Pan African Medical Journal (Pamj) – African Field Epidemiology Network (AFENET): A partnership for the future of medical publishing in Africa

No Abstract

Pan African Medical Journal (Pamj) and African Field Epidemiology Network (AFENET): A partnership for the future of medical publishing in Africa

In October 2008, AFANET and the Pan African Medical Journal signed a memorandum of understanding establishing the terms for future involvement of AFENET in open access publishing through the Pamj

Public health laboratory systems development in East Africa through training in laboratory management and field epidemiology

Laboratories are integral to the delivery of quality health care and for public health functions; however laboratory systems and services are often neglected in resource-poor settings such as the East African region. In order to sustainably strengthen national laboratory systems in resource-poor countries, there is a need to train laboratory personnel to work in clinical as well as public health laboratories. In 2004,Kenya, Uganda, Tanzania, and South Sudan began training public health laboratory workers jointly with field epidemiologists in the Kenya Field Epidemiology and Laboratory Training Program (FELTP), and later through the Tanzania FELTP, as a strategy to strengthen public health laboratories. These programs train laboratory epidemiologists through a two-year public health leadership development course, and also offer various types of short course training for frontline staff. The FELTP laboratory graduates in Kenya, Tanzania, Uganda, and South Sudan are working in their respective countries to strengthen public health laboratory systems while the short course participants provide a pool of frontline implementers with the capacity to support the lower tiers of health systems, as well as serve as surge capacity for the regions and the national level. Through training competent public health laboratory workers, the East African ministries of health, in collaboration with other regional partners and stakeholders are now engaged in developing and implementing a holistic approach that will guarantee an overall strengthening of the health system by using well-trained public health laboratory leaders to drive the process. Strengthening public health laboratory medicine in East Africa is critical to improve health-care systems. The experience with the FELTP model in East Africa is a step in the right direction towards ensuring a stronger role for the laboratory in public health

Laboratory capacity building for the International Health Regulations (IHR[2005]) in resource-poor countries: the experience of the African Field Epidemiology Network (AFENET)

Laboratory is one of the core capacities that countries must develop for the implementation of the International Health Regulations (IHR[2005]) since laboratory services play a major role in all the key processes of detection, assessment, response, notification, and monitoring of events. While developed countries easily adapt their well-organized routine laboratory services, resource-limited countries need considerable capacity building as many gaps still exist. In this paper, we discuss some of the efforts made by the African Field Epidemiology Network (AFENET) in supporting laboratory capacity development in the Africa region. The efforts range from promoting graduate level training programs to building advanced technical, managerial and leadership skills to in-service short course training for peripheral laboratory staff. A number of specific projects focus on external quality assurance, basic laboratory information systems, strengthening laboratory management towards accreditation, equipment calibration, harmonization of training materials, networking and provision of pre-packaged laboratory kits to support outbreak investigation. Available evidence indicates a positive effect of these efforts on laboratory capacity in the region. However, many opportunities exist, especially to support the roll-out of these projects as well as attending to some additional critical areas such as biosafety and biosecuity. We conclude that AFENET’s approach of strengthening national and sub-national systems provide a model that could be adopted in resource-limited settings such as sub-Saharan Africa

Awareness and Use of Pre-Exposure and Post Exposure Prophylaxes as Occupational Health and Safety Measure for Clinical Students at Copperbelt University Medical School in Zambia

Pre-exposure prophylaxis (PrEP.) and post-exposure prophylaxis (PEP) are additional preventative methods incorporated in a comprehensive HIV/AIDS preventative package in the Zambian health system. Despite PrEP and PEP being offered as a choice to people who are at sustained risk of HIV infection, most clinical students in sub-Saharan African medical schools continue to be disproportionately at risk of acquiring HIV during their clinical training. To avert this occupational health risk among clinical students, it is critical that awareness, access and use of these HIV preventive strategies, in Zambia and other sub-Saharan African countries be enhanced. This study therefore, examined awareness and use of PrEP and PEP among Copperbelt University Medical students in Zambia. A cross sectional survey was conducted among 203 medical students in their clinical years of study. The respondents were selected using stratified simple random sampling at two tertiary level public hospitals in the Copperbelt province of Zambia. Descriptive and inferential statistics were used for data analysis. Study found that 21.2% of the clinical students were exposed to HIV during their hospital practice and majority of these students were 3rd year students (24.5%), followed by the 2nd year students (23.5%) and the least proportion was 1styears (17.4%). Among those who were exposed, 76.7% reported the exposure while 23.3% did not report the exposure. The second years (20.6%) are shown to have reported most of the exposures compared to all the other classes. The majority of students (83.3%) were knowledgeable about PrEP and PEP. Sex (p value= 0.046) was the only factor that was significantly associated with knowledge of PrEP and PEP. There was no factor significantly association with utilization of PrEP and PEP, even participants’ knowledge of PrEP and PEP did not influence utilization of PrEP and PEP services (p value=0.741). Therefore, reducing barriers to access and use of PrEP and PEP among clinical students is an important intervention in the process of training medical personnel in Zambia and other countries in sub-Saharan Africa

Strengthening public health surveillance and response using the health systems strengthening agenda in developing countries

There is increased interest in strengthening health systems for developing countries. However, at present, there is common uncertainty about how to accomplish this task. Specifically, several nations are faced with an immense challenge of revamping an entire system. To accomplish this, it is essential to first identify the components of the system that require modification. The World Health Organization (WHO) has proposed health system building blocks, which are now widely recognized as essential components of health systems strengthening

Two decades of post-graduate training in Applied Public Health: The experience and challenges of the Uganda Public Health School Without Walls

The objective of this work is to describe the experience of the Uganda Public Health School Without Walls (PHSWOW) in training public health professionals at post-graduate level to offer leadership in planning, delivery of health services and research within a decentralized health system. As one of the constituents of the Makerere University College of Health Sciences, the Uganda PHSWOW has the vision of becoming a Centre of Excellence, providing leadership in public health and the mission of promoting the attainment of better health of the people in Uganda and beyond through public health training, research and community service. Key to the successes of the program are the 238 program graduates, most of whom have remained in-country to serve at district and national levels of service delivery. Collaborations have been established with government, private, non-governmental and international institutions leading to increased health service provision and research for the improvement of health status of populations and influence on public policy. There is still a lot to do in diversifying the skills mix of graduates and contributing to an ambitious increment from 0.4 to 4.7 public health professionals per 10,000 population; as is currently the case in high-middle income countries. Currently, the Uganda PHSWOW has exceeded the proposed output for FETPs of training 3 to 5 graduates per 1 million population suggested by some authors, however the output is still inadequate. More also needs to be done to promote a culture of publication in an effort to translate public health evidence into policy and practice

The African Field Epidemiology Network-Networking for effective field epidemiology capacity building and service delivery

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

Paradigm shift: contribution of field epidemiology training in advancing the “One Health” approach to strengthen disease surveillance and outbreak investigations in Africa

The occurrence of major zoonotic disease outbreaks in Sub-Saharan Africa has had a significant impact on the already constrained public health systems. This has, as a result, justified the need to identify creative strategies to address threats from emerging and re-emerging infectious diseases at the human-animal-environmental interface, and implement robust multi-disease public health surveillance systems that will enhance early detection and response. Additionally, enhanced reporting and timely investigation of all suspected notifiable infectious disease threats within the health system is vital. Field epidemiology and laboratory training programs (FELTPs) have made significant contributions to public health systems for more than 10 years by producing highly skilled field epidemiologists. These epidemiologists have not only improved disease surveillance and response to outbreaks, but also improved management of health systems. Furthermore, the FETPs/FELTPs have laid an excellent foundation that brings clinicians, veterinarians, and environmental health professionals drawn from different governmental sectors, to work with a common purpose of disease control and prevention. The emergence of the One Health approach in the last decade has coincided with the present, paradigm, shift that calls for multi-sectoral and cross-sectoral collaboration towards disease surveillance, detection, reporting and timely response. The positive impact from the integration of FETP/FELTP and the One Health approach by selected programs in Africa has demonstrated the importance of multi-sectoral collaboration in addressing threats from infectious and non- infectious causes to man, animals and the environment.Pan African Medical Journal 2011; 10(Supp1):1