Zambia field epidemiology training program: strengthening health security through workforce development

Abstract

The Zambia Field Epidemiology Training Program (ZFETP) was established by the Ministry of Health (MoH) during 2014, in order to increase the number of trained field epidemiologists who can investigate outbreaks, strengthen disease surveillance, and support data-driven decision making. We describe the ZFETP´s approach to public health workforce development and health security strengthening, key milestones five years after program launch, and recommendations to ensure program sustainability. Program description: ZFETP was established as a tripartite arrangement between the Zambia MoH, the University of Zambia School of Public Health, and the U.S. Centers for Disease Control and Prevention. The program runs two tiers: Advanced and Frontline. To date, ZFETP has enrolled three FETP-Advanced cohorts (training 24 residents) and four Frontline cohorts (training 71 trainees). In 2016, ZFETP moved organizationally to the newly established Zambia National Public Health Institute (ZNPHI). This re-positioning raised the program´s profile by providing residents with increased opportunities to lead high-profile outbreak investigations and analyze national surveillance data-achievements that were recognized on a national stage. These successes attracted investment from the Government of Republic of Zambia (GRZ) and donors, thus accelerating field epidemiology workforce capacity development in Zambia. In its first five years, ZFETP achieved early success due in part to commitment from GRZ, and organizational positioning within the newly formed ZNPHI, which have catalyzed ZFETP´s institutionalization. During the next five years, ZFETP seeks to sustain this momentum by expanding training of both tiers, in order to accelerate the professional development of field epidemiologists at all levels of the public health system.

Evaluation of Ethiopia’s field epidemiology training program – frontline: perspectives of implementing partners

“…Evaluation of FETP-Frontline in other countries also documented the effectiveness of the program. Studies conducted in Guinea [ 36 ], Liberia [ 37 ], Zambia [ 22 ] and Kenya [ 38 ] documented that the trained officers had improved capacity. Effectiveness of FETP-Frontline has also been reported with regards to improved surveillance data, quality surveillance reports, case investigations, outbreak investigations, and surveillance system improvements.…”

“…The two most common challenges in FETP training were lack of sustainable funding [ 19 , 20 ] and low retention of the workforce [ 19 , 39 ]. Recommendations to address these challenges include linking FETP with ministries, universities, and international funding organizations [ 40 ] and providing professional development opportunities for graduates, including additional training [ 22 , 34 , 41 ].…”

The Field Epidemiology Training Program’s Contribution to Essential Public Health Functions in Seven National Public Health Institutes

“…It has to be worthwhile for them to do this work after going through all that training." [Cambodia (12), German Development Agency (GIZ)] Another participant expressed that the program needed to improve leadership and management to make the FETP's work more visible within the country. Participants from Colombia expressed that having teams in every area led to some of them being underutilized and are working to improve their approach to conveying risk to the community.…”

“…In addition to their role in conducting critical public health functions, FETP graduates are expected to occupy leadership positions, mentor FETP residents [ 4 ], and work closely with partners and other public health experts within national public health institutes (NPHIs) and ministries of health [ 12 ]. For instance, in Zambia, FETP graduates are integrated into the Emergency Operations Center (EOC), which is embedded in the NPHI, and are established as essential members of outbreak response teams.…”