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Health Workforce Development with a Focus on CVD in Zimbabwe CHRIS Program, a Medical Education Partnership Initiative

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Health Workforce Development with a Focus on CVD in Zimbabwe CHRIS Program, a Medical Education Partnership Initiative GLOBAL HEART VOL. 6, NO. 4, 2011 ª 2011 World Heart Federation (Geneva). Published by Elsevier Ltd. All rights reserved. ISSN 2211-8160/$32.00 DOI: 10.1016/j.gheart.2011.07.001 gWATCHNEWS & NOVEL PROGRAMS Health Workforce Development with a Focus on CVD in Zimbabwe CHRIS Program, a Medical Education Partnership Initiative James Gita Hakim , Jonathan Arthur Matenga , Edward Havranek à, David Koa § Harare, Zimbabwe; and Denver, CO, USA The health workforce challenge in sub-Saharan THE MEDICAL EDUCATION Africa has gained prominence because of the piv- PARTNERSHIP INITIATIVE (MEPI) otal place that it plays in health care delivery and development in the continent [1–4]. Several The Medical Education Partnership Initiative workshops and conferences by the WHO and (MEPI), a collaborative funding mechanism be- other interested global partners have been held tween the US National Institutes of Health to address this challenge. Unless this serious short (NIH) and the President’s Emergency Plan for fall in the healthcare workforce is addressed, AIDS Relief (PEPFAR), awarded $130 million to- global health disparities between the developed wards the improvement of medical education and and the developing world will continue to hamper research capacity at 13 medical schools in sub- the implementation of plans that are resourced Saharan Africa [1,2]. This initiative is designed to and funded through well-meaning initiatives. improve the quality of training of doctors, to The Medical Education Partnership Initiative encourage the conduct of relevant health research, (MEPI) has been lauded as an intervention and to improve health worker retention of in sub- that begins to address this challenge [1,2]. Saharan Africa. MEPI is a welcome and innovative Zimbabwe, one of the countries with a serious initiative, which if implemented well will provide a health workforce shortage, is a beneficiary of this roadmap and a template of how to address the initiative. shortfall in health workforce in sub-Saharan Africa. During the decade from 1999 to 2009, Zimba- The University of Zimbabwe College of Health bwe suffered a serious economic downturn which Sciences (UZCHS) is a beneficiary of 3 MEPI seriously affected the training of all health profes- grants amounting to $13.6 million for the period sionals including doctors. In 2009, the vacancy 2010 to 2015. The grants consist of programmatic rate of doctors in the Ministry of Health institu- awards and smaller linked awards (each a maximum tions was as high as 62% [5]. Similarly, at the of $2.5 million over 5 years) to address areas that University of Zimbabwe College of Health are not included in the PEPFAR health priorities. Sciences (UZCHS), the only medical school in The two linked awards granted to the UZCHS the country, the faculty vacancy rate in some address cardiovascular diseases and mental health, departments was as high as 80%. Postgraduate respectively. The MEPI grant comes at an oppor- training, the source of future specialists and fac- tune moment to begin to address some of the dire ulty, fell to insignificant levels, while at the under- needs in human resources for health in the country. graduate level student performance fell dismally The Zimbabwe MEPI programmatic award, with alarming failure rates. NECTAR (Novel Education and Clinical Trainees From the University of Zimbabwe College of Health Sciences, Harare, Zimbabwe; àDenver Health Medical Centre, Denver, CO; and the §University of Colorado, Denver, CO, USA. Correspondence: J.G. Hakim ([email protected]) 220 Hakim et al. GLOBAL HEART, VOL. 6, NO. 4, 2011 December 2011: 219–20 Health Workforce in Zimbabwe and Researchers) program, will serve as a backbone undergraduate students with the knowledge and to the two linked awards, CHRIS (Cerebrovascular, skills necessary to become effective academic physi- Heart Failure, Rheumatic Heart Disease Interven- cians in cardiovascular disease, (3) to engage tions Strategy) and IMHERZ (Improving Mental UZCHS undergraduates, postgraduates and faculty Health Education and Research in Zimbabwe). in research methodology including survey methods NECTAR will address issues of curriculum develop- in rural communities, and (4) to create an academic ment, modernizing teaching methods, and improv- environment at UZCHS through the establish- ing internet communicating technology. Central to ment of a research support center and a teaching this initiative is the collaboration with partners in and learning center to champion training in re- the USA (University of Colorado, Denver and search competency and modern teaching methods. Stanford University), South Africa (Cape Town The whole program has been crafted so that it is University), and the United Kingdom (University embedded within the existing UZCHS and wider College London, King’s College and Bristol university structures to ensure sustainability after University). end of the grant period. The program will be mon- itored and adjusted to achieve the intended objectives. CHRIS PROGRAM Cardiovascular disease mortality has shown a stea- CONCLUSIONS dy decline in high income countries while the low and middle income countries have shown increas- The CHRIS award will enable the UZCHS to im- ing trends [6,7]. Chronic non communicable dis- prove cardiovascular disease training, including eases account for 60% of all deaths globally; 80% improvement in research competence. Using the of these deaths are in low and middle income coun- platform provided by the programmatic NECTAR tries [6,7]. The CHRIS award will address human award and the CHRIS awards as well as the part- resource constraints and training needs in cardio- nerships afforded by the MEPI award, the college vascular disease at UZCHS. The intention is to will use other mechanisms for the formal training use the grant as a platform to achieve a number of cardiologists, neurologists and other specialists of objectives. Zimbabwe has three physicians with in cardiovascular disease to ensure that undergrad- training in cardiology; two adult and one pediatric. uates, graduates and faculty are beneficiaries of the With a high burden of cardiovascular diseases there objectives of this initiative. is a dire need of physicians trained in adult and pediatric cardiology and other disciplines dealing with cardiovascular diseases. ACKNOWLEDGMENTS The objectives of the CHRIS program are (1) to integrate a focused cardiovascular curriculum into We acknowledge the collaboration of Dr T. Campbell, the existing medical school curriculum including Dr M Barry, Dr P. Mason, Dr F. Cowan, application of this curriculum in rural communities, Dr S. Nhiwatiwa and Dr M. Abas who are co-principal (2) to initiate a cardiovascular clinical scholars pro- investigators in the NECTAR, CHRIS and IMHERZ gram to provide highly motivated graduate and MEPI awards mentioned in the commentary. REFERENCES 1. Lancet Editorial. Health care: an Afri- for health workers. Geneva: World ResearchAreaProjects/Zimbabwe/Harare can solution. Lancet 2011;377:1047. Health Organization; 2008. Available Conference2009/index.html [accessed 2. Collins FS, Glass RI, Whitescarver J, from: http://www.who.int/workforce 20.08.2011]. Wakefield M, Goosby EP. Developing alliance/documents/Global_Health%20 6. Murray CJL, Lopez AD. Mortality by health workforce capacity in Africa. FINAL%20REPORT.pdf [accessed cause for eight regions of the world: Science 2010;330:1324–5. 20.08.2011]. Global Burden of Disease Study. Lan- 3. Mullan F, Ferhywot S, Omaswa F, Buch 5. Magure T. Health delivery systems in cet 1997;349:1269–76. E, Chen C, Greysen SR, et al. Medical the crisis and beyond. Presentation at 7. Rosamond WD, Folsom AR, Cham- schools in sub-Saharan Africa. Lancet the Moving Forward with Pro-poor berless LE, et al. Stroke incidence and 2011;377:1113–21, erratum 1076. Reconstruction in Zimbabwe interna- survival among middle-aged adults: a 4. Global Health Workforce Alliance. tional conference, Harare, 25 and 26 9-year follow-up of the Atherosclerosis Scaling up, Saving Lives: task force August 2009. Available from: http:// Risk in Communities (ARIC) cohort. for scaling up education and training www.bwpi.manchester.ac.uk/research/ Stroke 1999;30:736–43..
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