Taking the first step of a thousand mile journey: Global Health education in low and middle-income countries

In the past decade, there has been a remarkable increase in the number of institutions that have embraced Global Health(GH) education. Despite the fact that some of the best GH learning opportunities lie in low and middle income countries(LMICs), the growth of GH courses in LMICs has been far lower than in developed countries. We present here an example of how GH programs can be developed in LMIC settings. Dhulikhel Hospital Kathmandu University Hospital (DH) is the pioneer community-based tertiary level health institution in Nepal that has been successful in innovative rural health care delivery. DH has had collaborative programs with numerous international institutions in medical education. Using this as a foundation DH developed short-term, structured tailor-made courses jointly with partner institutions, incorporating the elements of GH that were primarily of interest for those institutions primarily targeting medical and public health students.  Emphasis was placed on the existing strengths of DH, mainly in infectious diseases management and innovations in rural health care delivery. The courses (generally 2-4 weeks long) were conducted in DH in collaboration with co-instructors from the partner institutions. Overall response from participants has been extremely encouraging and more courses are being organized. Based on this, DH is in the process of establishing an Institute of Global Health that will increase the scope of GH training and research activities. Identifying and utilizing existing strengths and resources, and initiating collaborations with international partners are small steps that are key to the development of GH training programs in LMICs.