Reports in Brief Wycliffe Ndege, Juliet Mwangi, Minnie Kibore, Linda Nyaga, Wycliffe Khaemba, Susan Wanja, and Luke D. Davies. Funding/Support: Funding for this work came from the Office of the U.S. Global AIDS Coordinator (OGAC) and the National Institutes of Health (NIH) through MEPI award number 1R24TW008889. Other disclosures: None reported. Ethical approval: Reported as not applicable. Disclaimers: The content is solely the responsibility of the authors and does not necessarily represent the official views of OGAC or NIH.
References 1 Mullan F, Frehywot S, Omaswa F, Buch E. Medical schools in sub-Saharan Africa. Lancet. 2011;377:1113–1121. 2 Chankova S, Muchiri S, Kombe G. Health workforce attrition in the public sector in Kenya: A look at the reasons. Hum Resour Health. 2009;7:58.
Evolution of a Multiuniversity Monitoring and Evaluation Technical Working Group Francis J. Njiri, MSc, Mara J. Child, MPH, MPA, Gabrielle O’Malley, PhD, Sarah Baird, PhD, MS, Vincent Ojoome, MMed, Luke D. Davies, and James Kiarie, MMed, MPH
Background: Monitoring and evaluation (M&E) of large-scale government and donor investments is essential for tracking quality improvement, documenting lessons learned, and measuring returns on investment. M&E becomes particularly salient when interventions are also large in scale and unproven, as is the case with the Medical Education Partnership Initiative (MEPI). Through the Principal Investigators’ Council, MEPI institutions observed that many schools faced similar challenges in M&E and that there was a need for more collaboration across programs. In response, an M&E Technical Working Group (TWG) was established in 2012, more than two years after the onset of MEPI, to facilitate interaction across the 13 MEPI institutions. The TWG was composed of M&E leads from each school, with technical support from the MEPI Coordinating Center (George Washington University and the African Center for Global Health and Social Transformation), the University of Nairobi, and the University of Washington. Innovations: The M&E TWG leadership facilitated seven webinars starting
S110
in March 2013, during which each institution gave a 20-minute presentation describing the M&E activities. During the three months of the webinar series, it became clear that there was a need for in-person discussion and additional technical assistance to help move the M&E activities of MEPI forward. With support from the Office of the U.S. Global AIDS Coordinator, a two-day workshop was held in August 2013 with 39 M&E staff from 17 African and U.S. academic institutions. The objectives of the workshop were to build M&E skills and capacity, share experiences, identify MEPI evaluation needs, and develop a work plan for the M&E TWG. Cross-cutting themes for evaluation emerged, and a subgroup was formed for each of five themes: (1) retention of physicians in rural areas, (2) information communication technology and eLearning, (3) local innovation, (4) research and curriculum development, and (5) partnerships. Outcomes: Through the activities conducted by the M&E TWG, a number of observations have emerged. First, although almost all the institutions had functional program M&E strategies in place and monitoring was occurring, assessing the impact of the program was universally a challenge. Second, although each of the MEPI schools had its own individual work plans and unique activities, common cross-cutting topics were identified at the workshop and formed the basis for crossinstitutional evaluation of MEPI. Finally, a functioning M&E TWG is likely to be essential for optimizing the impact of the M&E activities of MEPI. Comment: The TWG was successful in garnering support across schools because of the buy-in and ownership generated via its participatory approach. The addition of the TWG to the coordinating center in support of evaluation activities increased the pace of knowledge sharing across the consortium. Nevertheless, challenges still remain, including lack of resources of the TWG lead institution (both financial and time), difficulty in coordinating across multiple sites in numerous countries and time zones, and the formation of the TWG two years into the duration of the grant. Working through these challenges over the remainder of the MEPI program will be vital. MEPI schools must continue to collaboratively assess the impact of the MEPI program and to disseminate this information to key stakeholders across the
continent to ensure that successful efforts are sustained beyond the funding period. Correspondence should be addressed to Mr. Njiri, PO Box 2431-00202, Nairobi, Kenya; e-mail: [email protected]. Author affiliations: F. Njiri, University of Nairobi; M. Child, G. O’Malley, L. Davies, University of Washington; S. Baird, George Washington University and University of Otago; V. Ojoome, African Centre for Global Health and Social Transformation; J. Kiarie, University of Nairobi Acknowledgments: The authors would like to thank the following for their contributions to this Short Report and to the TWG: Natalie Brogan, George Washington University; Kalay Moodley, Stellenbosch University; Moses Simuyemba, University of Zambia; Nadia Tagoe, Kwame Nkrumah University of Science and Technology; Rhona Baingana, Makerere University; Netsanet Animut, Addis Ababa University; Esther Lisasi, Kilimanjaro Christian Medical Centre; Kagiso Sebina, University of Botswana; Vanessa Vaila, Mozambique Institute for Health Education and Research; Shemiah Nyaude, University of Zimbabwe; Moise Muzigaba, University of KwaZulu-Natal; and Ademola Oladipo, University of Ibadan. Funding/Support: Funding and support for this work came from the Office of the U.S. Global AIDS Coordinator (OGAC), the National Institutes of Health (NIH), and the Health Resources and Services Administration (HRSA). Other disclosures: None reported. Ethical approval: Reported as not applicable. Disclaimers: The content is solely the responsibility of the authors and does not necessarily represent the official views of OGAC, NIH, or HRSA. Previous presentation: University of Nairobi Collaborative meeting, January 2014.
The Ghana Emergency Medicine Collaborative Rockefeller A. Oteng, MD, and Peter Donkor, BDS, MS, MDSc
Background: A disproportionate percentage of the 5.8 million annual injury-related deaths occur in low- and middle-income countries because of poor emergency care.1,2 A deficit in the human resources for health infrastructure needed to address this issue is particularly acute in Sub-Saharan Africa. The authors report a process of introducing emergency medicine (EM) training programs in Ghana using funding from the Medical Education Partnership Initiative (MEPI).
Academic Medicine, Vol. 89, No. 8 / August Supplement 2014
References 1 Mullan F, Frehywot S, Omaswa F, Buch E. Medical schools in sub-Saharan Africa. Lancet. 2011;377:1113–1121. 2 Chankova S, Muchiri S, Kombe G. Health workforce attrition in the public sector in Kenya: A look at the reasons. Hum Resour Health. 2009;7:58.
Evolution of a Multiuniversity Monitoring and Evaluation Technical Working Group Francis J. Njiri, MSc, Mara J. Child, MPH, MPA, Gabrielle O’Malley, PhD, Sarah Baird, PhD, MS, Vincent Ojoome, MMed, Luke D. Davies, and James Kiarie, MMed, MPH
Background: Monitoring and evaluation (M&E) of large-scale government and donor investments is essential for tracking quality improvement, documenting lessons learned, and measuring returns on investment. M&E becomes particularly salient when interventions are also large in scale and unproven, as is the case with the Medical Education Partnership Initiative (MEPI). Through the Principal Investigators’ Council, MEPI institutions observed that many schools faced similar challenges in M&E and that there was a need for more collaboration across programs. In response, an M&E Technical Working Group (TWG) was established in 2012, more than two years after the onset of MEPI, to facilitate interaction across the 13 MEPI institutions. The TWG was composed of M&E leads from each school, with technical support from the MEPI Coordinating Center (George Washington University and the African Center for Global Health and Social Transformation), the University of Nairobi, and the University of Washington. Innovations: The M&E TWG leadership facilitated seven webinars starting
S110
in March 2013, during which each institution gave a 20-minute presentation describing the M&E activities. During the three months of the webinar series, it became clear that there was a need for in-person discussion and additional technical assistance to help move the M&E activities of MEPI forward. With support from the Office of the U.S. Global AIDS Coordinator, a two-day workshop was held in August 2013 with 39 M&E staff from 17 African and U.S. academic institutions. The objectives of the workshop were to build M&E skills and capacity, share experiences, identify MEPI evaluation needs, and develop a work plan for the M&E TWG. Cross-cutting themes for evaluation emerged, and a subgroup was formed for each of five themes: (1) retention of physicians in rural areas, (2) information communication technology and eLearning, (3) local innovation, (4) research and curriculum development, and (5) partnerships. Outcomes: Through the activities conducted by the M&E TWG, a number of observations have emerged. First, although almost all the institutions had functional program M&E strategies in place and monitoring was occurring, assessing the impact of the program was universally a challenge. Second, although each of the MEPI schools had its own individual work plans and unique activities, common cross-cutting topics were identified at the workshop and formed the basis for crossinstitutional evaluation of MEPI. Finally, a functioning M&E TWG is likely to be essential for optimizing the impact of the M&E activities of MEPI. Comment: The TWG was successful in garnering support across schools because of the buy-in and ownership generated via its participatory approach. The addition of the TWG to the coordinating center in support of evaluation activities increased the pace of knowledge sharing across the consortium. Nevertheless, challenges still remain, including lack of resources of the TWG lead institution (both financial and time), difficulty in coordinating across multiple sites in numerous countries and time zones, and the formation of the TWG two years into the duration of the grant. Working through these challenges over the remainder of the MEPI program will be vital. MEPI schools must continue to collaboratively assess the impact of the MEPI program and to disseminate this information to key stakeholders across the
continent to ensure that successful efforts are sustained beyond the funding period. Correspondence should be addressed to Mr. Njiri, PO Box 2431-00202, Nairobi, Kenya; e-mail: [email protected]. Author affiliations: F. Njiri, University of Nairobi; M. Child, G. O’Malley, L. Davies, University of Washington; S. Baird, George Washington University and University of Otago; V. Ojoome, African Centre for Global Health and Social Transformation; J. Kiarie, University of Nairobi Acknowledgments: The authors would like to thank the following for their contributions to this Short Report and to the TWG: Natalie Brogan, George Washington University; Kalay Moodley, Stellenbosch University; Moses Simuyemba, University of Zambia; Nadia Tagoe, Kwame Nkrumah University of Science and Technology; Rhona Baingana, Makerere University; Netsanet Animut, Addis Ababa University; Esther Lisasi, Kilimanjaro Christian Medical Centre; Kagiso Sebina, University of Botswana; Vanessa Vaila, Mozambique Institute for Health Education and Research; Shemiah Nyaude, University of Zimbabwe; Moise Muzigaba, University of KwaZulu-Natal; and Ademola Oladipo, University of Ibadan. Funding/Support: Funding and support for this work came from the Office of the U.S. Global AIDS Coordinator (OGAC), the National Institutes of Health (NIH), and the Health Resources and Services Administration (HRSA). Other disclosures: None reported. Ethical approval: Reported as not applicable. Disclaimers: The content is solely the responsibility of the authors and does not necessarily represent the official views of OGAC, NIH, or HRSA. Previous presentation: University of Nairobi Collaborative meeting, January 2014.
The Ghana Emergency Medicine Collaborative Rockefeller A. Oteng, MD, and Peter Donkor, BDS, MS, MDSc
Background: A disproportionate percentage of the 5.8 million annual injury-related deaths occur in low- and middle-income countries because of poor emergency care.1,2 A deficit in the human resources for health infrastructure needed to address this issue is particularly acute in Sub-Saharan Africa. The authors report a process of introducing emergency medicine (EM) training programs in Ghana using funding from the Medical Education Partnership Initiative (MEPI).
Academic Medicine, Vol. 89, No. 8 / August Supplement 2014
