Slide 2 Use of Web conferencing to deliver Continuing Medical
Education(CME), in resource constrained settings. Peter Mwaura-
Health informatics fellow Slide 3 Goal of the project The goal of
the proposed project in Kenya is to ensure coverage, equity, and
quality of care. Coverage gap is defined as difference between
current coverage and universal coverage. Equity gap is defined as
differences in access to coverage of the CMEs between the urban and
rural health workers Quality gap is defined as difference between
providing the standardized CME package and provision of effective
client friendly services Slide 4 Past experiences Continuing
medical education (CME) refers to a specific form of education that
helps those in the medical field maintain competence and learn
about new and developing areas of their field e.g. HIV guidelines
have typically evolved rapidly hence need for continued update.
These activities may take place as live events, written
publications, online programs, audio, video, or other electronic
media. In Kenya, CME activities are falling behind and cannot keep
up with the demand. Moreover, current paper and workshop based
approaches are quite inefficient and costly, CME in Kenya are
supported by big pharmaceutical companies which is not a
sustainable approach Slide 5 The CME are poorly coordinated, supply
driven, and that the content of the information and learning
provided is frequently not relevant to the diverse needs of todays
rural health care workers. The motivations and incentives of the
health workers to participate in CME efforts have been queried
Classroom learning reached many health workers rapidly but training
became diluted as it cascaded down the system. Slide 6 Classroom
teaching assumes a deficit in knowledge and not skills. In practice
there deficiencies in basic skills that are further aggravated by
task shifting. Eg. WHO staging assumes skills in clinical
examination and diagnosis. This is not a core skills in nursing
training. Re-deployment of staff results in loss of skills in the
institution Slide 7 Web conferencing bridges the gap Web
conferencing is one of the most revolutionary development in
communications technology, and has greatly influenced the way
businesses work. Web conferencing facilitates effective
communication while reducing infrastructure costs. Web conferencing
cuts down on travel expenses and time. Since the health workers who
are deployed at the rural areas do not move from their health
facilities hence, can save considerable amounts of money. It also
saves precious time, which can be utilized for other works and
increase productivity. Its is easy to standardized and coordinating
CMEs With the advent of high-speed broadband and wireless networks,
Web conferencing has become more efficient. Slide 8 Challenges in
implementing web based CMEs Based on the some peer reviewed
publication web conference has been used in developed countries, to
deliver CMEs, but there are challenges Connectivity problems Health
worker not willing to take up change Infrastructure issues Slide 9
literature review Web conference has been proved to has successful
been used in developed countries (Markova T, Roth LM), Curran V,
Lockyer J, Sargeant J, Fleet L) to deliver CMEs.Markova TRoth LM In
a baseline not yet published, on the acceptability of e- learning
in Central province in Kenya, the following were noted, 73.2% of
the health workers interviewed had access to the computer. The
confidence level on using the computer was noted as 25%-High, 38.5%
moderate and 14.6% lower. The health workers interviewed confirmed
that 43.5% of them had the access to computers for between 2-4hrs
per day. 78.5% of the client were willing to use e-based learning.
Slide 10 The strategy That CME itself should be recognized as a
high priority at all levels, including by government and health
workers. The political commitment is critical; the health workers
also need to be motivated, this will only be achieved through the
listing of CMEs in the annual operation plan for delivery of the
services at the district level as well as provincial level Develop
/ strengthen web based CMEs through DHMT/DPHN and within the
institutions Support the MOH to develop the web based system Train
the DHMT on how to train the health workers on how to use the
systems. Slide 11 Broad areas to be covered using web conferencing
PITC PMCT MNCH (Reproductive health, emergency obstetrics newborn
care, and child health) Chronic HIV care, chronic diseases
management Tb and other OIs Nutrition Commodity management (drugs
and others) Laboratory Documentation Monitoring and evaluation
Referral systems and linkages Clinical mentorship skills Slide 12
Expected outcomes Sustainable web based CME conferencing health
system At least 10% More health workers in the rural areas are
reached with CMEs. Improved quality of services, coverage, and
equity Chart review Observation of care sessions Documentation of
services Slide 13 References A realistic approach to the evaluation
of the quality management movement in health care systems: a
comparison between European and African contexts based on
Mintzberg's organizational models, P. Blaise,G. Kegels- The
International Journal of Health Planning and Management Volume 19,
Issue 4, pages 337364, October/December 2004Volume 19, Issue 4,
Financial support of continuing Medical Education, Robert
steinbrook, JAMA. 2008: 299(9): 1060-1062 The need for
rehabilitation of lost skills in health care delivery, Koech DK,
Africa journal of Health sciences, 1998 Jul-Dec;5(3-4):113. Etta,
F.E. and L. Elder, eds. 2005. At The Crossroads: ICT Policy Making
In East Africa. IDRC. www.idrc.ca/openebooks/219-8/ Farrell, G.M.
and C. Wachholz, eds. 2003. ICT in Education: Meta-Survey on the
Use of Technologies in Asia and the Pacific. UNESCO. Markova T,
Roth LM, -conferencing for delivery of residency didactics, Journal
of the association of American medical colleges 2002
Jul;77(7):748-9. Markova TRoth LM Curran V, Lockyer J, Sargeant J,
Fleet L -Evaluation of learning outcomes in Web-based continuing
medical education, Journal of the association of American medical
colleges, 2006 Oct;81(10 Suppl):S30-4. Decentralizing Kenyas Health
Management System: An Evaluation, P.M. Ndavi1,S. Ogola2,P.M.
Kizito2,K. Johnson, jan 2009 Wikipedia Report of a Conference held
in Moshi, Tanzania 8-10 April 2003- Information and Communication
Technologies and Continuing Medical Education in East and Southern
Africa
