Healthy Collaborations? A history of public health campaigns, comics and consumerism

Healthy collaborations?

Recently the supermarket chain Sainsbury’s launched the ‘Heroes’ campaign, offering collectable cards as a give-away alongside specific purchases which were associated (albeit tenuously) with health and wellbeing behaviours: ‘getting active’ ‘teaming up’ ‘being smart’ and ‘doing good’. Although that is hardly clear from the advert:

While we must ask critical questions about the motives behind collaborations between private companies and health or wellbeing initiatives, we must also remember that this sort of sales tactic is hardly new. As Jane Hand has shown, supermarkets and major brands have engaged in health-based promotion and advertising before, making health claims about specific products such as margarine to shift produce. Targeting parents through their children using a health message is also a tried and tested method of promoting a product, idea or behaviour, deployed by both private companies and the government. Perhaps surprisingly, the use of superheroes popular with children to promote health behaviours is also not new. The British Government’s Health Education Council recognised the power of fictional heroes as health promoters, and employed a number of heroes in the 1980s, from Hulk to Superman, collaborating with private companies for the privilege.

On Boxing Day in 1980, an anti-smoking advertisement paid for by the Health Education Council (HEC) and designed by the advertising agency Saatchi and Saatchi, aired on British televisions for the first time. The 30-second clip showed ‘Nick O’Teen’ attempting to encourage a group of children to start smoking, only to be thwarted at the last minute by Superman, who swoops in and throws Nick O’Teen and his cigarettes into the distance.

The TV advert was part of a wider HEC campaign which used the hero Superman in an attempt to persuade children under 11 from ever taking up smoking in their futures.

Nick O’Teen Posters. Saatchi and Saatchi for the Health Education Council, 1980a, 1980b, 1980c. This figure is covered by the Creative Commons Attribution 4.0 International License. Reproduced with permission of Crown; copyright © Crown, all rights reserved. This information is licensed under the Open Government Licence v3.0. To view this licence, visit http://www.nationalarchives.gov.uk/doc/open-government-licence/. Image courtesy of the Wellcome Collection

 

Superman’s X-ray vision, he tells viewers, allows him to see inside people’s bodies which is why he ‘Never says yes to a cigarette’. The TV advertisement was part of a campaign run by the HEC from 1980 until 1982, costing in excess of £3.5 million. The campaign deployed a wide range of visual sources, including posters, comic books and badges to encourage children to join Superman in his fight against Nick O’Teen.

This anti-smoking campaign was the product of a collaboration between the Health Education Council and Saatchi and Saatchi, with the heroic image of Superman obviously borrowed (at significant expense) from DC Comics.

Such collaborations between advertisers and the public health education arm of the British government were also not new. The expertise advertisers could offer in the delivery of a persuasive health campaign to the public had been recognised since at least the 1960s, but the Nick O’Teen campaign was still something a little special.

Children are a difficult public to reach with health education. One might assume that they’re a fairly captive audience given they spend much of the week at school, but research indicates that draconian health messages tend to be poorly received and often rebelled against. Outside school children don’t usually have much control over what they consume, so reaching them has to be achieved through media they’re likely to consume, or at school, but in a manner they won’t reject. The Health Education Council opted to place adverts for a free anti-smoking health education Superman Pack in children’s comics (below), sending similar adverts to schools. They also invited children to enter an anti-smoking poster competition.

Superman pack request sheet. Saatchi and Saatchi for the Health Education Council, 1980a, 1980b, 1980c. This figure is covered by the Creative Commons Attribution 4.0 International License. Reproduced with permission of Crown; copyright © Crown, all rights reserved. This information is licensed under the Open Government Licence v3.0. To view this licence, visit http://www.nationalarchives.gov.uk/doc/open-government-licence/. Image courtesy of the Wellcome Collection

 

These tactics engaged children directly in the campaign, taking them seriously as an audience with specific tastes, and asking them to contribute (or collaborate). Aside from a chance to enter a competition which might win them a bike, the pack contained a comic book, badges, posters and an anti-smoking pledge children could sign.

Certificate. Saatchi and Saatchi for the Health Education Council, 1980a, 1980b, 1980c. This figure is covered by the Creative Commons Attribution 4.0 International License. Reproduced with permission of Crown; copyright © Crown, all rights reserved. This information is licensed under the Open Government Licence v3.0. To view this licence, visit http://www.nationalarchives.gov.uk/doc/open-government-licence/. Image courtesy of the Wellcome Collection

 

Exciting and enticing though the Superman campaign was, it is very hard to measure if this healthy collaboration between the HEC, Saatchi and Saatchi and DC comics, had the intended effect and reduced the uptake of smoking among Britain’s youth in the late 20th Century. While an estimated 1 in 10 of Britain’s children had requested a Nick O’Teen pack by 1982, the effect this had on smoking is a great deal harder to quantify. Indeed, smoking rates amongst children did not change much over the course of the next 30 years, suggesting that some groups of children were largely impervious to anti-smoking messages, no matter how carefully delivered.

Want to know more? Read the article this short blogpost is based on! The product of another healthy collaboration between Alex Mold and myself as part of the Placing the Public in Public Health project.

Alex Mold, Hannah J. Elizabeth, Superman vs. Nick O’Teen: anti-smoking campaigns and children in 1980s Britain, Palgrave Communications 5, 116 (2019)

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How good are your #LSHTMemories?

We’re celebrating LSHTM’s 120th Anniversary throughout the 2019/20 academic year with a series of 120 events around the world, with blog posts about healthcare innovations here at the School and by our alumni globally, and with a special edition of your annual Alumni News magazine.

In the magazine, as well celebrating the many historic achievements of the School and throwing a spotlight on current developments, we’ll profile alumni working on innovative projects and say a big ‘thank you’ to all our wonderful volunteers, supporter and donors.

On the ‘Letters’ page of the magazine, we’d also love to include some of your favourite memories from your time at the School. Whether it was a stand-out lecture that changed your thinking (or perhaps it was a conversation in the bar!) or a lightbulb moment in the lab or the library.  Perhaps a group of fellow students or members of staff who supported you through a tough time. Or maybe it’s the local gems you discovered that remind you of your time in London.  Whatever it is, we’d love to hear from you.

Please email us your memories at or tweet them to us @LSHTM_alumni using the hashtag #LSHTMemories.

Updates to MeSH terms for 2020

The US National Library of Medicine has released the edits for their medical subject headings (MeSH) for 2020. These are used to index articles added to the PubMed and Medline databases, and are also used by other databases including the Cochrane Library. The MeSH terms are updated every year to incorporate new terminology or to re-classify existing terms with up to date definitions. Note that these changes are NOT retrospectively applied. Therefore you may need to incorporate old and new MeSH terms in your searches to retrieve all relevant articles. If you have saved searches or searches you run on a regular basis in order to stay up to date, it is important that you periodically update your search to make sure it continues to retrieve the papers you need.

Here are some of the edits which may be of interest to LSHTM users.

New MeSH terms

The full list of new MeSH terms can be downloaded as a PDF. Here are some particularly relevant to public health or infectious disease research.

There has been a major update of dietary terms including:

  • Animal proteins, dietary
  • Artificially sweetened beverages
  • Avoidant restrictive food intake disorder
  • Diabulimia
  • Edible films
  • Edible insects
  • Famine
  • Food fussiness
  • Horticulture
  • Pork meat
  • Salads
  • Sugar-sweetened beverages
  • Weight prejudice

There has also been an update to a number of technological advances including:

  • Augmented reality
  • Blockchain
  • Citizen science
  • Data management
  • Disruptive technology
  • Internet of things
  • Internet-based intervention
  • Smart glasses
  • Smart materials

New environmental health terms include:

  • Biological monitoring
  • Biosolids
  • E-cigarette vapor
  • Environmental indicators
  • Environmental science
  • Exposome
  • Extreme hot weather
  • Extreme weather
  • Microplastics
  • Sea level rise
  • Wastewater-based epidemiological monitoring
  • Water decolorisation

A number of terms relating to health services have been added, including:

  • Clinical decision rules
  • Community-based health insurance
  • Decision making, shared
  • Fertility clinics
  • Learning health system
  • Military health
  • Military health services
  • Public reporting of healthcare data
  • School mental health services
  • Universal health care
  • Veterans health services

Others include:

  • Empowerment
  • Historical trauma
  • Homonal contraception
  • Indigenous peoples
  • Intersex persons
  • Legal epidemiology
  • Limited English proficiency
  • Narcotic-related disorders
  • Obesity, maternal
  • Opioid epidemic
  • Public nondiscrimination policies
  • Right to health
  • Right to work
  • Undiagnosed diseases
  • Universal design
  • Vaccine excipients
  • Vaccine-prevantable diseases
  • Vector borne diseases

Edits to existing MeSH terms

A full list of changes to existing MeSH terms can be found in PDF format. There are no major changes, edits relevant to LSHTM researchers are the creation of new narrower terms. Therefore, in future, searches can be made more specific by choosing the new term rather than the more general old term.

  • Decision making has a new narrower term: Decision making, shared
  • Ecology has a new narrower term: Environmental Science
  • Environmental monitoring has a new narrower term: Biological monitoring
  • Red meat has a new narrower term: Pork meat
  • Starvation has a new narrower term: Famine
  • Transgender persons has a new narrower term: Intersex persons

New publication types

From 2020 veterinary RCTs will be indexed under the new publication type: Randomized controlled trial, veterinary

If you need more help on using MeSH terms in your search, or want to incorporate these changes in saved searches, you can contact the LSHTM Librarians for help via ServiceDesk.

LSHTM Innovators: Jillian Kowalchuk: Founder and CEO at Safe & the City, Ltd

“I decided to study at LSHTM because of its world-renowned history, the impact it has had as a university and the exceptional alumni. I knew I wanted to do this for not only my career but also for my personal development, as well as my ability to improve key global health issues.”

“LSHTM has been invaluable to my career path into entrepreneurship. Not only has it given me a competitive advantage with technical skills, but also a global perspective and resilience to continue to work towards change in complex and ever-changing public health issues. There were so many great relationships formed with LSHTM students, staff and alumni from around the world, and amazing mentors who supported me throughout my studies and afterwards.”

“Safe & The City came about after an incident where I experienced sexual harassment in London. Following the route suggested by a navigation app, I was threatened with sexual assault and harassed by two male kitchen staff in a narrow alley. I didn’t want anyone to have to walk into a similar or the same situation. I’m not sure without my MSc in Public Health I would have understood this as a problem that a public health approach could be used to solve. After researching, identifying relevant data sets and listening to others’ similar experiences and how they adapted their behaviours, I began to apply my knowledge of public health, psychology and previous lived experiences to develop a team, app and data insights SaaS platform to enable the design of safer and smarter city streets as people move through them.”

“LSHTM introduced me to many new thoughts, challenges and solutions to public health issues. Working in public health gives you a breadth of experiences across many different key global challenges. In the field, this could mean adapting yourself to variables, like a lack of resources or emergency situation, which are outside of your control. I found this helped prepare me to always be ready for the unexpected and be willing to quickly adapt and learn. This gave me the ability to move into building my own tech start-up with more preparation for agile development, the ever-changing day-to-day of running a growing team and being ready for the challenges of the wider eco-system you need to evolve within.”

“One of my personal metrics of success is to intersect technology and business into a public health framework. I believe we need to involve many more specialised fields to monitor and evaluate public health programme implementation and find ways to implement them into our daily habits and behaviours.”

3-9 October 2019

LSHTM’s launch of NEST360 is the subject of six BBC interviews, including Newsday and Focus on Africa, and a Telegraph story. Speaking to the Telegraph, Joy Lawn said: “most devices are not built and designed for work in Africa… This approach is exciting because we’re moving beyond the one device at a time approach to tackling newborn mortality.”

Chris Whitty, who became Chief Medical Officer on 1 October, is named as one of London’s most influential people in technology and biotech in the Evening Standard.

Tom Shakespeare provides expert comment to Associated Press on a Lancet Neurology study on a robotic exoskeleton enabling a paralysed man to walk. Tom’s comments appeared in over 800 outlets worldwide, including in Reuters, where he said it was a “welcome and exciting advance” but challenges still remain:“Proof of concept is a long way from usable clinical possibility… Even if ever workable, cost constraints mean that high-tech options are never going to be available to most people in the world with spinal cord injury.”

Rachel Lowe speaks to the Washington Post about 2019’s global rise in dengue outbreaks, explaining how unplanned city growth and “warmer, wetter conditions more favourable to the mosquito” can contribute.

LSHTM research published in 2018 was also mentioned in a Wired story about dengue outbreaks in the Philippines and its links with the Dengvaxia vaccine controversy.

Alison Grant’s comments feature in an Independent feature on a new drug course developed to treat TB, previously published in the New York Times. Alison said of standard, months-long courses: “Traditionally, completion rates have been very poor.”

Kara Hanson discusses health insurance schemes and routes to Universal Health Coverage on the BBC World Service (at 19:42). Kara said: “Anything that can be done to protect people from the costs of healthcare at the time they’re sick is a really good thing.”

Jeremy Brown and Ian Douglas’s study suggesting that younger children in the UK school year may be more likely to be diagnosed with depression by 16 than their older peers, which was covered widely following its publication last month, appears in The Times and The Week

On social media:

This week’s social media highlight comes from Instagram, where we highlighted NEST360 through an Instagram stories quiz (full version not accessible via desktop without extension):

We did the sums on South Africa’s mental health spend. They’re not pretty

By Sumaiyah Docrat and Crick Lund (Alan J Fisher Centre for Public Mental Health, University of Cape Town)

This blog has been posted with kind permission from The Conversation.

South Africa has taken steps towards strengthening mental health care in the last 20 years. These include reforming the Mental Health Care Act 2002 and developing a National Mental Health Policy Framework and Strategic Plan 2013–2020.

The strategic plan aims to integrate mental health into general health services to reduce the burden of untreated mental health conditions. It also aims to transform the system to provide quality mental health services that are accessible, equitable and comprehensive, particularly for community-based mental health care.

But significant information gaps have limited the country’s ability to initiate a sustained response to mental health care. For example, the most up to date population based prevalence estimates of the burden of mental disorders date as far back as 2003/4.

The failure to implement the public policy on mental health was brought to light by the Life Esidimeni tragedy in 2017. Nearly 150 patients died after being moved from the Life Esidimeni Hospital to unlicensed facilities.

New challenges are now arising with the planned introduction of the National Health Insurance (NHI) scheme, which is intended to move South Africa closer to universal health coverage. But early evidence from NHI pilot districts show an inconsistency with the strategic plan and limited integration of mental health. If the relevant priorities aren’t explicitly reflected in the policies and activities supporting the NHI, mental health is likely to remain on the back burner.

The system must be clear about the care that mental health patients are entitled to and how providers will be identified and paid. Mental health care has to be recognised as an integral part of the health care system.

South Africa needs a good grasp of the problem and the resources required to address it.

The gaps

Until recently the country knew very little about a range of important factors related to mental health care. These included: the current state of investment in mental health; whether these investments were being used optimally; where the inequities in resourcing and access lay; and what priorities and plans should be in place to address these inequities.

In response to some of the biggest information gaps, we worked with national and provincial health departments and the South African Medical Research Council. We evaluated the health system costs of mental health services and programmes in South Africa for the 2016/17 financial year. We also documented and evaluated the available resources and constraints to inform a rational approach to planning effectively to improve mental health service delivery.

Our findings, published in Health Policy and Planning, offer – for the first time – a nationally representative reflection of the state of mental health spending. They draw attention to inefficiencies and constraints in existing mental health investments in the country.

The current situation

South Africa spends 5% of the total health budget on mental health services. This is in line with the lower end of international benchmarks of the recommended amount that countries should spend on mental health.

Yet, alarmingly, our study crudely estimated a treatment gap of 92%. This means that fewer than 1 in 10 people living with a mental health condition in South Africa receive the care they need. We also found huge disparities between provinces in the allocation of mental health resources. Provincial spending on mental health ranged widely across all levels of the health system. For example, in Mpumalanga, spending on mental health per uninsured South African was R58.50 while in the Western Cape it was R307.40.

Inpatient care took up 86% of the mental health care budget. Spending at specialised psychiatric hospitals made up 45% of the total. Services at the primary level of care made up only 7.9% of overall mental health spending.

This reflects a reactive mental health care system that is focused on treating the most severe conditions, rather than preventing or providing early interventions.

Mental health care users were admitted for longer periods than other patients – twice as long as other patients at district hospitals. At regional and tertiary hospitals, their admissions lasted around 6 to 8 times longer. At central hospitals, they spent almost 5 times longer. Mental health patients spent an average of 157 days in psychiatric hospitals per admission. Nearly 1 in 4 mental health patients were readmitted within three months of being discharged from any hospital. Readmissions alone consumed 18% of South Africa’s total mental health spend.

This indicates a highly inefficient system that fails to help patients transition to care in their communities. There is potential for cost savings in providing continuity of care and supporting people to live well in their communities after discharge from hospital.

Other findings included:

  • Only three provinces had child psychiatrists in the public sector.
  • There was an extreme shortage of psychiatrists and auxiliary workers critical for rehabilitation and supportive services.
  • There wasn’t alignment between the national database of NGOs licensed by the department of health and those reported through primary data collection.
  • A number of drugs critical for the management of chronically disabling conditions such as bipolar disorder and depression, were not routinely available.
  • Most district hospitals weren’t compliant with the Mental Health Care Act, though they are expected to provide 72-hour assessments and subsequent referrals for further care, treatment and rehabilitation.

Way forward

For the first time, South Africa has a nationally representative reflection of the state of mental health spending and an appreciation of the inefficiencies and constraints emanating from existing mental health investments. This is one of the highest sample sizes of any costing study conducted for mental health in low- and middle-income countries.

Our study points to some obvious improvements that could be made. These include stronger service delivery at community and primary health care levels. And better referral pathways could reduce unnecessary readmissions. This would also shorten hospital stays.

The next phase must focus on accelerating the country’s progress towards meeting the goals set out in the strategic plan and taking forward the recommendations of the South African Human Rights Commission Report. With these study findings in hand, the government now has a baseline from which to begin a rational planning process.

The government has asked us to help develop a mental health investment case for the country, which comes at a crucial time for the country’s mental health response, in light of the recent passing of the NHI Bill. This work will involve intensive and ongoing dialogue with a range of players involved in the provision of mental health services and research across the country.


Read the paper in Health Policy and Planning

Mental health system costs, resources and constraints in South Africa: a national survey
Sumaiyah Docrat, Donela Besada, Susan Cleary, Emmanuelle Daviaud, Crick Lund
Health Policy and Planning, czz085, https://doi.org/10.1093/heapol/czz085

World Mental Health Day 2019

World Mental Health Day is 10 October 2019. The day provides an opportunity to raise awareness of mental health issues and to advocate against social stigma. World Mental Health Day is organised by the World Federation for Mental Health, and supported this year by the World Health Organization, the International Association for Suicide Prevention, and United for Global Mental Health.

The theme this year is suicide and suicide prevention. Every 40 seconds someone loses their life to suicide and so the Day’s organizers are calling for “40 seconds of action” to:

  • Raise awareness of suicide as a global public health problem
  • Improve knowledge of what can be done to help prevent suicide
  • Reduce the stigma around suicide
  • Let people who are struggling know they are not alone

We can all look out for others when it comes to mental health – whether they are friends, family, students or colleagues.  We can all take 40 seconds to start the conversation around mental health.

To support WMHD the Library has a display of books on mental health and wellbeing.  The shelfmark for this topic is UJ and books can be found in the Library’s Barnard Room.

More information on what the School is doing to support mental health wellbeing (including Time to Change, Mental Health Network, Mental Health First Aiders, etc.) can be found on the intranet.

For more information on Student Support Services, visit the Student Hub in person (G90, Keppel Street) or online.

Celebrating commitment to mental health care in primary health care settings

By Jessica Spagnolo (Department of Community Health Sciences and Charles-Le Moyne-Saguenay-Lac-Saint-Jean Research Centre on Health Innovations, Université de Sherbrooke)

Global mental health aims to increase access to mental health care and to encourage the social inclusion of people living with mental ill health by promoting services as close as possible to people’s communities. This view also aligns with the Declaration of Alma-Ata, an affirmation in advancing the health of all people including those living with mental health disorders. In October 2018, the global community gathered at the Global Conference on Primary Health Care to renew its commitment to building strong primary health care systems by celebrating the 40th anniversary of the Declaration of Alma-Ata and the launch of the Astana Declaration. Global leaders present at the conference committed to strengthening health systems by further investing in the infrastructure and workforce within primary health care in order to provide proximity health and mental health services.

Almost one year later, on this 2019 World Mental Health Day, we are still discussing and reinforcing efforts to improve access to mental health services worldwide, for example, via primary health care settings. Primary health care is an important setting in global mental health. First, it is a promising way to increase access to needed, timely, comprehensive, and effective mental health services that are affordable. Second, given the association between mental health disorders and communicable and non-communicable diseases, vertical (stand-alone) programs traditionally favoured in the mental health field are not as effective as integrated approaches. Last, with the strategic position of primary healthcare providers in many primary health care settings around the globe, the World Health Organization (WHO) has recognized mental health as a core component of their training.

In line with such evidence and international momentum, our research team (i.e., a collaboration between the School of Public Health at Université de Montréal, members of the Ministry of Health in Tunisia, the WHO office in Tunisia, and the Montreal WHO-PAHO Collaborating Center for Research and Training in Mental Health) offered a training based on the Mental Health Gap Action Program (mhGAP) Intervention Guide (IG) (version 1.0) and developed by the WHO to primary care physicians working in the Greater Tunis area of Tunisia. They were trained in effective ways to detect, diagnose, and treat depression, psychosis, self-harm/suicide, and substance use disorders. We used an exploratory trial (which included a randomized controlled trial) to evaluate the impact of the training on primary care physicians’ mental health knowledge, attitudes, and self-efficacy scores, as well as their self-reported practice. We evaluated the training program over the short-term (6 weeks post-training) and over the long-term (18 months post-training).

Key results from this paper (forthcoming) include:

  • The training had a statistically significant short-term impact on mental health knowledge, attitudes, and self-efficacy scores, but not on self-reported practice.
  • When comparing pre-training results and results 18 months after training, changes in mental health knowledge, attitudes, and self-efficacy scores were maintained.
  • Primary care physicians reported a decrease in self-reported referral rates to specialized health services 18 months after training in comparison to pre-training.

The implementation and evaluation of the mhGAP-IG training in Tunisia was novel. First, to our knowledge, it was the first evaluation of a mental health training program implemented in Tunisia. Second, it was one of the first research programs to implement and evaluate the mhGAP-IG training in a French-speaking nation. Last, it was one of the few identified peer-reviewed initiatives to evaluate the mhGAP-IG training using a randomized controlled trial and to our knowledge the first to assess its impact beyond 10 months.

While results are promising, our experience taught us that while mental health training is key in building individual capacity, primary healthcare providers work in a health context that may facilitate or challenge training uptake and their involvement in mental health care. Identifying these contextual factors is also pertinent to ensure that untreated symptoms of mental ill health are addressed. We identified these factors with complementary, qualitative research which may be used to help explain findings generated by the impact evaluation and to foster discussions with Tunisian policy-makers.

We hope that these complementary research methods and findings may also be useful to the global community in its efforts to further improve mental health care in primary health care settings worldwide. We also hope that this blog will encourage discussions on the Health Policy and Planning Debated platform and in celebration of World Mental Health Day around the following topics:

  1. What lessons have other research teams learned from their work on the implementation and evaluation of mental health training programs (whether in high- middle- or low-income countries)?
  2. What types of dissemination activities have been used to translate implementation and evaluation findings into policies that aim to further promote mental health care in primary health care settings?

Image credit: Jessica Spagnolo

Global Health Leadership: Senior Health Leaders at LSHTM

Global Health Leadership: Senior Health Leaders at LSHTM

Senior health leaders from around the world joined the Executive Programme Fellowship as the third cohort met in London last week for the first residential phase of the Executive Programme for Global Health Leadership.  The programme, LSHTM’s first Executive Education offer, is designed to address the lack of strategic leadership courses within global health. The programme offers experienced professionals the opportunity to develop their personal leadership skills and professional networks. The week in London focused on developing a deeper understanding of self and others, strengthening leadership effectiveness in managing the political dynamics of operating in the health sphere, and mastering powerful communication.

Baroness Sheehan talks about politics and leadership

While visiting Chatham House, the Fellows had the opportunity to hear David Heymann speak about instruments to effect agendas in global health, and to conduct negotiation simulations, allowing them to apply their learnings from previous workshops in influencing with integrity. They also heard from former Chief Medical Officer Professor Sir Liam Donaldson, and incoming Chief Medical Officer Professor Chris Whitty, who candidly shared their own insights on leadership to influence policy. Amongst the other contributors were high-level speakers such as Baroness Sheehan and DFID Chief Scientific Advisor Professor Charlotte Watts, who spoke about their own careers and tools of leadership in their respective political spheres. Fellows also visited the Health Foundation and enjoyed valuable sessions with Professors Jennifer Dixon and Anita Charlesworth, who shared their own personal leadership journeys.

Professor Chris Whitty shares insights on influencing health policy

Fellows expressed their appreciation for the “richness of the week”, commenting that they have been inspired, recognising that they have “many more opportunities in their careers – new openings, and new horizons”, and how “applicable and relevant the learning has been”. Coming from across the world, (Mongolia, the USA, Myanmar, Nigeria, the UK, Ethiopia, New Zealand and India) and from a wide range of health sectors, this year’s cohort again represents a diverse range of senior health leaders that described themselves as having “global diversity, in thoughts and perspectives”.

Fellows during a simulation exercise

As part of the Executive Programme, Fellows are assigned a Senior Academic Mentor at LSHTM who guides them on their health initiative – a project or policy on which Fellows focus throughout the programme, selected from their wide portfolio of commitments. Fellows and Mentors met at a networking event at Keppel Street, kindly hosted by Professor Dame Anne Mills, who underlined the huge success of this programme, which is now in its third year. The Executive Programme Team thank colleagues across LSHTM for their role in the ongoing development and delivery of the Executive Programme.

The Third Cohort in London

The cohort of Fellows now progresses on to the bespoke inter-residential phase of the courses, where they will benefit from expert mentorship and Executive Coaching to support their initiatives, as well as their personal and professional leadership strengths. They will meet again in Switzerland in March 2020, at the Geneva Graduate Institute, the Faculty’s collaborator, to focus on the skills needed for operating on the global stage, exploring the art of diplomacy, negotiation and horizon scanning, before meeting for a final week in South Africa with the University of Cape Town in June 2020 to enhance their systems and strategic leadership. We are all looking forward to reuniting for these enriching weeks.

If you are interested in joining the Executive Programme for Global Health Leadership or know a senior health leader who might value the opportunities and experience the programme offers, you are welcome to contact our team to discuss further. We can be reached at  or you can find out more on the programme webpage.

LSHTM is committed to improving health leadership for the benefit of populations worldwide.

Programme structure

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“This was the best academic course I have ever done!” – Roxana Dimond talks to us about the Professional Diploma in Tropical Nursing

Roxana Dimond chatted to us about her time at LSHTM studying the Professional Diploma in Tropical Nursing (DTN).  The DTN is recommended by Médecins Sans Frontières, Save the Children, Voluntary Services Overseas (VSO) the British Red Cross and many more international agencies, and has trained hundreds of nurses to work in low-income settings and make significant contributions to world health.

You can register your interest and apply for the programme here: bit.ly/2ozs2sk

Hi Roxana, can you please tell us a bit about your academic and professional background, and why you decided to apply for the DTN?
In 2013 I was awarded my Bachelor of Nursing degree from the University of Glasgow. Since qualifying, I have worked as a staff nurse in Glasgow on a medical ward specialising in diabetes care, and more recently in Sheffield in the Department of Infectious Diseases and Tropical Medicine. After travelling for a year, I worked as a  bank staff nurse for NHS Professionals, across different hospitals settings within the Sheffield Teaching Hospitals Trust. The majority of this work has continued to be on the Infectious Diseases wards, but I have also gained experience in Accident and Emergency, Haematology, Oncology, Theatre Assessment Unit and Day Case Surgery.

One of my main drivers in choosing to develop a career in nursing was the core humanitarian aspect – I strongly believe in the importance of working together to improve each other’s experiences and to reduce suffering – I am passionate about holistic health and wellbeing. There are many barriers across the globe that affect people’s ability to thrive and I have undertaken this course in order to develop a deeper understanding of such challenges and how we can work to overcome them.

I have developed a strong interest in Infectious and tropical diseases through my nursing career,  so decided to apply for the DTN. The knowledge and skills I have acquired will enable me to positively contribute to improving healthcare both within developing countries and here in the UK, in particular with marginalised groups.

It was great to be surrounded by so many people striving for a better future for all.

Can you talk us through a typical day on the DTN?
Usually, there are a couple of lectures in the morning, with a much appreciated coffee break afterwards, which gives you a chance to engage with fellow students. Another lecture follows before lunch. Lunch was always a treat, as the school have freshly cooked food and the “Planetary Pick” options provided lots of tasty, healthy and sustainable meal options which was great as I follow a vegan diet. An added bonus was getting to practice my Spanish with one of the catering staff! After lunch, there is another lecture, followed by a two-hour laboratory session, and then one final lecture in the afternoon. You will be tired after the full day, but it is so worth it, the course is eye-opening and inspiring.

What is the teaching like at LSHTM?
This was probably my favourite thing about the course – the lecturers were fantastic. They were individuals who were very engaged and passionate about the topics they were teaching. Many of them have had years of experience working overseas, in the field. It was invaluable to have lecturers from all walks of life, and from around the globe. They were very authentic, open and honest and talked about the injustices in the world.

How would you describe the DTN student body?
The student body brought a wide range of individuals – different ages, nursing backgrounds and years of experience working in the UK or further afield. I enjoyed meeting people from different countries and sharing our experiences.

What skills have you gained from the course?
I have gained a lot of knowledge about infectious and tropical diseases, and how management for such conditions may differ in low- and middle- income settings. I have also learned how to do some microscopy! I gained an insight into what working with different organisations overseas may entail and how best to prepare for such experiences.

What are you planning to do next, and how will the course help in your career?
I started a new job at University College London Hospital (UCLH) in the department for Infectious Disease, Tropical Medicine and Respiratory Medicine at the same time as starting the course, so, for now, I will continue my practice there and am in the process of applying for a band 6 position. I have been offered a volunteer role with ‘Doctors of the World’ at their clinic in Stratford which provides a service for those who struggle to access healthcare. I would definitely like to do some work overseas in the future.

What will you remember most about your time at LSHTM?
I will remember the fantastic and inspirational lecturers, the welcoming staff, the wonderful people I met on the course and the beautiful library!

What advice would you give to anyone considering studying the DTN?
Do it! You won’t regret it, this was the best academic course I have ever done! The lectures were so inspiring and I learned so much in a short space of time. It was great to be surrounded by so many people striving for a better future for all.

If you’re interested in studying the Professional Diploma in Tropical Nursing in 2020, you can register your interest and apply here: bit.ly/2ozs2sk