Conceptualising global health: theoretical issues and their relevance for teaching

Globalization and Health

John S Yudkin¹  Rae Wake³  Abi Smith⁴  Vicki Pollit⁵  J Jaime Miranda⁷  Sophie Martin²  Arti Maini⁸  Rob Hughes⁶  Chris Willott⁹  Mike Rowson⁹ 

[1] University College London, Gower Street, London, UK;Independent consultant, London, UK;Juba Teaching Hospital, Juba, Sudan;Academic Clinical Fellow in Obstetrics and Gynaecology. Women's Health, Southmead Hosptial, Westbury on Trym, Bristol, BS10 5NB, UK;National Clinical Guideline Centre, Royal College of Physicians, London, UK;UK Department for International Development, 1 Palace Street, London, SW1E 5HE, UK;CRONICAS Centro de Excelencia en Enfermedades Crónicas and Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru;General Practitioner and Medical Educationalist, NHS Ealing, London, UK;UCL Institute for Global Health, 30 Guilford Street, London, WC1N 1EH, UK

关键词: Equity;    Globalization;    Curriculum;    Undergraduate;    Medical education;    Global health;   

Others  :  819419
DOI  :  10.1186/1744-8603-8-36

 received in 2012-04-13, accepted in 2012-11-07,  发布年份 2012

【 摘 要 】

Background

There has long been debate around the definition of the field of education, research and practice known as global health. In this article we step back from attempts at definition and instead ask what current definitions tell us about the evolution of the field, identifying gaps and points of debate and using these to inform discussions of how global health might be taught.

Discussion

What we now know as global health has its roots in the late 19^th century, in the largely colonial, biomedical pursuit of ‘international health’. The twentieth century saw a change in emphasis of the field towards a much broader conceptualisation of global health, encompassing broader social determinants of health and a truly global focus. The disciplinary focus has broadened greatly to include economics, anthropology and political science, among others. There have been a number of attempts to define the new field of global health. We suggest there are three central areas of contention: what the object of knowledge of global health is, the types of knowledge to be used and around the purpose of knowledge in the field of global health. We draw a number of conclusions from this discussion. First, that definitions should pay attention to differences as well as commonalities in different parts of the world, and that the definitions of global health themselves depend to some extent on the position of the definer. Second, global health’s core strength lies in its interdisciplinary character, in particular the incorporation of approaches from outside biomedicine. This approach recognises that political, social and economic factors are central causes of ill health. Last, we argue that definition should avoid inclusion of values. In particular we argue that equity, a key element of many definitions of global health, is a value-laden concept and carries with it significant ideological baggage. As such, its widespread inclusion in the definitions of global health is inappropriate as it suggests that only people sharing these values may be seen as ‘doing’ global health. Nevertheless, discussion of values should be a key part of global health education.

Summary

Our discussions lead us to emphasise the importance of an approach to teaching global health that is flexible, interdisciplinary and acknowledges the different interpretations and values of those practising and teaching the field.

【 授权许可】

   
2012 Rowson et al.; licensee BioMed Central Ltd.

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