University of San Francisco School of Nursing
Global Issues and Community Health
Course Description
This elective course provides the opportunity to explore the impact of national and international policy decisions on the health and well being of individuals and communities. Additionally, the course provides the opportunity to explore the role of cultural beliefs and values in health seeking behaviors. Students will participate in an immersion learning program in which they will live and work in a culture different from their own. The associations among international conflict and corporate activities, poverty and lack of resources in communities, and health status of community members will be central to the learning experience.
Nurses face the challenge of providing care to an increasingly diverse population. The phrase "cultural competence" is used to describe the behaviors that a health care professional uses to individualize clinical care to individuals whose circumstances are different than those of the professional (e.g. culture, gender, economic status, language, geographic home, ethnicity). The culturally competent health care practitioner accepts and works with cultural differences in an open, sincere manner without condescension or patronization. Culturally competent care is sensitive to issues related to culture, race, gender, sexual orientation, social class and economic situation. Research suggests that immersion programs in which students experience the daily lives of other people may increase the cultural competency of student nurses.
Service Learning
This course is developed to provide a learning experience through a service learning project. The term "service learning" is an educational process:
a. in which students learn and develop through active participation in thoughtfully organized service experiences that meet actual community needs;
b. that is integrated into the students' academic curriculum or provides structured time for a student to think, talk or write about what the student did and saw during the service activity;
c. that provides students with opportunities to use newly acquired skills and knowledge in real life situations in their own communities; and
d. that enhances what is taught in school by extending student learning beyond the classroom and into the community and help to
foster the development of a sense of caring for others. (National and Community Service Act off 1990)
Essential elements of service learning include preparation prior to the experience, community service, reflection and evaluation of the service activity, and celebration/recognition of the experience.
Each service learning experience offered in this course identifies both a geographic and a clinical focus. While faculty participating in the course bring expertise in the clinical specialty and in international health initiatives, they recognize that they also are learners in the immersion process.
Geographic Focus: Central America/Guatemala
Clinical Focus: Family Health; Community Health
Course Objectives
At the completion of this course, the student will be able to:
1. Identify historical and political factors that influenced the development of the health care system in a particular country of interest.
2. Discuss "culture clashes" that occur when western medicine is introduced into traditional communities.
3. Discuss the major health problems experienced community members in a particular country of interest.
4. Evaluate the health care resources that are available to meet the health care needs of the community.
5. Discuss one health care initiative that has had a positive impact on community members.
6. Propose the integration of specific cultural approaches to health and illness into the provision of professional nursing care nationally and
internationally.
Grading
The grade for the course will be determined as follows:
Participation in pre- and post- project seminars 25%
Participation in daily seminars that explore the day's activities 25%
Completion of a scholarly paper 50%
Course Schedule
Seminar 1 Introduction to Course Requirements and Service Learning
Seminar 2 Issues in Global Health
Service Learning Project
Each evening students will participate in a one hour seminar to explore the community's health needs, the social and political influences on health and health care delivery, and the potential impact of the project.
Seminar 3 Presentation of the experience to University leaders
Seminar 4 Discussion of experience
Seminar 5 Presentation of scholarly papers
Additional planning meetings will most likely be necessary to discuss fundraising and preparation for the trip.
Course Prerequisites
Students must have successfully completed Family Health I and Family Health II prior to enrollment in this course.
Required Reading
Universal Declaration of Human Rights. (1948). United Nations.
International Declaration of Health Rights. (1992). Johns Hopkins School of
Hygiene and Public Health, Johns Hopkins University.
Institute of Medicine, National Academy of Sciences. (1997). America's vital interest in global health: Protecting our people, enhancing our economy, and advancing our international interests. Washington, DC: National Academy Press.
Bartlett, A. V., Paz de Bocaletti, M. E., & Bocaletti, M. A. (199 1). Neonatal and early postneonatal morbidity and mortality in a rural Guatemalan community: the importance of infectious diseases and their management. Pediatric Infectious Disease Journal, 10, 752 757.
Greenberg, L. (1982). Midwife training programs in highland Guatemala. Social Science and Medicine, 16, 1599 1609.
Lang, J. B., & Elkin, E. D. (1997). A study of the beliefs and birthing practices of traditional midwives in rural Guatemala. Journal of
Nurse Midwifery, 42(l), 25 3 1.
Menchu, R. (1992). Birth Ceremonies, Rigoberta Menchu An Indian Woman in Guatemala (pp. 7 17).
Menchu, R. (1998). Understanding and Accepting Diversity, Crossing Borders (pp. 211 227).
Nicolaidis, C. (1993). Las comadronas. JAMWA, 48(3), 73, 92.
Vaughn, P. (1996). Finding the heart of medicine at the end of the road in Guatemala. Canadian Medical Association Journal, 155(12),
1733 1734.
Recommended Reading
Kwast, B. E. (1996). Reduction of maternal and perinatal mortality in rural and urban settings: what works? European Journal of Obstetrics and Gynecology and Reproductive Biology, 69, 47 53.
Pebley, A., Hurtado, E. & Goldman, N. (1999). Beliefs about children's illnesses. Journal of Biosocial Science, 31, 195 219.
Van der Stuyft, P., Sorensen, S. C., Delgado, E., & Bocaletti, E. (1996). Health seeking behavior for child illness in rural Guatemala. Tropical Medicine and International Health, 1(2), 161 170.
