Development of a comprehensive and sustainable gynecologic oncology training program in western Kenya, a low resource setting

Abstract

To provide information on the development of a gynecologic oncology training program in a low-resource setting in Kenya.This is a review of a collaboration between Kenyan and North American physicians who worked together to develop a gynecologic oncology training in Kenya. We review the published data on the increase of cancer incidence in sub-Saharan Africa and outline the steps that were taken to develop this program.The incidence of cervical cancer in Kenya is very high and is the leading cause of cancer mortality in Kenya. WHO identifies cancer as a new epidemic affecting countries in sub-Saharan Africa. In Kenya, a country of 45 million, there is limited resources to diagnose and treat cancer. In 2009 in western Kenya, at Moi University there was no strategy to manage oncology in the Reproductive Health department. There was only 1 gynecologic oncologists in Kenya in 2009. A collaboration between Canadian and Kenya physicians resulted in development of a gynecologic oncology clinical program and initiation of fellowship training in Kenya. In the past 4 years, five fellows have graduated from a 2 year fellowship training program. Integration of data collection on all the patients as part of this program provided opportunities to do clinical research and to acquire peer reviewed grants.This is the first recognized fellowship training program in sub-Saharan Africa outside of South Africa. It is an example of a collaborative effort to improve women's health in a low-resource country. This is a Kenyan managed program through Moi University. These subspecialty trained doctors will also provide advice that will shape health care policy and provide sustainable expertise for women diagnosed with a gynecologic cancer.

Collaborations in gynecologic oncology education and research in low- and middle- income countries: Current status, barriers and opportunities

“…In order to make meaningful changes, well-organized education and training for gynecologists in LMIC is urgently needed. Examples of such initiatives include the successful implementation of a curriculum for resident education based on the Council for Resident Education in Obstetrics and Gynecology (CREOG) residents in Central America ( Schmeler et al, 2013 ), the training of physicians by The Society of Gynecologic Oncology of Canada to perform radical hysterectomy for women with cervical cancers through a teaching module in Kenya( Rosen et al, 2017 ), and a collaborative effort between the Society of Gynecologic Oncology (SGO), American Society of Clinical Oncology (ASCO) and Health Volunteers Overseas (HVO) in the development of education and surgical training in Honduras and Vietnam ( Chuang et al, 2014 ). This paper describes the efforts focused on improving women's cancer care outcomes through education, training and research that are carried out by major organizations around the world.…”

Training pediatric hematologist/oncologists for capacity building in Ethiopia

“…Subspecialty oncology training programs in LMIC remain a recent development 17 and specific attempts at PHO training are just beginning 29,30 . Modern pediatric oncology care requires myriad robust systems to be in place.…”

“…Experiential training blocks included 18 months of PHO service in Ethiopia with inpatient, outpatient, and consultation responsibilities. To augment onsite training by visiting faculty, we sponsored fellows for a 6‐month attachment at a high‐functioning cancer institution in a middle‐income country and, as noted, the support of full‐time onsite clinical faculty/mentorship for the early stages of the TASH and JUMC programs 15–17 . We initially attempted to supplement onsite training through a tele‐lecture series, but use of that tool was not feasible due to poor internet access.…”

Challenges and opportunities in the creation and implementation of cancer control plans in Africa

“…There is growing momentum among medical schools and universities in Africa to develop specialised oncology-related diploma courses and fellowships [22, 23]. While this is a positive development, the impact of these training programmes will take time to be reflected in the cancer workforce and improved timeliness and outcomes of cancer treatment.…”