Can you tell us about the partnership between Gillings and Hanoi Medical University?
Dr. Le Minh Giang: The partnership between Gillings and Hanoi Medical University (HMU) has started quite a few years back. Various activities included: HMU hosting Gilling’s pre-doctoral students, one HMU faculty obtaining PhD at Gillings, and several small research studies. Most recently, two major projects cemented the collaboration, including an implementation science study to improve linkages to HIV care among people who inject drugs and are HIV positive and a training program to improve implementation science research capacity for HMU and other institutions. Both project are funded by US NIH.
Dr. Vivian Go: UNC-Vietnam project has been collaborating with Hanoi Medical University over the last decade on a range of NIH-funded HIV, mental health and implementation science studies for vulnerable populations including people who inject drugs, men who have sex with men and transgender people. Most recently, HMU/UNC was awarded an NIH D43 training grant to build implementation science capacity across health science universities and health departments in Vietnam.
Can you tell us about the COIL program?
Dr. Vivian Go: Collaborative Online International Learning (COIL) is part of an initiative sponsored by the Office of the Vice Provost for Global Affairs. COIL courses involve shared learning between students in a course at UNC-Chapel Hill and peer students at a global partner university.
Over the fall 2021 semester, our instructional team implemented COIL program for interested students taking HBEH 784 — Implementation Science in Global Health. This 3-credit, masters-level course is required for global health MPH students at Gillings, and is co-taught by me and Brian Pence. The COIL program provided MPH students the unique opportunity to work with a group of students from Hanoi Medical University (HMU) and exchange experiences and perspectives on the challenges of translating evidence-based interventions into real-world settings. In implementing COIL, the UNC instructional team worked with a collaborating group of instructors at HMU to engage in the following activities: course planning and preparation, including syllabus and Sakai site development; developing lecture materials; facilitating class sessions and discussions; coordinating in-person and virtual course logistics; providing support to students through feedback on assignments; and answering student questions.
Can you give us an overview of HIV treatment/prevention in Vietnam?
Dr. Le Minh Giang: Over the past decade or so, with support from PEPFAR (The US President Emergency Plan For AIDS Relief) and the Global Fund, Vietnam has made great progress in terms of providing HIV treatment and HIV prevention for vulnerable populations. The HIV treatment coverage has reached about 70% of people living with HIV, and the PrEP program has reached about 30,000 people over the past two years. Despite such progress, there are still many inequities in terms of program access and quality. For example, people who inject drugs still fare worse as compared to other vulnerable groups. Or stigma still is a major barrier for people living with HIV to get access to services, HIV and otherwise, improve their overall health and quality of life.
What did you learn from engaging with the COIL program?
Dr. Le Minh Giang: I myself have appreciated the ways in which UNC faculty prepare and conducted class sessions. All sessions helped students to apply what they learn almost immediately and encourage engagement of all students.
Dr. Vivian Go: I enjoyed collaborating with our HMU colleagues and learning about the MPH curriculum at the HMU School of Preventive Medicine more broadly, and about the implementation science course syllabus, more specifically. The MPH courses are taught one at a time, for three-week periods at HMU and the teaching style tends to be more didactic in nature.
Natasha Hughes: Engaging in the COIL program allowed for me to truly see the essence of global public health in action. I learned how to engage with stakeholders with a more realistic and accurate depiction of various issues. In global health related classes, we talk a lot about global health issues that affect various locations and communities around the globe. Participating in this program allowed to see what engaging members of this community is really like as a public health professional. We were able to practice cultural humility while participating in these projects through taking a step back and communicating with stakeholders about the needs of the community.
Nguyen Duc Khanh: Implementation science, how to apply the context of America on the proposed projects. Plus, the chance to communicate with other scientists in America and learn from how they work and exchange opinions on how we should build our implementation models.
Can you tell us why implementation science is important in global health?
Dr. Le Minh Giang: Implementation science improves health globally, especially for those who are vulnerable and underserved, by making sure that effective solutions elsewhere are applied most appropriately and effectively in the new context in order to maximize the impacts of these solutions for those in need.
Dr. Vivian Go: Billions of dollars have been spent developing effective health interventions globally. Once interventions have been shown to be effective in randomized controlled trials, they are often not implemented, or if they are implemented, they are not implemented well. Implementation science is the study of translating evidence-based interventions into routine practice. It systematically identifies real-world barriers to implementation and evaluates strategies to overcome these barriers.
Natasha Hughes: Implementation science is important in global health because it helps public health professionals to take their interventions to the next level. Implementation of interventions is particularly useful in global health because of its interconnectedness within populations. Because of this, it is important to find ways of implementing evidence-based interventions in the most effective ways in order to reach the greatest amount of people. Public health professionals are able to work alongside communities to find their most needed resources and services resulting in the potential of overall better health systems in their areas.
Nguyen Duc Khanh: Implementation science gives different implementation methods opportunities to be adapted to different context.
What was your favorite part of the COIL program?
Dr. Le Minh Giang: I like sessions where there are intensive exchanges between UNC and HMU students. For examples, UNC students provided comments on the project prepared by HMU students and vice versa. I think both faculty and students learned a lot of those sessions.
Dr. Vivian Go: It was gratifying to watch students from HMU and UNC in a shared learning environment. We underestimated how often both HMU and UNC students wanted to meet; we didn’t want to overburden students with their already full class schedules. But in our evaluations, the students asked for more time to engage with each other (almost double) and described how much they learned from hearing each other’s perspectives.
Natasha Hughes: My favorite part of the COIL program was, by far, getting to know the Hanoi students and collaborating with them while we worked on our respective projects. It was very interesting to hear about life in Vietnam directly from those who live and have grown up in these communities. It was particularly interesting to see their different perspectives on global health as well as their differences in their academic and social lives. Talking and learning from those who are different from our selves teaches us more than we can ever learn from ourselves. The students and faculty at Hanoi Medical University were incredibly intelligent, kind, and understanding. I am very grateful that our group has gotten the chance to get to know them.
Nguyen Duc Khanh: Communicating with others to build our own implementation projects.
How has the COIL program impacted your studies and future career goals?
Natasha Hughes: Participating in the COIL program allowed me to gain further experience in global HIV research projects. Over the summer I participated in an internship that focused on mHealth interventions for adolescents living with HIV in South Africa. While participating in this internship, I became very interested in the topic of global HIV research. Participating in the COIL program has further increased my interest in this topic and in this population. For future research I would be very interested to combine these research topics and look for how certain mHealth interventions could possibly aid key populations in Vietnam.
Nguyen Duc Khanh: COIL program taught me about how to apply evidence-based implementation in different contexts. As my career is about public health and epidemiology, it enriched my experiences to apply in in my work.
What does “global health” mean to you?
Dr. Le Minh Giang: Global health in equity in health for all people around the world.
Dr. Vivian Go: To me, global-local means that global can be right at your doorstep; that the exchange of ideas and research experiences can flow in all directions from local to international, international to local, local to local and international to international. It’s not a division of local versus global but rather a holistic approach.
Natasha Hughes: Global health is a complex field of study that requires a collaborative effort from many different disciplines. If I had to explain global health in my own terms, I would say that global health is specialized section of healthcare dedicated to ensuring that all individuals from around the globe have an equal opportunity for fair, safe, and effective healthcare. My definition of global health is centered around the idea that every person deserves the same opportunity to be healthy no matter their location, background, financial status, or any other socioeconomic factors.
Nguyen Duc Khanh: To me, global health means health problems that impact the whole world, or have risk to impact on the global level. Researching on global health means we should not only look at the health problems, but also the contexts: the people, culture, policy…