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Enhancing formal educational and in-service training programs in rural Rwanda: a partnership among the public sector,
Corrado Cancedda1, Paul E Farmer, Patrick Kyamanywa
1Dr. Cancedda is associate physician, Divisions of Global Health Equity and Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, instructor of medicine, Harvard Medical School, Boston, Massachusetts, and former director of medical education and training, Partners In Health Rwanda/Inshuti Mu Buzima, Rwinkwavu, Rwanda. Dr. Farmer is associate physician and division chief, Divisions of Global Health Equity and Infectious Diseases, Brigham and Women's Hospital, professor of medicine and department chair, Department of Global Health and Social Medicine, Harvard Medical School, and cofounder, Partners In Health, Boston, Massachusetts. Dr. Kyamanywa is dean and associate professor, School of Medicine, University of Rwanda, College of Medicine and Health Sciences, Butare, Rwanda. Dr. Riviello is director, Global Surgery Programs, Brigham and Women's Hospital, Center for Surgery and Public Health, instructor in surgery, Harvard Medical School, and director, Global Surgery Programs, Partners In Health, Boston, Massachusetts. Dr. Rhatigan is associate physician and associate division chief, Division of Global Health Equity, Brigham and Women's Hospital, instructor in medicine, Harvard Medical School, and director, Global Health Delivery Partnership, Partners In Health, Boston, Massachusetts. Ms. Wagner is research fellow, Global Health Delivery Partnership, Harvard Medical School, Boston, Massachusetts. Dr. Ngabo is director, Division of Maternal and Child Health, Ministry of Health, Kigali, Rwanda. Mr. Anatole is program director, Mentoring and Enhanced Supervision-Quality Improvement Program, Partners In Health Rwanda/Inshuti Mu Buzima, Rwinkwavu, Rwanda. Dr. Drobac is associate physician, Divisions of Global Health Equity and Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, instructor in medicine, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, executive director, Partners In Health
Abstract:
Global disparities in the distribution, specialization, diversity, and competency of the health workforce are striking. Countries with fewer health professionals have poorer health outcomes compared with countries that have more. Despite major gains in health indicators, Rwanda still suffers from a severe shortage of health professionals.This article describes a partnership launched in 2005 by Rwanda's Ministry of Health with the U.S. nongovernmental organization Partners In Health and with Harvard Medical School and Brigham and Women's Hospital. The partnership has expanded to include the Faculty of Medicine and the School of Public Health at the National University of Rwanda and other Harvard-affiliated academic medical centers. The partnership prioritizes local ownership and-with the ultimate goals of strengthening health service delivery and achieving health equity for poor and underserved populations-it has helped establish new or strengthen existing formal educational programs (conferring advanced degrees) and in-service training programs (fostering continuing professional development) targeting the local health workforce. Harvard Medical School and Brigham and Women's Hospital have also benefited from the partnership, expanding the opportunities for training and research in global health available to their faculty and trainees.The partnership has enabled Rwandan health professionals at partnership-supported district hospitals to acquire new competencies and deliver better health services to rural and underserved populations by leveraging resources, expertise, and growing interest in global health within the participating U.S. academic institutions. Best practices implemented during the partnership's first nine years can inform similar formal educational and in-service training programs in other low-income countries.
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