Global Health Education in Chinese Universities: Potential for Collaboration with Schools of Nursing

Background The Consortium of Universities for Global Health (CUGH) and the Chinese Consortium of Universities for Global Health (CCUGH) were established within public health schools in North America in 2009 and in China in 2013. These consortiums are mandated to engage a variety of complementary disciplines including those in the health sphere such as public health, medicine, dentistry, pharmacy, and nursing as well as those outside of the health arena, including law, environmental studies, business, anthropology, etc. Specifically, expanding the exposure of nursing students to global health curricula is critical as nurses are essential actors in the health care system: making up 80% of the global health workforce and providing 90% of health care worldwide. Although the Chinese Nursing Association officially became a member of the International Council of Nurses (ICN) in 2013, information related to existing global health education within CCUGH-affiliated universities and the current engagement of Chinese schools of nursing in global health remains extremely limited. The aim of this study is to identify and describe the current definitions and conceptualizations of global health education in Chinese universities, with a focus on Schools of Nursing. We will also explore potential synergies between existing global health initiatives and Schools of Nursing in China. Methods A cross-sectional descriptive study was carried out from July to October 2014. Purposive sampling with snowballing was used to recruit 18 total key informants. The key informant interviews were carried out with critical stakeholders in global health and nursing in China, principally directors at global health institutes or deans at Schools of Public Health affiliated with the CCUGH, and deans at schools of nursing affiliated with the China Medical Board (CMB) China Nursing Network and were conducted by the lead researcher. Key informants included 5 directors/deans and 1 senior researcher from 5 CCUGH-affiliated schools of public health, 8 deans from CMB China Nursing Network affiliated schools of nursing, 1 vice president from Jiangxi University of Traditional Chinese Medicine, 1 professor from the Duke Global Health Institute, 1 former director from CMB Beijing office and 1 project director from Project Hope Shanghai office. Interviews were conducted in person, either by telephone/Skype, or e-mail, and in the case of telephone/Skype interviews they were audio-recorded and transcribed verbatim. Atlas.ti 7 and Microsoft Excel were used to carry out content analysis. Written informed consent was obtained from all informants prior to interviews. In addition, a desk review of syllabi and textbooks used in essential nursing courses including Introduction to Nursing and Community Nursing were collected to assess the current content of the curriculum related to global health nursing. Approval for this study was granted by the Institutional Review Board at the University of Washington in June, 2014. Results As of October 2014, 7 CCUGH-affiliated universities had global health institutes with varying levels and types of resources and support. These institutes were based at either public health schools or as standalone institutes within larger universities. An additional 3 CCUGH-affiliated universities and 2 non CCUGH-affiliated universities were in the process of establishing global health institutes or designing global health programs. Despite this burgeoning growth in the field, the definition of global health has still not been consistently applied in Chinese global health and nursing institutions. Two translations of global health have been used, either "quan qiu jian kang" or "quan qiu wei sheng": the former reflecting more the larger phenomenon of health status and the latter used to describe healthcare systems more. According to the key informants, these differing translations have influenced the scope and mandate of the various players in this burgeoning field in China. Both the Ministries of Health and Education expressed support for global health education and related activities. Two schools of nursing are engaged in global health curriculum at schools of public health, through offering nursing faculty-led global health-related courses. All key informants recognized the potential relationship between global health and nursing, and emphasized that collaboration between public health and nursing schools is growing and should be increasingly prioritized. Conclusion Increasingly Chinese universities are promoting global health education through the platform of CCUGH. It is an ideal moment to promote and expand work across the fields of global health and nursing, specifically to highlight opportunities for collaboration across education, research and practice. Engaging more nurses in global health, through education and research will increase nurse visibility in the field and foster their increased participation in global health policy bodies. Increasing nursing engagement in global health will result in more appropriate and efficient allocation of resources to address health needs of people worldwide.