africa health journal
DESCRIPTION
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).If you wish to attend one of our future webinars, you can visit this link and register now: http://liverpool-degrees.com/Events.aspxTRANSCRIPT
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
Outline
• Definition of Fit For Purpose (FFP)
• Need for new thinking and effort
• Human Resource for Health Challenges• Human Resource for Health Challenges
• Competency Based Education
• Way forward
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• Experts, Professionals, Leaders
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
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 environmentcommercialisation, working environment
• Changing scope of practice; unmet skills
needs: Nurse Practitioners, Task Shifting,
Needs based training etc
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
productproduct
• Sub Saharan African Medical Schools Study:
faculty shortages, infrastructure, private
sector
Environment in Africa
• Large population
• Limited resources
• Human Resource shortages
• Big Disease burden
Source: www.worldmappers.org
Leading causes of disease burden in Africa, 2000
Source: The World Health Report 2001, WHO
HS definition
African HWF spectrum
Super-specialists
Specialists
General
Practitioners
Contributing factors:
•Good governance, law and order
•Gender
•Social justice
•Social and economic development
National
Referral
Regional
Referral Practitioners
Mid-level
CHWs
Referral
District level
Sub-District level
Household & community
SH
AR
ED
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
Scale-up frameworkGOAL: HEALTH OUTCOMES
Integrated Health Service Delivery Networks
PRIORITISED SKILL MIX
"CLOSE-TO-CLIENT HEALTH TEAMS"Defined within country context
INDICATOR:
MDGs
Defined within country context
EXISTING CAPACITY DEVELOPMENT OF NEW CAPACITIES
FINANCIALPOLITICAL TECHNICAL
- Resources
- Incentives
- Partnerships
- Supportive environment
- Leadership
- Commitment
- Legislation
- Policy
- Partnerships
- Training
- Institutions
- Infrastructure
- Connectivity
- Partnerships
Critical success factors for scaling up
Study of GHWA Task Force on Education and Training
• 9 country experiences across regions
Critical 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
New directions
Competency /
Outcome Based Needs Based
EducationOutcome Based
EducationEducation
Competency based education
• Education aimed at imparting underlying
characteristics related to job performance
• Encompasses knowledge, traits, skills and abilities
• Fit for Purpose
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• Able to be leaders and change agents
• Continuous self directed learners
• Effective communicators
Achieving competencies
• Selection process for candidates• Right attitudes, belong to community (underserved areas)
• Training in real life practice environment
• Mentorship• Mentorship
• Team Based Learning
• Strong linkages with communities
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 – 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
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
systemssystems
• Create Country Multi-stakeholder Alliances (CCF)
• Establish HWF Information Systems (Observatories)
Outline of this talk
• Outline of medical education in the UK
• Current perspectives in UK medical education
• Professionalism and Leadership
• Studying health and leadership
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
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
Junior doctors
• Undergo a further period of training
– Foundation years (2 years)
– Specialty training
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 • Leadership has been established as a core competency for
medical students and junior doctors
1 Royal College of Physicians (2005) Doctors in Society: Medical Professionalism in a
Changing world. RCP. London.
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
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 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
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