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Central African Field Epidemiology and Laboratory Training Program: building and strengthening regional workforce capacity in public health
Gervais Ondobo Andze, Abel Namsenmo, Benoit Kebella Illunga, Ditu Kazambu, Dieula Delissaint, Christopher Kuaban, Francois-Xavier Mbopi-Kéou, Wilfred Gabsa, Leopold Mulumba, Jean Pierre Bangamingo, John Ngulefac, Melissa Dahlke, David Mukanga, Peter Nsubuga
Pan African Medical Journal , 2011,
Abstract: The Central African Field Epidemiology and Laboratory Training Program (CAFELTP) is a 2-year public health leadership capacity building training program. It was established in October 2010 to enhance capacity for applied epidemiology and public health laboratory services in three countries: Cameroon, Central African Republic, and the Democratic Republic of Congo. The aim of the program is to develop a trained public health workforce to assure that acute public health events are detected, investigated, and responded to quickly and effectively. The program consists of 25% didactic and 75% practical training (field based activities). Although the program is still in its infancy, the residents have already responded to six outbreak investigations in the region, evaluated 18 public health surveillance systems and public health programs, and completed 18 management projects. Through these various activities, information is shared to understand similarities and differences in the region leading to new and innovative approaches in public health. The program provides opportunities for regional and international networking in field epidemiology and laboratory activities, and is particularly beneficial for countries that may not have the immediate resources to host an individual country program. Several of the trainees from the first cohort already hold leadership positions within the ministries of health and national laboratories, and will return to their assignments better equipped to face the public health challenges in the region. They bring with them knowledge, practical training, and experiences gained through the program to shape the future of the public health landscape in their countries. Pan African Medical Journal 2011; 10(Supp 1):4
Wrong schools or wrong students? The potential role of medical education in regional imbalances of the health workforce in the United Republic of Tanzania
Beatus K Leon, Julie Riise Kolstad
Human Resources for Health , 2010, DOI: 10.1186/1478-4491-8-3
Abstract: This paper reviews available research evidence that links medical students' characteristics with human resource imbalances and the contribution of medical schools in perpetuating an inequitable distribution of the health workforce.Existing literature on the determinants of the geographical imbalance of clinicians, with a special focus on the role of medical schools, is reviewed. In addition, structured questionnaires collecting data on demographics, rural experience, working preferences and motivational aspects were administered to 130 fifth-year medical students at the medical faculties of MUCHS (University of Dar es Salaam), HKMU (Dar es Salaam) and KCMC (Tumaini University, Moshi campus) in the United Republic of Tanzania. The 130 students represented 95.6% of the Tanzanian finalists in 2005. Finally, we apply probit regressions in STATA to analyse the cross-sectional data coming from the aforementioned survey.The lack of a primary interest in medicine among medical school entrants, biases in recruitment, the absence of rural related clinical curricula in medical schools, and a preference for specialisation not available in rural areas are among the main obstacles for building a motivated health workforce which can help correct the inequitable distribution of doctors in the United Republic of Tanzania.This study suggests that there is a need to re-examine medical school admission policies and practices.The United Republic of Tanzania, is among the many countries in sub-Saharan Africa facing a human resources crisis in its health sector, with a small and inequitably distributed health workforce [1] that shoulders a disproportionately high burden of disease[2]. Although all poor countries in the world face a severe human resource crisis in their health sectors [3,4], the problem is most acute in Sub-Saharan Africa, in which an estimated workforce of 750 000 health workers in the region serves 682 million people [2]. By comparison, the ratio is 10 to 15 times higher
Epidemiology and control of human schistosomiasis in Tanzania
Mazigo Humphrey D,Nuwaha Fred,Kinung’hi Safari M,Morona Domenica
Parasites & Vectors , 2012, DOI: 10.1186/1756-3305-5-274
Abstract: In Tanzania, the first cases of schistosomiasis were reported in the early 19th century. Since then, various studies have reported prevalences of up to 100% in some areas. However, for many years, there have been no sustainable control programmes and systematic data from observational and control studies are very limited in the public domain. To cover that gap, the present article reviews the epidemiology, malacology, morbidity, and the milestones the country has made in efforts to control schistosomiasis and discusses future control approaches. The available evidence indicates that, both urinary and intestinal schistosomiasis are still highly endemic in Tanzania and cause significant morbidity.Mass drug administration using praziquantel, currently used as a key intervention measure, has not been successful in decreasing prevalence of infection. There is therefore an urgent need to revise the current approach for the successful control of the disease. Clearly, these need to be integrated control measures.
Training the Global Public Health Workforce Through Applied Epidemiology Training Programs: CDC’s Experience, 1951-2011
Dana Schneider,Michele Evering-Watley,Henry Walke,Peter B. Bloland
Public Health Reviews , 2011,
Abstract: The strengthening of health systems is becoming increasingly recognized as necessary for the achievement of many objectives promoted or supported by global public health initiatives. Key within the effort to strengthen health systems is the development of a well-prepared, skilled, and knowledgeable public health work-force. Over 60 years ago, the United States Centers for Disease Control and Prevention (CDC) began the first training program in applied epidemiology, the Epidemic Intelligence Service (EIS), a two-year, in-service training program in epidemiology and public health practice. Since 1951, the EIS has produced well-trained and highly qualified applied or field epidemiologists, many of whom later became leaders within the US public health system. In 1980, the CDC began assisting other countries to develop their own field epidemiology training programs (FETPs), modeling them after the highly successful EIS program. FETPs differ from other training programs in epidemiology in that: (1) they are positioned within Ministries of Health and the activities of the residents are designed to address the priority health issues of the Ministry; (2) they stress the principle of training through service; and (3) they provide close supervision and mentoring by trained field epidemiologists. While FETPs are designed to be adaptable to the needs of any given country, there exist many fundamental similarities in the skills and knowledge required by public health workers. Recognizing this, CDC developed a standard core FETP curriculum that can be adapted to any country’s needs. Countries can further customize FETP trainings to meet their specific needs by adding specialized “tracks” or by targeting different audiences and levels of the health system. Although FETPs require substantial investments in time and resources as well as significant commitment from ministries, CDC’s vision is that every country will have access to an FETP to help build its public health workforce and strengthen its public health systems.
The Problems and Solutions to the Building of the New-type Rural Cooperative Medical Workforce  [cached]
Lidan Wang,Yu Zhang,Yahui Zhang,Yayun Yu
Asian Social Science , 2011, DOI: 10.5539/ass.v7n9p78
Abstract: In order to improve the rural medical conditions, China has started to try a new policy ---- New-type Rural Cooperative Medical Insurance from July, 2003, which has greatly improved rural medical facilities and alleviated the burden of the rural medical treatment. Rural health care reform has made great achievements. However, research shows that there are still some aspects which are worthy of attention and improvement. Focusing on the collection, collation and research of the survey data, we have found some relatively urgent issues, particularly on the medical team-building, such as an aging medical staff term; what’s more, the quality of the medical staff issues should be improved. From the perspective of the doctors, we are analyzing and proposing solutions to these issues. It is significant for the sustainable development of the New-type Rural Cooperative Medical Insurance.
The African Field Epidemiology Network - Networking for effective field epidemiology capacity building and service delivery
Sheba Nakacubo Gitta, David Mukanga, Rebecca Babirye, Melissa Dahlke, Mufuta Tshimanga, Peter Nsubuga
Pan African Medical Journal , 2011,
Abstract: Networks are a catalyst for promoting common goals and objectives of their membership. Public Health networks in Africa are crucial, because of the severe resource limitations that nations face in dealing with priority public health problems. For a long time, networks have existed on the continent and globally, but many of these are disease-specific with a narrow scope. The African Field Epidemiology Network (AFENET) is a public health network established in 2005 as a non-profit networking alliance of Field Epidemiology and Laboratory Training Programs (FELTPs) and Field Epidemiology Training Programs (FETPs) in Africa. AFENET is dedicated to helping ministries of health in Africa build strong, effective and sustainable programs and capacity to improve public health systems by partnering with global public health experts. The Network’s goal is to strengthen field epidemiology and public health laboratory capacity to contribute effectively to addressing epidemics and other major public health problems in Africa. AFENET currently networks 12 FELTPs and FETPs in sub-Saharan Africa with operations in 20 countries. AFENET has a unique tripartite working relationship with government technocrats from human health and animal sectors, academicians from partner universities, and development partners, presenting the Network with a distinct vantage point. Through the Network, African nations are making strides in strengthening their health systems. Members are able to: leverage resources to support field epidemiology and public health laboratory training and service delivery notably in the area of outbreak investigation and response as well as disease surveillance; by-pass government bureaucracies that often hinder and frustrate development partners; and consolidate efforts of different partners channelled through the FELTPs by networking graduates through alumni associations and calling on them to offer technical support in various public health capacities as the need arises. AFENET presents a bridging platform between governments and the private sector, allowing for continuity of health interventions at the national and regional level while offering free exit and entry for existing and new partners respectively. AFENET has established itself as a versatile networking model that is highly responsive to members’ needs. Based on the successes recorded in AFENET’s first 5 years, we envision that the Network’s membership will continue to expand as new training programs are established. The lessons learned will be useful in initiating new programs and building sustainability frameworks for FETPs and FELTPs in Africa. AFENET will continue to play a role in coordinating, advocacy, and building capacity for epidemic disease preparedness and response. Pan African Medical Journal 2011;10(Supp):3
Using Participatory Epidemiology Tools to Investigate Contagious Caprine Pleuropneumonia (CCPP) in Maasai Flocks, Northern Tanzania
Emmanuel Senyael,M.O. Neselle
International Journal of Animal and Veterinary Advances , 2010,
Abstract: Participatory Epidemiology (PE) was applied on the Maasai rangeland of northern Tanzania to understand pastoralist’s perceptions of the clinical and epidemiological features of Contagious Caprine Pleuropneumonia (CCPP). The study was conducted during the period of April 2008 and caprine disease event was directed during the period of July 2006 to June 2007. Participatory methods such as Focus Group Discussion (FGD), proportional piling and matrix scoring were used to characterize pastoralist perceived clinical signs and risk factors for CCPP. The estimated mean incidence and case mortality rate of CCPP was 31.6 and 61.4%, respectively. Matrix scoring showed moderate to good agreement between informant groups on the clinical signs and risk factors. It was concluded that PE complimented with local knowledge could generally be used to generate disease information at low cost and therefore assist the design of feasible disease surveillance systems and control programmes at local and national level.
The Ethiopian Field Epidemiology and Laboratory Training Program: strengthening public health systems and building human resource capacity
Daddi Jima, Getnet Mitike, Zegeye Hailemariam, Alemayehu Bekele, Adamu Addissie, Richard Luce, Peter Wasswa, Olivia Namusisi, Sheba Nakacubo Gitta, Monica Musenero, David Mukanga
Pan African Medical Journal , 2011,
Abstract: The Ethiopian Field Epidemiology and Laboratory Training Program (EFELTP) is a comprehensive two-year competency-based training and service program designed to build sustainable public health expertise and capacity. Established in 2009, the program is a partnership between the Ethiopian Federal Ministry of Health, the Ethiopian Health and Nutrition Research Institute, Addis Ababa University School of Public Health, the Ethiopian Public Health Association and the US Centers of Disease Control and Prevention. Residents of the program spend about 25% of their time undergoing didactic training and the 75% in the field working at program field bases established with the MOH and Regional Health Bureaus investigating disease outbreaks, improving disease surveillance, responding to public health emergencies, using health data to make recommendations and undertaking other field Epidemiology related activities on setting health policy. Residents from the first 2 cohorts of the program have conducted more than 42 outbreaks investigations, 27analyses of surveillance data, evaluations of 11 surveillance systems, had28oral and poster presentation abstracts accepted at 10 scientific conferences and submitted 8 manuscripts of which 2are already published. The EFELTP has provided valuable opportunities to improve epidemiology and laboratory capacity building in Ethiopia. While the program is relatively young, positive and significant impacts are assisting the country better detect and respond to epidemics and address diseases of major public health significance. Pan African Medical Journal 2011; 10 (Supp 1):5
Health workforce development planning in the Sultanate of Oman: a case study
Basu Ghosh
Human Resources for Health , 2009, DOI: 10.1186/1478-4491-7-47
Abstract: The Sultanate's early development initiatives focused on building a strong health care infrastructure by importing workforce. However, the policy-makers stressed national workforce development for a sustainable future. Beginning with the formulation of a strategic health workforce development plan in 1991, the stage was set for adopting workforce planning as an essential strategy for sustainable health development and workforce self-reliance. Oman continued to develop its educational infrastructure, and began to produce as much workforce as possible, in order to meet health care demands and achieve workforce self-reliance.Other policy initiatives with a beneficial impact on Oman's workforce development scenario were: regionalization of nursing institutes, active collaboration with universities and overseas specialty boards, qualitative improvement of the education system, development of a strong continuing professional development system, efforts to improve workforce management, planned change management and needs-based micro/macro-level studies. Strong political will and bold policy initiatives, dedicated workforce planning and educational endeavours have all contributed to help Oman to develop its health workforce stocks and gain self-reliance.Oman has successfully innovated workforce planning within a favorable policy environment. Its intensive and extensive workforce planning efforts, with the close involvement of policy-makers, educators and workforce managers, have ensured adequacy of suitable workforce in health institutions and its increased self-reliance in the health workforce.Oman's experience in workforce planning and development presents an illustration of a country benefiting from successful application of workforce planning concepts and tools. Instead of being complacent about its achievements so far, every country needs to improve or sustain its planning efforts in this way, in order to circumvent the current workforce deficiencies and to further inc
Retrospective study on sero-epidemiology of peste des petits ruminants before its official confirmation in northern Tanzania in 2008  [PDF]
E.D. Karimuribo,,P. M. Loomu,,L.S.B. Mellau,E.S. Swai
Research Opinions in Animal & Veterinary Sciences , 2011,
Abstract: A retrospective sero-epidemiological investigation of Peste des petits ruminants (PPR) was carried out in Ngorongoro district, situated in northern part of Tanzania and bordering Kenya. The study involved collection of field information from 101 respondents who own goats and sheep in four villages which had experienced a ‘rinderpest-like’ syndrome in domestic small ruminants between first suspected cases of PPR in 1995 and official confirmation of the disease in Tanzania in 2008. A total number of 198 serum samples from goats and sheep collected in 1998 and 2004 for different research projects or suspected disease investigation were retrieved from the Veterinary Investigation centre (VIC) Arusha and subjected to competitive ELISA test for detecting antibodies to PPR virus. Findings of this study suggest that PPR was in northern Tanzania at least four years before official confirmation and reporting based on clinico-pathological grounds, local field-based reports from livestock field officers and District Veterinary Officer. The seroprevalence of PPR from 198 serum samples analysed was 12.6% with the serum samples collected from suspected PPR cases showing significantly (p=0.000) higher seroprevalence (71.4%) than that in samples collected for investigation of other diseases (5.7%). Interviewed farmers were aware of PPR including clear description of clinical signs of the disease. Although farmers were aware of efforts made to control the disease, only 32% of them had their animals vaccinated against PPR. The low vaccination coverage suggests continued prevalence of PPR in the study area. It is concluded that there is limited capacity with respect to veterinary disease surveillance, reporting and control of transboundary and emerging diseases which need to be addressed in the country.
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