International Academy for Physician Assistant Educators Conference Birmingham Sept 2013

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Gerard Cole
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1 AFRICA NETWORK FOR ASSOCIATE CLINICIANS ``UNIVERSAL ACCESS TO HEALTH SERVICES`` International Academy for Physician Assistant Educators Conference Birmingham Sept 2013 DAVID LUSALE (BSc, MIH, MLP) REGIONAL DIRECTOR AFRICA NETWORK FOR ASSOCIATE CLINICIAN

2 ISSUES IN THE PRESENTATION Africa Network for Associate Clinicians (ANAC)- what is it? What is the membership for ANAC? What has happened during the 12months? Apportunities Challenges/threats Role Conclusion

3 AFRICA NETWORK FOR ASSOCIATE CLINICIANS (ANAC) - WHAT IS IT? ANAC is an African Regional Body that bring together associate clinicians through professional associations and training institutions formed in 2010 ANAC support the strengthening of the ACs profession through education, research regulation, and association-building as keys to improving access to health.

4 WHO ARE ASSOCIATE CLINICIANS (ACS)? Associate clinicians are professionals with formal training. They perform essential care at community and first level hospital that include surgery in some countries Their practice is regulated by their national or subnational regulatory authority. (WHO 2012)

6 WHAT IS THE MEMBERSHIP FOR ANAC? 11 member countries Professional Associations for Associate Clinicians Training Institutions

7 MAP OF AFRICA

8 WHAT HAS HAPPENED DURING THE 12 MONTHS? ANAC Membership increased from 7 to 11 Kenya, Uganda and South Africa joined o Country Activities Uganda ACs were organized and national committee is in place Tanzania and Malawi are also organizing ACs to form professional association Kenya Association to conduct study about ACs practice in Kenya Zambia Started degree program for Medical Licentiates Conducted research on Medical Licentiate Training in Zambia. To share report with other countries

9 CONTINUED South Sudan started training ACs at two training institutions and sent 8 students to train in Zambia (South to South cooperation) South Africa ACs association conducted community activities Hypertension screening and tree planting. Resolving prescription issues with regulators. Held joint annual conference and AGM with Rural doctors association and rural rehabilitation Association in Sept 2013

10 CONTINUED Secretariat level Organized regional meeting in Nov 2012 hosted by Tanzania. 33 members from member countries and partners attended. Some outcomes were; 1. adopted the ANAC strategic plan 2. resolved to develop the constitution for ANAC 3. to strengthen the secretariat by employing a full time program officer 4. Continue the membership drive (Rwanda contacted) 5. Continue networking south to south and south to north (Zambia had a study visit to Tanzania)

11 OPPORTUNITIES Training Institutions worked on curriculum improvements degree programs for Tanzania, Zambia Academic staff exchanged visits. university of Pritoria staff visited Malawi) Chainama college staff visited Ifakara internl training centre - Tanzania

12 OPPORTUNITIES Studies conducted in Tanzania, Malawi, Mozambique, Zambia and Ethiopia have shown that ACs do effectively deliver quality health services in medicine and essential surgery including lifesaving maternal and neonatal care (Cumbi, et al 2007, Pereira, et al 2010) AC members are vehicles to improved access to health services in africa. East Central Southern Africa Ministrial Committee recognises the vital role of ANAC to health delivery (Sept 2013)

13 CASE STORY OF IMPROVED ACCESS: MEDICAL LICENTIATE PRACTITIONERS IN ZAMBIA - BACKGROUND o 1990 Severe shortage of doctors more than 1000 missing. Less than 800 were available. o Produced less than 100 medical school graduates per year o 30% of rural health facilities run by unqualified staff (MoH, 2010) Available Required

14 MAL-DISTRIBUTED AND MISSING 2010: DOCTORS IN ZAMBIA Provincial Distribution of Doctors in Zambia 40-50% are in the capital & copperbelt

15 MEDICAL LICENTIATE PRACTITIONERS TRAINING STARTED IN DISTRIBUTION 14 Provincial Distribution of trained MLPs MLPs in the right places, stay long with improved pt access..

16 VEHICLES TO UNIVERSAL ACCESS TO HEALTH CARE IN AFRICA Vehicles Improved access Policy (Political will) Education Regulation Professional Associations

17 THREATS TO ASSOCIATE CLINICIANS PROFESSION Policy about ACs Training and Practice is unresolved (some countries) Regulation of Practice is unresolved in some countries ACs remunerations and other conditions are poor affects morale, retention, job satisfaction ACs associations are young, inadequate capacity and resources to address/resolve most issues that affect them

18 IAPAE ROLE Beyond IAPAE bussiness; To advocate for ACs quality training, To advocate responsive regulation for ACs

19 UPCOMING ANAC EVENTS ANAC Regional meeting in Malawi 17 21st Nov 2013

20 CONCLUSSION ANAC through the Associate Clinicians continue to contribute to universal access to health care in Africa and globaly. Benefits Referals reduce, access to quality care improves Morbidity, Mortality and other costs reduces (Gambia, Mozambique, Zambia)

21 Universal access to health is a Human Right ANAC For more info;

Implementation Guidance Note

Implementation Guidance Note American College of Nurse-Midwives (ACNM) Averting Maternal Death and Disability (AMDD) Program Chainama College of Health Sciences (CCHS) College of Medicine, Malawi (COM)