Reaping MEPI Investments: Post award sustainability in Research,

ICT and Health EducationProf JG Hakim FRCP, DSc(HC), PGDipHPE

University of ZimbabweAFREhealth Symposium, Durban, 7 Aug 2018

Outline

• Brief Description of MEPI programmes in Zimbabwe (2010-2015)

• Sustainability of programmes– Department of Health Professions Education– Research Support Centre– Partnerships– Competitive awards

• Challenges• Conclusions

MEPI in Zimbabwe-NECTAR

• Programmatic Award– NECTAR-Novel Education Clinical Trainees And Researchers

programme

• Linked Awards– CHRIS-Cerebrovascular, Heart failure, Rheumatic heart disease

Interventions Strategy– IMHERZ-Improving Mental Health Education and Research in

Zimbabwe

Objectives of MEPI/NECTAR

• Objectives– Capacity

• Quantity & Quality of Health professions education

– Retention• Retention where they are most needed-faculty/rural areas

– Regionally relevant research– Ensure sustainability of MEPI programmes

PARTNERSHIPS

UZCHS

UCD

UCT

UZCHS

SU

UCD

UZCHS

UCLIoPBU

UCT

NECTAR

IMHERZ

CHRIS

UZCHS-University of Zimbabwe College of Health SciencesUCD-University of Colorado, DenverSU-Stanford UniversityUCL- University College London; IoP-Institute of PsychiatryUCT-University of Cape Town BU-Bristol University

Interdisciplinary Implementation of NECTAR Programmes

Medicine Dentistry Pharmacy Nursing Rehab Lab Sciences

NECTAR Programmatic Activities

Improvement of Quality HPE

Research Capacity Strengthening

ICT, Libraries & eLearning

Community-based Education

Partnerships-Local & External

Monitoring & Evaluation

Research Support Centre/Services

• Established in 2010– UZCHS, MEPI, SACORE, NACCAP– Director & staff appointed

• Activities– Research methodology courses– Grants administration management– Research information dissemination– Research policy– Research Admin handbook in

development

• Achievements– 88% of faculty & students access

pre & post award services

• RSC Building construction completed in April 2013

Department of Health Professions Education

• Established in Mar 2013• Space renovated• Allocated chair & staff

– Chair appointed– Support staff appointed– Part time teaching staff from other

departments

• Challenge– Identification of dedicated staff

Monitoring & Evaluation

• Partnership of UCD & NECTAR evaluators

• Build capacity at UZCHS• Conduct surveys & other

activities• Produce comprehensive reports

Acad Med 2016

Sustainability

• Embed activities in the Curriculum and core activities and financing of UZ & UZCHS

• UZ faculty members to continue to compete for individual and institutional grants

• Maintain & enhance partnerships – Established and New

UZ Leadership & Faculty Engagement

Health Professions Education Enhancements

DHPE

MCSP

FDW

HEALZ

Mentored ClinicalScholars Program

Health EducationAdvanced LeadershipFor Zimbabwe Pgm

Faculty DevelopmentWorkshops

Department of Health

Professions Education

Research Capacity Strengthening

RSC

MRSP

RMW

CRM

Mentored ResearchScholars Program

Research Methodology Workshops

Centralized ResearchManagement Office

ResearchSupport Centre

Stroke Unit-Ward C7

• Established in 2013• Protocols developed• Training of staff• Database established• More than 2000 patients

admitted to the unit by 2017

Cardiac Training & Research Laboratory• Tests

– ECG, Treadmill stress– Echocardiography (+TEE)– Holter monitoring

• Services– Cardiac clinic– Pacemaker implantation– Bronchoscopy

• Research– RHD survey, AF, PPCM, Stroke,

Arrhythmias, COAD

Research Scholars & Faculty

• Mentored Research Scholars Program– 95 fellows/scholars

• 33 undergraduate scholars – 52 CHRIS and – 12 IMHERZ

– Of the 52 CHRIS and 12 IMHERZ fellows– 11 have joined faculty in the departments of Medicine, Paediatrics and

Psychiatry while the rest have now joined the MOH as specialists – All have remained in the country except for 1 who left the country – Applications for the MMed postgraduate training has risen from 123 in

2009 to 210 in 2015– There have been 53 publications in referenced journals

Bidirectional Exchange Programme Residents & Faculty

Year UCDenver

Stanford Univ

Total

2015 4 4 8

2016 13 5 18

2017 7 4 11

2018 7 2 9

TOTAL 31 15 46

• Fully sponsored by partner institutions

• Assists in sustaining specialist training

• Avails Research Mentorship opportunities

ICT

• The Promoting Research through ICT excellence program (2015-2018)-PRICE– RedCAP (Research Electronic Data Capture)– Advanced EXCEL– EPI INFO– R Statistical software– GWAS

Challenges

• Funding needed:– DHPE and RSC to fully implement their strategic plans– ICT equipment maintenance and replacement– New academic programs and initiatives

• Limited opportunities for local training in some specialist areas

Conclusion

• The MEPI award has been a game changer at the UZCHS

• MEPI enabled establishment of a robust health professions education and research capacity foundation

• The UZ and MEPI Programme leaders proactively established structures and synergies which have enabled sustainability of many projects

• Partnerships are important allies in sustainably– Mutual respect and mutual benefit are critical for a

successful collaboration • Competitive awards-PERFECT, Clayton Dedonder

Lancet Global Health 2017, e143

Global Health Science & Practice 2018;6;82

Acad Med 2014;89:589

Acknowledgements• PEPFAR/NIH• University of Zimbabwe

– Prof L Nyagura-Vice Chancellor

• UZCHS– Prof Masanganise-Dean– Prof Chidzonga-Former Dean

• NECTAR/CHRIS/IMHERZ Executive– Thomas Campbell– Michele Barry– Edward Havranek– Frances Cowan– Melanie Abas– Sekai Nhiwatiwa

• UCD & UZ Evaluations Centre– Susan Connors– Bonnie Walters– Simbarashe Rusakaniko

• NECTAR Secretariat• Information Communication Tech

– Tungamirai Simbini

• Curriculum Committee Co-chairs– Godfrey Muguti– Christopher Samkange– Eva Aagaard– Bonnie Maldonado

• Mentored Clinical Scholars Program– Kusum Nathoo– Margaret Borok– Nancy Madinger

• Mentored Research Scholars Program– Mike Chirenje– Tsungai Chipato– David Katzenstein

• Faculty Development Program– Eva Aagaard– Midion Chidzonga

• Visiting Professors Program– Jonathan Matenga

Thank You