Master in Public Health-Zimbabwe Field Epidemiology Training Program 20 th Anniversary Commemorations Report Rainbow Towers, Harare International Conference Centre, Zimbabwe 26 June 2014 20 Years of Public Health Training and Service: Looking back and inspiring the future
Cover Photo: L-R: Prof Mufuta Tshimanga, Dr Peter Kilmarx, Prof Simbarashe Rusakaniko, Dr Davies Dhlakama, Hon Dr David Parirenyatwa, Prof Dionisio Herrera, Mr Vengai Mugabe, Dr Elizeus Rutebemberwa, Dr Chiratidzo Ndlovu Report compiled by Juru Tsitsi (MPH FETP 1) and Nyika Howard (MPH FETP 1) and edited by Peter Wasswa and Racheal Chelimo (AFENET) 2
Preamble The Zimbabwe Field Epidemiology Training Program (FETP) celebrated her 20 th Anniversary on 26 June 2014 at the Harare International Conference Center, Zimbabwe. The event was themed 20 years of Public Service: Looking back and inspiring the future. It was a day of reflection on the program s achievements since its establishment in 1993. Being the first public health training program in Africa, the Zimbabwe FETP provided the foundation that lead to the growth and expansion of similar training programs (FELTPs) in Africa. The Zimbabwe FETP is also one of the four founding member programs of the African Field Epidemiology Network (AFENET). The celebration drew over 150 guests that included residents and graduates from Zimbabwe FETP, and Program Directors from seven African FELTPs: Kenya, Tanzania, Uganda, Rwanda, Ghana and South Africa. The event also attracted delegates from partnering organizations such as the Zimbabwe Ministry of Health and Child Welfare, CDC Zimbabwe, Rockefeller Foundation, Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET), and AFENET among others. The event was graced by the Minister of Health and Child Care, Honorable Dr. David Parirenyatwa and other dignitaries such as Prof. Dionisio Herrera - TEPHINET Executive Director, Prof. Elizeus Rutebemberwa - AFENET Board Chair, Dr. Sheba N. Gitta AFENET Ag. Executive Director, Dr. Peter Kilmarx - CDC Zimbabwe Director, Mr. Vengai Mugabe - representative of the University of Zimbabwe s Vice Chancellor and Prof S. Rusakaniko, Chair Department of Community Medicine, University of Zimbabwe. The proceedings which were moderated by Dr Phineas Makurira- the Master of Ceremony commenced at 09.00hrs. 3
1.1 Welcome remarks and Introductions: Prof Simbarashe Rusakaniko- Chairman Department of Community Medicine University of Zimbabwe (DCM-UZ) Prof S Rusakaniko gave a brief description of the MPH program history-up until 1992. At that time, Zimbabwe faced an acute shortage of graduate level public health training. He stated that most posts were filled by expatriate doctors, mostly Dutch. Doctors were trained outside were ill equipped to address local public health situations. In response to public health needs, Ministry Of Health and Child Care (MOHCC) in partnership with UZ, Department of Community Medicine (DCM), with funding from Rockefeller Foundation started MPH program using Public Health Schools Without Walls Strategy (PHSWOW). The first cohort was enrolled in 1993, with four trainees. During its 20 year existence, the program has made the following achievements listed below: Over 200 graduates since inception, of which 66% have assumed leadership positions in different organisations, including MOHCC. At least 200 outbreak investigations, 200 surveillance system evaluations, 200 program evaluations. Over 150 data sets analysed Over 20 publications in peer reviewed journals Most outstanding scientific oral presentation at 63rd EIS Conference in April 2014. The program has trained 208 residents comprising of 124 male, 84 female including doctors, nurses, Environmental Health Officers (EHOs), Nutritionists, Occupational Therapists, Laboratory Scientists, Dentists, Health Promotion Officer (HPOs), Pharmacists, Biochemists and Veterinarians. Alumni have assumed key positions most notably of which is the current Permanent Secretary of Health Brigadier General Dr G. Gwinji and former Minister of Health Dr Henry Madzorera as well as PMDs and City Health Directors. The program plans the following in the future: Expand the program to ensure program has well trained cadres Diversifying funding resources Recruitment of alumni as coordinators and supervisors Active alumni association Working towards accreditation with TEPHINET Advocate for budget allocation for MPH from MOHCC In conclusion, Dr. Makurira reiterated good working relationship between academic faculty and the MOHCC. 4
1.2 Speech by Mr C. Samkange- Director, Institute of Continuing Health Education (ICHE), UZ Mr Samkange gave brief history of the MPH program. He outlined needs assessment survey conducted on Provincial Medical Directors (PMDs) to assess competencies which led to the drafting of UZ regulations through PHSWOW model. This process also led to the advocacy of MPH course at the Senate which efforts were led by Prof Exnevia Gomo. He stated that time, there was limited capacity to train all health professionals, hence doctors took precedence and other health professional were trained later. A curriculum was developed that included Research Methodologies, Biostatistics, and management among other modules. A two-year competency based training consisting of 30% theory and 70% job field training with six core learning activities was developed. The competencies were: o Outbreak investigation o Surveillance o Program evaluation o Secondary data analysis o Management analysis o Field study The conclusions from the Zimbabwe Institute of Public Administration and Management ZIPAM meeting in 1995 to review program experiences included: o Resources were adequate but needed strengthening o Need to expand intake o Trainees needed to be separated from origin o Modules should be stand alones o Front loading concept to give 1 st years and 2 nd years Residentstime to interact. o Research and dissertations were introduced. o To date, there are more than 10 field training sites. Although the program attempted part time training, this has since stopped. 1.3 Dr Chiratidzo Ellen Ndlovu- Acting Dean, College of Health Sciences Dr Ndlovu gave brief history and achievements of MPH Program since inception. She stated that the program intake has increased from 4 in 1993 to 20 in 2014. Graduates were highly competent and shape public health landscape of Zimbabwe. More than 35 publications have been made in peer reviewed journals and the program contributes to the annual research day were MPH students very often win awards for best presentations. Residents have also made presentations at regional and international conferences, most notably of which was Mr Donald Bangure who won the William H Foege award for best oral scientific presentationsecond African to win the award. She stated that the programs had built an extensive community of well-wishers and partners as well as that from the government and partners. 5
1.4 Dr Davies Dhlakhama- MPH Advisory Committee Chairman Dr Dhlakhama gave brief history of MPH program. He reiterated that District Medical Officers were ill equipped to address public health challenges and were unwilling to work in rural areas. They therefore urged DMOs and their District Health Executives tobe trained in Public Heatlth. 1.5 Speech by Dr Elizeus Rutebemberwa- Board Chairman AFENET Dr Rutembemberwa gave a brief history of setting up of Ugandan FETP after Zimbabwe in 1994. He reiterated the need for PHOs to be trained by public health experts and in the community where surveillance and outbreaks occur. Dr Rutebemberwa observed the presence of Program Directors from Ghana, Tanzania, Kenya, South Africa and Rwanda and MPH alumni from different countries. He reiterated the need to identify and maintain career path for alumni and also track their progress and achievements. He stated that 15 MPH programs from across Africa had been brought together by AFENET. Lastly, he stated that AFENET had mandate to ensure collaboration between countries in addressing cross boarder public health disasters, for example, the Ebola outbreak in West Africa in 2014. 1.6 Prof. Dionisio Herrera- TEPHINET Executive Director Prof. Dionisio gave brief history of TEPHINET which was now 16 years old, having been registered in 1997. He said that Prof Tshimanga was one of the founder members of TEPHINET whose mission was to strengthen public health interventions and facilitate networking and collaboration. TEPHINET has 59 programs in 85 countries. Globally, TEPHINET has over 7000 graduates and 1700 in training. He mentioned that the Network s alumni have the capacity to make a difference since the programs provide a solid foundation. He thanked all these who have dedicated their time to support the program and all those who have helped in the preparation of the ceremony. He thanked the pogrom for their work and outputs for the program. Prof Dionisio then awarded a certificate from TEPINET to Zimbabwe FETP. 1.7 Dr Peter Kilmarx- Country Director- CDC Zimbabwe Dr Kilmarx outlined the importance of FETPs supported by CDC. He stated that CDC had supported the MPH program for the past 14 years. Currently, US$2 million has been injected for the MPH program for the next 5 years and a PMI has a grant to support two PHOs involved in malaria research had been awarded to the program. 1.8 Vice Chancellor- University of Zimbabwe represented by Mr Vengai Mugabe The Vice Chancellor gave brief history of MPH Program. He stated that the program is a highly regarded course among health professionals as evidenced by over 120 applicants every year. The Program ensures gender balance in their recruitment. He stated that the University of Zimbabwe will continue to partner the Ministry Of Health towards a common vision. 6
1.9 Testimonies by Alumni 1.9.1 How MPH is Changing lives in Kadoma City- Mr Daniel Chirundu, Director City Health Kadoma Kadoma City Health provides services to 96000 people. Kadoma City established as a training site and accredited in 2011 and first Public Health Officer arrived in 2012. Contributions of FETP( 2012-2013) o Establishment of fully developed TB and HIV centre which was cascaded to 8 other centres. o Establishment of wellness clinic and wellness policy was drafted for the employees. o Establishment of a vibrant Epidemic Preparedness and Response Plan o Awarded Best Gender Empowerment Prize at South Africa Development Community (SADC) level by Zorodzai Jakopo. o To date, five publications have been contributed by Kadoma City PHOs. o The initiative also provides support to PHOs through provision of fuel, accommodation and a monetary allowance. 1.9.2 Auxillia Muchedzi- Technical Advisor for Operation Research EGPAF Dr Muchedzi was from the 2004-2005 cohort. She did five core activities Her thesis - Evaluation of the effectiveness on nevirapine prophylaxis in Murehwa district: a retrospective cohort which was accepted for oral presentation at the Epidemic Intelligence Service Conference held in Atlanta Georgia in 2006 and TEPHINET conference held on Ghana in 2005. She supervises PHOs attached to Elizabeth Glazier Paediatric AIDS Foundation 1.10 Scientific Presentation Effectiveness of Short Message Sending Reminder on Childhood Immunization in Kadoma, Zimbabwe 2013, a Randomized Controlled Trial- Mr D Bangure (See abstract presented at local, regional and international scientific conferences: Special; Edition 1993-2013) 1.11 Keynote Address- Minister Of Health and Child Care Hon. Dr David Parirenyatwa Dr Parirenyatwa gave brief history of MPH program. He mentioned that its alumni are taking key leadership positions in public health systems. The partnership between MOHCC and UZ has been strengthened and the Zimbabwe government fully supports the program. He stated that Zimbabwe has 97% literacy rate and he was hence not surprised by the program s achievements. The MOHCC looks to provide preventive, curative and rehabilitative service of high quality and to decentralize basic services to Provinces, Districts and Health facilities. 7
He urged Public Health Officers to apply principles used in controlling AIDS, TB and Malaria to control the rising prevalence of Non Communicable Diseases (NCDs). Dr Parirenyatwa stated that doctors working in rural areas need to be incentivised in order to retain them in service thus averting brain drain and its effects. He recognised doctors and other health workers who have stayed and made a difference, particularly during a cholera outbreak of 2008. The Minister reiterated prevention as a strategy for reduction of disease prevalence. In his speech, the Minister mentioned that the Government still faced some challenges such as the limited funding and resources for programs and ensuring sustainability in the absence of funding partners and to adequately respond to outbreaks. He reiterated MOHCC commitment to providing career pathway for graduates. He gave special thanks to CDC, TEPHINET, AFENET and WHO and urged for their continued support. The minister participated in cake cutting ceremony assisted by Prof Herrera and other dignitaries. 1.12 Closing Remarks- Prof Tshimanga, Director Zimbabwe FETP Prof Tshimanga thanked the MOHCC for reaffirming training, support and career pathways for MPH graduates. He thanked Vice Chancellor, Dean of College of Health Sciences and all the guests, especially those who had come from outside Zimbabwe. He thanked the organising committee and all participants who contributed to preparations of the celebrations. Prof Tshimanga gave special thanks to Zimbabwe FETP partners CDC Zimbabwe, Rockefeller Foundation, PMI, PEPFAR, Alumni and entertainers. The proceedings ended at 12:50 and lunch was served. 8
PICTORIAL The Guest of Honour Hon. Dr. Parirenyatwa cuts the anniversary cake at the climax of the celebrations A cross-section of the guests at listen to a speech 9