Table 3. Specific features of the two programmes categorized by the five categories of health promotion action as defined by the Ottawa Charter43.
| Health promotion action | ELAM | MEAH |
|---|---|---|
| Build public policy for health | Builds on success of Cuban models but little direct influence on national policy (I) | Strategic partners with precedents for engagement at national and international level e.g. Centro Estudios y Asesoría en Salud and, more recently Universidad Andina Simón Bolívar (N, I) |
| Create supportive environments | More difficult as an individual practitioner but possible with cross-sectoral support. Depends on graduate commitment and opportunities for links (P, N) | Aiming for a culture shift towards community-university engagement in each university as well as building a national network of universities (P, L, N) |
| Alumni networks (P, N) | Alumni networks (P, N) | |
| Links to international communities of practice in ecosystem approaches to health (I) | ||
| Strengthen community action | Precedents of Cuban system but may be difficult to translate in isolation from the political economy (N, I) | Masters research thesis projects are required to engage community partners and demonstrate community impact (P, L, N) |
| Develop personal skills | Sound knowledge and confidence in core clinical competency; heightened knowledge of social and environmental determinants; knowledge of building disease prevention and health promotion frameworks at the community level (P, L, I) | Skills for collaboration and intersectorality are emphasized but cross-disciplinary research can be difficult to operationalize (P, L, N) |
| Emphasize on skills and value of self-directed learning may increase capacity to self-initiate for ongoing opportunities for learning and exchange (P) | ||
| Reorient health services | Cuban model is based on a culture of ”health-in-the-community” and community service (P, L) | Potential for innovations based on community-university-policy alliances (L, N) |
| Incentives for career trajectories focused on promoting health in disadvantaged populations (L, N) | Incentives for career trajectories focused on promoting health in disadvantaged populations (L, N) |
ELAM, Escuela Latinoamericana de Medicina (Latin American School of Medicine) in Cuba; I, international capacities and scale; MEAH, Masters in Ecosystem Approaches to Health; L, local capacities and scale; N, national capacities and scale; P, personal (individual) capacities of health worker.