A Global Health Immersion Program for Nursing and Public Health Students

DATE	ACTIVITIES	PURPOSE OF ACTIVITY
Tue., Jan. 2	Arrival and tour of LeBoHA HQ in Maseru	Help students become familiar with the local partner and capital city of Lesotho
Wed., Jan. 3	Tour of Queen Mamohato Memorial Hospital (national hospital, formerly a public–private partnership)	Introduce the types of staffing and services provided in the highest‑level hospital in Lesotho, compared with US hospitals
Thur., Jan. 4	Travel to Leribe (~2‑h drive)	See the terrain of Lesotho; view roads and how transportation can be a barrier to access to health services
Fri., Jan. 5	Course overview; burden of disease in Lesotho Motebang Hospital tour	Identify measures of population health, data sources, and how health issues differ in Lesotho compared to the United States (e.g., HIV/AIDS, TB, and maternal health) View the layout, staffing, services, and patient flow of a regional hospital
Sat., Jan. 6	Visit to Katse Dam	Observe rural and remote areas of Lesotho, including roads and housing Gain appreciation of governance issues in access to safe water and costs and benefits of alternative water supplies
Sun., Jan. 7	Study and free time	Time for observation and reflection
Mon., Jan. 8	Overview of health systems Session Review (student assignment) WHO Health System Framework, LeBoHA history Teach back (student assignment)	Learn about the WHO health system building blocks, and LeBoHA projects and its relationship with government; experience problems and problem‑solving (delays and electrical outages) and teatime and meals with LeBoHA staff
Tue., Jan. 9	Community health and quality improvement Session Review (student assignment) Pontmain Health Center visit, Phelisanong Centre for Disabled Children visit Quality improvement and nursing programs Teach back (student assignment)	Experience the staffing, layout, services, and quality issues at a rural health clinic; view and discuss facilities for supporting disabled children; meet nursing staff and appreciate the different levels of training and practice in Lesotho versus the United States for nursing and public health
Wed., Jan. 10	Health professions education and training Session Review (student assignment) Internship and FMSTP programs Center for Excellence in PHC Teach back (student assignment)	Appreciate how LeBoHA works with the government in organizing and provided health professions education at different levels, including reform challenges and successes
Thu., Jan. 11	Service delivery and district health management Session Review (student assignment) District health management Behavioral health in Lesotho Teach back (student assignment)	Meet a District Health Officer and appreciate the role and responsibilities of the District Health Management Team in overseeing district services, including mental health; discuss differences between community health services in the United States and Lesotho
Fri., Jan. 12	Monitoring, evaluation, and financial systems Session Review (student assignment) Monitoring, evaluation, and financing Students conduct research for final projects Teach back (student assignment)	Meet the monitoring and finance officers; discuss problems in calculating burden of disease; discuss Lesotho’s health financing system in relation to the goals of Universal Health Care; work with local faculty to choose a topic for the final project and begin research
Sat., Jan. 13	Tshehlanyane National Park	Interact informally with staff and members of the community; appreciate the customs, environment, and natural beauty of Lesotho
Sun., Jan. 14	Work on final project presentations	Apply and integrate health systems knowledge to describe a real problem affecting health services in Lesotho; research causes and viable solutions from other countries or other NGOs locally; develop recommendations
Mon., Jan. 15	Student presentations Feedback on course Hike Dinner and dancing	Apply skills in oral communication, visual presentation, and leading discussions Reflect on course learning Spend time with LeBoHA staff during a strenuous hike and a celebration with music, dancing, and food
Tue., Jan. 16	Departure	Reflect on the immersion experience, lessons learned, and re‑integration

[i] Notes: HQ: headquarters; LeBoHA: Lesotho‑Boston Health Alliance; HC: health center; FMSTP: Family Medicine Specialty Training Program; PHC: primary health care.

Table 2

Teach Back Topics and Articles.

TOPICS	ARTICLE
Sexual violence	Brown, L., Thurman, T., Bloem, J., & Kendall, C. (2006). Sexual violence in Lesotho. Studies in Family Planning, 37(4), 269–80.
Digital health interventions for sexual and reproductive health	Nkabane‑Nkholongo, E., Mokgatle, M., Bickmore, T., et al. (2023). Adaptation of the Gabby conversational agent system to improve the sexual and reproductive health of young women in Lesotho. Frontiers in Digital Health, 5, 1224429.
Tuberculosis	Andom AT, Gilbert HN, Ndayizigiye M et al. (2023). Understanding barriers to tuberculosis diagnosis and treatment completion in a low‑resource setting: A mixed‑methods study in the Kingdom of Lesotho. PLoS ONE, 18(5), e0285774.
Child health and anemia	Letuka, T. & Frade, S. (2020). Household and individual risk factors of anaemia among under‑5 children in Lesotho. African Health Sciences, 20(3), 1478–1486.
Health financing	World Bank. (2017). Lesotho Public Health Sector Expenditure Review. Washington, DC: World Bank.
Health statistics	Ministry of Health [Lesotho] and ICF International. (2016). 2014 Lesotho Demographic and Health Survey Key Findings. Rockville, MD: Ministry of Health and ICF International.
HIV/AIDS and the LGBT community	Logie CH, Perez‑Brumer A, Mothopeng T, et al. (2020). Conceptualizing LGBT stigma and associated HIV vulnerabilities among LGBT persons in Lesotho. AIDS and Behavior, 24, 3462–3472.

Table 3

Guidance for Reflective Essays.

ESSAY AND TIMING

GUIDING FRAMEWORK AND QUESTIONS

Reflective Essay 1, due one week after arrival

Framework: The Five Senses

Using each of your senses, touch, sight, hearing, smell, and taste, describe something you have experienced so far in Lesotho. Write about why this was salient or interesting to you.
What has happened so far that was surprising or unexpected? Reflect on one experience and what you draw or conclude from it.
Reflect on what you are learning about the types of assistance needed for health systems strengthening in Lesotho. What questions do you have, or topics do you want to learn more about to better understand the challenges the country faces and ways to surmount them?

Essay 2, due the last day of the program

Framework: The Significant Learning Model

Reflect on what you are learning during the Lesotho Immersion, according to the six dimensions of Fink’s significant learning model. These include:
- Foundational knowledge: “Understand and remember” learning (such as facts, terms, and concepts)
- Application: Thinking (critical, creative, practical—problem‑solving, decision‑making)
- Integration: Making “connections” (i.e., finding similarities or interactions among subjects or concepts)
- Human dimensions: Learning about self (differences learning has made in intellectual, ethical, or professional development); understanding and interacting with others
- Caring: Identifying/changing one’s feelings, interests, values; high and low emotional moments
- Learning how to learn: Becoming a better student, learning to ask and answer questions, and becoming a self‑directed learner
How has the experience in Lesotho helped you to grow professionally? What aspects of the program have or will influence your work and career?

Table 4

Student Evaluation Data.

DIMENSIONS OF LEARNING	AVERAGE SCORE OUT OF 6 (%)
Instructional Design
Learning outcomes were clearly stated.	5.71 (95%)
Student responsibilities were clearly defined.	5.57 (93%)
The course schedule was clearly laid out.	5.00 (83%)
Criteria for assessing performance were clearly stated.	5.71 (95%)
Comments The syllabus clearly stated the learning outcomes. The assignments had clear instructions about what our responsibilities were. Grading rubrics were included in assignments. There was a day‑to‑day schedule that was followed clearly. There was variability …but it was not a deterrent to our education. The course schedule was laid out when we arrived, but there were certain changes at the last minute.
Instructional Practices
The course’s subject matter was covered in a clear manner.	5.14 (86%)
Course sessions were well prepared.	5.57 (93%)
Feedback on this course was constructive.	5.43 (90%)
Comments The content was covered clearly. It was all well prepared. All lectures were presented in a timely manner and allowed time for discussion. Feedback was very timely. There was a slight disconnect between some articles provided for the Teach Backs and the opinions/feedback given by some LeBoHA staff members.
Student Engagement
Instructional activities contributed to my desire to engage in the course.	5.29 (88%)
This course stimulated my interest in the subject matter.	5.71 (95%)
This course motivated me to learn.	5.71 (95%)
Comments The activities we did were interesting. I learned so much about global health. [The course] piqued my interest. Allowing me to immerse myself in the clinic setting and view the way the healthcare system worked was great! It added to more interest in the subject and understanding of the content being presented as well. It motivated me to learn more about global health and health administration. There was a little too much lecture for my liking. I would have liked more interactive elements.
Student Learning
I increased my knowledge of this subject as indicated by the course learning outcomes.	5.86 (98%)
Strategies for learning (learning how to learn) on this course are transferable to other subjects.	5.86 (98%)
This course contributed to my understanding of the subject matter.	5.86 (98%)
Comments We did a lot of reflections, which is how I like to learn. Learning and improving the skills and techniques of teaching and note‑taking allowed for further discussion and understanding of content and materials. This class was a great experience to view the hospitals and the way the health systems work as well as the lectures about the health‑care sector. [We learned] through viewing the changes that need to be made and how to impact the systems and develop further improvements. It also allowed us to view the setbacks in health care and how the community is going about to change the system. This class was amazing. I learned so much about the culture of Lesotho and the public health system in Lesotho. I enjoyed this course and traveling to Lesotho! It has positively made an impact on my professional and personal goals.

Articles in this issue

DOI: https://doi.org/10.5334/aogh.4746 | Journal eISSN: 2214-9996

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Language: English

Submitted on: Mar 26, 2025

Accepted on: Jun 24, 2025

Published on: Jul 18, 2025

Published by: Ubiquity Press

In partnership with: Paradigm Publishing Services

Publication frequency: 1 issue per year

Keywords:

global health education,

curriculum,

global nursing,

international cooperation,

learning,

service,

cultural immersion,

Lesotho

© 2025 Taryn Vian, Sebaka Malope, Elizabeth Nkabane-Nkholongo, Jill E. Sanders, Brian W. Jack, Laura Chyu, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 91 (2025): Issue 1

A Global Health Immersion Program for Nursing and Public Health Students

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