TRAINING PROGRAMS IN COOPERATION PROJECTS
Challenges of capacity buildingBesim Nuri
Unité de Santé Internationale CHUM/Université de Montréal
The need for training in developing countriesIn Sub-Saharan Africa:
Only 4% of medical schools (64 out of 1642)21 countries had 1 medical school and 6 countries had
none;Half of the African countries – no graduate program in
public health173 800 young doctors graduate each year in Europe
versus 5100 in AfricaCurricula misaligned with countries health problems;
outdated pedagogical methods, excluding practical problem-solving skills;
Few health leadership and management programs Major gaps in continuing education Human Resources for Health. Overcoming the crisis. Joint Learning
Initiative, 2004
Proposed strategies- Joint Learning Initiative, 2004 Enhancing competencies by educating for appropriate skills
Fostering leadership and entrepreneurship
Training for continual learning
Training programs in cooperation projects – an engine for capacity building?Academic institutions (universities, schools,
institutes, centers…)Health service organizations (health centers,
hospitals, clinics, etc.)Sub-systems (PHC, HRH, MIS etc.)
Unité de Santé Internationale - UdeM20 ans de partenariats pour la santé dans le monde
Population and Health Program in Africa, 2003-2013, 11 million $ US, Gates Foundation
Support to Health Management capacities in Haiti (PARC), 2006-2011, 15 million $C, CIDA
Professional Development System in Albania, Phase 1 - 2007-2010, 2,7 milion SFr, Swiss Cooperation
Capacity building at academic levelGraduate and post-graduate training programs
Develop curriculum and content Professor/teachers/trainersInstitutional challengesTeaching materials and access to informationFinancial resources to ensure sustainability
Training programs: why their impact is sometimes limited?Problems related with training needs
assessmentTraditional training courses and pedagogical
methods Lack of support systems Enabling working conditions (salaries,
motivation etc.)
Challenges of implementationImplementation of knowledge and skills: problems
Training Program in Health Planning and Management in Albania, 2005-2008
Frequent turn-over of directors and decision-makers
Political influence versus merit-based appointments
Autonomy of health services not yet implemented in practice
Not all members of health teams are trained
Culture of health sector organizations doesn’t allow personal initiative
Leadership and Management in health systemshttp://www.who.int/management/strengthen/en/index.html
Systemic capacity buildingCh.Potter and R. Brough, Health Policy and planning, 19(5), 2004
Systemic capacity buildingCh.Potter and R. Brough, Health Policy and planning, 19(5), 2004
Strengthening Health Management Capacities in Haiti Conceptual framework of the project PARC (2006-2011)
HUMAN CAPITAL
PersonnalitYQualities
Basic éducation etc.
Individual capabilities Knowledge and skills
CAPACITY
Personal(know-how)
CAPACITY
Organiz.
CAPACITIY
System
Performance of peoplePerformance
of organizations
Performance of the system
Internal end external factors with an impact on HRH : - Governance -
- skills and appropriate use of HRH - - availability of resources -
Learning and continuing education
NEEDS TO STRENGTHEN/BUILD/DEVELOP
PERFORMANCE
Beneficiaries: project PARC, Haiti
Individuals: managers and
professionals attending training programs (graduate diploma and Masters)
Central level decision-makers, mostly in the area of HRH
Organizations: Academic Health services
Health system (MoH, health departments, etc.)
PDS Project in Albania, 2007-2010Schematic view
Certification of health
workforce
Centre of Cont. Education Universities
Schools
Training org.
Planning, organizing,
implementing, financing
Training programs
Quality of health services and
performance of health system
Accreditation of programs
Summary of ideas…Training programs through cooperation
project – an engine for capacity building:Personal capacitiesCapacities of academic institutions -
sustainabilityTraining can have an impact on health
organizations’ capacities when combined with other interventions
Support to build/improve structures and processes in order to enhance the impact of training/education programs
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