Global Health Service Partnership: building health professional leadership.

Shortages of nurses, doctors, and health professionals in resource-poor countries challenge the success of many health initiatives and health-system strengthening. In many of these countries, medical and nursing schools are few and severely short of faculty, limiting their capacity to scale-up and increase the number of skilled graduates and professionals to support the health system. In an eff ort to address this problem, the US Peace Corps has partnered with Seed Global Health, a non-profi t organisation with expertise in education for health professions, to launch an innovative new programme that sends faculty to medical and nursing schools in under-resourced settings. The programme, called the Global Health Service Partnership, placed 31 American clinical faculty—dedicated educators— in medical and nursing schools in Tanzania, Uganda, and Malawi in July, 2013. In collaboration with the schools, the partnership hopes to help to train new health professionals and to retain those already working. It is partly funded by the President’s Emergency Plan For AIDS Relief and is augmented by private philanthropy. The programme is expected to increase the numbers of faculty they place in medical and nursing schools, the countries involved, and the health disciplines included. The Global Health Service Partnership is a targeted response to a well documented and tenacious global crisis in global health workforce that was dramatically exacerbated by the HIV/AIDS pandemic in many parts of the world. Recent eff orts to stem pandemics such as those of HIV and malaria, have helped to uncover an underlying, but profound issue; too few health professionals are available to tackle the health needs of populations in which disease burden is highest. Additionally, trained professionals from a mix of specialties are needed to address the long-term health needs of a country. A two-fold approach is needed to address these problems: more professionals should be trained and more should practice where the health problems are most pronounced. National governments, donors, and health leaders now understand that the health-care workforce is crucial to strengthen health systems, deliver care, tackle epidemics such as HIV, and address the rapidly growing challenges for chronic disease management. The President’s Emergency Plan For AIDS Relief includes a focus on training new healthcare workers, as do the plans of several other countries responding to the same concern. For example, Ethiopia has substantially increased the numbers of health profession schools and students. The Malawi Government has devoted substantial proportions of their national health budget to its health workforce, and Mozambique has opened two new medical schools, which will eventually triple the number of medical graduates. Expansion of human resources will not only need increased numbers of staff , but also an appropriate mix of health professionals and their specialties. A recent report from South Sudan outlined a full range of national specialty needs, showing the absence of advanced medical training in the country. In recognition, countries are increasingly working to develop more specifi c train ing for clinical expertise and leadership. Shortage of faculty in many resource-poor settings limits their ability to expand education, graduate basic medical and nurse clinicians, and to produce specialists and health system leaders. This shortcoming has been shown by a recent commission of professional medical education, which noted that health professional education has faltered because of burgeoning health challenges, and that faculty are essential to the investment of future health dividends through training of the next generation of health professionals. Sustainability and selfsuffi ciency of a country’s health systems will depend on building a pipeline of new doctors and nurses trained to continue teaching of future generations. But faculty and specialist shortages in resource-poor settings are exacerbated by emigration of graduates to countries in North America, Europe, and the Gulf region. In addition to job insecurity, safety, and low salaries, emigration is aff ected by large teaching loads, lack of professional development opportunities, and scarce career options. Any meaning ful response to increase health leadership and promote a sustainable pipeline of highly trained phys icians, nurses, and other health professionals will need broad investments in professional opportunity and faculty. The Global Health Service Partnership support for African health professional faculties is intended to improve the educational environments of medical and nursing schools. Improvements in degree training for nurses and basic and post-graduate training for medical doctors will help to address the ubiquitous need for more practitioners and faculty. Global Health Service Partnership doctors and nurses will bring with them experiences and links that can be of assistance to colleagues in host countries, such as innovative teaching methods, clinical guidelines, treatment protocols, and interprofessional collaboration. The Global Health Service Partnership aims to contribute to a pipeline of health professionals that are invested in the health education systems of their countries and focused on the disease burden aff ecting their population. After a review of factors, including the capacity of Peace Corps posts, other partners in the countries, and the interest and commitment of host governments, the Published Online December 18, 2014 http://dx.doi.org/10.1016/ S0140-6736(13)61683-9