The Development of Sustainable Emergency Care in Ghana: Physician, Nursing and Prehospital Care Training Initiatives

Abstract

Background Ghana’s first Emergency Medicine residency and nursing training programs were initiated in 2009 and 2010, respectively, at Komfo Anokye Teaching Hospital in the city of Kumasi in association with Kwame Nkrumah University of Science and Technology and the Universities of Michigan and Utah. In addition, the National Ambulance Service was commissioned initially in 2004 and has developed to include both prehospital transport services in all regions of the country and Emergency Medical Technician training. Over a decade of domestic and international partnership has focused on making improvements in emergency care at a variety of institutional levels, culminating in the establishment of comprehensive emergency care training programs. Objective We describe the history and status of novel post-graduate emergency physician, nurse and prehospital provider training programs as well as the prospect of creating a board certification process and formal continuing education program for practicing emergency physicians. Discussion Significant strides have been made in the development of emergency care and training in Ghana over the last decade, resulting in the first group of Specialist level EM physicians as of late 2012, as well as development of accredited emergency nursing curricula and continued expansion of a national EMS. Conclusion This work represents a significant move toward in-country development of sustainable, interdisciplinary, team-based emergency provider training programs designed to retain skilled healthcare workers in Ghana and may serve as a model for similar developing nations.

Postgraduate Medical Education in Sub-Saharan Africa: A Scoping Review Spanning 26 Years and Lessons Learned

“…71 Another challenge leading to suboptimal training were medical students, who overwhelmed local clinical capacity, and thus limited PGME trainee access to procedures. 11,[78][79][80] Resident Recruitment, Support, and Well-Being: A number of programs reflected on factors that influenced recruitment to their specialty such as perceived workload, quality of life, unpredictability of training duration, and unclear path to licensure. 71,[81][82][83][84] Several publications reported residents experienced high rates of stress and fatigue related to their considerable workload.…”

“…19,42,44,[98][99][100] Newer Specialties Face Unique Challenges Family medicine and emergency medicine services were evolving specialties in the PGME literature from Sub-Saharan Africa, and programs described efforts to garner support from the public, policy makers, regulators, and governments to understand the scope of practice in these specialties and ensure career paths for graduates. 11,48,64,66,[101][102][103][104][105][106][107] Programs discussed the need for international partners to help train an initial critical mass of specialists, including faculty, and ensure that curricula prepared graduates to serve as leaders, teachers, and supervisors in these disciplines. 11,48,[64][65][66]108,109 Resources and Financing of PGME Programs reported on suboptimal resources for training, including accommodations, transportation, electricity, safe drinking water, and access to good quality food.…”

“…[7][8][9][10] PGME positions in the region are sponsored by governments, district hospitals or rural hospitals, or trainees may be self-sponsored. 11,12 Most programs are affiliated with universities that confer a Master of Medicine degree. Some programs are affiliated to a regional body such as the West African College of Surgeons (WACS) or the College of East, Central, and Southern African Surgeons (COSECSA).…”

Consensus recommendations for essential vascular care in low- and middle-income countries

“…61,62 Given the increasing burdens of injury and vascular conditions, the education systems and task-sharing programs must adapt their curriculum to the needs of the population. 63–65 In addition, continuing vascular care education of existing providers should be incorporated into graduate and other levels of training modules.…”

Pioneering small-group learning in Tanzanian emergency medicine: Investigating acceptability for physician learners

“…[3] A follow-up survey from the EM programme in Ghana highlighted the need for region-specific medical knowledge to enhance training curricula. [4] Many of the EM curricula used in African training programmes were based on models from prior established residency programmes in North America, Europe, and Australia. These curricula consisted of multimodal approaches to learning, with the use of small-group learning (SGL), including case-based seminars, simulation training, and procedure-based skills labs to supplement traditional didactic lectures.…”