Abstract
Objective:We set out to assess inequalities to access health professional education, and the impact of an education improvement program supported by MEPI (Medical Education Partnership Initiative). Inequalities in the higher education system in sub-Saharan Africa remain despite some transformative policies and affirmative action.Methods:We reviewed enrollment data from four universities for the period 2001–2014 for various health professional training programs, and conducted group discussions through an iterative process with selected stakeholders, and including a group of education experts. Two time periods, 2001–2010 and 2011–2014, were considered. In 2010–11, the MEPI education program began. Gender ratios, regional representation, secondary schools, and the number of admissions by university and year were analysed. We used SPSS version 17 software to analyse these data with level of significance p < 0.05. We collated qualitative data along predetermined and emerging themes.Results:The overall male-to-female ratio among the student population was 2.3:1. In total, there were 7,023 admissions, 4,403 between 2001–2010 (440 per annum) and 2,620 between 2011–2014 (655 per annum) with p = 0.018. There were no significant increases in admissions in the central and western regions over the two time periods, 1,708 to 849 and 1,113 to 867 respectively, both p = 0.713 and p = 0.253. We propose improving the university admission criteria and increasing enrollment to health professions training schools.Conclusion:There were significant inequalities for higher education training in Uganda by gender, regional representation and school attended. Modifying the admission criteria and increasing enrollment may reduce these inequalities.
Highlights
Admissions to medical schools in Uganda and the African region are reported to be predominantly taken up by students from urban areas and from mostly wealthy families [1, 2]
The MESAU consortium was supported by a Medical Education Partnership Initiative (MEPI) grant meant to improve training of Health workers [9]
In all, 7,023 students were admitted to the health professional training programs available
Summary
Admissions to medical schools in Uganda and the African region are reported to be predominantly taken up by students from urban areas and from mostly wealthy families [1, 2]. This raises questions about equitable access to training opportunities in the health science domain. Like equality, aims to promote fairness and justice, but it can only work if everyone starts from the same place and needs the same things; equity ensures that disadvantages are offset. The factors considered before accepting for rural deployment by graduates are factors that affect the quality of life of these graduates in underserved rural areas (good quality schools for children, presence of electricity, running water, access to the internet, television, brain drain, etc.) [4]
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