We started Peoples-uni with the mission to provide meaningful, good quality, affordable, online public health education to students in low and middle income countries (LMICs) and built up the organisation organically and opportunistically over the years by collaborating with others wherever possible. There was no traditional business plan and it was an evolving strategy – with this mission uppermost in our minds we reviewed and refined our plans periodically, matching needs with available resources. This ‘experiment’ worked simply because of the power of volunteering – large numbers of people from various backgrounds joined in, to provide all the services like any higher education organisation including administrative, student support and technology services and the academics. Peoples-uni therefore is proof of the value of volunteering to make a difference by helping to build much needed public health capacity globally.
On this journey we learnt many lessons, some of these are as
follows and there are many publications of our experiences
which provide further details, and which may be useful for
Our fundamental guiding principle was to ensure affordable, yet high quality, online education and indeed we had the idea that the education should be free to students who could not afford even a small fee – potentially feasible through the use of Open Source educational and IT materials with the help of expert volunteers.
We wanted to create a sustainable model for securing resources, since despite tremendous support the harsh reality is that some money is needed, for operations for paid staff or equipment and services.
We realised that a sustainable future was not possible if we depended on periodic grant support, although we did secure a few. To supplement small fees from the students who could afford them, we adopted a differential model with more charges to students in developed countries than in LMICs, and to gain an accredited MPH from Manchester Metropolitan and Euclid Universities, even though the course was identical for all students.
We approached many professional bodies for an association with them to enable our students to utilise their education with us for employment purposes - the link between education and employment and hence economic viability was an ever-present thought. Although in the early years we managed to secure an agreement with the UK Royal Society of Public Health, our efforts on the whole were not very successful in creating such associations. As we were not registered as an educational provider, we were not able to gain accreditation for our courses ourselves, and sought partnerships with universities for this purpose. Our many attempts at such partnerships with universities in different countries were generally unsuccessful. Manchester Metropolitan University in the UK was our initial partner for four semesters and was extremely valuable as we worked with them to ensure validation of the programme at the master’s level, although the partnership ceased as there was no perceived value for the partner university. Euclid University became our later partner and offered an accredited MPH to our graduates.
Among the reasons given for failures to gain appropriate partnerships were Peoples-uni being seen as competition by the formal and established providers, not enough money being generated though our model, and over-reliance on volunteers. The first two are genuine real world issues since education is now a business and not a vocation, and educational providers have their own pressures and certainly in the UK the regulatory demands are onerous. We did try to find compromises but the latter was unbridgeable, volunteers were central to our model and in fact, we had created an international cadre of expert committed volunteers. We were very reluctant to scale up to increase student numbers, as often required with traditional business models with low cost ‘products’, since that would have put more pressure on volunteers and compromised the quality of teaching that we could offer; this was specially true for the dissertations which, despite our approach to add structure and streamline processes, required a lot of personal and academic support for students.
Our volunteers ranged from newly qualified graduates to fully established and retired professionals, and the main reason for the success of the model was the ability to create specific roles and tasks which fit in with what the volunteers wanted to offer and they could choose to stay for as long or as short as they could. This strength of the model was also its weakness since although volunteers can and often did major elements of work, managing the whole enterprise and discrete components of work do require dedicated administration and management. We experimented with paid roles – apart from for the administrative services – but our aspiration to keep costs down to ensure affordable education and hence very low fees and our intention of containing student numbers to avoid overloading the tutors – meant that we could not create equivalent paid positions for the needed roles.
So there was a vicious cycle – with the need for money versus affordable education dilemma – and we were really targetting the most needy in very poor circumstances – and we could not turn it into a virtuous cycle by creating alternative sources of funding such as through charities or government grants. Could we have done something different was a recurring thought and we sought advice - generously given by some senior figures – but the ‘ideal’ vs ‘practical’ gap remained unbridgeable, certainly for us. There is clearly a lesson for others, and we hope, and believe, that there are people who are better able to overcome some of the challenges we faced, and we wish them luck. Since our educational courses have been created under Creative Common Licences, and the software infrastructure published on an open source facility, we hope that others can use and built on our developments. In any case, after 15 years and having achieved our major objectives, in the light of other developments with other providers coming up, and our personal positions and need to focus on other things where we are now better placed to add - value, we had to close the operations. NextGenU.org has already taken the infrastructure over to continue what we started, under their banner and we wish them luck.
The need for public health capacity, already there, has become more apparent with the Covid 19 pandemic and so is the need for online education. Covid 19, like many other public health problems, shows that ultimately what is needed is strengthening of health systems overall and on an ongoing continuous basis. This can not happen with the current and established university system – new models of quality, affordable and accredited education are needed. Whilst many of the obstacles are being overcome in various ways through Creative Commons licencing, Open Source etc, the biggest block that still remains is accreditation. Clearly something needs to change in the system globally, otherwise the workforce shortages estimated by the WHO can not be met and inequalities will rise as expensive education will push workers to better paid jobs, not least to cover their costs. The starting point for strengthening health systems is and will be workforce. We hope that things will change and soon, and that others will take note of the Peoples-uni model; if it makes even a slight difference we would feel honoured to have played a small role. The main credit is due to our supporters and volunteers (past and present) – we could not have sustained Peoples-uni for so long without you.
Thank you and good luck.
Rajan Madhok chaired the Board of Trustees, a public health specialist he worked in senior posts in the NHS. For further information see https://www.nhs70.org.uk/story/rajan-madhok
Dick Heller was the founder of Peoples-uni, is Emeritus Professor at the Universities of Newcastle, Australia and Manchester, UK.