Medical Education Scale-UP in Africa: Notes from the Field

Transcription

1 Medical Education Scale-UP in Africa: Notes from the Field Fitzhugh Mullan, MD Murdock Head Professor of Medicine and Health Policy Professor of Pediatrics George Washington University Academic Pediatric Association Global Health SIG May 4, 2013 Washington, DC

2 African Health Systems Complexity of HIV/AIDS treatments Health system requirement No health workers = no system Community health workers are necessary but not sufficient Medical doctors and nurses are essential to a stable, functional system

3 Why Invest in African Medical Education? Humanitarian Reasons Diplomatic Reasons Strategic Reasons

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5 Physician Density per 100,000 Population Cuba Russia France U.S. U.K. Poland Brazil China South Africa India Ghana Mozambique Source: World Health Organization (2006) Working Together for Health. The World Health Report 2006: WHO Press.

6 Global Misdistribution of Health Workers

7 Unequal Distribution of Health Workers

8 Health Workers Save Lives

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16 SAMSS The Sub-Saharan African Medical School Study (SAMSS) Funded by the Bill and Melinda Gates Foundation

17 Sub-Saharan African Medical School Study (SAMSS) George Washington University African Advisory Committee Gates Foundation Funded Ten Comprehensive Site Visits Survey of All SSA Medical Schools

18 SAMSS Site Visited Schools

19 Sub-Saharan African Medical Schools Founding Dates

20 Estimated Location of Sub-Saharan African Medical School Graduates Five Years After Graduation

21 Reasons for Teaching Staff Loss in Sub-Saharan African Medical Schools

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24 MEPI Medical Education Partnership Initiative Funded by PEPFAR and NIH Managed by HRSA and NIH

25 MEPI Structure $135 million investment over five years 13 medical schools in 12 countries 32 African, 17 American, 2 British and 1 Canadian partners Coordinating Center GW Department of Health Policy/African Center for Global Health and Social Transformation (ACHEST)

26 MEPI Aims/Themes Medical education capacity (quantity and quality of graduates) Retention and geographic distribution of graduates Regionally relevant research training

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28 Increasing the Number of Graduates Increased Enrollment Ethiopia - Class sizes at Addis Ababa University have gone from Zambia Parallel class of private students New Schools Zambia Copperbelt University, Cavendish University Zimbabwe 2 nd school at Buluwayo Uganda Busetima medial school

29 Innovative Pedagogy Kilimanjaro Christian Medical Center implemented Team-based learning University of Nairobi is implementing Problembased learning Skills labs University of Nairobi, Addis Ababa University, Zambia

30 elearning LMS Digital Resources Distance Learning Infrastructure Moodle-based (Nairobi, Zambia) egranary: Zambia, Kwazulu Natal Pharmacy courses Internet/Intranet Blue Docs (KCMC) Claroline U of Nairobi, Mozambique, Ghana Addis Ababa University Digital Histology: Copperbelt University University of Nairobi connecting to decentralized site Makerere video conference with US partner elearning policies elearning team Computers, tablets

31 Community-Based Learning 3 Strategies: 1. Community-exposure focus on public health, research, community clinic (Ethiopia, Zambia, Uganda ) 2. Community clinical rotations (internal medicine, pediatrics, surgery) in the district hospitals (Nairobi, KCMC) 3. Rural Immersion 6months to 1 year with a family doctor in the rural area (Stellebosch)

32 MEPI Technical Working Groups Monitoring and evaluation E-learning Community based practice Research Support Centers Tracking Competency based practice Medical Education Research

33 Areas of success Annual Symposium PI Council Networking, collaborating, organizing Focus on medical education, locally Focus on regional medical education Curriculum review and revision Faculty development Enhanced research training

34 Areas of Challenge Expanded Capacity Improved quality Links to new schools Retention Tracking Distribution Sustainability

35 Communities of Practice 2012 MEPI Annual Symposium Participants

36 Global Health Service Corps

37 Healers Abroad Americans Responding to the Human Resource Crisis in HIV/AIDS

38 The History of the Global Health Service Corps

39 The Global Health Service Partnership The Peace Corps The Global Health Service Corps (GHSC) The Global Health Service Partnership (of the Peace Corps) (GHSP) Peace Corps Response (PCR) Medical and Nursing Schools in Malawi Tanzania Uganda

40 GHSC Launch, Summer, people in July 2013 Malawi, Tanzania and Uganda Uganda: 12 MD/100k 131 RNs/ 100k Tanzania: 1 MD/100k 24 RNs/ 100k Malawi: 2 MDs/100k 248 RNs/ 100k

41 Global Health Service Partnership A Partnership between the Peace Corps and the Global Health Service Corps GHSC-PCVs to serve as clinical faculty for at least one year GHSC-PCVs... MDs must have completed training RNs must hold BSN plus additional degree Teaching experience preferred

42 Global Health Service Partnership Peace Corps will provide stipend, health insurance, travel, and benefits Global Health Service Corps will provide loan repayment and professional support Medical/nursing school will provide faculty appointment, housing, and individualized scope of work

43 GHSP Mission Partner with host school to address the local educational challenges Augment faculty capacity Provide clinical instruction in hospital and ambulatory settings Engage in mentoring and other faculty activities as needed Assist host school in addressing national health system strengthening

44 Benefits to GHSP-PCV GHSP experience will provide the opportunity To increase the number of graduates in the host country To contribute to the quality of medical/nursing education in the host country To promote health system strengthening through medical/nursing education To gain an increased appreciation for sociocultural aspects of care provision To develop expertise in practicing and teaching medicine/nursing in low resource settings

45 GHSP -- Long Term Benefits Health Diplomacy Critical component of HIV/AIDS global campaign Contribution to global understanding by US medical and nursing leaders

46 GHSP Mission Partner with host school to address the local educational challenges Augment faculty capacity Provide clinical instruction Mentor/model Assist host school in addressing national health system strengthening

47 GHSP -- Contributions Represent the United States Export healing Contribute to global understanding

48 More Information Global Health Service Corps globalhealthservicecorps.org Global Health Service Partnership peacecorps.gov/response/globalhealth

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