Wednesday, December 15, 2010

Long Wait for More Competent Physicians, Nurses and Midwives Nears End

As was mentioned in the speech of Dr. Margaret Chan, WHO Director-General, at the WHO/PEPFAR consultation on transformative scale up of medical, nursing and midwifery education, the need for transformative change in the health care education has long been overdue. It’s enclosed in the opening remarks delivered by Dr. Chan, wherein emphasis was largely given to the huge disparity of physician-patient ratio as well as 20th century standard of education.

The long wait must be over, and it’s about time for effective reforms to become reality, not just in the developed and developing countries, more so in the poor lands where there is a greater need for practitioners wearing lab coats and scrubs uniforms. Sub-Saharan Africa is hit most hard by this problem, the places where there is also the greatest need for care because the disease burden in these places is also the greatest.

What could the educational reform for physicians, nurses and midwives do for Africa? The goal is to improve education for these groups of health care workers in order to bring the physician-to-population ratio, at least, in near balance for better health care. How to retain the products of such improved educational system is but another issue.

Currently, some of the new policies are already under way in Africa. Community-based education allows students to have hands-on experience in the community work. Schools also use problem-based and multi-disciplinary team-based learning. But such competency trainings remain short in matching priority domestic health needs. These problems are made more burdensome due to the low quality graduates that resulted from the weak systems in secondary education, not enough number of students can enroll in nursing and medical schools to wear their dreamed nurses uniforms. Many students who have the abilities and brain to pass face financial difficulty, further cutting the number of enrollees. Africa is also left far behind when it comes to information technology, putting the learning capacity of students in a very limited area.

Moving into the mainstream, overloaded work and low salary rate are the biggest blockages. The incentive program done by some companies is far from being enough in order to keep graduates in the sub-Sahara. For instance, the salary of a registered nurse working in for acute care is R120,216, which equals only to $17,634. An acute care nurse practitioner in the U.S., though, receives an average of 78,000 USD or 531,733 ZAR, the total amount of salary for almost four and a half months of an acute care RN in Africa. The difference is clearly huge. These problems are also the most probable reasons why many students, who go to Europe or North America for specialized post-graduate training, never return to serve the countries that invested in their basic trainings.

In her opening remarks, Dr. Chan mentioned about financial support and partnering of African schools with U.S. institutions, and the need to upgrade infrastructures and laboratories. Specific plans of the committee plans to help solve the problems in health care education in Africa and in other poor and vulnerable countries are yet to be revealed.