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Sunday, September 12, 2010


The Department ‘International Health' and the attached Programme ‘Comparative Health' is part of CAPHRI and its Public Health Cluster.

The reason for starting such activities is rooted in the European perspective on research that Maastricht University takes. Furthermore the programme will offer a base for the translation of (fundamental)research findings from Maastricht UMC+ into a European context. Mounting collaboration between European governments and organisations has major consequences for the life of citizens within the Member States. It is expected that the role of the EU will increase in the years to come. The consequences are apparent from the way in which health and healthcare are considered and discussed in the international arena, within Europe and nationally. Growing European-level involvement can be observed in today's research agenda, fostering the concept of a European Research Agenda. The necessary link between research and education within an academic setting implies an increased European-level orientation within research and a transition of this orientation into education.

The Department of International Health and the programme ‘Comparative Health' have a European outlook which origins from the content of their key-activities. The ‘Europe' of the department and of the programme is not limited to the memberstates of the EU, its activities cover the WHO-EURO geographic area.

It is influencing national, transnational, and European policy and institutes. Its research places local, regional, and national health developments into a wider European and global perspective.

Next to its educational and research activities the department distinguishes itself in being active in European projects which are related to research in health. The following key research themes have been projected:
• Research in the area of the work done of the European Commission regarding health (e.g. EU Health Strategy)
• Epidemiological research linked to European policy research;
• Euregional and European/international comparative research on cross border developments in the field of health and care
• Research focusing on public health surveillance systems
• Research into Education of Public Health on a European level
• Public Health Problems of accession countries in transition (especially the Balkan countries)

We envisage integration with international networks through linking up with strategic alliances and partnering, introducing specific research in cooperation with partners. In addition to research networks, political and decision-making networks are needed.

... The necessary link between research and education within an academic setting implies an increased European-level orientation within research and a transition of this orientation into education...

Beside the level of the nation states, the regional level is highly relevant to master the challenges to come. Border regions are confronted with certain specific challenges but they canalso be seen as small-scale laboratories of the larger integration process and cross-border activities. EUREGIO II will work on closing information gaps, identifying good practise, developing tools for the planning and realisation of programmes and projects as well as capacity building and enabling mutual learning, which can motivate action and support good practice.

The objectives for HLS-EU are to establish a European Health Literacy Network and develope a model instrument for measuring health literacy in Europe. By this first-time data on health literacy will be generated in European countries, providing indicators for national and EU monitoring. By this comparative assessments of health literacy in European countries will be possible.

In the EU funded projects EUREGIO III (complementary to EUREGIO II) and SIDARTHa (European Emergency Data-based Syndromic Surveillance System) the programme ‘Comparative Health' is active as a research partner.

‘Public Health Research Network in Southeast Europe' (PHR-Net)

To date, there is insufficient research work in countries of Southeast Europe (SEE) targeting the health consequences of transition and other major determinants of health outcomes. Most of the SEE countries have scarce institutional and professional capacity to conduct and execute high-quality public health research work. Nonetheless, the accession process into the EU requires the SEE countries to reconsider and reshape their existing research institutions in line with the current EU standards and best practices.
The growing awareness and common agreement on the need to strengthen research capacities and enhance funding opportunities for research projects led to the establishment of the Public Health Research Network (PHR-Net). The mission of the network is to bring together the human resources and capacities for public health research in Southeastern Europe, from other transitional countries in Europe and from Western EU member states. The research vision of the PHR-Net is to investigate and explore the potential for improvement of the population's health in SEE countries and other transitional countries in Europe by research into the public health evidence of interventions.

Mutli-national European team working in ‘Comparative Health'.

The research programme ‘Comparative Health' and the Department of International Health try to live the programme's research mission. The mix of nationalities in the programme is a good reflection of the geographic coverage of the European research projects: colleagues from Denmark to Albania and from Poland to Belgium represent the different cultural backgrounds and contribute to a proper European setting at Maastricht University. ¦

The Department is part of CAPHRI and its Public Health Cluster:

Public Health is defined as ‘The science and art of preventing disease, prolonging life and promoting health through the organized efforts of society’. These efforts consist of collective measures in various areas, necessary to improve public health and to maximize the outcome of care on public health with the ultimate goal of enhancing quality of life. Although interventions may be very diverse, they should all be firmly based in theory and evidence. The missions of Caphri’s programmes in public health is to contribute to this scientific base; to translate theory and evidence into tailored solutions for societal health problems; to develop instruments and tools for sustainable and effective interventions, and to deliver these solutions effectively to individuals, organizations and national bodies.
Caphri has five programmes in Public Health. These programmes represent the major aspects of public health: developing research tools (theory and methods) for diagnosis, intervention and evaluation, with ethical and methodological reflection. The main activities of the five programmes can be described as a chain of activities in public health: establishing risk factors, studying the etiology of health problems, diagnosing specific problems and contexts, developing theory for diagnosis and intervention, translating this to specific interventions, implementing interventions and evaluating the different steps.

The cluster Public Health aims to develop new models, theory, methodology and tools for the enhancement of Quality of Life. Sustainable change is assumed to presuppose equity in health and health care, and the development of evidence base and best practices.

The programmes share a strong international orientation, while the work is often embedded in local practical and professional organizations with participation of relevant stakeholders (including GGD, occupational health services, companies, health insurance companies).

Effective public health interventions require an interdisciplinary approach that is innovative in theoretical approach, methodology and normative reflection.

Future developments
The field of Public Health will be affected by societal developments such as a tendency towards privatization and a growing emphasis on personal accountability, but also by demographic developments (increasing population age), changes in society (e.g. need for increase in labor participation, late retirement) and care dynamics (chronicity of disease and comorbidity), demanding the further development of normative and ethical models, longitudinal research methods and dynamic models of causality. Consequently, innovative statistical research is also needed focussing on e.g. the analysis of different clusters of (un)healthy people and organizations, new strategies for longitudinal research, advanced techniques to address nested models and causal modeling.

The increased attention for comprehensive person and patient centred approaches – both in public health as well in primary care settings - require the development of effective interventions that need be attuned to each other. As theory development requires sound designs, participation in cohort studies will become more important in which various perspectives from public health are integrated and also extended to other disciplines such as primary care. Effective interventions can only have a national public health impact (effectiveness x reach) when they are implemented, hence implementation research will need to receive increasing attention. Consequently, more joint projects between public health programmes are called for, creating more synergy between the different expertise areas.




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