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Bukenya J, Kebede D, Mwambi H, Pate M, Adongo P, Berhane Y, Canavan CR, Chirwa T, Fawole OI, Guwatudde D, Jackson E, Madzorera I, Moshabela M, Oduola AMJ, Sunguya B, Sall A, Raji T, Fawzi W. The future of public health doctoral education in Africa: transforming higher education institutions to enhance research and practice. Lancet Public Health 2024:S2468-2667(24)00056-2. [PMID: 38735302 DOI: 10.1016/s2468-2667(24)00056-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 03/06/2024] [Accepted: 03/12/2024] [Indexed: 05/14/2024]
Abstract
The African Union and the Africa Centers for Disease Control and Prevention issued a Call to Action in 2022 for Africa's New Public Health Order that underscored the need for increased capacity in the public health workforce. Additional domestic and global investments in public health workforce development are central to achieving the aspirations of Agenda 2063 of the African Union, which aims to build and accelerate the implementation of continental frameworks for equitable, people-centred growth and development. Recognising the crucial role of higher education and research, we assessed the capabilities of public health doctoral training in schools and programmes of public health in Africa across three conceptual components: instructional, institutional, and external. Six inter-related and actionable recommendations were derived to advance doctoral training, research, and practice capacity within and between universities. These can be achieved through equitable partnerships between universities, research centres, and national, regional, and global public health institutions.
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Affiliation(s)
- Justine Bukenya
- School of Public Health, Makerere University, Kampala, Uganda.
| | - Derege Kebede
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Henry Mwambi
- School of Mathematics, Statistics, and Computer Science, Durban, South Africa
| | - Muhammed Pate
- Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Philip Adongo
- School of Public Health, University of Ghana, Accra, Ghana; Association of Schools of Public Health in Africa, Accra, Ghana
| | - Yemane Berhane
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Chelsey R Canavan
- Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Tobias Chirwa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Olufunmilayo I Fawole
- Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - David Guwatudde
- School of Public Health, Makerere University, Kampala, Uganda
| | - Elizabeth Jackson
- Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Isabel Madzorera
- Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Mosa Moshabela
- Vice Chancellor's Office, University of KwaZulu-Natal, Durban, South Africa
| | - Ayoade M J Oduola
- University of Ibadan Research Foundation, University of Ibadan, Ibadan, Nigeria
| | - Bruno Sunguya
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Tajudeen Raji
- Africa Centers for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Wafaie Fawzi
- Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA.
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Kebebew T, Woldetsadik MA, Barker J, Cui A, Abedi AA, Sugerman DE, Williams DE, Turcios-Ruiz RM, Takele T, Zeynu N. Evaluation of Ethiopia's field epidemiology training program - frontline: perspectives of implementing partners. BMC Health Serv Res 2023; 23:406. [PMID: 37101262 PMCID: PMC10131477 DOI: 10.1186/s12913-023-09384-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 04/10/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Field Epidemiology Training Program (FETP) has been adopted as an epidemiology and response capacity building strategy worldwide. FETP-Frontline was introduced in Ethiopia in 2017 as a three-month in-service training. In this study, we evaluated implementing partners' perspectives with the aim of understanding program effectiveness and identifying challenges and recommendations for improvement. METHODS A qualitative cross-sectional design was utilized to evaluate Ethiopia's FETP-Frontline. Using a descriptive phenomenological approach, qualitative data were collected from FETP-Frontline implementing partners, including regional, zonal, and district health offices across Ethiopia. We collected data through in-person key informant interviews, using semi-structured questionnaires. Thematic analysis was conducted, assisted with MAXQDA, while ensuring interrater reliability by using the consistent application of theme categorization. The major themes that emerged were program effectiveness, knowledge and skills differences between trained and untrained officers, program challenges, and recommended actions for improvement. Ethical approval was obtained from the Ethiopian Public Health Institute. Informed written consent was obtained from all participants, and confidentiality of the data was maintained throughout. RESULTS A total of 41 interviews were conducted with key informants from FETP-Frontline implementing partners. The regional and zonal level experts and mentors had a Master of Public Health (MPH), whereas district health managers were Bachelor of Science (BSc) holders. Majority of the respondents reflected a positive perception towards FETP-Frontline. Regional and zonal officers as well as mentors mentioned that there were observable performance differences between trained and untrained district surveillance officers. They also identified various challenges including lack of resources for transportation, budget constraints for field projects, inadequate mentorship, high staff turnover, limited number of staff at the district level, lack of continued support from stakeholders, and the need for refresher training for FETP-Frontline graduates. CONCLUSIONS Implementing partners reflected a positive perception towards FETP-Frontline in Ethiopia. In addition to scaling-up the program to reach all districts to achieve the International Health Regulation 2005 goals, the program also needs to consider addressing immediate challenges, primarily lack of resources and poor mentorship. Continued monitoring of the program, refresher training, and career path development could improve retention of the trained workforce.
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Affiliation(s)
- Tolcha Kebebew
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, Addis Ababa, Ethiopia.
| | - Mahlet A Woldetsadik
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jordan Barker
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education (ORISE) Fellow, Oak Ridge Associated Universities, Oak Ridge, TN, USA
| | - Angelina Cui
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education (ORISE) Fellow, Oak Ridge Associated Universities, Oak Ridge, TN, USA
| | - Aisha A Abedi
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - David E Sugerman
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Desmond E Williams
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Reina M Turcios-Ruiz
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Tariku Takele
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Neima Zeynu
- Center for Public Health Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Hemingway-Foday JJ, Diallo BI, Compaore S, Bah S, Keita S, Diallo IT, Martel LD, Standley CJ, Bah MB, Bah M, Camara D, Kaba AK, Keita L, Kone M, Reynolds E, Souare O, Stolka KB, Tchwenko S, Wone A, Worrell MC, MacDonald PDM. Lessons learned for surveillance system strengthening through capacity building and partnership engagement in post-Ebola Guinea, 2015-2019. Front Public Health 2022; 10:715356. [PMID: 36033803 PMCID: PMC9403137 DOI: 10.3389/fpubh.2022.715356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/27/2022] [Indexed: 01/21/2023] Open
Abstract
The 2014-2016 Ebola outbreak in Guinea revealed systematic weaknesses in the existing disease surveillance system, which contributed to delayed detection, underreporting of cases, widespread transmission in Guinea and cross-border transmission to neighboring Sierra Leone and Liberia, leading to the largest Ebola epidemic ever recorded. Efforts to understand the epidemic's scale and distribution were hindered by problems with data completeness, accuracy, and reliability. In 2017, recognizing the importance and usefulness of surveillance data in making evidence-based decisions for the control of epidemic-prone diseases, the Guinean Ministry of Health (MoH) included surveillance strengthening as a priority activity in their post-Ebola transition plan and requested the support of partners to attain its objectives. The U.S. Centers for Disease Control and Prevention (US CDC) and four of its implementing partners-International Medical Corps, the International Organization for Migration, RTI International, and the World Health Organization-worked in collaboration with the Government of Guinea to strengthen the country's surveillance capacity, in alignment with the Global Health Security Agenda and International Health Regulations 2005 objectives for surveillance and reporting. This paper describes the main surveillance activities supported by US CDC and its partners between 2015 and 2019 and provides information on the strategies used and the impact of activities. It also discusses lessons learned for building sustainable capacity and infrastructure for disease surveillance and reporting in similar resource-limited settings.
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Affiliation(s)
| | | | | | | | | | | | - Lise D. Martel
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Claire J. Standley
- Center for Global Health Science and Security, Georgetown University, Washington, DC, United States
| | | | | | | | | | | | | | | | | | | | - Samuel Tchwenko
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Abdoulaye Wone
- International Organization for Migration, Conakry, Guinea
| | - Mary Claire Worrell
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Pia D. M. MacDonald
- RTI International, Durham, NC, United States,Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC, United States
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