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Transforming Health Professions' Education Through In-Country Himmelfarb Health Sciences Library, The George Washington University Health Sciences Research Commons Medicine Faculty Publications Medicine 1-14-2015 Transforming health professions' education through in-country collaboration: Examining the consortia between African medical schools catalyzed by the medical education partnership initiative Zohray Talib George Washington University Elsie Kiguli-Malwadde Hannah Wohltjen George Washington University Millard Derbew Yakub Mulla See next page for additional authors Follow this and additional works at: http://hsrc.himmelfarb.gwu.edu/smhs_medicine_facpubs Part of the International and Comparative Education Commons, and the Interprofessional Education Commons Recommended Citation Talib, Z.M., Kiguli-Malwadde, E., Wohltjen, H., Derbew, M., Mulla, Y. et al. (2014). Transforming health professions' education through in-country collaboration: examining the consortia between African medical schools catalyzed by the medical education partnership initiative. Human Resources for Health, 13:1. This Journal Article is brought to you for free and open access by the Medicine at Health Sciences Research Commons. It has been accepted for inclusion in Medicine Faculty Publications by an authorized administrator of Health Sciences Research Commons. For more information, please contact [email protected]. Authors Zohray Talib, Elsie Kiguli-Malwadde, Hannah Wohltjen, Millard Derbew, Yakub Mulla, David Olaleye, and Nelson Sewankambo This journal article is available at Health Sciences Research Commons: http://hsrc.himmelfarb.gwu.edu/smhs_medicine_facpubs/ 515 Talib et al. Human Resources for Health 2015, 13:1 http://www.human-resources-health.com/content/13/1/1 RESEARCH Open Access Transforming health professions’ education through in-country collaboration: examining the consortia among African medical schools catalyzed by the Medical Education Partnership Initiative Zohray M Talib1*, Elsie Kiguli-Malwadde2, Hannah Wohltjen3, Miliard Derbew4, Yakub Mulla5, David Olaleye6 and Nelson Sewankambo7 Abstract Background: African medical schools have historically turned to northern partners for technical assistance and resources to strengthen their education and research programmes. In 2010, this paradigm shifted when the United States Government brought forward unprecedented resources to support African medical schools. The grant, entitled the Medical Education Partnership Initiative (MEPI) triggered a number of south-south collaborations between medical schools in Africa. This paper examines the goals of these partnerships and their impact on medical education and health workforce planning. Methods: Semi-structured interviews were conducted with the Principal Investigators of the first four MEPI programmes that formed an in-country consortium. These interviews were recorded, transcribed and coded to identify common themes. Results: All of the consortia have prioritized efforts to increase the quality of medical education, support new schools in-country and strengthen relations with government. These in-country partnerships have enabled schools to pool and mobilize limited resources creatively and generate locally-relevant curricula based on best-practices. The established schools are helping new schools by training faculty and using grant funds to purchase learning materials for their students. The consortia have strengthened the dialogue between academia and policy-makers enabling evidence-based health workforce planning. All of the partnerships are expected to last well beyond the MEPI grant as a result of local ownership and institutionalization of collaborative activities. Conclusions: The consortia described in this paper demonstrate a paradigm shift in the relationship between medical schools in four African countries. While schools in Africa have historically worked in silos, competing for limited resources, MEPI funding that was leveraged to form in-country partnerships has created a culture of collaboration, overriding the history of competition. The positive impact on the quality and efficiency of health workforce training suggests that future funding for global health education should prioritize such south-south collaborations. Keywords: Medical education, South-south partnerships, Workforce scale-up * Correspondence: [email protected] 1The George Washington University School of Medicine and Health Sciences, Washington, DC, USA Full list of author information is available at the end of the article © 2015 Talib et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Talib et al. Human Resources for Health 2015, 13:1 Page 2 of 8 http://www.human-resources-health.com/content/13/1/1 Background school. The consortium is now called the Medical Educa- In recent years, the demands on African medical tion for Equitable Services to All Ugandans (MESAU) schools have intensified [1,2]. The critical shortage of consortium. In Ethiopia, the primary grantee is Addis healthcare workers has driven many African governments Ababa University and the consortium includes two new to mandate significant increases in medical school enroll- public medical schools and a military school. In Nigeria, ment and improvements in the quality of training [3]. Rec- the lead school for the MEPI award is the University of ognizing the gap between the ideal health workforce and Ibadan, which formed the Medical Education Partnership the capacity of training institutions, a landmark report Initiative in Nigeria (MEPIN) consortium with six in- called for critical reforms in global health education [4]. country public schools. The University of Zambia did not One of the proposed institutional reforms is the estab- initially apply for MEPI funds with in-country medical lishment of ‘networks, alliances and consortia’ as a school partners but soon after the grant was awarded, the strategy for schools to collaborate and share resources countrywide consortium formed with one public and two [4]. Historically, African medical schools worked either new private medical schools. alone or with northern partners to produce a capable This paper describes these four consortia within the health workforce in environments with limited resources. Medical Education Partnership Initiative and examines Kolars et al. highlight the challenges of north-south part- their common goals, their approach to sharing limited nerships, which include the dominance of the northern resources, their collaborative efforts to overcome com- partners’ agenda, the inadvertent contribution to brain- mon challenges, and ultimately how they are improving drain, a low degree of sustainability due to external the quality of medical education and health workforce sources of funding, and a focus on short-term goals rather planning. Given the paucity of south-south collaboration than long-term capacity-building interventions [5]. Re- among medical schools, this paper also seeks to describe ports of south-south partnerships are limited but include the challenges and key enablers that have allowed these the Collaboration for Health Equity in Education and partnerships to succeed. Research (CHEER) among eight Health Science Faculties in South Africa focusing on community-based education Methods and the Consortium of New Southern African Medical Grounded theory was used as a qualitative framework for Schools (CONSAMS), which recently formed among this study. This approach was selected because it empha- five relatively new medical schools [6,7]. Thus, while sizes an inductive approach to data collection and analysis medical schools in Africa face similar challenges, there and provides an opportunity to discover and compare nu- has been relatively little networking and collaboration ances in individual schools’ experiences with consortia among schools to date. partnerships. The study team used semi-structured inter- In 2010, the United States Government directed unpre- views to explore these experiences and the role of consor- cedented resources to support African medical schools in tia in medical education scale-up and workforce planning. meeting their training needs and triggered a number of Key informants for the semi-structured interviews were collaborations, including those between south-south selected from the first four MEPI programmes to form in- partners in Africa [8,9]. The Medical Education Part- country consortia. Three programmes (Nigeria, Ethiopia nership Initiative (MEPI) distributed $150 million to 13 and Uganda) formed their consortia at the time of apply- medical schools in 12 sub-Saharan African countries. ing for MEPI while Zambia formed their consortia soon The thematic focus of MEPI is on improving the qual- after they received the award. In subsequent years, other ity, quantity, and in-country retention of medical grad- MEPI programmes formed in-country consortia but the uates along with building research capacity of African decision was made to only include the first 4 in this study medical schools. The initiative emphasizes country- to ensure that the programmes participating had at least 2 ownership, allowing recipient schools to tailor their
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