Access to Health in Emergency Contexts: New Models of International Curriculum Development to Address Global Challenges

Helen Avery, Monne Wihlborg, Yahya Almualm, Mohammed Almahfali, Fanny Christou

Research output: Contribution to conferenceAbstractpeer-review


Capacity-building in international cooperation projects is typically founded on a conceptualisation of transmission or transfer, and thus also typically contributes to the international diffusion of certain models, systems or technologies. In European policy, this approach has been part of the strategy to strengthen the position of European HE by making HE structures in other parts of the world compatible with European standards and structures (EUA, 2013; Jones et al., 2016). We can observe these processes and aims in the TEMPUS programme and in the Bologna processes (Wihlborg & Avery, 2017). Thus, in the Catania declaration of 2006 for cooperation in the Mediterranean region, it is stated that aims include to “Establish common education and training paths based on a system of transferable credits and on easily readable qualifications and exploitable as well by the labour market, by sharing criteria, evaluation methods and quality assurance schemes” (Catania Declaration, 2006).These dynamics are also at work in the area of curriculum development. Fundamentally, there is an assumption that both knowledge and professional competence are universal, and that excellence can be judged according to shared criteria. Among other consequences, the assumption leads to the notion that universal knowledge and competence can then be applied or adapted to local conditions (Robson & Wihlborg, in press). The assumptions underlying this paradigm have been contested by several scholars (see Singh, 2011; Ndofirepi & Gwaravanda, 2018), pointing to the fact that knowledge and competence are necessarily embedded in particular historical, geographical, institutional, social and cultural contexts. A paradigm of transmission in international collaboration for curriculum development will consequently lead to a centring of practices based in high-income countries with English language HEIs, and a corresponding de-centring of HEIs in the global south. Recognising the need for alternative models (cf. Goddard & Hazelkorn, 2016), various initiatives are emerging, such as the People’s Uni (WHO Bulletin).The study is drawn from an international collaboration project for equitable access to health, involving HEIs in Lebanon, Jordan, Yemen and Sweden. Travelling is currently restricted for Yemeni academics, due to visa requirements and cost. Networked forms of internationalisation, such as this project, can therefore provide access to some of the advantages otherwise offered by student and staff mobility. The Yemeni part of the project focuses on curriculum development for the health professions. Due to the war in Syria, Lebanon and Jordan have received large numbers of refugees, while in Yemen, many people are internally displaced. The region of Hadhramout has been relatively peaceful throughout the conflict and has therefore received people fleeing from other parts of the country where fighting has been intense. Local structures and humanitarian relief have been insufficient to address the needs of the displaced people, and available resources are likely to remain limited.The Yemeni partner of the project, the Community Health department at Hadhramout university has a focus on approaches relevant to equitable access to health, but the overall organisation of the university and the programmes for the health professions are conventional. An additional challenge for this context is that international models for community health often presuppose the existence of relatively cohesive and stable communities, while the ongoing conflict and situation of displacement has led to a situation of conflicting interests and low trust.Methodology, Methods, Research Instruments or Sources UsedAs a first stage of the ongoing project, a survey including open questions and scales to prioritise concerns will be developed and given to various types of practitioners and health professionals working in the Hadhramout region, to gain a comprehensive picture both of working conditions and needs of the concerned communities. Descriptive statistics are used to describe the basic features of the data in a study. In addition, a qualitative approach (Mayring, 2000) is used to analyse the content of the survey and identify main concerns. Contextual information and descriptions of practices will be summarised in narrative form (cf. Hansen, 2006), and survey excerpts used to illustrate typical situations and practices. The aim of this step is to have a sufficiently detailed understanding of existing challenges to discuss implications for training, in terms of competences and content, but also for how work can be organised across professions with available resources. In a second stage, results from this mapping will be used to develop the curriculum (Leask, 2015) in collaborative workshops both locally and jointly in the international network of partners for the project. Conclusions, Expected Outcomes or FindingsMany qualified Yemenis have received their training in other countries, oriented towards quite different conditions. An additional challenge are the different types of professions that need to cooperate in this context, and the generally low level of education of the displaced. Curricular development can in this case not be limited to a particular section of the university, or to academic actors, but needs to involve various kinds of practitioners as well as the concerned populations.Several of the characteristics of the situation observed in Hadhramout can be found also in Lebanon and Jordan (Sim et al., 2018; Al-Rousan et al., 2018). Although availability of resources and infrastructure is greater in Europe, and the number of refugees is comparatively small, Sweden like other European countries experiences similar structural tensions (cf. WHO, 2018). International collaboration on curriculum development therefore holds potential benefits for all partner HEIs.Implications of mismatches between local needs and the orientation of the curricula of professional programmes are serious. Programmes and curricular content in HEIs from the global south will tend to be organised to suit the needs of the global north, which at country levels can encourage brain drain of qualified professionals. Similar disparities between regions exist in Europe both within and across countries. Developing more collaborative models for international cooperation between HEIs in the area of curriculum development to better match local needs is therefore an important concern, not only to address the global challenges of Agenda 2030, but for the future of Europe, to reduce disparities and promote social justice (McAllister-Grande, 2018; Rumbley & Proctor, 2018; de Wit et al., 2017; Proctor, 2016; Altbach, 2004).ReferencesAl-Rousan, T., Schwabkey, Z., Jirmanus, L., & Nelson, B. D. (2018). Health needs and priorities of Syrian refugees in camps and urban settings in Jordan: perspectives of refugees and health care providers. Eastern Mediterranean Health Journal, 24(3).Altbach, P. G. (2004). Globalization and the university: Myths and realities in an unequal world. Tertiary Education and Management, 10, 3-25.Catania Declaration (2006). Euro-Mediterranean Area of Higher Education and Wit, H., Gacel-Avila, J., Jones, E., & Jooste, N. (Eds.) (2017). The Globalization of Internationalization: Emerging Voices and Perspectives. NY/London: Routledge. European University Association (2013) Internationalisation in European higher education: European policies, institutional strategies and EUA support. EUA Membership Consultation 2013. Brussels: EUA.Goddard, J. & Hazelkorn, E. (2016). Re-asserting the Public Good Role of Higher Education in Turbulent Times. November 25. Hansen, H. (2006). The ethnonarrative approach. Human Relations, 59(8), 1049–1075.Jones E., Coelen R ., Beelen J. & de Wit, H. (2016) Introduction (1-4) In Jones, Coelen,Beelen & de Wit (Eds.) Global and Local Internationalization. Global Perspectives on Higher Education, 34. Rotterdam: Sense Publishers.Leask, B. (2015). Internationalizing the Curriculum. Routledge, London/NY.McAllister-Grande, B. (2018). Toward humanistic internationalization. In Proctor & Rumbley (Eds.) The Future Agenda for Internationalization in Higher Education (pp. 123-132). NY: RoutledgeNdofirepi, A. P., & Gwaravanda, E. T. (2018). Epistemic (in) justice in African universities: a perspective of the politics of knowledge. Educational Review, 1-14.Proctor, D. (2016). The changing landscape of international education research. International Higher Education, 84, 19-21Robson, S. & Wihlborg, M. (in press /2019) Internationalization of Higher Education: impacts, challenges and future possibilities. Special edition EERJ. Rumbley, L.E. & Proctor, D. (2018). Perspective on internationalization from and for a new generation. In Proctor & Rumbley (Eds.) The Future Agenda for Internationalization in Higher Education (pp. 225-229). NY: Routledge.Sim, A., Bowes, L., & Gardner, F. (2018). Modeling the effects of war exposure and daily stressors on maternal mental health, parenting, and child psychosocial adjustment. Global Mental Health, 5.WHO (2018). Report on the health of refugees and migrants in the WHO European Region: no public health without refugee and migrant health.WHO Bulletin. Wihlborg, M. & Avery, H. (2017) Opening or closing doors? Perspectives on Bologna from inside and outside the European Union. ECER 2017, Copenhagen.Wihlborg, M. & Robson, S. (2018) Internationalisation of higher education: drivers, rationales, priorities, values and impacts, EJHE 8(1), 8-18. Intent of PublicationEERJ or European Journal of Higher Education
Original languageEnglish
Publication statusPublished - 2019
EventECER 2019: Education in an Era of Risk – the Role of Educational Research for the Future - Universität Hamburg, Hamburg, Germany
Duration: 2019 Sept 22019 Nov 6


ConferenceECER 2019
Internet address

Subject classification (UKÄ)

  • Public Health, Global Health, Social Medicine and Epidemiology
  • Educational Sciences

Free keywords

  • internationalisation
  • higher education
  • global health
  • access to health care
  • social justice


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