Estimation of global visual impairment due to uncorrected refractive error.

B Bulletin of the World Health Organization | August 2008, 86 (8) the two schools have remained responsive to the students’ learning context needs by retaining a text-led mode of distance learning amidst strong pressure to switch to web-based learning. Surveys we have conducted indicate that only about 30% of our students are able to access the internet reliably for lengthy periods, making web-led learning at this stage possible for only a minority of African health and allied professionals. The web, however, remains a valuable support mechanism for our programmes, and its potential is regularly trialled and monitored and will be more fully developed when the context allows. So far SOPH has been able to offer two electives as CD-based options and one as a web-based course for those who have such access. The programmes at the two schools are, we believe, innovative in several ways: the multidisciplinary curricula cater for a wide range of health professionals working at different levels of the public-health system; as far as possible, they are open-learning systems, allowing students to proceed at their own pace according to the time they have available. The development of applied research skills is given high priority, as is public-health professional development involving students in exploring a wide range of transformative strategies to address key problems facing public-health services in a developing country context. Aside from the pressure of combining work and study, students gain considerably from this pedagogical model, which facilitates the immediate application of theoretical concepts and models to their situations in the work arena.3–5 We believe that the only way in which Africa (and indeed other “developing” continents) can successfully address the human resource crisis, especially in public health, is by dramatically expanding access while simultaneously preserving quality service provision. Financially accessible distance learning provision, applied to practical public-health problems, offers such a possibility. ■