Field Epidemiology and Laboratory Training Programs in sub-Saharan Africa from 2004 to 2010: need, the process, and prospects

Abstract

As of 2010 sub-Saharan Africa had approximately 865 million inhabitants living with numerous public health challenges. Several public health initiatives [e.g., the United States (US) President's Emergency Plan for AIDS Relief and the US President's Malaria Initiative] have been very successful at reducing mortality from priority diseases. A competently trained public health workforce that can operate multi-disease surveillance and response systems is necessary to build upon and sustain these successes and to address other public health problems. Sub-Saharan Africa appears to have weathered the recent global economic downturn remarkably well and its increasing middle class may soon demand stronger public health systems to protect communities. The Epidemic Intelligence Service (EIS) program of the US Centers for Disease Control and Prevention (CDC) has been the backbone of public health surveillance and response in the US during its 60 years of existence. EIS has been adapted internationally to create the Field Epidemiology Training Program (FETP) in several countries. In the 1990s CDC and the Rockefeller Foundation collaborated with the Uganda and Zimbabwe ministries of health and local universities to create 2-year Public Health Schools Without Walls (PHSWOWs) which were based on the FETP model. In 2004 the FETP model was further adapted to create the Field Epidemiology and Laboratory Training Program (FELTP) in Kenya to conduct joint competency-based training for field epidemiologists and public health laboratory scientists providing a master's degree to participants upon completion. The FELTP model has been implemented in several additional countries in sub-Saharan Africa. By the end of 2010 these 10 FELTPs and two PHSWOWs covered 613 million of the 865 million people in sub-Saharan Africa and had enrolled 743 public health professionals. We describe the process that we used to develop 10 FELTPs covering 15 countries in sub-Saharan Africa from 2004 to 2010 as a strategy to develop a locally trained public health workforce that can operate multi-disease surveillance and response systems.

Frontline Field Epidemiology Training Programs as a Strategy to Improve Disease Surveillance and Response

“…Deficits in the public health surveillance system to identify cases and contacts at the local level and to respond in a timely manner were factors that contributed to the expansion and prolonged nature of the Ebola outbreak ( 5 , 6 ). Until the Ebola epidemic, most of the experience with FETP in Africa had been with the 2-year advanced-level program, which trained staff to work at national surveillance and disease control programs ( 7 , 8 ). This approach did not address the need to have adequately trained staff at the local level to detect outbreaks and respond appropriately.…”

Uganda public health fellowship program’s contribution to building a resilient and sustainable public health system in Uganda

“…Because PHFP is non-degree awarding and Fellows are required to already have at least a Master's degree on entry, fellows spend more time working on program-oriented projects that address national health needs, and less time in didactic courses. This is different from most FETPs, in which residents earn degrees while in their programs [21]. This model allows the fellows to obtain wide range of experience at all levels of public health in Uganda.…”

Peer Review #1 of "A seven-year surveillance of epidemiology of malaria reveals travel and gender are the key drivers of dispersion of drug resistant genotypes in Kenya (v0.1)"

“…This is an implication that other factors contribute to CQR. Literature shows that irrational use of drugs (Nsubuga et al, 2011) gender dimensions (WHO, 2007), travel (Juliao et al, 2013), number of parasites exposed to a drug, the drug concentration to which the parasites are exposed, and the simultaneous presence of other antimalarials in the blood to which the parasite is not resistant influence the emergence and spread of drug resistant malaria parasites (WHO, 2018). These Manuscript to be reviewed approaches, collaboration -across disciplines, sectors and regions -, multi-stakeholder engagement, and sensitivity to social equity (Wiese, 2012).…”