Abstract:

Mexico faces the challenge of training, educating and updating its health professionals to achieve the required competencies resulting from epidemiological transitions and emergencies in the country. It is essential that educational and service health institutions be prepared to meet these challenges related to the fulfilment of the goals in the strategic areas of coverage, care quality, prevention and promotion of health, as well as those related to epidemiological emergencies.

An example of this issue is the epidemiological emergency that took place in September 2013, when an outbreak of cholera emerged in the state of Hidalgo, Mexico. This occurred 10 years after the disease was eradicated from the country.

Giving this situation, the Ministry of Health set up a contingency committee made up by experts of different institutions to conduct a situational analysis in Hidalgo, detecting the urgency of training all health professionals for the containment and the correct handling of this disease. On October 1st, the committee held a meeting with the following institutions:

This effective action led the committee to develop the content of the course "Containment measures and proper management of cholera" and the National Institute of Public Health, based on its 9 years of experience in educational innovation, produced the training strategy through a 100% automated, self-directed, open, without many technological requirements, online course. The course had curricular validity and a short duration (about 10 hours). Without neglecting the quality of the instructional design, a ludic, interactive and friendly course was created, due to the broad students' profile, going from hospital janitors to primary healthcare medical doctors.

On Thursday October 10th, the first version of the course "Containment measures and corrective management of Cholera" was released. A downloadable version was done for population where Internet access was limited was also created.

According to the first results of the students’ records, which completed the course Vs the total healthcare professionals in Mexico, the following observations were found:

1) 34,000 students successfully completed the course during the period between the 10th of October and 10th of December of 2013. Overall, this fact allows us to consider that the course was successful as an effective tool for containing an epidemiological emergency, because for the first time a student registration achieved such a high participation in a single course in Mexico’s health sector.
2) However, a careful analysis of the contained information in the referenced databases showed an uneven geographical issue of the course’s success:
• 3 out of 6 states bordering the state of Hidalgo (Querétaro, Puebla and San Luis Potosí) obtained the last three places in terms of student records / total healthcare professionals.
• 2 of Hidalgo’s most distant states (Zacatecas and Quintana Roo) obtained the largest number of student records / total healthcare professionals.

a) How can we understand this uneven geographical data within the course’s success?
b) What are the barriers and facilitators that must be considered for this type of courses to achieve success in epidemiological emergencies?

In order to raise the first answers to the above questions, it was decided to deepen in the quantitative analysis and complement this analysis with a qualitative research.

Keywords:

Health education, epidemiological surveillance, massive course, qualitative research methods, public health, Mexico, Cholera, ethnographying public health.