during the period of transition and reforms

6. Establishing a SPH within Medical Faculty START • - Through a MPH curriculum and program • - According to the international standards • and Macedonian legislative • Based on existing Preventive Health Departments • (Social Medicine, Epidemiology and Biostatistics, • Hygiene, Occupational Health) • - Support of a consulting team from Braun SPH

7. Establishing a MPH within Medical Faculty START Two years preparation Start of the first group in 2003 (40 students) The part-time MPH Modular program CTS

8. The core curriculum of MPH Program • Multidisciplinary approach • Main areas of PH knowledge: • - Public health theory and practices • - Biostatistics • - Epidemiology • - Environmental Health • - Occupational Health • Health service administration, management and • health economics • - Social and behavioral sciences • Elements of qualitative and • quantitative sciences

9. Methods of learning • Combined methods of: • - learning with classical lectures • - lectures in group discussion • self-instruction of the students with reading • literature and searching relevant data from • Internet • Problem solving exercises

10. Module 1 • Introduction to Public Health • - PH organization and practice • Computers and Internet skills as tools • in PH Module 2 Quantitative Methods - Principles of epidemiology and research methods - Biostatistics Module 3 Health Economics and Management - Health economics - Health management

11. Module 4 Population Health Needs - Family and special health needs - Nutrition in PH Module 5 Quantitative methods - Social and behavioral sciences in health - Health promotion and disease prevention Module 6 Environment and Health - Environmental health - Occupational health Module 7 Disease Control Methods - Control of communicable diseases - Control of non-communicable diseases

12. Elective courses Research Forum Integrative Workshop Master’s Paper

13. Outcomes Students - Enhanced leadership roles - Capacity (problems, program, solution) - Professional competence and progress Faculty - Academic strength - Status - Satisfaction • Health system • Training • Service • Research

14. Students - who and what? Trains PH professionals related to their backgrounds and career interests Mostly employed in PH and health management Goal – enhanced competence to identify, analyze and solve PH problems

15. Support Strong support in the University and Medical Faculty, as well as in NGOs, was crucial, to enroll a good group of students

16. Academic Preparation - Send faculty to visit existing SPH - Send young faculty for MPH abroad - Translate textbook of public health - Curriculum - Monitor standards of teaching - Monitor students performance

17. Lessons Learned to Date Start - Develop curriculum - Send people abroad for MPH and short faculty visits - Consortium of existing cathedras - Common commitment - Support of dean and faculty - Support of OSI - Support of Braun SPH - Attract students from field and new grads - It isn’t perfect at start - Adapt and modify

18. NEXT STEPS Further development depends of support of ministry and university authorities academic, working and community settings, health care services, NGOs within national PH priorities and educational needs The first group will graduate and the second enroll in 2004-05

19. New SPH in Macedonia