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Global Health Task Force Wraps Up After Five Years of Service

Thursday, February 21, 2019 - 12:30

Global health is big these days. So, you may be asking, what is “big?”

Geographically, it covers the entire world — including the United States. Socially, it goes well beyond working in a remote village in a low-income country for a few weeks or even years. Global health issues walk into nearly every pediatrician’s office every day.

According to the U.S. Census Bureau, about one in four children under age 18 in the United States has at least one foreign-born parent1. Nearly 44 million people in the United States are immigrants, and more than 1 million arrive in the United States each year2. It is increasingly likely that a child will come to a U.S. pediatrician with an illness more commonly seen in other countries. These children also bring their own language and cultural backgrounds.

Dr. Cynthia KrullPediatric training programs are working to respond to these demographic trends by offering cross-cultural training experiences. (Photo: Dr. Cynthia Krull, currently a general pediatrician at Children's Minnesota Hugo Clinic, participated in an elective rotation in Ghana as a senior pediatric resident at the University of Minnesota.)

A survey published in 2015 revealed that more than a quarter of pediatric residency programs have global health-specific tracks, with more than half of all programs offering global health electives3. However, opportunities to provide care for recently immigrated children, or children in international, resource-limited settings remain scarce, and there is a growing call for more formalized standards for global health training.

Enter a group of globally minded pediatricians from around the United States. The ABP brought the group together in 2013 to form the Global Health Task Force (GHTF), charged with improving the standards for global health training and working to increase opportunities for education in the field.

Dr. Stephen Ludwig“We wanted to approach both what pediatricians should know and then also what trainees should know,” says Stephen Ludwig, MD, former GHTF Chair; Senior Director for Medical Education, Children’s Hospital of Philadelphia; and Professor of Pediatrics, University of Pennsylvania Perelman School of Medicine.

The GHTF had five goals:

  • Define what all pediatricians should know about global health;
  • Improve global health knowledge, skills, and attitudes for all pediatric trainees in the United States;
  • Improve the quality of global health training rotations by setting standards;
  • Evaluate the potential impact of the ABP’s role in global health; and
  • Develop a mechanism to sustain global health awareness and education.

Dr. Sabrina Butteris“The task force has accomplished a lot in the past five years because it is made up of an incredibly impressive group of people who are unbelievably dedicated and work very hard,” says Sabrina Butteris, MD, GHTF Chair, Associate Professor of Pediatrics and Global Health Education Director at the University of Wisconsin School of Medicine and Public Health.

The GHTF has published multiple articles that address key issues surrounding global health, including five articles already published in Pediatrics.

Dr. Maneesh Batra“This [number of publications] happened because we had a highly effective group working on them, and the ABP staff and senior management team were responsive and committed to reviewing drafts to make sure we stayed true to the focus of the task force,” says Maneesh Batra, MD, MPH, Chair of the GHTF Publications Work Group and a Professor of Pediatrics at the University of Washington and Associate Director of the Pediatric Residency Program at Seattle Children’s.

Another notable achievement of the task force was the development of Global Health in Pediatric Education: An Implementation Guide for Program Directors.

Dr. Nicole St Clair“The guide is a culmination of efforts by global health educators, members of the task force, and stakeholder organizations such as the Association of Pediatric Program Directors and the American Academy of Pediatrics,” says Nicole St Clair, MD, Associate Professor of Pediatrics at the University of Wisconsin School of Medicine and Public Health and Editor of the implementation guide. “We have been collaborating for many years to develop resources for global health educators. The purpose of the guide is to provide a comprehensive, practical resource for incorporating global health education into pediatric residency and fellowship training programs. In creating it, we spent several years developing, curating, and collating pertinent resources, expert opinions, and guidelines into one central resource for educators. And we’ve already received a lot of positive feedback on how useful it is.”

Dr. St Clair says the guide can be tailored for other uses.

“Many medical schools are also integrating global health education into their framework. In developing this tool, we fully recognize that undergraduate medical educators, as well as practicing providers, may want to use these resources,” she says. “There’s very little in the guide that wouldn’t be applicable to another specialty, so I think there is potential for other disciplines to use it.”

Dr. Butteris says the task force has been successful in developing opportunities for pediatricians to learn more about global health issues, both domestically and internationally.

“People have become more keenly aware of some of the more challenging issues for our country in terms of immigrants, refugees, and the health of children who are placed in difficult situations at the border or after they enter our country,” she says. “We’ve developed two Self-Assessment [Part 2] activities for Maintenance of Certification. One helps physicians learn more about the health issues facing immigrant and refugee children, and another covers professionalism and ethics when working in international settings.”

The task force also is creating a guide that global health educators can use to enhance their global health educational programs while earning MOC Part 4 (Quality Improvement) credit.

The task force will sunset at the end of 2019, having laid a strong foundation for work that will continue.

Valerie Haig“It has been an honor to work with this group of passionate, motivated, and productive volunteers,” says ABP program manager Valerie Haig, who staffed the GHTF. “They made a commitment to share their time and expertise with the ABP to develop a multitude of resources that support pediatricians caring for children and adolescents of all backgrounds, inside and outside our borders.”

“I love working with this task force,” says Dr. Batra. “I know it’s going to have impact. The most rewarding volunteer experience is when you have ability to see the fruit of your work. I can say with a huge smile on my face that this has been so important and so fun.”

1U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. Child Health USA 2014. Rockville, Maryland: U.S. Department of Health and Human Services, 2014.
2Radford J, Budiman A. Facts on U.S. immigrants, 2016. Pew Research Center. Updated September 14, 2018. Accessed February 1, 2019.
3Butteris SM, Schubert CJ, Batra M, Coller RJ, Garfunkel LC, Monticalvo D, Moore M, Arora G, Moore MA, Condurache T, Sweet LR, Hoyos C, Suchdev PS. Global health education in US pediatric residency programs. Pediatrics. 2015;136(3):458-465. doi:10.1542/peds.2015- 0792