Health Professional Training and Capacity Strengthening Through International Academic Partnerships: The First Five Years of the Human Resources for Health Program in Rwanda
نویسندگان
1 Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
2 Rwanda Human Resources for Health Program Team, Ministry of Health, Kigali, Rwanda
3 Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, MA, USA
4 Center for Health Equity, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
5 Office of the Principal, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
6 School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
7 School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
8 Rwanda Human Resources for Health Program Team, Ministry of Health, Kigali, Rwanda
9 Rwanda Human Resources for Health Program Team, Ministry of Health, Kigali, Rwanda
10 Department of Internal Medicine, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
11 School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
12 Department of General Medicine, Calvary Mater Hospital, Newcastle, NSW, Australia
13 Department of Orthopedic Surgery, Rwanda Military Hospital, Kigali, Rwanda
14 Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
15 Department of Radiology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
16 Yale School of Medicine, New Haven, CT, USA
17 Department of Pediatrics, BronxCare Health System, Bronx, NY, USA
18 Division of Hospital Medicine, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA, USA
19 Global Health Leadership Institute, Yale School of Public Health, New Haven, CT, USA
20 Office of the Dean and Department of Oral and Maxillofacial Surgery, Oral Pathology and Oral Medicine, School of Dentistry, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
21 School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
22 University of Global Health Equity, Kigali, Rwanda
23 Clinton Health Access Initiative, Boston, MA, USA
24 Clinton Health Access Initiative, Kigali, Rwanda
25 Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
26 Department of General Pediatrics, Boston Children’s Hospital, Boston, MA, USA
27 Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
28 Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, USA
29 sidHARTe Program, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City, NY, USA
30 Department of Emergency Medicine, Columbia University College of Physicians and Surgeons, New York City, NY, USA
31 Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
32 Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
33 Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
34 Duke Global Health Institute, Durham, NC, USA
35 Duke University Medical Center, Durham, NC, USA
36 Obstetrics & Gynecology and Women’s Health, Montefiore Medical Center, New York City, NY, USA
37 Division of Nursing, Howard University College of Nursing and Allied Health Sciences, Washington, DC, USA
38 University of Connecticut School of Nursing, Storrs, CT, USA
39 Office of the Vice-Chancellor, University of Rwanda, Kigali, Rwanda
40 Office of the Dean, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
41 Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
42 Department of Medicine, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
43 Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
44 Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
45 Department of Surgery, Faculty of Clinical Medicine and Dentistry, Kampala International University - Western Campus, Ishaka, Uganda
46 Office of the Dean and Department of Oral and Maxillofacial Surgery, Oral Pathology and Oral Medicine, School of Dentistry, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
47 Department of Anesthesiology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
48 Department of Ear, Nose, and Throat, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
49 Department of Internal Medicine, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
50 Department of Neurosurgery, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
51 Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
52 Department of Pediatrics, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
53 Department of Mental Health, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
54 Department of Surgery, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
55 Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
56 Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
57 Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
58 School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
59 Department of Preventive and Community Dentistry, School of Dentistry, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
60 Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
61 Clinton Health Access Initiative, Boston, MA, USA
62 Clinton Health Access Initiative, Boston, MA, USA
63 Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
64 Office of Global and Community Health, Harvard School of Dental Medicine, Boston, MA, USA
65 Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA
66 Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
67 Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
68 Department of Anesthesiology, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
69 Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
70 Department of Medicine, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
71 Department of Surgery, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
72 Duke Hubert-Yeargan Center for Global Health, Durham, NC, USA
73 Department of Medicine, Duke University School of Medicine, Durham, NC, USA
74 Duke Global Health Institute, Durham, NC, USA
75 Duke University School of Nursing, Durham, NC, USA
76 Department of Obstetrics & Gynecology and Women’s Health, Albert Einstein College of Medicine, New York City, NY, USA
doi
10.15171/ijhpm.2018.61چکیده
BackgroundThe Rwanda Human Resources for Health Program (HRH Program) is a 7-year (2012-2019) health professional training initiative led by the Government of Rwanda with the goals of training a large, diverse, and competent health workforce and strengthening the capacity of academic institutions in Rwanda. MethodsThe data for this organizational case study was collected through official reports from the Rwanda Ministry of Health (MoH) and 22 participating US academic institutions, databases from the MoH and the College of Medicine and Health Sciences (CMHS) in Rwanda, and surveys completed by the co-authors. ResultsIn the first 5 years of the HRH Program, a consortium of US academic institutions has deployed an average of 99 visiting faculty per year to support 22 training programs, which are on track to graduate almost 4600 students by 2019. The HRH Program has also built capacity within the CMHS by promoting the recruitment of Rwandan faculty and the establishment of additional partnerships and collaborations with the US academic institutions. ConclusionThe milestones achieved by the HRH Program have been substantial although some challenges persist. These challenges include adequately supporting the visiting faculty; pairing them with Rwandan faculty (twinning); ensuring strong communication and coordination among stakeholders; addressing mismatches in priorities between donors and implementers; the execution of a sustainability strategy; and the decision by one of the donors not to renew funding beyond March 2017. Over the next 2 academic years, it is critical for the sustainability of the 22 training programs supported by the HRH Program that the health-related Schools at the CMHS significantly scale up recruitment of new Rwandan faculty. The HRH Program can serve as a model for other training initiatives implemented in countries affected by a severe shortage of health professionals.
