Family Medicine in Ethiopia: Lessons from a Global Collaboration

Evensen, Ann; Wondimagegn, Dawit; Ashebir, Daniel Zemenfes; Rouleau, Katherine; Haq, Cynthia; Ghavam-Rassoul, Abbas; Janakiram, Praseedha; Kvach, Elizabeth; Busse, Heidi; Conniff, James; Cornelson, Brian M.

doi:10.3122/jabfm.2017.05.170086

Cited by 7 publications

(11 citation statements)

References 10 publications

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“…14 Partnerships between LMIC and HIC investigators are sometimes paternalistic, and academic global health collaborations may unequally benefit HIC investigators when compared with LMIC investigators. 15,16 Case studies and opinion pieces describing challenges and successes in single partnerships between LMIC and HIC investigators have been published previously, 8,[17][18][19][20] and policies have been put forth to establish guidelines for equitable academic global health collaborations. [21][22][23] However, previously published studies on perceptions of academic global health collaborations have been limited to single partnerships, and policies for equitable academic global health collaborations have been based on a paucity of evidence.…”

Section: Introductionmentioning

confidence: 99%

Improving Pediatric Academic Global Health Collaborative Research and Agenda Setting: A Mixed-Methods Study

Rees

Keating

Dearden

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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Academic global health collaborations have the potential to improve joint understanding of health issues in low-and middle-income countries (LMICs). Our objective was to elucidate perceptions of benefits and challenges of academic global health collaborations as well as areas for improving collaborative research conducted in LMICs. This cross-sectional, mixed-methods study surveyed investigators' perceptions of benefits and challenges of pediatric academic global health collaborations. Authors of articles from four pediatric journals reporting pediatric research conducted in LMICs published between 2006 and 2015 were surveyed. Responses of LMIC investigators were compared with those of investigators in high-income countries (HICs). Responses to open-ended questions were analyzed using a combined thematic and content analysis approach. Of 1,420 potential respondents, 252 (17.7%) responded to the survey. Collaborative research with investigators from other countries was perceived as beneficial by 88.5% of respondents (n = 223), although this perception was more common among HIC respondents (n = 110, 94.0%) than LMIC respondents (n = 113, 83.7%) (p = 0.014). Sixty-seven percent (n = 170) of respondents perceived that HIC investigators had set the research agenda in work conducted in a LMIC. Respondents identified several critical factors to improve academic global health collaborations, including research capacity building, communication, and early involvement of LMIC investigators with shared decision-making during study conception and grant writing. Pediatric academic global health collaboration was widely perceived as positive. However, despite calls for capacity building and locally generated research ideas, many respondents felt that HIC investigators set the research agenda for work conducted in LMICs. This study provides suggestions for improving collaboration among pediatric academicians globally.

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Section: Introductionmentioning

confidence: 99%

Improving Pediatric Academic Global Health Collaborative Research and Agenda Setting: A Mixed-Methods Study

Rees

Keating

Dearden

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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“…Programs reported innovative teaching opportunities, advanced training courses, and varied settings for patient care that were consistent with best practices for international partnerships. [25][26][27][28][29][30] Our study identified many opportunities for growth in the field of GH fellowship training such as improving interprofessional training, building partnerships with tribal councils, honing advocacy skills, and pairing fellows from high-resource and low-resource institutions. In the face of the rapid increase in GH fellowship programs and the common problems of funding and lack of qualified applicants, it is critical to continually reassess and prioritize needs of the international partners to ensure mutual benefit for all participants.…”

Section: Discussionmentioning

confidence: 99%

Status of global health fellowship training in the United States and Canada

Evensen¹,

Duffy

Dawe

et al. 2019

Can. Med. Ed. J

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Background: Increasing numbers of residency graduates desire global health (GH) fellowship training. However, the full extent of training options is not clear. Objective: To identify clinical GH fellowships in all specialties in the U.S. and Canada and to describe their demographics, innovative features, and challenges. Methods: The authors surveyed program directors or designees from GH fellowships with a web-based tool in 2017. Program directors reported demographics and program characteristics. Results: The authors identified 85 potential programs. Fifty-four programs (63.5%) responded confirming 50 fellowships. The number of U.S. GH fellowship programs increased by 89.7% since 2010. One-third of fellowships accepted graduates from more than one specialty. The most common single-specialty programs were Emergency Medicine or Family Medicine. Fellowship duration was most commonly 24 months. Median size was one fellow per year. Funding and lack of qualified applicants were significant challenges. Most programs were funded through fellow billing for patient care or other means of self-support. Conclusions: The number of U.S. and Canadian GH fellowship programs has nearly doubled since 2010. Programs reported lack of funding and qualified applicants as their most significant challenges. Consensus amongst stakeholders regarding training requirements may improve outcomes for future fellows, their employers, and the patients they serve.

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“…In well-equipped PHC facilities and district hospitals [56][57][58][59][60] The model that emerged in South Africa required the FP to work at district hospital and in PHC, with the key roles as shown in Fig. 5.…”

Section: Key Question 5: What Roles Do Family Physicians Play In Sub-mentioning

confidence: 99%

“…Another key finding was the importance of collaboration and support between universities, both South-South and North-South as shown by the Primafamed network, in order to develop the discipline in SSA. Good communication and collaboration with policymakers and other key stakeholders was another important finding [8,18,45,58]. Presently, FPs are most often not mentioned in policy documents in SSA [82].…”

Section: Table 10mentioning

confidence: 99%

A scoping review on family medicine in sub-Saharan Africa: practice, positioning and impact in African health care systems

et al. 2020

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Background: Family medicine (FM) is a relatively new discipline in sub-Saharan Africa (SSA), still struggling to find its place in the African health systems. The aim of this review was to describe the current status of FM in SSA and to map existing evidence of its strengths, weaknesses, effectiveness and impact, and to identify knowledge gaps. Methods: A scoping review was conducted by systematically searching a wide variety of databases to map the existing evidence. Articles exploring FM as a concept/philosophy, a discipline, and clinical practice in SSA, published in peer-reviewed journals from 2000 onwards and in English language, were included. Included articles were entered in a matrix and then analysed for themes. Findings were presented and validated at a Primafamed network meeting, Gauteng 2018. Results: A total of 73 articles matching the criteria were included. FM was first established in South Africa and Nigeria, followed by Ghana, several East African countries and more recently additional Southern African countries. In 2009, the Rustenburg statement of consensus described FM in SSA. Implementation of the discipline and the roles and responsibilities of family physicians (FPs) varied between and within countries depending on the needs in the health system structure and the local situation. Most FPs were deployed in district hospitals and levels of the health system, other than primary care. The positioning of FPs in SSA health systems is probably due to their scarcity and the broader mal-distribution of physicians. Strengths such as being an "allround specialist", providing mentorship and supervision, as well as weaknesses such as unclear responsibilities and positioning in the health system were identified. Several studies showed positive perceptions of the impact of FM, although only a few health impact studies were done, with mixed results. Conclusions: FM is a developing discipline in SSA. Stronger evidence on the impact of FM on the health of populations requires a critical mass of FPs and shared clarity of their position in the health system. As FM continues to grow in SSA, we suggest improved government support so that its added value and impact on health systems in terms of health equity and universal health coverage can be meaningfully explored.

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Family Medicine in Ethiopia: Lessons from a Global Collaboration

Cited by 7 publications

References 10 publications

Improving Pediatric Academic Global Health Collaborative Research and Agenda Setting: A Mixed-Methods Study

Improving Pediatric Academic Global Health Collaborative Research and Agenda Setting: A Mixed-Methods Study

Status of global health fellowship training in the United States and Canada

A scoping review on family medicine in sub-Saharan Africa: practice, positioning and impact in African health care systems

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