Tropical Health Education Trust Research Articles

Development of Somaliland national harmonised medical curriculum

Background and objectives The rational for the Somaliland national harmonised curriculum (NHC) was driven by shared concern about the quality of medical education. Process The Ministry of Education and Science and the Ministry of Health Development produced a Medical Education Policy 2018. Policy objectives included the development of the NHC and accreditation for medical schools that met the standards of the World Federation for Medical Education (WFME). Two bodies were asked to oversee these aims: the National Health Professions’ Commission (NHPC) and the National Commission of Higher Education (NCHE). Between 2018 and 2020, a collaborative approach between the Somaliland government, medical school stakeholders, King’s Global Health Partnership’s (KGHP) volunteers and the Tropical Health Education Trust (THET) team was used to design the 6-years NHC. The NHC structure, content and delivery were grounded by WFME standards, health needs of the local population, student focused and active learning methods, and feasibility of implementation in medical schools. Outcomes The NHC comprises details about the educational outcomes, curriculum model and framework, educational principles, instructional and learning methods, core as well as optional content, and assessment strategy. Conclusions The approach used to develop the NHC ensured it is bespoken for Somaliland. Ongoing evaluation of patient and population needs, each medical school’s review of programme implementation and outcomes will inform continuous revision and renewal.

Do International Health Partnerships contribute to reverse innovation? a mixed methods study of THET-supported partnerships in the UK

BackgroundInternational health partnerships (IHPs) are changing, with an increased emphasis on mutual accountability and joint agenda setting for both the high- and the low- or middle-income country (LMIC) partners. There is now an important focus on the bi-directionality of learning however for the UK partners, this typically focuses on learning at the individual level, through personal and professional development. We sought to evaluate whether this learning also takes the shape of ‘Reverse Innovation’ –when an idea conceived in a low-income country is subsequently adopted in a higher-income country.MethodsThis mixed methods study used an initial scoping survey of all the UK-leads of the Tropical Health Education Trust (THET)-supported International Health Partnerships (n = 114) to ascertain the extent to which the IHPs are or have been vehicles for Reverse Innovation. The survey formed the sampling frame for further deep-dive interviews to focus on volunteers’ experiences and attitudes to learning from LMICs. Interviews of IHP leads (n = 12) were audio-recorded and transcribed verbatim. Survey data was analysed descriptively. Interview transcripts were coded thematically, using an inductive approach.ResultsSurvey response rate was 27% (n = 34). The majority (70%) strongly agreed that supporting LMIC partners best described the mission of the partnership but only 13% of respondents strongly agreed that learning about new innovations and models was a primary mission of their partnership. Although more than half of respondents reported having observed innovative practice in the LMIC, only one IHP respondent indicated that this has led to Reverse Innovation. Interviews with a sample of survey respondents revealed themes primarily around how learning is conceptualised, but also a central power imbalance between the UK and LMIC partners. Paternalistic notions of knowledge could be traced to partnership power dynamics and latent attitudes to LMICs.ConclusionsGiven the global flow of innovation, if High-income countries (HICs) are to benefit from LMIC practices, it is paramount to keep an open mind about where such learning can come from. Making the potential for learning more explicit and facilitating innovation dissemination upon return will ultimately underpin the success of adoption.

Cancer and palliative care in Africa.

Cancer and palliative care in Africa.

The personal value of being part of a Tropical Health Education Trust (THET) links programme to develop a palliative care degree programme in Sub Saharan Africa: a descriptive study of the views of volunteer UK health care professionals.

BackgroundThere is a global need to expand palliative care services to reach the increasing number requiring end of life care. In developing countries where the incidences of cancer are rising there is an urgent need to develop the palliative care workforce. This paper reports on a UK Department for international development (DFID) initiative funded through the Tropical Health Education Trust (THET) where palliative care staff, both clinical and academic, volunteered to help to develop, support and deliver a degree in palliative care in sub-Saharan Africa. The objective of the study was to explore the personal impact on the health care professionals of being part of this initiative.MethodsAn evaluation approach using a confidential electronic survey containing quantitative and qualitative questions was distributed to all 17 volunteers on the programme, three months after completion of the first cohort. Data were analysed using descriptive statistics and content thematic analysis. Ethical review deemed the study to be service evaluation.Results82 % (14) responded and several themes emerged from the data including the positive impact on teaching and educational skills; clinical practice and finally personal development. Using a score of 1–10 (1-no impact, 10 maximum impact) ‘Lifestyle choices - life work balance’ (rating 7.83) had the most impact.ConclusionsThis approach to supporting the development of palliative care in Sub-Saharan Africa through skill sharing in supporting the delivery of a degree programme in palliative care was successful in terms of delivery of the degree programme, material development and mentorship of local staff. Additionally, this study shows it provided a range of positive impacts on the volunteer health care professionals from the UK. Professional impacts including increased management skills, and being better prepared to undertake a senior role. However it is the personal impact including lifestyle choices which the volunteers reported as the highest impact. Interestingly, several of the faculty have joined other volunteer programmes to continue to support the international development of palliative care.

Developing a health link partnership with dermatology services in Nigeria: Preliminary feedback from a tropical health education trust start-up project

In January 2013 we visited Nigeria to build a partnership with Nigerian dermatology service and a dermatology charity. The needs assessment that was conducted supported a DClinPsy doctorial study. This article reports on the initial phase of the start-up project and presents some of the results of the needs assessment.

LESSONS FROM FOUR COUNTRIES IN SUB-SAHARAN AFRICA IN DEFINING AND DEVELOPING INTEGRATED MODELS OF PALLIATIVE CARE

BackgroundThe THET (Tropical Health & Education Trust) partnership project on Strengthening and integrating Palliative Care into national health systems commenced in 2012. The project aims at enhancing the provision of...

PM.63 International Volunteering to Promote Maternal and Newborn Health: Optimising Impact

This paper presents the results of an interim evaluation of an initiative funded by the Tropical Health Education Trust (THET) and hosted by the Liverpool-Mulago-Partnership. Internationalisation is becoming an essential...

OC-028 Developing sustainable GI endoscopy training in Malawi

IntroductionSustainable endoscopy services could improve management of upper gastrointestinal malignancy and haemorrhage, both common in Malawi. Since 2008 we have committed to improving endoscopy training through an International Health Link...

Helping the developing world…..the story of an outward looking hospice

A hospice in the UK became linked with Africa when one of the medical staff left in 2001 to set up a hospice in Tanzania. The aim was to extend...

Impact of a high dependency unit in a resource limited setting

IntroductionThe maternity department in Mulago Hospital, Kampala delivers >30 000 women with extremely limited staffing and resources. There is a high maternal mortality, often the result of late detection of...

Training in the management of post-traumatic stress disorder in Uganda

The aims of this study were to establish the feasibility and effectiveness of training Ugandan mental health workers in the management of post-traumatic stress disorder (PTSD) based on guidelines from the UK National Institute of Health and Clinical Excellence (NICE). The Butabika Link is a mental health partnership between the East London Foundation NHS Trust (ELFT) and Butabika National Psychiatric Referral Hospital, Kampala, Uganda, supported by the Tropical Health Education Trust (THET), and based on the recommendations of the Crisp report (Crisp, 2007). The Link has worked on the principle that the most effective partnership between high-income and low- or middle-income countries is through organisations already delivering healthcare, that is, through the support of existing services. Butabika Hospital is a centre of excel-. Butabika Hospital is a centre of excellence, serving an entire nation of 30 million people, many of them recovering from 20 years of armed conflict that took place mainly in the north of Uganda. In addition, Uganda has received refugees from conflicts in neighbouring states, including Congo, Rwanda, Kenya, Sudan and Burundi. The Ugandan Ministry of Health's Strategic Plan (2000) has prioritised post-conflict mental disorders and domestic violence, which is reflected in the vision of the Link's work.

THET- Lancet Research Award in international health

The Tropical Health Education Trust (THET) and The Lancet this week launch an annual research award in international health. The aim of the award, worth at least £2000, is to promote clinical work and inquiry in everyday health care in any developing-world setting. The larger wish is to assist development of capacity and capabilities of individual doctors and medical schools. We seek research papers, research letters, or case-reports that will in some way help to improve health care or develop clinical services. THET has been working since 1989 with medical schools and other training institutions in African countries to assist them to reach their goals, so that they can deliver the sort of education and training that they consider to be relevant for the people whom they serve. THET, with the Reuter Foundation, already runs an annual competititon for the best student projects in African medical schools; the THET-Lancet award now offers qualified health workers a similar but wider opportunity, not restricted to Africa. The submissions will be judged by a joint THET-Lancet awards committee. The winning entries will be published in The Lancet. To apply for a THET-Lancet research award, please send five copies of the article, together with a covering letter setting out the strengths and limitations of the work, to Richard Horton at The Lancet by March 31, 2001.