Background. Climate change and environmental degradation have severe public health impacts. Education about planetary health (PH) and sustainable healthcare (SH), or the interdependence of health and healthcare and planetary ecosystems, is developing globally to enable health professionals to protect public health from these threats, and to build sustainable healthcare systems.
Objective. To assess the status of PH and SH in health professions education in South African (SA) faculties of health sciences as a foundation for future work.
Methods. Educators at all 24 SA faculties of health sciences were surveyed regarding undergraduate and postgraduate faculty courses with PH- and SH-related learning objectives and outcomes, learning activities and assessments. Pivot tables were constructed to analyse their responses.
Results. Forty-one responses were received, representing 9 health professions from 15 of 24 faculties of health sciences in SA (62.5%). More than half (53.7%) were unaware of any courses with PH and SH content at their faculties. Nineteen respondents from 11 faculties reported 44 courses and provided data on 18 non-duplicate courses. Learning activities included advising patients about environmental and health co-benefits of their lifestyle choices (33.3%); written assignments (38.9%); oral presentations (55.6%); and community-based research (38.9%). Nine courses (50%) reported PH- and SH-related assessments, most commonly oral presentations (88.9%); reflective essays (77.8%); multiple-choice or short assessment questions (55.6%); and research outputs (55.6%).
Conclusion. Education about PH and SH is starting to develop in SA faculties, although with a limited variety of learning activities and assessments. This study provides a useful baseline for curriculum development and assessment of progress.
Costello A, Abbas M, Allen A, et al. Managing the health effects of climate change. Lancet 2009;373(9676):1693- 1733. https://doi.org/10.1016/S0140-6736(09)60935-1
Watts N, Amann M, Ayeb-Karlsson S, et al. Countdown on health and climate change: From 25 years of inaction to a global transformation for public health. Lancet 2018;391(10120):581-630. https://doi.org/10.1016/S0140- 6736(17)32464-9
Walpole SC, Mortimer F, Inman A, et al. Exploring emerging learning needs: A UK-wide consultation on environmental sustainability learning objectives for medical education. Int J Med Educ 2015;6:191-200. https://doi. org/10.5116/ijme.5643.62cd
Macpherson CC, Wynia M. Should health professionals speak up to reduce the health risks of climate change? AMA J Ethics 2017;19(12):1202-1210. https://doi.org/10.1001/journalofethics.2017.19.12.msoc1-1712
Tun S. Fulfilling a new obligation: Teaching and learning of sustainable healthcare in the medical education curriculum. Med Teach 2019;41(10):1168-1177. https://doi.org/10.1080/0142159X.2019.1623870
Walpole S, Vyas A, Maxwell J, et al. Building an environmentally accountable medical curriculum through international collaboration. Med Teach 2017;39(10):1040-1050. https://doi.org/10.1080/0142159X.2017.1342031
Centre for Sustainable Healthcare. Education for sustainable healthcare network. 2020. https://networks.
sustainablehealthcare.org.uk/network/education-sustainable-healthcare (accessed 14 October 2022).
Madden DL, McLean M, Brennan M, et al. Why use indicators to measure and monitor the inclusion of climate change and environmental sustainability in health professions education? Med Teach 2020;42(10):1119-1122.
Shea B, Knowlton K, Shaman J. Assessment of climate-health curricula at international health professions schools. JAMA Netw Open 2020;3(5):e206609. https://doi.org/10.1001/jamanetworkopen.2020.6609
Walpole SC, Pearson D, Coad J, et al. What do tomorrow’s doctors need to learn about ecosystems? BEME Guide No. 36. Med Teach 2015;10:1-15. https://doi.org/10.3109/0142159X.2015.1112897
Walpole SC, Barna S, Richardson J, et al. Sustainable healthcare education: Integrating planetary health into clinical education. Lancet Planetary Health 2019;3(1):e6-e7. https://doi.org/10.1016/S2542-5196(18)30246-8
Barna S, Maric F, Simons J, et al. Education for the Anthropocene: Planetary health, sustainable health care,
and the health workforce. Med Teach 2020;42(10):1091-1096. https://doi.org/10.1080/0142159X.2020.1798914
Shaw E, Walpole S, McLean M, et al. AMEE consensus statement: Planetary health and education for sustainable
healthcare. Med Teach 2021;43(3):272-286. https://doi.org/10.1080/0142159X.2020.1860207
Whitmee S, Haines A, Beyrer C, et al. Safeguarding human health in the Anthropocene epoch: Report of the Rockefeller Foundation-Lancet Commission on planetary health. Lancet 2015;386(10007):1973-2028. https://
Boelen C, Pearson D, Kaufman A, et al. Producing a socially accountable medical school. AMEE Guide No. 109. Med Teach 2016;38(11):1078-1091. https://doi.org/10.1016/S0140-6736(15)60901-1
Pearson D, Walpole S, Barna S. Challenges to professionalism: Social accountability and global environmental change. Med Teach 2015;37(9):825-830. https://doi.org/10.3109/0142159x.2015.1044955
McLean M, Gibbs T. Addressing code red for humans and the planet: We are in this together. Med Teach 2022;44(5):462-465. https://doi.org/10.1080/0142159X.2022.2040733
World Health Organization. COP26 special report on climate change and health: The health argument for climate action. 2021. https://www.who.int/publications/i/item/cop26-special-report (accessed 14 October 2022).
World Health Organization Civil Society Working Group to Advance Action on Health and Climate Change. A all for strengthening climate change education for all health professionals: An open letter to universities and all education stakeholders. https://climateandhealthalliance.org/wp-content/uploads/2022/06/Curriculum-letter. pdf (accessed 14 October 2022).
Tun S, Martin T. Education for Sustainable Healthcare. A Curriculum for the UK. London: Medical Schools Council, 2022. https://www.medschools.ac.uk/media/2949/education-for-sustainable-healthcare_a-curriculum- for-the-uk_20220506.pdf (accessed 14 October 2022).
General Medical Council. Outcomes for Graduates. London: GMC, 2018. https://www.gmc-uk.org/education/ standards-guidance-and-curricula/standards-and-outcomes/outcomes-for-graduates (accessed 14 October 2022).
Tun S, Wellbery C, Teherani A. Faculty development and partnership with students to integrate sustainable healthcare into health professions education. Med Teach 2020;42(10):1112-1118. https://doi.org/10.1080/0142 159x.2020.1796950
Musaeus P, Wellbery C, Walpole S, et al. E-collaborating for environmentally sustainable health curricula. In: Azeiteiro U, Filho WL, Aires L, eds. Climate Literacy and Innovations in Climate Change Education. Climate Change Management. Berlin: Springer, 2018.
Davis-Reddy CL, Vincent K. Climate Risk and Vulnerability: A Handbook for Southern Africa. 2nd ed. Pretoria: Council for Scientific and Industrial Research, 2017.
Chersich MF, Wright CY, Venter F, et al. Impacts of climate change on health and wellbeing in South Africa. Int J Environ Public Health 2018;15(9):1884. https://doi.org/10.3390/ijerph15091884
Godsmark CN, Irlam J, van der Merwe F, et al. Priority focus areas for a sub-national response to climate change and health: A South African provincial case study. Environ Int 2019;122:31-51. https://doi.org/10.1016/j. envint.2018.11.035
Department of Environment Forestry and Fisheries. National Climate Change Adaptation Strategy. Pretoria: DEFF, 2019.
National Department of Health. National Climate Change and Health Adaptation Plan 2020 - 2024. Pretoria: NDoH, 2019.
Academy of Science of South Africa (ASSAf). Reconceptualising health professions education in South Africa. 2018. http://research.assaf.org.za/handle/20.500.11911/95 (accessed 14 October 2022).
Gandhi V, Al-Hadithy N, Göpfert A, et al. Integrating sustainability into postgraduate medical education. Future Healthc J 2020;7(2):102-104. https://doi.org/10.7861/fhj.2020-0042
Mortimer F. The sustainable physician. Clin Med 2010;10(2):110.
Lokotola CL, Mash R, Naidoo K, et al. Climate change and primary health care in Africa: A scoping review.
J Climate Change Health 2023;11:100229. https://doi.org/10.1016/j.joclim.2023.100229
Global Green and Healthy Hospitals. Case studies. https://greenhospitals.org/case-studies (accessed 20 April 2023). 34. Irlam J, S Reid, H-A Rother. Education about planetary health and sustainable healthcare: A national Delphi
panel assessment of the AMEE Consensus for health professions education in South Africa. Afr J Health Professions Educ 2024;16(1):e327. https://doi.org/10.7196/AJHPE.2024.v16i1.327
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