Relevance and resources in medical education: an African view

The worldwide economic crisis enjoins all planners of social services to a principle of relevance and efficiency in the deployment of scarce available resources. On the continent of Africa this is more crucial for the compelling influence of natural disasters and the population explosion. In the field of medical education relevance implies commitment of training programmes to the health needs of the society and in Africa this means addressing crude birth rates of 46 per 1000, death rates of 22 per 1000, maternal mortality of 17 per 10,000, infant mortality of 112 per 1000 and a life expectancy of just under 50, statistics which represent the most dismal health indicators for the five continents of the world. The training of the African doctor should therefore ensure intimate familiarity with the environmental and sociocultural influences on health, placing a premium on capability for management of human, material and financial resources and a plan for team-work. It must also inculcate the appropriate learning strategy which emphasizes the searching and enquiring mind, applying this problem-solving attitude to the life-long practice of medicine. It is now accepted by most observers that these objectives are achievable most readily through a translation of the principles of primary health care into educational strategies. The planning of medical educational policy in Africa is thus a formidable task as it is to be done against a background of diminishing resources in real terms and the modern explosion of knowledge in science and technology. Selectivity which is sensitive to the service to which education is to be put is currently the most promising means to achieve relevance and efficiency.