Models on how to integrate health service and research varies from country to country. Recently Dzau and colleagues from Duke University wrote about the experiences of using academic health science to transform medicine. They write that 5 billion people living in developing countries have inadequacies in hygiene and economic development, and health-care access are the main causes of shortened life expectancies.
They write that academic health science centres (previous medical schools) should play an important role promoting health and economic development. New organizational forms might improve health service delivery. By integrating health services, education and research and making this a collective responsibility it is possible to transform medicine, improve health, and reduce health-care disparities.
In most developing countries there is a strict division between universities and public health service providers such as hospitals and community health programmes. Often the Ministries of Education own the universities and Ministries of Health own the health institutions. Thus, universities become places where students get their degrees, and the quality of training often lacks the practical and real-life touch. The little research that is done is often weak and does not influence practice or policy making.
I believe we need new organisational frameworks integrating education, service and research to solve the huge challenges facing health in developing countries. Such an organization, that could include external partnerships, need to set research priorities, and develop models of education, care delivery and community health programmes, and has potential to enable health transformation.
Dzau, V., Ackerly, D., Sutton-Wallace, P., Merson, M., Williams, R., Krishnan, K., Taber, R., & Califf, R. (2010). The role of academic health science systems in the transformation of medicine The Lancet, 375 (9718), 949-953 DOI: 10.1016/S0140-6736(09)61082-5