Lifestyle Diseases 14: Transformative Education on Health

This is the 3rd paper that Dr. Tony Leachon, a free and volunteer consultant to the Department of Health (DOH) on non-communicable diseases (NCDs), sent me. Thanks again, Tony.
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Universal Health Care needs Transformative Education of all Filipinos on Health

Anthony C . Leachon MD
Philippine College of Physicians

The great Filipino thinker, entrepreneur, and philanthropist , Washington Sycip said that "Education is the greatest equalizer in life."

And why is this so?

Well, education empowers people; education provides equity; and education is more cost effective. A Filipino college graduate has a fighting chance to secure a stable job than one who's not.

Thus, an educated populace is perhaps an answer to our anemic economic progress. According to DepEd, only 2 out 10 students will finish collegiate education and health and poverty are predominant reasons for the gripping data. DepEd Sec. Armin Luistro has been championing K to 12 since he said that we are the only country in Asia lagging behind in educational curriculum. Sec. Luistro is a major proponent of the K+12 Basic Education Program in the Philippines. The program seeks to add two years to the current 10-year basic education curriculum.

Now the 64 dollar question looms in the horizon: are our students, teachers, educators, and healthcare professionals ready and equipped to face this constantly changing environment? Seventy percent of the country 's population is below the poverty line. This segment is highly considered the economic workforce of a third world country like the Philippines.

Recently, in a high level meeting of some of the great minds in health education convened in Cebu 3 months ago and addressed this disturbing finding. The Philippines' information, educational system and workforce are not ready to confront this social epidemic in a dangerous era of climate change , rapid population growth, and globalization.

Prof . Julio Frenk MD et al in their thought provoking Lancet article last year, said that the world will need a new breed of Health professionals with a different skills set for the new century utilizing education to strengthen health systems in an interdependent world. In 1970 , Omran et al theorized that globalization, improvement in science and technology eg vaccines and new antibiotics , and urbanization will reduce infections or communicable diseases. He boldly predicted though that with economic progress , noncommunicable diseases ( NCDs ) will increase and reach epidemic proportions. Now , this is a hard reality and without us knowing it.

Today , believe it or not , NCDs namely strokes, cancers, chronic respiratory diseases, cancers and diabetes , are not the domain of the affluent rich in their 60's. We have seen the unstoppable surge of NCDs almost of epidemic proportions across all social classes and across the globe ; however , the glaring reality , based on the Lancet article of top epidemiologist Prof. Antonio Dans last February 2010 ,NCDs are common now in younger and poorer patients in Southeast Asian countries and threaten the middle and low economic countries where the people are not ready to face this social epidemic.

Through integration of modern science into the curricula at university-based schools, the reforms equipped health professionals with the knowledge that contributed to the doubling of life span during the 20th century.
By the beginning of the 21st century, however, all is not well.

Glaring gaps and inequities in health persist both within and between countries.

Professional education has not kept pace with these challenges, largely because of fragmented, outdated, and static curricula that produce ill-equipped graduates, basically in preventive health education and in public health.

The problems are systemic: mismatch of competencies to patient and population needs; poor teamwork; persistent gender stratification of professional status; narrow technical focus without broader contextual understanding; episodic encounters rather than continuous care; predominant hospital orientation at the expense of primary care; quantitative and qualitative imbalances in the professional labour market; and weak leadership to improve health-system performance. Laudable efforts to address these deficiencies have mostly floundered, partly because of the so-called tribalism of the professions—ie, the tendency of the various professions to act in isolation from or even in competition with each other.

To advance third-generation reforms, the authors forward a vision: all health professionals in all countries should be educated to mobilise knowledge and to engage in critical reasoning and ethical conduct so that they are competent to participate in patient and population-centred health systems as members of locally responsive and globally connected teams.

The ultimate purpose is to assure universal coverage of the high-quality comprehensive services that are essential to advance opportunity for health equity within and between countries.

Realisation of this vision will require a series of instructional and institutional reforms, which should be guided by two proposed outcomes: transformative learning and interdependence in education.

We regard transformative learning as the highest of three successive levels, moving from informative to formative to transformative learning.

1.Informative learning is about acquiring knowledge and skills; its purpose is to produce experts.

2.Formative learning is about socialising students around values; its purpose is to produce professionals.

3.Transformative learning is about developing leadership attributes; its purpose is to produce enlightened change agents.

Effective education builds each level on the previous one. As a valued outcome, transformative learning involves three fundamental shifts: from fact memorisation to searching, analysis, and synthesis of information for decision making; from seeking professional credentials to achieving core competencies for effective teamwork in health systems; and from non-critical adoption of educational models to creative adaptation of global resources to address local priorities.

Interdependence is a key element in a complex environment. As a starter, if there are 3 major behavioral risk factors namely : tobacco use, unhealthy dietary lifestyle and physical inactivity that have shaped the destiny of patients in a globalized and technological world , then we need to design our educational curriculum from grade school to high school and even to collegiate levels . Thinking and behaving to be healthy should be a way of life and that the government should be responsible to provide the necessary infrastructure to complement with the changes in the educational system.

Health is wealth. A nation's health is a nation's wealth. The human capital is composed of a healthy and educated populace. A strong and solid human capital is the bedrock of the country ' s economic progress.
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See also:
Lifestyle Diseases 11: Obesity and Cancer, January 08, 2012
Lifestyle Diseases 12: On Fat Filipinos, January 17, 2012
Lifestyle Diseases 13: Curbing and Preventing NCDs, January 17, 2012