How studying Health Policy, Planning and Financing is helping me be a better health advocate

As a public health physician in the Philippines, RJ has worked for a number of years as a health policy advocate. He discovered the MSc in Health Policy, Planning and Financing (HPPF) when searching for a programme that would further his health policy knowledge alongside providing the technical skills to become a better advocate. Take a read of his blog to see how the progamme is helping him become a better advocate.
Student, Raymond, stood in front of a globe.

Over the past few years, much of my work as a public health physician focused on mental health and substance use advocacy work. I, together with other youth advocates, lobbied for and successfully passed the Philippines’ first national mental health policy. I have worked with local government officials to integrate harm reduction approaches in programs for people who use drugs. As a public health consultant for various non-profits, I managed technical assistance projects related to HIV and disaster risk reduction management for health. In a way, one can say that I am already doing some form of health policy work. But I did so without having formal training for it. For much of the work, I relied mainly on my personal values, my background in medicine and community development, and the belief that things can be better for the marginalized groups I work with.

However, I realized later that sheer passion can only take you so far. I gathered that I need to have the technical skills that would allow us to institutionalize the progress we’ve started. A written policy is not enough to drive changes in health outcomes. We need these policies to be translated into actual programs that are adequately funded, evaluated, and documented. These are the skills I knew I had to develop to become a better advocate.

For this reason, I chose the MSc in Health Policy, Planning and Financing (HPPF) offered by the London School of Hygiene & Tropical Medicine (LSHTM) and London School of Economics (LSE). I believed the program would provide relevant and practical technical skills that I can use to support civil society actors as they engage the government. After undergoing all the taught modules, I believe the HPPF programme has helped me to become a better advocate by providing a space to reflect on my advocacy work, tools to support advocacy work, and a network of fellow travelers in the public health space.

Raymond with the Programme Director and classmate.
Raymond with Programme Director, Tracey Chantler, and classmate, Miluska.

A space for reflection on advocacy work

In my previous work, I have always argued for public health interventions based on what makes sense from a clinical or human rights perspective. I used to think that public health problems have single 'right' interventions that can be determined through empirical ways. Coming from a low-middle income country, I also had this perception that our local health systems need to play 'catch up' with all the discussions and innovations from Geneva and the countries from the other side of the world.

Through the different modules in HPPF, I have come to be more reflective of my previous work and what I believe to be true. I found that the previous mental models I held, while not necessarily wrong, were insufficient to sustain the progress in my advocacy work. For example, I have come to realize that advocating for harm reduction for people who use drugs as a policy would require more than raising public support or giving clinical or human rights-based arguments during policy discussions. My Economic Evaluation class in LSHTM gave me ideas on how randomized control trials and cost-effectiveness analyses can be utilized for our drug policy reform work. In my Financing Healthcare module in LSE, I have come to appreciate the complexities of the health system. I’ve realized that there is no one way of doing things. You just need to decide what you want to achieve, be transparent with how you decide, select the course of action despite imperfect information, and anticipate and mitigate possible consequences of your choices.

Another practice I picked up from our modules is on how we should be critical on the things we know and the process of how we get to know things. Through my Health Policy: Process and Power and Medical Anthropology modules in LSHTM, I have come to appreciate how deconstructing a problem and consciously seeking other ways of understanding a phenomenon can be more productive than thinking directly about the possible solutions. These modules also made me more sensitized about the impacts of colonialism, how it manifests, and how it influences the practice of global health. Now, I have now been more conscious of my tendency to fall into the colonial mindset and practice of trying to replicate everything from the West without considering the context. I have also volunteered to be part of the decolonizing the curriculum student working group in the hope of contributing to the initiatives to decolonize how modules are taught in LSHTM. Being exposed to these things further fueled my drive to generate more evidence coming from the communities I work with and from my own country.

These modules have helped me be a better advocate by giving me the intellectual humility that I needed to improve myself as an advocate and the strategies I employ.

Better tools for advocacy work

One of the good things about the program is that it offers you various modules that provide practical tools. The Health Policy: Process and Power module at LSHTM gave a good introduction on frameworks that be used for policy analysis and agenda setting. It gave me tools to understand and hopefully, wield power better to support our public health advocacy. The Randomized Evaluation for Health Programs module at LSE gave me a comprehensive guide on how to design and implement randomized control trials. It gave me other ways of collecting data beyond the usual survey. I know this skill will be very helpful in terms of beefing up the evidence base for policies and programs for marginalized groups.

HPPF provides you with so many course options that focus on building a practical skill.

If all your eight modules have been filled up or if there are schedule conflicts that prevent you from enrolling in your preferred courses, you always have the option of auditing courses through Moodle, the Virtual Learning Environment (VLE). Personally, I have tried to maximize this by enrolling in modules such as Design and Evaluation of Mental Health Programmes (LSHTM), Qualitative Methodologies (LSE), and Evidence Appraisal for Health Policy (LSE) which I found very helpful for my dissertation and future work prospects.

Network of public health professionals

Lastly, I believe one of the great things about the HPPF program is the network that you can build and maintain even after your program ends. Both schools provide you with opportunities to meet students, professors, and researchers from two leading academic institutions.

Some of my favorite events to attend in LSHTM are the inaugural lectures of professors where they share their professional journeys and the global health lectures which gives you up-to-date insights based on the work of researchers in the School. Aside from the academic events, socials are organized by the department or people from your cohort where you get to meet people in a more relaxed and personal manner.

I was also glad to have been connected to similarly minded people in LSHTM. As early as my first few weeks into the program, I have been connected to the London Harm Reduction Reading Group, a network of students and faculty members working in the substance use field, through the LSHTM mailing list. Through referrals of people in the harm reduction movement, I have also been acquainted with a professor in the School and a PhD student who I was able to consult for a study that I am currently doing for an organization I volunteer for.

In one of the events organized by LSE, I had the chance of attending a mental health training conducted by Dr. Dixon Chibanda, a well-known psychiatrist from Zimbabwe. He served as one of my influences in  taking up public mental health as my area of work after watching his TEDx Talk when I was still a medical student. Weeks after, I found myself attending his lectures on the Design and Evaluation of Mental Health Programmes module in LSHTM.

I learned a lot from my classmates as well. I used to think that it was very cliché to say that. But after being exposed to public health professionals and scientists both at LSHTM and LSE, I couldn’t agree more!

Some of them have had way more experience than me or had a different pathway in public health which I would always be very curious to hear and learn from. These networks allowed me to broaden my perspective and identify possible ways on how to collaborate with others, which I think is essential for successful advocacy work.

Coming into the program, I sort of had the expectation of getting direct answers to the public health challenges back home. However, six months into the program I am quite certain that expectation will not necessarily be met for the right reasons. I realize that finding the solutions is the task that I need to personally take on and co-create with local health actors after the program. What the HPPF program gave is a more nuanced understanding of public health, better tools that would allow me to develop a good policy, and a supportive community of people working tirelessly for public health. I believe these are more than enough to support my advocacy work back home in the Philippines.