Cross-Disciplinary Perspective on Healthcare Delivery in Low and Middle-Income Countries

A new IPE business course is offered at U-M in fall semester, and students faculty find a lot to appreciate about it.

“University of Michigan is unusual in that it has a group of very high quality schools all speaking to health care,” says Paul Clyde, PhD, of the William Davidson Institute, a non-profit research and educational organization located at U-M that works to drive economic development through the development of the private sector in low- and middle-income countries (LMICs). Clyde is also a professor at U-M’s Ross School of Business and the course director of a new-in-2020 U-M interprofessional course: A Cross-Disciplinary Perspective on Healthcare Delivery in Low and Middle-Income Countries.

Listed as BA620 and offered in the second half of fall semester, this interprofessional LMIC course takes advantage of U-M’s collective strength in areas related to global health care delivery. It is coordinated by Clyde and co-taught by accomplished global health scholars, some at associate-dean level, from four U-M health science schools (see some faculty reflections on the course below). The students in BA620 come from across disciplines to work together to address current, critical, real-world problems. It is the first business course to receive Michigan Center for Interprofessional Education (IPE) designation for being intentionally interprofessional. 

Health care delivery in LMICs relies on a good understanding of the different disciplines’ approaches to care and how they can vary between cultures, including but not limited to provider expertise, patient trust, access, financing, medication/treatment availability, policies, and evolving technologies. BA620 introduces students to the perspectives and challenges faced by people in disciplines and cultures that differ from their own, leading to critical thinking about the effect of that understanding on each individual discipline’s engagement in health care delivery in LMICs. 

Understanding the roles and challenges facing all of the decision makers in the global markets (including medical, nursing, pharmacy, public health, and business managers) is important for businesses–but is also important for work in all of the other disciplines, Clyde explained. 

Because the course ran for the first time at the height of COVID-19 pandemic, it had to pivot to a virtual format. Instructors and students found valuable areas for interaction despite the pandemic–and in some ways because of it. For example, emergency vaccines could be discussed with a variety of perspectives, from supply side to delivery in challenging settings. Likewise, discussions around the sudden and significant increase in bodies needing to be buried during the crisis brought appreciation for backgrounds on environmental impact, which might not have been as available in a single-discipline course (see some student reflections on the course below).   

Although the faculty rotated teaching sessions, Professor Clyde brought them all together for a course preview session that was open to the public (still available for viewing). In fall 2021, each session will focus on a particular topic and have faculty from two disciplines discuss it together and react to each other’s responses. 

“In the long run, we hope to grow the number of students enrolled in the class while maintaining a mix between the different disciplines,” Clyde said. “The goal for the William Davidson Institute program, of which this course is one part, is to make the Ross School of Business the best place to go to hire MBA graduates to work in health care companies – both multinational and local — operating in low and middle income countries.”

Along the way, every discipline benefits from people with perspectives not readily available in their degree programs–yet ready for collaboration amid challenges in the real world, amid international crises or not.

BA620 is offered on Wednesdays from 3-5 pm in the second half of fall semester. Seats available to each U-M school and college are limited for fall 2021, so enrollment is by permission: Students can send name, program, school and degree to BA620-Apply@umich.edu

Reflections on the course from some faculty and students:

Joe Kolars, Medical School Associate Dean: This is a unique course that I haven’t seen at other institutions that will advantage students who are seeking to understand and have impact in the global environment. Some of our greatest advances in health will come from those who are working in interdisciplinary, collaborative teams in low and middle income countries.”

Jody Lori, School of Nursing Associate Dean: “The complex issues facing healthcare today in low-and middle-income countries require an integrated team approach from multiple disciplines. This IPE course provides students with a first-hand look at how various disciplines work together with in-country partners to improve healthcare delivery. Students and faculty work together to understand the unique contributions of different disciplines and together how to work effectively.”

Vicki Ellingrod, College of Pharmacy Associate Dean: “This class was a great exploration of issues that we often don’t think about in the United States. I felt like I learned just as much from the other faculty and students as they learned from me, given the interdisciplinary design of the course, as well as the fact that each of the faculty have experience in different low to middle income countries.”

Kathy Sliwinski, Nursing Student: “My fellow classmates who had these varying backgrounds were able to bring unique perspectives and thoughts about healthcare delivery. For example, I was able to learn about topics such as supply-chain management in healthcare, a topic that I have never been exposed to prior, from my fellow business peers. I will be able to apply this knowledge moving forward in my nursing career.” 

Kathryn Quantrom, Medical Student: “When I think of the complexity of building systems that can provide healthcare or medical care in LMICs, I really had not considered just how difficult it might be to obtain high-quality drugs that are not counterfeit, store them properly, and develop a system for safe dissemination…. I think challenging our assumptions and own ways of seeing requires putting ourselves in situations of learning, and circumstances outside our comfort zone.”