Training African health practitioners within Africa; expanding the skills pool
The African Paediatric Fellowship Programme (APFP) was established by the University of Cape Town (UCT) and the Red Cross War Memorial Children’s Hospital (RCWMCH) in 2007. The aim of the APFP is to create a network of skilled African health care professionals who can build capacity in child health through clinical service provision, training, education and research throughout Africa. Also to empower these skilled health care professionals to use the knowledge they gain to lobby for improved child health in their local setting.
The APFP’s African institutional partners identify trainees for the program based on the needs of the partner institution, the region and the suitability of applicants. To date, APFP has partnered with 40 institutions across 12 African countries.
The APFP’s institutional partners are encouraged to develop three- to five-year strategic training plans, which assist the APFP in allocating training placements under the Department of Paediatrics and Child Health, RCWMCH, but also focus the partner centres on their long term training goals. These plans include the concept of building multidisciplinary teams i.e. not only training individuals in isolated specialities but planning for whole services which require the combined training of teams of specialist medical doctors, child rehabilitation therapists and paediatric nurses. This means partner training institutions are moving away from selecting a motivated trainee purely on the trainee’s merit but are now, in addition, taking into account and targeting their regional health care needs, identifying service areas for targeted and strategic capacity building, and developing multidisciplinary teams to evolve services locally.
The partnerships are maintained through site visits by APFP staff, and affiliates, to the partner institutions as well as hosting the referring supervisors from partner institutions at Red Cross War Memorial Children’s Hospital (RCWMCH). As the critical number of returning clinicians is reached the centres are encouraging to develop their own paediatric training nodes with support from the APFP.
The impact of past APFP trainees upon return to their home institutions and countries is diverse. A number of the returning fellows are the first trained sub-specialists in their hospital, region or country. Some fellows have been instrumental in establishing specialist units at their hospitals; in developing or updating clinical guidelines and in strengthening systems to improve patient referral, treatment and care. Many are involved in paediatric training in their home countries and are actively conducting research. Lobbying has been successf in implementing vaccination roll-outs, access to antiepileptic medications, and acceptability of kangaroo care for small newborn babies.
To date 62 African fellows have completed their training in paediatrics or paediatric sub-specialities (Table 1). 100% of the trainees have returned to their home institutions or countries post-training, and 95% have remained there, together forming a network of motivated, highly-skilled African clinicians who are equipped to advance child health on the continent. There is no doubt that one of the driving forces behind this is the effectiveness of developing robust engaged partnerships, and the provision of context-appropriate training, tailored to take into account local child health priorities and infrastructure. The programme offers a rich educational environment and resources to ensure successful completion of the training. Subspecialty fellows are equipped with the scientific and clinical background to diagnose and manage diseases. Fellows are fully engaged in patient care. The program provides progressive clinical, technical and consultative experience that enables the fellows to develop expertise at consultant specialist level. We know that, with our partners, we can build a sustainable long-term paediatric healthcare workforce in Africa.
Avril du Preez1 and Jo M Wilmshurst2
1Program coordinator, African Paediatric Fellowship Program,
Department of Paediatrics and Child Health, University of Cape Town
2Program director, African Paediatric Fellowship Program,
Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital,
University of Cape Town
The African Pediatric Fellowship Program: Training in Africa for Africans.
Wilmshurst JM, Morrow B, du Preez A, Githanga D, Kennedy N, Zar HJ
Pediatrics. 2016 Jan