COVID-19 in Africa: care and protection for frontline healthcare workers

Medical staff caring for COVID-19 patients face mental stress, physical exhaustion, separation from families, stigma, and the pain of losing patients and colleagues. Many of them have acquired SARS-CoV-2 and some have died. In Africa, where the pandemic is escalating, there are major gaps in response capacity, especially in human resources and protective equipment. We examine these challenges and propose interventions to protect healthcare workers on the continent, drawing on articles identified on Medline (Pubmed) in a search on 24 March 2020. Global jostling means that supplies of personal protective equipment are limited in Africa. Even low-cost interventions such as facemasks for patients with a cough and water supplies for handwashing may be challenging, as is ‘physical distancing’ in overcrowded primary health care clinics. Without adequate protection, COVID-19 mortality may be high among healthcare workers and their family in Africa given limited critical care beds and difficulties in transporting ill healthcare workers from rural to urban care centres. Much can be done to protect healthcare workers, however. The continent has learnt invaluable lessons from Ebola and HIV control. HIV counselors and community healthcare workers are key resources, and could promote social distancing and related interventions, dispel myths, support healthcare workers, perform symptom screening and trace contacts. Staff motivation and retention may be enhanced through carefully managed risk ‘allowances’ or compensation. International support with personnel and protective equipment, especially from China, could turn the pandemic’s trajectory in Africa around. Telemedicine holds promise as it rationalises human resources and reduces patient contact and thus infection risks. Importantly, healthcare workers, using their authoritative voice, can promote effective COVID-19 policies and prioritization of their safety. Prioritizing healthcare workers for SARS-CoV-2 testing, hospital beds and targeted research, as well as ensuring that public figures and the population acknowledge the commitment of healthcare workers may help to maintain morale. Clearly there are multiple ways that international support and national commitment could help safeguard healthcare workers in Africa, essential for limiting the pandemic’s potentially devastating heath, socio-economic and security impacts on the continen

Employment Opportunities and Experiences among Recent Master’s-Level Global Health Graduates

Objectives: To examine the job search, employment experiences, and job availability of recent global health-focused master’s level graduates. Methods: An online survey was conducted from October to December 2016 based out of Washington, DC. The study sample includes students graduating with master’s degrees in global health, public health with a global health concentration or global medicine from eight U.S. universities. Results: Out of 256 potential respondents, 152 (59%) completed the survey, with 102/152 (67%) employed. Of unemployed graduates, 38% were currently in another educational training program. Out of 91 employed respondents, 62 (68%) reported they had limitations or gaps in their academic training. The average salary of those employed was between $40,000 and$59,000 annually. The majority of respondents reported they currently work in North America (83.5%.); however, only 31% reported the desire to work in North America following graduation. Conclusions: Discrepancies exist between graduates’ expectations of employment in global public health and the eventual job market. Communication between universities, students and employers may assist in curriculum development and job satisfaction for the global public health workforce

Modeling global transfusion medicine education

This document provides an analysis and oversight of the necessary educational infrastructure at national level needed for successful and sustainable education programs undergraduate and post-graduate and is focused on desired outcomes needed to secure general Transfusion Medicine (TM) competence and basic skills when appointed in a professional TM position. It provides a global model framework for TM education allowing individual countries to tailor the context and contents of the institutional curriculum. Education in transfusion medicine is a complex set of intimately interrelated and interconnected components that allow student and fellow exposure to knowledge and skills, the ultimate curriculum. The extent to which knowledge and skills, professionalism and leadership principles are offered depends on the expected outcomes needed for the desired roles, tasks and functions. A model for the development and implementation of an education (teaching and training) curriculum in Transfusion Medicine aimed at medical students and doctors, nurses and midwives, and laboratory professionals should ideally include an outcomes-based component, with clear recommendations on the required roles, skills, attitudes, and knowledge of a trainee completing such a curriculum. This should correspond to the environment and scope of practice required from such a vocational or academic professional and should address deficiencies in knowledge, skills and attitudes present before the curriculum is completed, while taking into account fundamental international standards of knowledge and the needs of their working climate and environment. Therefore, it is considered more practical to provide a set of outcomes that would be useful in most contexts and settings, while equipping students, as adult learners, with the tools for advancing their educational, professional and leadership development suited to their availability and socio-economic environment. The framework or model recognizes that no one set of education or training initiatives will be appropriate in all countries or settings and should be tailored to specific settings based on the assessment of local needs and available environments

Visiting Trainees in Global Settings: Host and Partner Perspectives on Desirable Competencies

Background: Current competencies in global health education largely reflect perspectives from high-income countries (HICs). Consequently, there has been underrepresentation of the voices and perspectives of partners in low- and middle-income countries (LMICs) who supervise and mentor trainees engaged in short-term experiences in global health (STEGH). Objective: The objective of this study was to better understand the competencies and learning objectives that are considered a priority from the perspective of partners in LMICs. Methods: A review of current interprofessional global health competencies was performed to design a web-based survey instrument in English and Spanish. Survey data were collected from a global convenience sample. Data underwent descriptive statistical analysis and logistic regression. Findings: The survey was completed by 170 individuals; 132 in English and 38 in Spanish. More than 85% of respondents rated cultural awareness and respectful conduct while on a STEGH as important. None of the respondents said trainees arrive as independent practitioners to fill health care gaps. Of 109 respondents, 65 (60%) reported that trainees gaining fluency in the local language was not important. Conclusions: This study found different levels of agreement between partners across economic regions of the world when compared with existing global health competencies. By gaining insight into host partners' perceptions of desired competencies, global health education programs in LMICs can be more collaboratively and ethically designed to meet the priorities, needs, and expectations of those stakeholders. This study begins to shift the paradigm of global health education program design by encouraging North–South/East–West shared agenda setting, mutual respect, empowerment, and true collaboration

Object recognition ability predicts category learning with medical images

Abstract We investigated the relationship between category learning and domain-general object recognition ability (o). We assessed this relationship in a radiological context, using a category learning test in which participants judged whether white blood cells were cancerous. In study 1, Bayesian evidence negated a relationship between o and category learning. This lack of correlation occurred despite high reliability in all measurements. However, participants only received feedback on the first 10 of 60 trials. In study 2, we assigned participants to one of two conditions: feedback on only the first 10 trials, or on all 60 trials of the category learning test. We found strong Bayesian evidence for a correlation between o and categorisation accuracy in the full-feedback condition, but not when feedback was limited to early trials. Moderate Bayesian evidence supported a difference between these correlations. Without feedback, participants may stick to simple rules they formulate at the start of category learning, when trials are easier. Feedback may encourage participants to abandon less effective rules and switch to exemplar learning. This work provides the first evidence relating o to a specific learning mechanism, suggesting this ability is more dependent upon exemplar learning mechanisms than rule abstraction. Object-recognition ability could complement other sources of individual differences when predicting accuracy of medical image interpretation