Dear Colleagues,

Here is a submission on how to continue training health professionals during the COVID -19 imposed lock down. The author is Dr. Elsie Kiguli-Malwadde, Director, Health Workforce Education and Development at ACHEST.

E-Learning is the utilization of electronic technologies to access educational materials outside of the traditional classrooms. E- Learning has emerged as an important tool for Continuous Professional Development for health workers and students of health Professions’ institutions in the COVID Era.
Considering that health professions education institutions have been closed and face to face Continuous Professional Development (CPD) activities like global, regional and national conferences have been cancelled.  Health professions have to adopt creative ways of sharing education materials. To this extent, creative strategies have to be adopted to ensure that learning continues despite the pandemic. There is also an urgent need to train health workers on COVID 19 and to keep them updated on its spread.

Currently global health has been threatened by the COVID 19 pandemic and Global Health Security has been challenged as the disease spreads across all continents.  Many people have lost the state of complete physical wellness; fear has gripped the whole world, affecting the mental well-being of the populations.  Our social well-being has been disrupted by various control measures including physical/social distancing, avoidance of hugs, no touching and wearing masks among others.  In a bid to restrict gatherings and therefore keep people at home, schools and universities including health professions education institutions have been closed.

“Health Workers for All and All for Health Workers” Slogan of the First Global Forum on Human Resources for Health
“Our job is to ensure access to a skilled, supported and motivated health worker for every person in every village everywhere” Dr. J W Lee, former WHO Director General.
In these trying times of the COVID -19 pandemic, there are Health Workforce (HWF) issues that keep recurring in all countries. Yet HWF is one of the most critical inputs into the pandemic control response. This message needs to be appreciated by all intersetoral actors in governments and the general population. There are persistent complaints about lack of protective equipment, long working hours, hazards of travel to and from work in the face of lock down regulations and lack of support to undertake non COVID related medical work leading to collateral damage to public health.
“Health Workers for All and All for Health Workers” was the slogan of the First Global Forum on Human Resources for Health in 2008. Another related trending theme at that time and still relevant today is the quote from Dr. J W Lee that “Our job is to ensure access to a skilled, supported and motivated health worker for every person in every village everywhere”.
Let us take the discussion forward based on this quotation:
1. Skilled HWF need general knowledge, attitudes and skills for good and bad times and the required competencies for this are:
• Prepared to work where services are most needed: selection process, attitudes, socially accountable
• Able to respond to health needs of community: training in real life situations in community
• Able to deliver quality care with available (limited) resources. (Achieving the most with available resources.)
• Clinical excellence as foundation for teaching and research.
• Able to be leader, manager , teacher and change agent: mentors
• Continuous self-directed learners
• Effective communicators: team based learning, practice
The HWF also needs to be prepared and fit for purpose to handle the special skills for COVID-19 and the required competencies are:
• Full understanding of Infection control practices including correct use of PPEs
• Knowledge of Novel Corona virus behavior and its manifestations especially modes of transmission, symptoms, signs and complications
• Team work and empathy with ability to delegate skills through Task Shifting approach

2. Supported HWF should have:
• Enjoy the full support of political leadership with established structures for HWF planning and management embracing all relevant sectors
• Enjoy full support supervision of competent technical leaders with clear structures for dialogue and communication
• Enjoy the full support and understanding of the general population
• Have access to the tools that they require for their work such as PPEs, supplies,
• Organized and well led HWF with a critical mass of individuals professional associations and other institutions that work with their respective governments as both support and accountability agents, for sustaining highly performing health systems

Dear Colleagues,

In the wake of COVID-19 control effort, here is an insightful contribution by Dr David Okello.

“This is a time for prudence, not panic. Science, not stigma. Facts, not fear. Even though the situation has been classified as a pandemic, it is one we can control...” --UN Secretary-General António Guterres.

With the COVID-19 infections now confirmed in African countries, governments have put in place various measures to contain the spread of the outbreak. These measures include screening of suspected cases, contact tracing, public education on hand washing and avoiding touching the face, isolation of confirmed cases, and physical distancing – closure of schools and large public gatherings and complete lockdown of movement of people including curfews. All these measures are normal public health procedures used in disease outbreak control.

As time passes, it has become clear that the ramifications of COVID-19 go well beyond the realms of the health sector. The lockdown of business activities and confining people in their homes is having major social, psychological and economic ramifications. Already, Africa is watching a potential health disaster quickly turn into an economic and social crisis.

Dear Colleagues,

In these trying times let us share thoughts on strategies that can help us get over the COVID -19 pandemic. We start with a challenging quotation:

"Gentlemen, it is the microbes who will have the last word".
This quotation is attributed to the French microbiologist Louis Pasteur. How soon this will happen depends on how when we humans recognize and seriously respond to this threat from viruses and bacteria.

The COVID-19 pandemic presents yet another challenge and opportunity following upon Ebola, SARS, and MERS. It is also a loud call for the world to relearn and hopefully to remember once again that infectious diseases are a grossly neglected dimension of global security. In 2016, I was a member of an independent Commission on a Global Health Risk Framework for the Future that published a report titled; The Neglected Dimension of Global Security: A Framework to Counter Infectious Disease Crises. This Commission recommended three strategies namely:

Dear Colleagues,

Here is our discussion topic for August, 2019. It is inspired by the outcome of a recent Consultation.

The opportunity presented by the Sustainable Development Goals (SDGs) once again place Africa at the crossroads as was the case 60 years ago when we gained independence from colonialism. Africa may either grasp and run with the opportunity offered by the SDGs or waste it. This was the subject of a three day meeting that took place in Kampala, Uganda 16 – 18 July, 2019; under the theme “Governance for Health in Africa; Lessons learnt since independence to inform the future”.

The current huge gap in health and other development indices between Africa and other regions of the world were noted as a matter for concern, pain and shame and some participants were deeply moved and were seen crying and shedding tears! Why did Asian countries such as Singapore, South Korea and Malaysia that got independence at the same time and with similar indices develop much faster than African counterparts? Some of the causes of these disparities are known to be clearly wrong and intolerable but are accepted as “normal” and are allowed to persist when corrective actions are within reach. Why is this?