Maximizing the Impact of Training Initiatives for Health Professionals in Low-Income Countries: Frameworks, Challenges, and Best Practices

Abstract

Corrado Cancedda and colleagues outline a framework for health professional training initiatives in low-income countries.

The Medical Education Partnership Initiative (MEPI), a collaborative paradigm for institutional and human resources capacity building between high- and low- and middle-income countries: the Mozambique experience

“…Grant applications are often developed and designed primarily by entities within the granting country and local personnel are essentially ‘hired’ to execute the project if it is funded under the direction of the grant holder [5,7,9,22]. In many international capacity-building projects, the ‘deliverable’ is the number of research publications or health care workers who have attended a course or who receive a degree.…”

“…These conflicts in spending restrictions and operating procedures may prevent programs from utilizing funds effectively [5,7,8]. In traditional models of collaboration, a ‘home country’ entity such as a university or a non-governmental organization (NGO) usually serves as the primary grant or contract recipient.…”

“…Health research collaborations between institutions from high-income countries (HICs) and low- and middle-income countries (LMICs), designated in this paper as countries from the North and South, respectively, have taken several forms and have evolved over time. Structural differences in these relationships have been driven by wide North–South disparities that vary according to the participating country and institutions, the socioeconomic environments surrounding collaborating partners, the projects and researchers involved, and to some extent the specific research issue under study [1–7]. …”

“…In his Berlin 2014 Africa Day speech entitled ‘On the Impossibility of Speaking of Africa’, the former President of the Federal Republic of Germany, Professor Horst Kohler, stated that ‘many colonial and post colonial attitudes persist to this day, sometimes latent and unsuspected but sometimes quite overtly.’ For a number of reasons substantial changes are still required within many funding agencies to restructure longstanding relationships that have largely defined the culture of research collaborations between researchers from Northern and Southern countries. Among these agencies, the agenda and priorities of research, the management, and the fiscal administration are still defined largely by the North [4,5,7,9]. …”

“…There are a few existing outstanding examples of mutually beneficial North–South research collaborations, for example the Ghanaian–Dutch partnership, the European and Developing Countries Clinical Trials Partnership (EDCTP), the Rwanda Human Resources for Health Program, The Global Health Service Partnership, and the United States (US) President’s Emergency Plan For AIDS Relief (PEPFAR)-supported Medical Education Partnership Initiative (MEPI) that we will examine in this manuscript [7–9,11,12]. …”