Interprofessional Collaboration Manual by International Federation of Medical Students' Associations

WHSA in a nutshell The World Health Students’ Alliance (WHSA) is the official gathering and representative of health students and one of the largest interprofessional health alliances worldwide. The International Association of Dental Students’ (IADS), the International Federation of Medical Students’ Associations (IFMSA), the International Pharmaceutical Students’ Federation (IPSF) and the International Veterinary Students’ Association (IVSA) have joint forces to form a strong coalition of international health student organizations that advance global health through common initiatives. The aim of WHSA is to strengthen interdisciplinary advocacy, to commonly contribute to the advancement of health and to develop and implement improved health policies together with multi sectoral stakeholders. We understand that it is important to have a common action on challenges that are now present in our society. The Alliance has a reach-out capacity of over 1.8 million health students in more than 150 countries worldwide.

What is interprofessional work? Have you ever seen doctors and veterinarians working together to fight an infectious disease? Or pharmacists collaborating with dentists to optimize drug use and prevent AMR? These practices go under interprofessional collaboration, and it encompassesmany other issues and challenges related to health and other SDGs. It occurs when healthcare providers work with people outside their profession. Within WHSA, this means for dental, medical, pharmacy, and veterinary students to come together and collaborate on common global health issues.

Why Interprofessional collaboration? Alone we can go fast, but together we can go far. ❖ Our world is interlinked. Different global health issues tend to have several causing factors related to multiple fields. Working with other professionals is essential to bring comprehensive solutions to such issues. ❖ Modern healthcare is a highly specialized discipline. Joint work is needed for the continuous development of our healthcare systems and to improve the health of patients and thus of populations around the world.

❖ Working together gives students a good foundation and respect for other healthcare colleagues when they go into the workforce. ❖ Collaborations provide you with more resources, greater impact and makes your voice stronger and easier to be heard

Start your interprofessional collaboration from scratch If you and your national/local organizations are new to interprofessional collaboration then don’t panic. Just keep reading and follow our step by step guide and you will get there.

0. Do you really want this? Before starting any step, we want you to ask yourselves: Are you ready and willing to work on interprofessional collaborations? We outlined above some of the many reasons for you to engage on this journey but it is up to you to keep in mind that we as student organizations aren’t competing or conflicting with each other. We are here to raise the voice of health students, empower them, and serve our communities. This common vision that we all have is what you should keep in mind while working with other organizations, the process can take time, the working methods can be different, but as long as you are standing together, your work and impact will be much more outstanding. 1. Making the links The first step is to identify and link with other student organizations in your country. To do that reach out to your president or external affairs vice president (VPE). If you are a president or a VPE, send an email to secretariat.whsa@gmail.com Stating your organization, country and position and asking to be linked with other students in your country. We will then provide you with contacts of other national WHSA members. BONUS: In many countries, there are multiple other health student organizations that you can invite to your national health students’ alliance. This includes nursing, psychology , physician assistants students, and others. You can check if they exist in your country by googling “country nursing/psychology/PA… students association/organization” You can also ask us by email for help and input if you are not sure.

2. First things first Your first contact is crucial to make sure your organizations are on the same page and will work for the same cause. Make sure to introduce yourselves, your working structure, and priority issues. The goal is understanding each other’s working styles, procedures and focus areas. 3. Time for paperwork After knowing each other, you will have to identify common goals, working areas and joint actions to start working together. Here is a list of different areas of work on which you can collaborate. More detailed explanations on different points will be explained in later chapters: ● Joint campaigns and actions on ○ Public health issues (mental health, AMR, Climate Change & Health, UHC..) ○ Human rights, ○ Sexual and Reproductive Health and Rights issues either in field or online. ● Collective efforts to improve health education ○ Advocacy on curriculum improvement ○ Interprofessional education competitions, ● Advocating on issues affecting the wellbeing of the health workforce ○ Mental health, ○ Working conditions ● Capacity-building collaborations ○ Exchange and invitation of trainers and participants, ○ Joint training programs, and events…) ● Exchanges collaboration and joint social programs ● Sharing of each other’s resources, updates, opportunities, and useful information ● Invitation to each other’s events and assemblies ● Joint advocacy campaigns, position statements, and press releases on common issues. ● Joint statements and collaborations in external events. Once the first contact is created, it will be good to agree on one or more areas to start collaborating on, but sooner or later, drafting and signing an MoU is desirable to document all possible common areas that you plan to collaborate and work on in the long run. A Memorandum of Understanding or an MoU is a type of agreement between two or more parties, which communicates the mutually accepted expectations of all of the parties involved. Basically it describes all areas on which your

organizations will be collaborating on and what each organization will be contributing from its side. You can find more details and examples of making your MoU from scratch at the end of the toolkit.

4. Making sure all is well: tips and advice ● Make sure you have a coordination group with defined representatives from each organization which are the main contact person; ● Agree on a regular coordination meetings to ensure continuity of communication and advancement of work; ● Start preparing for initiatives well in advance as joint actions take more time for planning, approvals, and implementation; ● Agree on your main way of communication, whether that be whatsapp, facebook messenger or email. ● Always communicate any difficulties or challenges you may be facing in relation to your joint work, having open and honest communication is the road to success in collaborative projects

What you can collaborate on This section details the main issues and challenges on which you can collaborate on. It helps you reflect on different existing problems, prioritize those that pose a serious issue in your local or national context then take the needed actions to tackle them. ● Health emergencies Interprofessional collaboration was never needed as much as today. Modern problems require modern solutions and dealing with pandemics and other health emergencies must be done together. Such emergencies negatively disrupt not only people’s health but also their lifestyle, socio-economic conditions, and their wellbeing. While joining hands in this case it is crucial to identify what levels and priorities you are dealing with first. Emergency management starts with a preparedness phase, moving to response, then recovery and mitigation. Areas to focus on can go from health workforce support to mental health actions, spreading information literacy, assisting vulnerable populations, field response initiatives and innovations and others.

● AMR Antimicrobial resistance or AMR is a main global health challenge threatening more than 10 million deaths per year by 2050. Its root cause is the misuse of antimicrobials by humans, for animals and in the agricultural field resulting in multiresistant microbes immune to antimicrobials. AMR involves all healthcare professionals therefore an interprofessional approach is essential to tackle AMR. Major focus should be put on educating health professionals and students, AMR in the curriculum, and antimicrobial stewardship. Educating and raising the awareness of the issue is always needed, be it patients, agriculture and animal farmers and also media and decisionmakers. Advocacy efforts to improve regulations structuring antimicrobial use is another effective approach. ● IPE Interprofessional education is when students from two or more professions in health and social care learn together during all or part of their professional training with the object of cultivating collaborative practice for providing clientor patient-centered health care. Interprofessional work within teams is one of the most needed skills for today’s health professionals. Learning it starts with education and IPE. Working together to promote IPE can be done with many tools. Starting with educating and raising students’ awareness about its existence, principles and importance, organizing interprofessional and joint education actions, such as workshops, case discussions sessions, or advocating for the inclusion of IPE as a part of the university teaching strategy. Another innovative way is organizing an interprofessional online competition where multidisciplinary teams work on a virtual patient case while applying an interprofessional approach. ● One Health One Health is an approach that recognizes that the health of people is closely connected to the health of animals and our shared environment. Today interactions between humans and animals have grown to a high extent, movement of humans and animals have also increased, and earth has experienced changes in climate and land use. This causes an increase in speed and frequency of diseases spread. One health as an approach is tightly related to interprofessional collaboration and should be inculcated in our work against public health problems. Efforts should be made on inclusion of One Health into healthcare curriculum, establishing One Health national networks, linking with One Health experts and stakeholders, and applying a One Health approach in tackling public health challenges.

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Health workforce

In September 2016, the final report of the United Nations High Level Commission on Health Employment and Economic Growth projected a global shortage of 18 million health workers by 2030, primarily in low and lower-middle income countries. Without action for the growing shortage, health workers and health systems will be unable to meet the growing population, longer lifespans and increasing burden of diseases. It is thus urgent to implement the right policies on a national and international level, invest in education and job creation in the health sector and establish strong interdisciplinary and multisectoral collaboration to achieve equality, universal health coverage and social cohesion. Focus should also be madeon improving working conditions of the health workforce and providing adequate support to preserve their mental health and wellbeing.

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Sexual and Reproductive Health and Rights (including HIV & AIDS)

Good sexual and reproductive health is a state of complete physical, mental and social well-being in all matters relating to the reproductive system. It implies that people are able to have a satisfying and safe sex life, the capability to reproduce, and the freedom to decide if, when, and how often to do so. Today the world faces multiple SRHR challenges including access and stigma issues related to Diverse Sexual Orientation, Gender Identity and Gender Expression (SOGIE), Comprehensive Sexuality Education, Women’s and Adolescents’ Sexual and Reproductive health, Gender Based Violence including traditional harmful practices against girls and women as well as obstetric violence, maternal health and access to safe abortion, and HIV-related discrimination in healthcare against people living with HIV and key populations. It is crucial to increase the knowledge among healthcare students on the impact of the discrimination in healthcare settings on the health outcomes of adolescents and young people. We should also focus on offering support, empowerment and awareness to vulnerable populations and those in need. Efforts must be also targeted towards community education and awareness as well as policy making and decision-makers and media engagement.

World days celebrations (World Diabetes Day, TB day, World Health Day, World Malaria Day, World Immunization Week, World No Tobacco Day, World Blood Donor Day, World AIDS day) World health days offer great potential to raise awareness and understanding about health issues and mobilize support for action, from the local community to the international stage. They will commonly focus on health issues that involve all healthcare professionals and the days marked by the Member States as official health days. ●

Utilizing these days is one of the easiest and effective ways to collaborate on major Public Health issues. It is essential to identify where other healthcare professionals can contribute, what are the areas of collaboration, and how you will

do this. For World Diabetes Day, medical students may want to focus on how to limit the risk of developing diabetes, pharmacy students may want to educate the public on what to do in diabetic emergencies, or the 2 different types of diabetes, dental students could advocate for the impact on oral hygiene in poorly controlled diabetes and veterinary students could discuss the signs and symptoms of diabetes in animals for pet owners. Now you’ve identified the areas of collaboration, you need to think of HOW. This can be done by joint social media promotion, collaborative webinars, and field actions or campaigns and advocacy efforts by the respective organization with who you are collaborating with. ●

Climate Change and environmental health

Climate change is named by the Lancet as the biggest threat to global health and it is all of our responsibility to turn it into the greatest opportunity. Disturbances to climate stability severely harm the health of humans, animals and the environment by affecting social and environmental determinants of health. Between 2030 and 2050, climate change is expected to cause approximately 250 000 additional deaths per year. The leading cause of climate change, air pollution, is already one of the largest killers globally, causing one out of eight deaths annually. Many mitigation measures, such as promoting active transport, have the opportunity to majorly improve health. As well as that our own choices, actions and lifestyles have an impact. As healthcare students we must take the lead on inclusion of climate change in our health curiculum. More actions should be made on population awareness and education about health effects of climate change and different mitigation and adaptation measures. Advocacy efforts should be conducted towards engaging policy-makers toards health inclusion in their National plans.

● Mental health There is no health without mental health. One in … people had experienced a mental issue at least once in their lives. ….. Targeting mental health needs a collaborative approach. We can start by ourselves and work on preserving mental health of health professionals and students, and youth. We shall also target vulnerable groups and assist them to ● Improving health access for vulnerable populations One of the major causes of poor health, premature mortality and health inequity is a lack of access to essential health services. This poses a major problem across the globe and is a product of a multitude of health sector and external factors. The latest UHC monitoring report shows that over half of the world's’ population does not have access to the essential health-service they need. Access to healthcare must be universal, guaranteed for all on an equitable basis. Adequate healthcare infrastructure, goods, and services must be available in all geographical areas and to all communities. Healthcare must be accessible and provided without discrimination based on health status, race, ethnicity, education, age, sex, sexuality, disability, language, religion, national origin, income, or

other status. Strengthening primary care services can be a cornerstone in achieving UHC. Targeting vulnerable groups, either those living in remote areas, slums, migrants, homeless people or others needs a collaborative approach. Working together to provide basic health and live improving services for those populations is a must. Working together can help not only preserve their health but also improve their socio-economic situation and affect other SDGs positively. Actions like caravans or humanitarian health access programs can bring great help. Advocacy should also be done for decision makers to bring lasting solutions for those populations and improve their living conditions.

Conclusion In the end we hope that this toolkit has given you the needed motivation and information to start youri interprofessional collaboration journey. Don’t hesitate to contact us to be linked with other students and go ahead with your local work as we believe this is the way for all of us to empower ourselves and change our communities for the better.. TOGETHER. Links: ● Guide by Neil on SOs online meetings + example meeting on med students & one health

MoU Example [Logos of organisations]

Memorandum of Understanding between

xxxxxxx and

Xxxxxxx and xxxxxxx Table of Contents Section 1: Introduction Section 2: Background Section 3: Overview of Memorandum of Understanding Shared Values Representation Section 4: Shared Responsibilities and Collaborations Section 5: Terms of Termination and Validity of the collaboration

Section 1: Introduction

This Memorandum of Understanding(MoU) is signed by the [organisation] which will be addressed as xxxx, represented by Ms/Mr/Mx xxx, [Positionusually president/VPE], located at xxxx, the [organisation] Which will be addressed as xxx, represented by Mr/Ms/Mx xxx [Position- usually president/VPE], located in xxxx and the [organisation] Which will be addressed as xxx, represented by Mr/Ms/Mx xxx [Position- usually

president/VPE], located in xxxx To enhance and ensure the cooperation and collaboration between the parties. Section 2: Background Background of organisations which can include when they were founded, what their values are and who they represent Section 3: Overview of Memorandum of Understanding Shared Values What are the shared values of all organisations upon which they base this collaboration. It is essential for all organisations to have some common background and reasoning to work together otherwise the collaboration will face many difficulties and challenges. Representation Identify from each organisation, who will be the individual to represent that organisation and their position. It is essential to detail this important information as it will ensure all parties are kept accountable to keeping up their side of the agreement. It is also recommended to document their contact information, such as email. Section 4: Shared Responsibilities and Collaborations This forms the true substance of the MoU, first detail what are the main areas of collaboration you intend: 1. Providing invitations to each other's events. 2. Joint projects in fields of interest 3. Joint statements and publications 4. Research and Scientific Exchanges Then detail what the responsibilities are of each organisation, for this MoU and to each other. Here are some examples of responsibilities: 1. 2. 3. 4. 5. 6.

Supporting [organisations] projects or events by social media and online promotion where possible; Sharing the partners’ logos on the website and online announcement of the agreement; Promoting positive measures in healthcare, for the students’ and patients’ benefit; Promoting interprofessional collaboration in healthcare, through joint events, workshops and positions; Mutual support in legal and public initiatives; Sharing resources among the parties.

Section 5: Terms of Termination and Validity of the collaboration This section is to state under which terms does this MoU become invalid and terminated. It also states how long this MoU will remain valid for, it is important to note that having an MoU valid for more than 3 years can pose many challenges to new teams coming into the organisations, as it means they are tied to agreements made by a previous team, therefore it is recommended that MoUs are valid for 3 years or less. 1.

Adjustments to this MoU are possible anytime, upon approval of organizations. 2. Each party shall be entitled to terminate this MoU by a written notice officially emailed to the contact person of the other party provided x month notice and a detailed explanation of the reasons for this decision. A meeting between the parties shall be arranged upon this notice, to discuss causes for the termination and possible alternative solutions. 3. If the MoU is not renewed x months before expiration date it will automatically terminate. Signatures: Representatives or executive board members of each organization include their names positions and signatures.