South-East Asia Regional Conference on Epidemiology

290 | <strong>South</strong>-<strong>East</strong> <strong>Asia</strong> <strong>Regional</strong> <strong>Conference</strong> on Epidemiology
Curriculum and competencies
MAE-FETP is a member of the Training Programs in Epidemiology and Public Health Intervention
Network (TEPHIENT) (3), a consortium of applied epidemiology training programmes across
the world and uses an international curriculum template for the programme. However, the MAE-
FETP has additional modules to suit the needs of the Indian public health system. The MAE-FETP
curriculum combines in-class training and practical, hands-on experience through mentored fieldwork.
The fieldwork provides practical learning opportunities for the scholars to implement concepts learnt
during the contact sessions and acquire the competencies expected of them. The curriculum uses more
than 25 case-studies based on Indian investigations in the areas of outbreak investigations, laboratory
support for outbreaks, surveillance data analysis, evaluation of surveillance system, programme
evaluation, framing the research questions, and ethics (4).
The seven core competencies of the programme are: (1) mastering epidemiological science;
(2) investigating outbreaks; (3) managing public health surveillance; (4) conducting epidemiological
studies; (5) protecting human subjects in research; (6) oral and written communication; and
(7) programme management and evaluation. Towards achieving these competencies, the scholars
conduct the following field-based projects during the 18 months of field posting:
(A) Public health situation analysis: As part of this assignment conducted at the beginning of the
first field posting, the scholars review the field placement site and its population to place it into a public
health perspective. It presents key selected health indicators (e.g. indicators towards the achievement
of the Millennium Development Goals or others), identifies the key public health priorities of the
district and identifies topics for various field projects as well as for the dissertation.
(B) Outbreak investigations: The MAE-FETP model offers quality investigations of disease
outbreaks, with full technical support from the faculty. Standard operating procedures consist of the
classical 10-step approach that goes through four main stages of (1) confirmation; (2) hypothesis generation;
(3) hypothesis testing; and (4) prevention measures. Peer review at all stages of the investigations
and reporting is the keystone of the quality assurance process. Over the last 10 years, the scholars
have investigated more than 100 outbreaks caused by bacteria (e.g. cholera, anthrax, leptospirosis,
pertussis), viruses [e.g. measles, hepatitis A, hepatitis E, chikungunya, influenza A (H1N1)],
parasites (e.g. malaria) and toxic agents (e.g. organophosphorous).
(C) Surveillance projects: The MAE-FETP scholars produce two reports: first, an analysis of
secondary data from surveillance, and, second, an evaluation of a surveillance system. These two
mandatory projects build the key attitudes that a public health person needs in terms of surveillance:
knowing everything one can say with data and knowing everything one cannot say with data.
(D) Programme evaluation: The MAE-FETP scholars evaluate public health programme with
a focus on logical framework and development of input, process, output and outcome indicators to
identify existing gaps.
(E) Operational research projects: As part of writing of the dissertation, the scholars have to
conduct an epidemiological study on a locally-relevant health problem. The process that leads to
the right research question is the key to the epidemiological investigation. The scholars do not do a
project because they like a topic but they choose a subject because it will generate a body of data that
will fill a gap in the information needs, and filling that gap must trigger some kind of action. The line
managers play an important role in guiding the scholars to identify a locally-relevant health problem
for epidemiological investigation.