Africa health journal


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The slides from the University of Liverpool Online webinar ‘Can Medical Education in Africa Become Fit for Purpose?’ with guest speaker Dr Francis Omaswa, Executive Director of the African Centre for Global Health and Social Transformation (ACHEST).

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Africa health journal

  1. 1. Meet our guest speakers Dr Francis Omaswa Executive Director of the African Centre for Global Health and Social Transformation (ACHEST) Formerly Director General Ministry of Health, Uganda Founding Executive Director of the Global Health Workforce Alliance Current Chair of Board of African Platform on Human Resources for Health Principal Investigator Medical Education Partnership Initiative (MEPI) Chancellor Busitema University, Uganda
  2. 2. Outline• Definition of Fit For Purpose (FFP)• Need for new thinking and effort• Human Resource for Health Challenges• Competency Based Education• Way forward
  3. 3. What is Fit For Purpose• Good enough to do the job for which it was designed• Possess attributes required to achieve intended objective• Experts, Professionals, Leaders
  4. 4. What FFP is not• Low quality Health Workforce (HWF) for the poor only• HWF with restricted market• Origins of FFP HWF: Africa first missionaries• FFP HWF: UK (surgeons); USA surgical technicians
  5. 5. Why new directions?• Global shortage: 4.3m, African shortage 1m• Globalised connected world with inequities• Tensions: Health Professionals vs Population expectations: vocation or jobs, distribution, commercialisation, working environment• Changing scope of practice; unmet skills needs: Nurse Practitioners, Task Shifting, Needs based training etc
  6. 6. Education: critical solution• Underlying global HWF crisis is failure to train and retain enough• Education Institutions are factories: good factory = good product; bad factory = bad product• Sub Saharan African Medical Schools Study: faculty shortages, infrastructure, private sector
  7. 7. Environment in Africa• Large population• Limited resources• Human Resource shortages• Big Disease burden Source:
  8. 8. Leading causes of disease burden in Africa, 2000 Source: The World Health Report 2001, WHO
  9. 9. HS definition
  10. 10. African HWF spectrumContributing factors: Super-specialists•Good governance, law and order•Gender National Specialists Referral•Social justice•Social and economic development General Regional Referral Practitioners District level Mid-level SHARED Sub-District level Household & community CHWs
  11. 11. AU health strategy• Determine the categories of professional, auxiliary (mid- level) and community health workers that will provide an appropriate human resource mix for their needs• Develop costed national human resources development and deployment plans, including revised packages and incentives, especially for working in disadvantaged areas• Fund the establishment of the training capacity required to produce the desired number of health workers• Build multi-purpose trained staff as the nucleus of health care delivery
  12. 12. Scale-up framework GOAL: HEALTH OUTCOMES Integrated Health Service Delivery Networks INDICATOR: MDGs PRIORITISED SKILL MIX "CLOSE-TO-CLIENT HEALTH TEAMS" Defined within country context EXISTING CAPACITY DEVELOPMENT OF NEW CAPACITIES TECHNICAL POLITICAL FINANCIAL - Training - Supportive environment - Resources - Institutions - Leadership - Incentives - Infrastructure - Commitment - Partnerships - Connectivity - Legislation - Partnerships - Policy - Partnerships
  13. 13. Critical success factors for scaling upStudy of GHWA Task Force on Education and Training• 9 country experiences across regionsCritical factors identified:• Political commitment and good governance – Sustained high level support, one country-led health plan, significant financial investment• Enabling environment – Multi-sector participation, Good information systems, effective management and leadership, labour market capacity and policy• Workforce planning – Plan long term, act short-term and update regularly, commitment to production / appropriate skill mix integrated teams, needs based, expansion of pre-service programmes
  14. 14. New directions Competency / Needs Based Outcome Based Education Education
  15. 15. Competency based education• Education aimed at imparting underlying characteristics related to job performance• Encompasses knowledge, traits, skills and abilities• Fit for Purpose
  16. 16. Required competencies• Prepared to work where services are most needed• Able to respond to health needs of community• Able to deliver quality care with available (limited) resources• Able to be leaders and change agents• Continuous self directed learners• Effective communicators
  17. 17. Achieving competencies• Selection process for candidates • Right attitudes, belong to community (underserved areas)• Training in real life practice environment• Mentorship• Team Based Learning• Strong linkages with communities
  18. 18. Kampala declaration and agenda for global action• Key elements: – Building coherent national and global leadership for health workforce solutions – Ensuring capacity for an informed response based on evidence and joint learning – Scaling up health worker education and training with needs based skill mix – Retaining an effective, responsive and equitably distributed health workforce – Managing the pressures of the international health workforce market and its impact on migration – Securing additional and more productive investment in the health workforce
  19. 19. Implication for countries• Prioritise Education and Training of HWF• Link with National Development Plans• Plan long-term, act short-term and review frequently• Link E &T to Population health needs & health systems• Create Country Multi-stakeholder Alliances (CCF)• Establish HWF Information Systems (Observatories)
  20. 20. Outline of this talk• Outline of medical education in the UK• Current perspectives in UK medical education• Professionalism and Leadership• Studying health and leadership
  21. 21. Meet our guest speakers Dr Helen O’Sullivan Senior Lecturer in Medical Education Director of the Centre for Excellence in Evidence Based Learning and Teaching, Faculty of Health and Life Sciences, University of Liverpool
  22. 22. Medical education in the UK• Two phases: undergraduate (medical student) and postgraduate (junior doctors)• The General Medical Council regulates medical education in the UK• At undergraduate level “Tomorrow’s Doctors” specifies outcomes in three categories: – The doctor as a scholar and a scientist – The doctor as a practitioner – The doctor as a professional
  23. 23. Junior doctors• Undergo a further period of training – Foundation years (2 years) – Specialty training
  24. 24. Current perspectives on medical education• Increasing interest in medical professionalism• “a set of values, behaviours and relationships that underpins the trust that the public has in doctors” 1• Particular interest in how you develop and assess these aspects• Leadership has been established as a core competency for medical students and junior doctors 1Royal College of Physicians (2005) Doctors in Society: Medical Professionalism in a Changing world. RCP. London.
  25. 25. Leadership development• Healthcare provision in the UK is in a period of enormous change: – Technological advances – Austerity – Changes in society• All healthcare professionals need to understand how to manage change and provide leadership• Leadership education is now required in undergraduate and postgraduate education
  26. 26. Studying health care and health• Advanced programmes of study such as Masters in health and public health provide an opportunity for doctors and other healthcare professionals to develop the appropriate theoretical and practical skills to improve global health• The key to successful improvements in health is to have healthcare professionals who are also trained in leadership and management• By combining the study of the main disciplines of public heath with management of health systems graduates from these types of programmes can really make an impact on healthcare and healthcare education in their communities, regionally and nationally
  27. 27. Stay connected Follow us: Facebook Twitter @thinkdegrees Twitter hashtag - #LiverpoolOnline Linked In “University of Liverpool Online” Google + “University of Liverpool Online”
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