[The development of public health education: the Mauritius experience]

A public course has been initiated in 1990 in Mauritius for covering the national growing needs of public health specialists. This training course was organized jointly by the Ministry of Health, the University of Bordeaux II and the French Cooperation. After 3 sessions dedicated specifically to the Mauritian physicians, the course has been re-designed for the needs of the other countries of the region. A feasibility study performed in 1994 in the countries of the Indian ocean region showed that during the past decade, the district level had become the focus point to integrate the health programs. This process has progressively transferred a wider and stronger part of the responsibilities from the central level to the district level and the survey showed that most of the health district managers were physicians that did not have the proper background for carrying such responsibilities. According to these results, a course curriculum was created by the Mauritian Ministry of Health and the University of Bordeaux II and submitted to various organisms supporting health program development in the region. This proposal was strongly supported by several agencies (the french Cooperation, Unicef, WHO, World Bank...) who agreed to sponsor candidates for that training course. The first session was organized in 1995, a second one in 1996. This training course is targeted to the medical doctors who are in charge of the management of health services at the district level. It is divided in two parts: A six-weeks intensive training course performed in Mauritius that include formal teaching and practical exercises in small groups for a total of 210 hours. The curriculum is mainly targeted on the various aspects of management as the management of health information (biostatistics epidemiology and computing), the management of human resources, financial resources and material resources. In addition to these main topics, there is an introduction to pedagogy, communication skills and applied research methodology. Following this six-weeks, training the students come back to work in their country and have 8 months to perform a thesis supervised by a local public health specialist. The subject of the thesis has to be closely related with one of the topic taught and should provide an obvious improvement for the public health situation in the district where this physician is acting. In 1995, 22 candidates attend to the course (13 from Madagascar, 4 from Mauritius, 3 from Comoros, 1 from Angola, 1 from Equatorial Guinea and 1 from Tchad), 19 had successively completed all the modules and got the diploma of public health delivered by the University of Bordeaux II. This diploma has been recognized as an equivalent to a master in public health in Mauritius. The evaluation of the courses-performed by the students, the teachers and the financial agencies gave a very positive results although the workload was considered as too important for a six-weeks training course. The recommendations of the 1995 session were included in the 1996 programs which is still on going for 23 candidates. The 97 session will probably extend the number of students up to 40, divided in 4 subgroups for practical exercises. In parallel to the course, a quarterly bulletin will be created and sent to the present and past candidates of this course in order to support a continuous medical education training program targeted to the district physicians.