Regulation of health professions education and the growth of schools in Somalia.
Health professions education
Medical regulation
Somalia
Journal
BMC medical education
ISSN: 1472-6920
Titre abrégé: BMC Med Educ
Pays: England
ID NLM: 101088679
Informations de publication
Date de publication:
19 Oct 2024
19 Oct 2024
Historique:
received:
10
04
2024
accepted:
11
10
2024
medline:
20
10
2024
pubmed:
20
10
2024
entrez:
19
10
2024
Statut:
epublish
Résumé
Health professions education, encompassing training programs for medicine and surgery, nursing, midwifery, medical laboratory sciences,, and public health, along with their regulations, are pivotal to achieving universal health coverage and Sustainable Development Goals, contributing significantly to health outcomes and public trust in the healthcare workforce. However, low- and middle-income countries, especially in sub-Saharan Africa, face challenges, such as inadequate resources, outdated curricula, and weak governance. Somalia in particular grapples with a fragmented health system and a critical shortage of skilled health professionals, exacerbated by decades of civil war and political instability. This study employed a mixed-method approach that incorporated both qualitative and quantitative data collection and analysis. A comprehensive literature review was conducted along with semi-structured interviews with 44 key informants, including representatives from professional health schools and officials from the Ministry of Health. Additionally, five focus group discussions were held with young professionals and an online survey was administered to students enrolled in professional health courses. The data analysis employed descriptive for quantitative data, and thematic analysis for qualitative data, guided by the human resources for health (HRH) maturity model framework. This study identified 112 health professions schools across Somalia, with a significant concentration in urban areas, particularly in Benadir. The health workforce analysis revealed a pronounced urban-rural disparity and a density of health professionals below the WHO's recommended threshold. The focus group discussions and surveys highlighted the employment challenges faced by young physicians and students' perceptions of their training and future employment opportunities. The proliferation of health professions schools without adequate quality control, the critical shortage and maldistribution of skilled health professionals, and the absence of a comprehensive regulatory framework are significant challenges facing Somalia's healthcare system. The establishment of the National Health Professionals' Council (NHPC) Act in 2020 marks a step towards addressing these issues. This study emphasizes the need for accreditation of health professions schools, capacity building of HRH teams, and collaboration among stakeholders to improve healthcare workforce development and regulation. Addressing urban-rural disparities and combating professional misconduct are also crucial for achieving universal health coverage and improving health outcomes in Somalia.
Sections du résumé
BACKGROUND
BACKGROUND
Health professions education, encompassing training programs for medicine and surgery, nursing, midwifery, medical laboratory sciences,, and public health, along with their regulations, are pivotal to achieving universal health coverage and Sustainable Development Goals, contributing significantly to health outcomes and public trust in the healthcare workforce. However, low- and middle-income countries, especially in sub-Saharan Africa, face challenges, such as inadequate resources, outdated curricula, and weak governance. Somalia in particular grapples with a fragmented health system and a critical shortage of skilled health professionals, exacerbated by decades of civil war and political instability.
METHODS
METHODS
This study employed a mixed-method approach that incorporated both qualitative and quantitative data collection and analysis. A comprehensive literature review was conducted along with semi-structured interviews with 44 key informants, including representatives from professional health schools and officials from the Ministry of Health. Additionally, five focus group discussions were held with young professionals and an online survey was administered to students enrolled in professional health courses. The data analysis employed descriptive for quantitative data, and thematic analysis for qualitative data, guided by the human resources for health (HRH) maturity model framework.
RESULTS
RESULTS
This study identified 112 health professions schools across Somalia, with a significant concentration in urban areas, particularly in Benadir. The health workforce analysis revealed a pronounced urban-rural disparity and a density of health professionals below the WHO's recommended threshold. The focus group discussions and surveys highlighted the employment challenges faced by young physicians and students' perceptions of their training and future employment opportunities.
CONCLUSION
CONCLUSIONS
The proliferation of health professions schools without adequate quality control, the critical shortage and maldistribution of skilled health professionals, and the absence of a comprehensive regulatory framework are significant challenges facing Somalia's healthcare system. The establishment of the National Health Professionals' Council (NHPC) Act in 2020 marks a step towards addressing these issues. This study emphasizes the need for accreditation of health professions schools, capacity building of HRH teams, and collaboration among stakeholders to improve healthcare workforce development and regulation. Addressing urban-rural disparities and combating professional misconduct are also crucial for achieving universal health coverage and improving health outcomes in Somalia.
Identifiants
pubmed: 39427191
doi: 10.1186/s12909-024-06179-3
pii: 10.1186/s12909-024-06179-3
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1178Informations de copyright
© 2024. The Author(s).
Références
A. Samanta and J. Samanta, “Regulation of the Medical Profession: Fantasy, Reality and Legality,” J R Soc Med, vol. 97, no. 5, pp. 211–218, May 2004, doi: 10.1177/014107680409700502.
Payne SR, Olatosi J, Mabedi C, Adeyoju A. Adaptations in models of urological regulation and their application to < scp > sub-Saharan Africa. BJU Int. 2022;130(6):712–721. https://doi.org/10.1111/bju.15917 .
Anyangwe SCE, Mtonga C. Inequities in the Global Health workforce: the Greatest impediment to Health in Sub-saharan Africa, 2007. [Online]. Available: https://www.ijerph.org
WHO EMRO. | Home | Somalia site | Countries. Accessed: Jul. 17, 2024. [Online]. Available: https://www.emro.who.int/countries/somalia/index.html
The State of the Health Workforce in the Who Africa Region Survey Report. 2021. [Online]. Available: https://www.who.int/news-room/feature-stories/detail/somalia-building-a-stronger-primary-health-care-system
WHO, “Somalia: building a stronger primary health care system,” World Health Organization. Accessed: Oct. 11, 2024. [Online]. Available: https://www.who.int/news-room/feature-stories/detail/somalia-building-a-stronger-primary-health-care-system
Muya I, Garside J, Van-der M, Plas, Mohammed MA. Emergency health education in a conflict stricken environment: A situational analysis. Afr J Emerg Med. 2018;8(4):129–133. https://doi.org/10.1016/j.afjem.2018.05.001 .
Said AS, Kicha DI. Implementing health system and the new federalism in Somalia: challenges and opportunities. Front Public Health. 2024;12. https://doi.org/10.3389/fpubh.2024.1205327 .
Somalia. - urbanization 2012–2022 | Statista. Accessed: Jul. 17, 2024. [Online]. Available: https://www.statista.com/statistics/455928/urbanization-in-somalia/
WHO, “Training public health workforce: a strategy for effective disease surveillance and response Policy brief,” Oct. 2021. Accessed: Oct. 11, 2024. [Online]. Available: https://www.emro.who.int/images/stories/somalia/documents/policy_brief_shaping_national_health_security_in_somalia_october_2021.pdf
UNICEF, “Demographics, Health & Infant Mortality,” UNICEF. Accessed: Oct. 11, 2024. [Online]. Available: https://data.unicef.org/country/som/
UNFPA, “The Somali Health and Demographic Survey 2020,” Apr. 2020. Accessed: Oct. 11, 2024. [Online]. Available: https://somalia.unfpa.org/en/publications/somali-health-and-demographic-survey-2020
WHO, “The Global Health Observatory,” World Health Organization. Accessed: Oct. 11, 2024. [Online]. Available: https://data.who.int/countries/706
M. G. Qayad, “Health Care Services in Transitional Somalia: Challenges and Recommendations.,” Macalester College, 2007, Accessed: Oct. 11, 2024. [Online]. Available: https://digitalcommons.macalester.edu/cgi/viewcontent.cgi?article=1069&context=bildhaan
L. V. Cassanelli and F. S. Abdikadir, “Somalia: Education in Transition,” Bildhaan: An International Journal of Somali Studies, 2007, Accessed: Oct. 11, 2024. [Online]. Available: https://segments.noblogs.org/files/2014/08/Somalia-Education-in-Transition.pdf
WDOMS, “World Directory of Medical Schools.” Accessed: Oct. 11, 2024. [Online]. Available: https://www.wdoms.org/
Iftin Foundation, “Somali Universities Graduates survey data in 2021. – Iftin Foundation.” Accessed: Oct. 11, 2024. [Online]. Available: https://iftinfoundation.org/somali-universities-graduates-survey-data-in-2021/
Kirby R. The consequences of medical mistakes: the stakes are getting higher! Trends in Urology & Men’s Health, vol. 5, no. 6, pp. 16–18, Nov. 2014, https://doi.org/10.1002/tre.425
WHO, “Time to act–Making motherhood and childhood safer in Somalia,” Sep. 2023. Accessed: Oct. 11, 2024. [Online]. Available: https://www.emro.who.int/images/stories/somalia/RMNCAH-Policy-Brief-August-2023.pdf
NHPC - Ministry of Health Somalia. Accessed: Jul. 17, 2024. [Online]. Available: https://moh.gov.so/en/nhpc/
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101. https://doi.org/10.1191/1478088706qp063oa .
WHO, “Global strategy on human resources for health: Workforce 2030,” Jul. 2020. Accessed: Oct. 11, 2024. [Online]. Available: https://www.who.int/publications/i/item/9789241511131
Okoroafor SC, et al. Investing in the health workforce in Kenya: trends in size, composition and distribution from a descriptive health labour market analysis. BMJ Glob Health. Aug. 2022;7. https://doi.org/10.1136/bmjgh-2022-009748 .
Shemdoe A, et al. Explaining retention of healthcare workers in Tanzania: moving on, coming to ‘look, see and go’, or stay? Hum Resour Health. 2016;14(1). https://doi.org/10.1186/s12960-016-0098-7 .
Kizito S, et al. Career intentions of final year medical students in Uganda after graduating: the burden of brain drain Career choice, professional education and development. BMC Med Educ. 2015;15(1). https://doi.org/10.1186/s12909-015-0396-0 .
Shabani JBB, et al. The capacity of young national medicine regulatory authorities to ensure the quality of medicines: case of Rwanda. J Pharm Policy Pract. 2022;15(1). https://doi.org/10.1186/s40545-022-00492-2 .
Morgan C, Teshome M, Crocker-Buque T, Bhudia R, Singh K. Medical education in difficult circumstances: analysis of the experience of clinical medical students following the new innovative medical curriculum in Aksum, rural Ethiopia. BMC Med Educ. 2018;18(1). https://doi.org/10.1186/s12909-018-1199-x .
Tama E et al. What Lies Behind Successful Regulation? A Qualitative Evaluation of Pilot Implementation of Kenya’s Health Facility Inspection Reforms. Int J Health Policy Manag. 2022;11(9):1852–1862. https://doi.org/10.34172/IJHPM.2021.90 .
Matiki DRS, Chibambo MI, Divala JJ. A comparison of teacher’s involvement in curriculum development in developing and developed countries: a case study of Namibia. Front Educ (Lausanne). 2023;8. https://doi.org/10.3389/feduc.2023.1243573 .
Mumbo HM, Kinaro JW. Assessment of quality and relevance of curricula development in health training institutions: a case study of Kenya. Hum Resour Health. 2015;13(1). https://doi.org/10.1186/s12960-015-0048-9 .