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

Faustine Ndugulile ,Lora Davis ,Jim Vaughan ,Christopher Tetteh ,Kenneth C Johnson ,Chima Ohuabunwo ,Joseph Oundo ,Patrick Nguku ,Hiari Imara ,Mufuta Tshimanga ,Nykiconia Preacely ,Michele Evering-Watley ,Fausta Mosha ,Ditu Kazambu ,Richard Luce ,John Ngulefac ,Simon Antara ,Peter Nsubuga ,Dieula Delissaint ,Yassa Ndjakani ,Yescenia Espinosa ,Kariuki Njenga ,Obinna Ositadimma Oleribe ,Andrew Weathers ,S.m Elbon ,Timothy J Doyle

doi:10.4314/pamj.v10i0.72235

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.

Highlights

There were approximately 865 million people living in sub-Saharan Africa amidst multiple public health challenges and limited spending on public health in 2010 [1]
We describe the process that we used to develop 10 Field Epidemiology and Laboratory Training Program (FELTP) covering 15 countries in sub-Saharan Africa over 6 years to develop a locally trained public health workforce that can operate multi-disease surveillance and response systems
Before starting the FELTP in each country, Centers for Disease Control and Prevention (CDC) received an invitation from the ministries of health (MOH) which led to a cascade of activities, including: a) a pre-assessment visit, b) a formal assessment and program planning visit, c) identifying a funding source for the program plan, d) developing an MOH-led steering committee, e) developing and obtaining approval of the FELTP curriculum, f) recruiting key staff for the FELTP, g) implementing short courses in field epidemiology for key frontline staff and for screening of the initial cohort of FELTP participants, h) recruiting the first cohort of the FELTP, and i) implementing the 2-year FELTP

Summary

Introduction

There were approximately 865 million people living in sub-Saharan Africa amidst multiple public health challenges and limited spending on public health in 2010 [1]. Achieving public health goals in sub-Saharan Africa remains an elusive target despite major donor funded initiatives, some of which have been widely successful. Sub-Saharan Africa suffers considerable preventable mortality from maternal deaths, deaths due to motor vehicle crashes, cardiovascular diseases, and cancers [5,6]. Effective public health surveillance and response systems allow countries to prioritize and address public health problems, but countries in the region have had challenges with developing robust systems and training the workforce to operate them [7]. With an improving economic outlook there is likely a growing demand for effective public health surveillance and response systems that can protect communities from communicable and non-communicable disease conditions

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Results

Discussion

Conclusion