Education about Planetary Health and Sustainable Healthcare in low- and middle-income countries: Planetary Health Report Card assessment of perceptions at University of Cape Town Faculty of Health Sciences

Background. The Planetary Health Report Card (PHRC) was developed by medical students in the USA as a metric-based scorecard and institutional advocacy tool for planetary health (PH), with respect to five categories: Curriculum, Community Engagement, Student Leadership, Research, and Campus Sustainability. The PHRC has expanded into a global initiative, although its use by faculties in low- and middle-income countries (LMICs) has been very limited. Objectives. To assess perceptions at the Faculty of Health Sciences (FHS) of the University of Cape Town (UCT) about PH and sustainable healthcare (SH); and perceptions of the barriers and opportunities for integrating PH and SH into curricula in the UCT FHS. Methods. A PHRC was completed for the UCT FHS by means of interviews with key educators. Interview summaries, and scored report cards (where applicable), were shared for validity checking before compilation of the UCT FHS summary report. Results. Thirty-nine interviews were conducted, 31 of them with key educators representing nine academic departments. Twenty- three graded report cards were completed with those engaged in PH and SH activities. The PHRC category scores ranged from a grade of D minus (20%) for Student Leadership to a C grade for Curriculum (54%), with an overall grade of C minus (42%). Education about PH and SH in the UCT FHS is seen as increasingly important yet insufficient. Curriculum overload, “siloed” learning, and poor understanding among educators were perceived as key barriers. PH and SH were proposed as cross- cutting curricular themes for all health sciences disciplines in the UCT FHS. More community engagement, student leadership development, collaborative research, and campus sustainability interventions were recommended in the other PHRC categories. Conclusion. The PHRC provides a baseline assessment of PH and SH in a faculty of health sciences in a LMIC contributing towards greater environmental accountability. It should be repeated regularly at the UCT FHS to measure and evaluate progress in integrating PH and SH into transformed curricula, engagement with the communities it serves, development of student leadership, in ch, and campus sustainability.