Evaluating a ten years training  course in child psychiatry in Jimma, South-West Ethiopia

Abstract

Background: In Ethiopia, as many other low-and middle income-countries, health professionals, particularly of mental health workers are scarce. The purpose of this paper is therefore to describe the process of developing, establishing and evaluating a training course for child psychiatry within this program.Method: Cooperation between local and foreign institutions and instructors used to offer the course in child psychiatry between 2010 and 2019. The core elements of the course were to train mental state description from locally produced video examples, make decisions on possible disorders, do occupational activities and design psychosocial interventions. Patient-oriented method of teaching was implemented. The basic structures of course development were a phase of preparation, a focus on case presentations during the course, mutual feedback and evaluation, and a workup after the course. The concept in the method of teaching was adapted in an iterative process according to the needs of patients and evaluations of participants and teachers overtime. Results: From 2010 to 2019 eight courses were organized. A total of 71 trainees took part in the courses successfully. The initial step was to establish collaboration with guest lecturers and implementation of the teaching program. Each course contributed to expand the course materials subsequently. Main modifications were to elaborate on the mental state description successively to get a feeling for children's’ problems by age and severity. The second period was a phase of transition from guest lecturers to local trainers. At the request of graduates, a refresher course was held in 2017. Relying on an OSCE format, clinical abilities could be updated within one weekend. Capacity building was a major aim of the program. Three graduates developed to be trainers in child mental health and they subsequently continued the course on their own. Alongside the teaching program, an outpatient clinical service for children established by the lead author is now running at Jimma University.Conclusion: The establishment of the training program was time consuming. The long-term commitment of local and guest teachers enabled them to develop culturally appropriate solutions for the local context. A similar approach could be applied to other settings.