The African Center for Global Health and Social Transformation (ACHEST) Director of Health Workforce and Development Dr. Elsie Kiguli Malwadde moderated a webinar on the state of accreditation of health professions training institutions in Africa. Dr. Kiguli-Malwadde is also the Vice President of the African Forum for Research, Education, and Health (AFREhealth)
The webinar held on November 11, 2020, was organized by AFREhealth under the theme Health Work Force Accreditation and Regulation in Africa.
Other speakers were Dr. Kgosi Letlape, the President of Health Professions Council of South Africa; William Pinsky, the President, and CEO, ECFMG; and Professor David Gordon the President of the World Federation for Medical Education (WFME).
The webinar discussed the need to strengthen the quality and performance of the health workforce in Africa during and after COVID-19; and well-functioning regulatory mechanisms, such as registration, licensing/certification bodies, and accreditation processes for training institutions.
Dr. Kiguli-Malwadde while opening the webinar stated that accreditation is not an end in itself, it is like taking a biopsy, it helps to come up with a diagnosis that assists the institutions to become better by examining their relevance, quality, and equity policies and implementation while regulation is like positive policing. All these are aimed at standardizing and maintaining and improving quality.
Dr. Letlape said Africa needs an autonomous accrediting authority that is independent of the Ministries of Health and Education; and the institutions of medical training.
“In the UK and US, they have institutions like that. In Africa, the biggest challenge we have is that accreditation of the institutions and training of the health professional is under the control of the Ministry of Education (MOE), their deployment and the training platform is under the Ministry of Health (MOH) in most countries... The regulator is also the accreditor. So, in most countries in Africa, it is almost like a one-stop-shop, ” said Dr. Letlape
He explained that this process was not just tedious, time-consuming and but it is also subject to abuse and conflict of interest. The institutions have to be accredited by the MOH and MOE.
“It becomes a tag of war. Institutions have to get a double win,” said Dr. Letlape.
He added, “We need to create a framework of coherence and ensure standards for accreditation are set up. We lack an independent authority that is appropriately resourced, whose main credential is to accredit.”
Dr. Letlape also observed that creating common standards for regional structures would further make a difference. “The East African community has come together, and there is a common platform for the member countries for six countries to accredit training institutions and improve service provision,” he said.
Prof. David Gordon gave an overview of the current World Federation of Medical Education on accreditation. There are 20 lead criteria for accreditation available on the Federation’s website (www.wfme.org).
Among the criteria, he highlighted the importance of on-site visits. He used two examples to illustrate his point. One is was a medical school with dilapidated structures and broken furniture. It has an empty soda bottle lying on the window seal. A closer look reveals students in demonstrating outside the school demanding better service.
“If you didn’t visit a school like this, you wouldn’t know how terrible it is,” explained Prof. Gordon.
Another example offers a sharp contrast. It sits in an imposing building, with well-furnished walls. However, Prof. Gordon said a site visit revealed this outlook is deceptive – there were no facilities in place, contrary to what was indicated on paper.
“I went around opening many doors as I could and almost nothing was going on. There were no facilities. So a site visit is necessary to accredit a medical school,” said Prof. Gordon.
“I believe that even if you are short of money you need to be sure that the medical school is working efficiently,” said Prof. Gordon.
During his presentation, he stressed that it was important for medical education to continue during the COVID-19 pandemic, to ensure that students have clinical exposure. He criticized a move by some institutions to teach the future health professionals remotely. It should be noted that due to the COVID-19 imposed a lockdown on education, several institutions have had to close.
“The idea that we can train medical students without them having access to patients is just crazy. How do they learn to take the history of the patient, how to examine the patient, and how to do their best for the patient? Medical schools need to offer clinical opportunities, let them benefit from patient care which will potentially help to prevent workforce shortages. Students need to see the patients even in difficult times. We just have to be careful, and protect them. We need to integrate them into the health system,” said Prof. Gordon.
William Pinsky, the President, and CEO, ECFMG, showcased the state of accreditation of the Health Workforce Training in Africa, based on the summary report on the 2019 Global Symposium on Health Workforce. He noted many countries have had to suspend their accreditation efforts due to the COVID-19 pandemic.
Jennifer Nyoni, from the WHO Africa Region, said: “We are glad that as Africa we are coordinating and organizing ourselves on this matter (accreditation.)
Full recording of the webinar available on https://www.afrehealth.org/mediapage/webinar/261-title-health-work-force-accreditation-and-regulation-in-africa
Compiled by Carol Natukunda