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The Global Health Service Partnership (GHSP) is a public-private-partnership between Seed Global Health, a US non-profit; Peace Corps, a US Government agency; and host country health education systems. The program attempts to address the global shortage of skilled health professionals by sending US doctors and nurses as medical and nursing educators to training institutions in Uganda, Malawi and Tanzania. The program has sent 73 volunteers of myriad specialties over two years to 13 institutions. Through volunteer self-reporting and stakeholder interviews, the program was evaluated for early quantitative outputs and 25 Wo r l d H e a lt H & P o P u l at i o n • V o l . 16 n o . 1 qualitative impact. Volunteers improved clinical and classroom teaching, new teaching methods, reduced local faculty workloads and modelled professionalism.Challenges cited included difficulty adapting to the setting and existing practice. GHSP is a new program whose full impact will be better understood over time. The first year revealed numerous opportunities for pedagogical innovation, professional modelling and infrastructure investment.

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Program/Project Purpose: Maldistribution of health care workers is a global health challenge that exacerbates health disparities especially in resource-limited settings. Interventions to assuage the problem have targeted qualified personnel with little focus on medical students. However, studies have demonstrated that rural rotations positively influence students to practice in rural settings upon graduation. Within this context, the Kilimanjaro Christian Medical University College introduced a 13-week clerkship rotation in rural hospitals for third-year medical (MD3) students in 2012. To assess students' perceptions, and attitudes toward rural practice after graduation, we surveyed them after their rural rotation. Structure/Method/Design: Anonymous questionnaires were administered to MD 3 students in April 2014. The questions assessed perceptions of the experience, and attitudes towards rural practice upon graduation. The perceptions were assessed using strength of consensus measures (sCns). The effect of the experience on likelihood for rural practice was assessed using Crude Odds Ratio (COR) at 95% Confidence Interval (CI), and 5% level of significance. Binary logistic regression analysis was used to determine predictors accepting rural practice after graduation with Adjusted Odds Ratio (AOR) at 95% CI, and variation assessed with Nagelkerke R2. Outcomes & Evaluation: One hundred and eleven MD3 students participated; 62% male; 62% < 25 years; and 72% direct from secondary school students. Overall, 81% MD3 students were satisfied with rural rotations,(sCns¼ 83%). Likelihood of accepting to be deployed in rural practice after graduation was predicted by being satisfied with the rural rotation program (AOR, 4.32; 95% CI, 1.44-12.96; p, 0.009) and being male (AOR, 2.73; 95% CI, 1.09-6.84; p, 0.032). Also, being an in-service student increased the likelihood of accepting rural practice after graduation by 300% compared to enrolment direct from school, although the difference was not significant (AOR, 4.99; 95% CI, 0.88-28.41; p, 0.070). 29% of variation was explained these variables (Nagelkerke R2, 0.289). However, students who joined school after health-related practice were almost 3X more likely to be satisfied than students direct from school, with no significant difference (COR, 2.6; 95% CI, 0.7-9.4; p, 0.310). Likewise, in-service students were more 2X more likely to be satisfied than direct from school students with insignificant difference (COR, 2.4; 95% CI, 0.9-6.4; p, 0.073). No significant difference was exhibited for students born in rural or urban areas. Going Forward: The rural rotation program increased the likelihood of rural practice after graduation. More effort should be undertaken to further improve the program to increase student satisfaction with rural rotations, and hence likelihood for rural practice after graduation.