Addressing the shortage of pathologists in Africa: Creation of a MMed Programme in Pathology in Zambia

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Abstract

Background

With approximately one pathologist for one million people compared to ratios of approximately 1 to 25 000 in the United States and United Kingdom, there is a severe shortage of pathologists in much of Africa. The situation is particularly severe in Zambia, where, in 2009, the ratio was 1 to 1.4 million.

Objective

To address this, a postgraduate Master of Medicine (MMed) training programme was launched in Lusaka in 2011.

Methods

The process and most significant challenges and lessons learned were documented, as they may be of value to other countries facing similar challenges.

Results

Since 2011, four Zambian pathologists have graduated, doubling the number of indigenous pathologists in the country. Currently 10 students are in training. The most significant problem was issues arising from the split responsibilities of the Ministries of Health and of Education and the most important lesson learned was the crucial need for broad local ownership and commitment.

Conclusion

Successfully addressing the shortage of local pathologists by creating country-specific, postgraduate MMed training programmes, even in situations of restricted resources, is feasible. However, having access to and support from the shared resources, expertise and knowledge of a regional College of Pathologists would be a major advantage.

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Access to pathology and laboratory medicine services: a crucial gap

Michael Wilson, Kenneth Fleming, Modupe Kuti … (2018)

As global efforts accelerate to implement the Sustainable Development Goals and, in particular, universal health coverage, access to high-quality and timely pathology and laboratory medicine (PALM) services will be needed to support health-care systems that are tasked with achieving these goals. This access will be most challenging to achieve in low-income and middle-income countries (LMICs), which have a disproportionately large share of the global burden of disease but a disproportionately low share of global health-care resources, particularly PALM services. In this first in a Series of three papers on PALM in LMICs, we describe the crucial and central roles of PALM services in the accurate diagnosis and detection of disease, informing prognosis and guiding treatment, contributing to disease screening, public health surveillance and disease registries, and supporting medical-legal systems. We also describe how, even though data are sparse, these services are of both insufficient scope and inadequate quality to play their key role in health-care systems in LMICs. Lastly, we identify four key barriers to the provision of optimal PALM services in resource-limited settings: insufficient human resources or workforce capacity, inadequate education and training, inadequate infrastructure, and insufficient quality, standards, and accreditation.

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The Collaborative African Genomics Network Training Program: A Trainee Perspective on Training the Next Generation of African Scientists

Busisiwe Mlotshwa, Savannah Mwesigwa, Gerald Mboowa … (2017)

Purpose The Collaborative African Genomics Network (CAfGEN) aims to establish sustainable genomics research programs in Botswana and Uganda through long-term training of Ph.D. students from these countries at Baylor College of Medicine. Here we present an overview of the CAfGEN Ph.D. training program alongside trainees’ perspectives on their involvement. Background Historically, collaborations between High Income Countries (HICs) and Low and Middle Income Countries (LMICs), or North-South collaborations, have been criticized for the lack of a mutually beneficial distribution of resources and research findings, often undermining LMICs. CAfGEN purposes to address this imbalance in the genomics field through a program of technology and expertise transfer to the participating LMICs. Methods An overview of the training program is presented. Trainees from the CAfGEN project summarized their experiences, looking specifically at the training model, benefits of the program, challenges encountered relating to the cultural transition, and program outcomes after the first two years. Conclusion Collaborative training programs like CAfGEN will not only help establish sustainable long-term research initiatives in LMICs, but foster stronger North-South and South-South networks. The CAfGEN model offers a framework for the development of training programs aimed at genomics education for those for whom genomics is not their “first language.”