South-South cooperation in health professional education : a literature review

In the literature on the evolution of funding approaches there is criticism of traditional funding strategies and the promotion of inclusive models, such as South-South Cooperation (SSC) and triangular models. The latter are felt to have a number of advantages. This article has four broad objectives: (i) to present a literature review on the evolution of Southern approaches to development co-operation; (ii) to indicate examples of current co-operative programmes in health and health professional education in Africa; (iii) to assess the advantages and disadvantages of these models; and (iv) to mention some emerging issues in monitoring and evaluation. The Boolean logic approach was used to search for applicable literature within three topic layers. Searches were conducted using PubMed, PLoS and other accessible databases. An initial draft of the article was presented to a group of academics and researchers at the Flemish Inter-University Council (VLIR-UOS) Primafamed annual workshop held in August 2010 in Swaziland. Comments and suggestions from the group were included in later versions of the article. It is important to note that the existence of various funding models implemented by a variety of actors makes it difficult to measure their effects. In health and health professional education, however, SSC and triangular models of aid provide conditions for more effective programming through their focus on participation and long-term involvement. With an eye towards evaluating programmes, a number of salient issues are emerging. The importance of context is highlighted

Development and validation of EMP-3 : an instrument to measure physicians' attitudes towards ethnic minority patients

Background and Objectives: The growing diversity of patient populations challenges health care providers. Physicians' attitudes and perceptions toward cultural diversity in health care could be partly contributing to difficulties in communication between physicians and ethnic minority patients. To evaluate these attitudes and perceptions, an instrument was developed and validated. Methods: A preliminary version of the instrument was developed through literature research and expert consultation and completed by 112 family physicians. Factor analysis was performed and reliability and construct validity tested. Results: The instrument revealed three factors that were interpreted as: (1) physicians' task perception and ideas on cultural differences in health and health care, (2) physicians' attitudes toward physician-patient communication with minority patients, and (3) physicians' perception of minority patients' needs in communication. Moderate but significant correlations were found between factors of the EMP-3 and practice organization, practice location, and physicians' gender. Several factors of the Jefferson Empathy Scale, the Patient Practitioner Orientation Scale, and the Health Beliefs and Attitude Scale related to the first two factors of the EMP-3. Conclusions: This instrument, designed specifically to measure physicians' attitudes toward cultural diversity, showed moderate validity and reliability results. Further adaptations and evaluation could be useful

Rwandan family medicine residents expanding their training into South Africa : the use of South-South medical electives in enhancing learning experiences

Background: International medical electives are well-accepted in medical education, with the flow of students generally being North-South. In this article we explore the learning outcomes of Rwandan family medicine residents who completed their final year elective in South Africa. We compare the learning outcomes of this South-South elective to those of North-South electives from the literature. Methods: In-depth interviews were conducted with Rwandan postgraduate family medicine residents who completed a 4-week elective in South Africa during their final year of training. The interviews were thematically analysed in an inductive way. Results: The residents reported important learning outcomes in four overarching domains namely: medical, organisational, educational, and personal. Conclusions: The learning outcomes of the residents in this South-South elective had substantial similarities to findings in literature on learning outcomes of students from the North undertaking electives in the Southern hemisphere. Electives are a useful learning tool, both for Northern students, and students from universities in the South. A reciprocity-framework is needed to increase mutual benefits for Southern universities when students from the North come for electives. We suggest further research on the possibility of supporting South-South electives by Northern colleagues

Family medicine training in Sub-Saharan Africa : South-South cooperation in the Primafamed project as strategy for development

BACKGROUND. Health-care systems based on primary health care (PHC) are more equitable and cost effective. Family medicine trains medical doctors in comprehensive PHC with knowledge and skills that are needed to increase quality of care. Family medicine is a relatively new specialty in sub-Saharan Africa. OBJECTIVE. To explore the extent to which the Primafamed South–South cooperative project contributed to the development of family medicine in sub-Saharan Africa. METHODS. The Primafamed (Primary Health Care and Family Medicine Education) project worked together with 10 partner universities in sub-Saharan Africa to develop family medicine training programmes over a period of 2.5 years. A SWOT (strengths, weaknesses, opportunities and threats) analysis was done and the training development from 2008 to 2010 in the different partner universities was analysed. RESULTS. During the 2.5 years of the Primafamed project, all partner universities made progress in the development of their family medicine training programmes. The SWOT analysis showed that at both national and international levels, the time is ripe to train medical doctors in family medicine and to integrate the specialty into health-care systems, although many barriers, including little awareness, lack of funding, low support from other specialists and reserved support from policymakers, are still present. CONCLUSIONS. Family medicine can play an important role in health-care systems in sub-Saharan Africa; however, developing a new discipline is challenging. Advocacy, local ownership, action research and support from governments are necessary to develop family medicine and increase its impact. The Primafamed project showed that development of sustainable family medicine training programmes is a feasible but slow process. The South–South cooperation between the ten partners and the South African departments of family medicine strengthened confidence at both national and international levels

Una breve nota sobre la música popular en Cien botellas en una pared de Ena Lucía Portela

I study the presence of popular music and its functionality in Ena Lucía Portela’s novel Cien botellas en una pared (2002). I explore the genres that are used and the circumstances in which the characters evoke popular music. I argue that the inclusion of popular music —in the text and in the footnote references— contributes to Portela’s poetics. It differs from the use by other Cuban authors as part of the Special Period Exotic.En este artículo se estudian la presencia de la música popular y su funcionalidad en la novela Cien botellas en una pared (2002) de Ena Lucía Portela. Se analizan los géneros utilizados y las circunstancias en las que los personajes recurren a la música popular. Se plantea que la inserción de la música popular —en el texto y en las explicaciones de las notas— contribuye a plasmar la poética porteliana. Su uso es distinto de la manera como procedieron otros autores para crear un “Special Period Exotic”