Abstract
Purpose: To describe a case study-based approach for training students in gap analysis and cultural humility to articulate and support community health needs in low-resource settings.
Background: Through collaborative academic-community partnership1, an intensive service-learning program on health promotion was implemented in low-resourced indigenous Mayan communities of Guatemala, as part of a quarter-long 2023 hybrid study abroad course. The goals of the program were to 1) support the primary healthcare needs of the communities 2) allow students to build competencies in global health (GH) practice, including a) articulate barriers to health and healthcare in low-resource settings and b) demonstrate the ability to adapt clinical or discipline-specific skills and practice in a resource-constrained setting.2
Methods: In preparation for the service-learning experience, four student teams worked with community partners to prepare for field projects and general clinic activities. The teams completed a community health needs assessment3 and case study analysis4 of childhood malnutrition, chronic disease prevention/management, and cervical cancer screening.
Outcomes: Despite robust pre-planning, students faced real-time challenges in the field. Gap analysis revealed program components that were lacking in both preparatory and implementation phases. Student field observations and engagements provided insights into local social determinants of health5 and the community’s presenting needs. Culturally sensitive adjustments were made quickly to all clinic activities and projects due to unpredictable circumstances in the field, often fueled by lack of resources and cultural differences. For example, the initial cervical cancer screening goal was to conduct at least 200 PAP/HPV tests. Despite efforts on health literacy, all but three eligible women were hesitant and declined screening. While IUDs, implants and injectable birth control options were available, the incidence of STI-related symptoms was high among the patients, so the team successfully pivoted efforts toward STI and condom education.
Conclusion: To deliver sustainable GH programs, intentional gap analysis is critical for continued quality improvement in settings where marginalized patients have low health literacy and ingrained mistrust of outside providers. Involving students as future GH leaders at all stages will enhance their learning and articulation of effective global engagement.
Notes
References:
1.Amisi, J.A., et al. "A Pragmatic Approach to Equitable Global Health Partnerships in Academic Health Sciences." BMJ Global Health, vol. 8, 2023, p. e011522, https://doi.org/10.1136/bmjgh-2022-011522.
2.Consortium of Universities for Global Health (CUGH). Global Health Competencies Toolkit. 2024, https://www.cugh.org/wp-content/uploads/sites/95/2024/04/Global-Health-Competencies-Tool-Kit-3rd-Ed.pdf.
3.Rayan Gharra, et al. "Shaping health: Conducting a community health needs assessment in culturally diverse peripheral population groups." International Journal for Equity in Health, 2022, https://doi.org/10.1186/s1293902201735z.
4.The University of Arizona Global Campus. Writing a Case Study Analysis. 2023, https://writingcenter.uagc.edu/writing-case-study-analysis.
5.Baah, F.O., et al. "Marginalization: Conceptualizing Patient Vulnerabilities in the Framework of Social Determinants of Health—An Integrative Review." Nursing Inquiry, vol. 26, 2019, p. e12268, https://doi.org/10.1111/nin.12268.
Sigma Membership
Psi at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Academic-clinical Partnership, Public and Community Health, Teaching and Learning Strategies, Clinical Practice, Health Promotion and Disease Prevention, Service Learning
Recommended Citation
Ezeonwu, Mabel and Sendele, Amanda, "Engaging Students in Gap Analysis in Global Service-Learning in Low-Resource Settings" (2025). Biennial Convention (CONV). 154.
https://www.sigmarepository.org/convention/2025/presentations_2025/154
Conference Name
48th Biennial Convention
Conference Host
Sigma Theta Tau International
Conference Location
Indianapolis, Indiana, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2025-12-02
Engaging Students in Gap Analysis in Global Service-Learning in Low-Resource Settings
Indianapolis, Indiana, USA
Purpose: To describe a case study-based approach for training students in gap analysis and cultural humility to articulate and support community health needs in low-resource settings.
Background: Through collaborative academic-community partnership1, an intensive service-learning program on health promotion was implemented in low-resourced indigenous Mayan communities of Guatemala, as part of a quarter-long 2023 hybrid study abroad course. The goals of the program were to 1) support the primary healthcare needs of the communities 2) allow students to build competencies in global health (GH) practice, including a) articulate barriers to health and healthcare in low-resource settings and b) demonstrate the ability to adapt clinical or discipline-specific skills and practice in a resource-constrained setting.2
Methods: In preparation for the service-learning experience, four student teams worked with community partners to prepare for field projects and general clinic activities. The teams completed a community health needs assessment3 and case study analysis4 of childhood malnutrition, chronic disease prevention/management, and cervical cancer screening.
Outcomes: Despite robust pre-planning, students faced real-time challenges in the field. Gap analysis revealed program components that were lacking in both preparatory and implementation phases. Student field observations and engagements provided insights into local social determinants of health5 and the community’s presenting needs. Culturally sensitive adjustments were made quickly to all clinic activities and projects due to unpredictable circumstances in the field, often fueled by lack of resources and cultural differences. For example, the initial cervical cancer screening goal was to conduct at least 200 PAP/HPV tests. Despite efforts on health literacy, all but three eligible women were hesitant and declined screening. While IUDs, implants and injectable birth control options were available, the incidence of STI-related symptoms was high among the patients, so the team successfully pivoted efforts toward STI and condom education.
Conclusion: To deliver sustainable GH programs, intentional gap analysis is critical for continued quality improvement in settings where marginalized patients have low health literacy and ingrained mistrust of outside providers. Involving students as future GH leaders at all stages will enhance their learning and articulation of effective global engagement.
Description
In global health (GH) practice, lack of resources and cultural differences present unpredictable fieldwork environments in low-resource communities. Engaging students in gap analysis and comprehensive health needs assessments is key to training well-rounded future GH leaders. A strong academic-community partnership fostered an ecosystem that aided in meeting community public health needs and supported students in building essential GH practice competencies.