Developing Epidemiology Workforce Through FELTP as Critical Needs for Networks : Lessons Learned and Next Steps. Dr Patrick M Nguku

Transcription

1 Developing Epidemiology Workforce Through FELTP as Critical Needs for Networks : Lessons Learned and Next Steps Dr Patrick M Nguku 1

2 Field Epidemiology & Laboratory Training Program (FELTP) Closely supervised competency-based training US CDC Epidemic Intelligence Service (EIS) Pyramidal approach Two year full-time postgraduate training Intermediate and frontline Other modular /thematic approaches About 25% class work, 75% field placement May receive a certificate or a degree Aims at developing public health systems 2

3 Frontline Field Epidemiology Targets surveillance officers at district level Aims at improving surveillance, investigation, data analysis and use Supports IDSR /IHR capacities

4 Public health system Workforce Culture FELTP Systems Institutions

5 Requirements of an Effective Surveillance Surveillance is the backbone of disease control Prerequisite for success of implementation: Well trained network of motivated staff Clear standardized guidelines and tools Networked and functional laboratory Communication means Rapid response and feedback Sustainable funding 5

6 Competencies Required to Operate an Integrated Disease Surveillance and Response System Source Perry et al, BMC Medicine, 2007

7 FELTP in Africa Over 1500 trained or in training in 16 countries Support to IDSR /IHR Multi-disease surveillance Response to numerous outbreaks Research Networking AFENET One health Disease specific HIV Polio Ebola Noncommunicable 7

8 African Field Epidemiology Network (AFENET) A non-profit organization and networking alliance dedicated to helping Ministries of Health in Africa build strong, effective and sustainable programs and capacity to improve public health systems Network of Field Epidemiology and Laboratory Training Programs (FELTPs) in Africa Vision A healthier Africa Mission Committed to ensuring effective prevention and control of epidemics and other priority public health problems in Africa Objective To strengthen field epidemiology and public health laboratory capacity and, effectively contribute to addressing epidemics and other major public health problems in Africa 8

9 AFENET s Footprint 2016 Operations in 30 African countries including; Anglophone, Francophone and Lusophone countries FE(L)TPs in Africa 1. Advanced FELTPs: 16 Field Epidemiology Programs Angola, Central Africa, DRC, Ethiopia, Ghana, Kenya, Mozambique, Nigeria, Namibia, Rwanda, South Africa, Tanzania, Uganda, West Africa, Zambia, Zimbabwe 9

10 AFENET s Footprint Frontline FETPs Benin, *Burkina Faso, *Cameroon, Cote d Ivoire, *DRC, Gambia, Guinea, Guinea Bissau, *Kenya, Mali, Mauritania, *Nigeria, Senegal, Sierra Leone, *South Africa, *Tanzania, Togo, and *Uganda *Countries with established FELTPs 10

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12 Paradigm shift Training based service to service based training 12

13 Enumeration outreach among underserved, Aug 12- April 15 No. LGAs visited Total settlements visited U5yrs children enumerated U5yrs children missed previous IPD (%) Zero-dose U5yrs children (%) ,642, ,500 (8.5) (6.1) 13

14 FELTP Support to HIV Service Delivery Data quality assessment & improvement In-depth site level assessment for quality and accuracy of data collection and reporting Facility level data validation Data quality improvement plan HIV Impact Assessment at sub-national Describe the HIV epidemic; assess the access to, use of and impact of ART, PMTCT, and HIV Measure HIV-related risk behaviors ART outcome evaluations PMTCT cascade evaluation 14

15 Tropical Diseases r/foo d Zoonoses/VHF Vaccine Preventable Enviroment al Outbreak investigation & response activities of the NFELTP: (N=243) Buruli ulcer Leishmaniasis Schistosomiasis Ebola Dengue Fever Leptospirosis Trypanosomiasis Lassa Fever Rabies Cholera Hepatitis Meningococcal Meningitis Mumps Diptheria Acute Flaccid Paralysis Measles Lead Poisoning Methanol poisoning Chlorine poisoning Diethylene Glycol Reduced response time Containment Less number of cases/deaths 55 63

16 Noncommunicable diseases and injuries STEPwise approach to noncommunicable disease risk factor surveillance (STEPS) Questionnaire Physical measurements Biochemical measurements Road traffic injuries 16

17 Dec 2006 Sept 2010 Mar 2012 Jan 2006 Aug 2008 Aug 2011 Oct 2012 Formation of National Influenza Taskforce (NIT) in response to global H5N1 threat ZTWG starts quarterly meeting MOU signed to form ZDU Official opening of ZDU and launch of OH Strategic Plan NIT Responded to RVF outbreak as RVF Task Force NIT Renamed ZTWG Epidemiologists from MoH & MALF deployed to ZDU Multi-sectoral workshop to discuss formation of OH Office 17

18 Environmental Health Disasters

19 Key Lessons Learned Epidemiology workforce development has to be integrated within the existing public health system Relevant to existing public health challenges Within existing national HRH plans Service/needs driven Multi-disciplinary / multi-sectoral approach Deliberate efforts to cover all sub-national levels number per population or administrative unit Database, networking, quality / accreditation Supportive public health structure retention, deployment, tools for working, technology

20 Use of data to guide interventions that benefit populations more efficiently is precision public health. 1. Register births and deaths- civil registration, vital statistics, mortality surveillance 2. Track diseases IHR framework 3. Incorporate laboratory analysis 4. Competent skilled workforce