Strengthening health systems in Africa: a case study of the Kenya field epidemiology training program for local frontline health workers

Abstract

The logistical and operational challenges to improve public health practice capacity across Africa are well documented. This report describes Kenya’s Field Epidemiology and Laboratory Training Program’s (KFELTP) experience in implementing frontline public health worker training to transfer knowledge and practical skills that help strengthen their abilities to detect, document, respond to, and report unusual health events.Between May 2014 and May 2015, KFELTP hosted five training courses across the country to address practice gaps among local public health workers. Participants completed a 10-week process: two 1-week didactic courses, a 7-week field project, and a final 1-week course to present and defend the findings of their field project. The first year was a pilot period to determine whether the program could fit into the existing 2-year KFELTP model and whether this frontline-level training would have an impact on local practice. At the end of the first year, KFELTP certified 167 frontline health workers in field epidemiology and data management. This paper concludes that local, national, and international partnerships are critical for improving local public health response capacity and workforce development training in an African setting.

Addressing the workforce capacity for public health surveillance through field epidemiology and laboratory training program: the need for balanced enhanced skill mix and distribution, a case study from Tanzania

“…Most of TFELTP trainees were observed to be clinicians, laboratory scientists and environmental health officers. Similar tendency has been seen in other FETPs including Kenya [ 26 ], Jordan [ 27 ], India [ 7 ] and many more including EIS [ 11 ]. Nevertheless, effective implementation of surveillance activities requires strength in all surveillance components including detection, diagnosis, treatment, laboratory investigation and reporting, utilizing the information (for evidence-based decision) [ 23 ], which demand expertise from other disciplines.…”

“…This pattern might be driven by selection criteria, (original) requirements (e.g. qualification with a Bachelor´s degree which was not always available in some professions) and national priorities, on the other hand, poor awareness of the benefits of such a training to other disciplines might be a contributing factor [ 26 , 28 ]. As the program grows and considering surveillance technical demands and capacity requirements at the subnational level, there is a need to establish strategies to improve awareness through sharing successes and lessons learned to create demand.…”

“…That being the case, it is important for the program to monitor such patterns and make strategies to reach applicants from remote regions, newly introduced regions, regions with financial hardships, with poor connectivity and those that have not been covered at all [ 4 , 26 ]. On the other hand, deliberate recruitment of national level staff may be done to strengthen the central unit, nevertheless, decentralization of responsibilities, skills and capacities at sublevels is vastly needed [ 26 ]. Impact and importance of skill mix in clinical outcomes have been studied by a number of scholars [ 29 - 32 ].…”

“…Within 8-years of the TFELTP, our analyses observed gaps in enhanced-skill mix in more than half of the regions indicating a slow rate in filling complete skill mix throughout the country. Tailored strategies such as introduction of short-term training frontline public health workers might fill the observed gap [ 12 , 26 , 35 ]. In addition, there is a need to establish financial support from local sources (regions and districts health budget) for those interested to join the course.…”

Impact Evaluation of the Kenya Frontline Field Epidemiology Training Program

“…Strengthened health systems played a key role in the rise in global life expectancy that occurred throughout the 20th century [Roka et al, 2017]. The health workforce is the backbone of each health system, which facilitates the smooth implementation of health action for sustainable socio-economic development [Jones et al, 2017].…”