Besim Nuri Unité de Santé Internationale CHUM/Université de Montréal

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outdated pedagogical methods, excluding practical problem-solving skills;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