A survey of Sub-Saharan African medical schools
A survey of Sub-Saharan African medical schools
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DOI：
10.1186/1478-4491-10-4
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发表时间：
2012-02-24
影响因子：
4.5
通讯作者：
Olapade-Olaopa, Emiola Oluwabunmi
中科院分区：
文献类型：
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作者：
Chen, Candice;Buch, Eric;Olapade-Olaopa, Emiola Oluwabunmi
背景：撒哈拉以南非洲地区承受着世界上不成比例的疾病负担，同时也面临着世界上最严重的医疗保健劳动力短缺问题。医生是任何高效医疗保健系统的重要组成部分。然而，由于医学院数量少、招生有限、毕业生国际移民、医生地理分布不均以及医学院数据不足，加强该地区医生队伍的努力受到限制。撒哈拉以南非洲医学院研究 (SAMSS) 的目标是提高了解水平并扩大该地区医学院的基线数据。方法：SAMSS 调查是一项针对撒哈拉以南非洲医学院的描述性调查研究。调查工具包括定量和定性问题，重点关注机构特征、学生概况、课程、研究生医学教育、教学人员、资源、能力扩展的障碍、教育创新以及与政府和非政府组织的外部关系。调查通过电子邮件发送给医学院院长或院长指定的官员。分析既是描述性的，又是多变量的。结果：调查分布于 48 个撒哈拉以南非洲国家中的 40 个国家的 146 所医学院。收到 105 份答复（答复率为 72%）。调查期结束后，又确定了 23 所学校。自 1990 年以来已有 58 所受访者成立，其中包括 22 所私立学校。医学院的入学人数从 2 人到 1800 人不等，毕业生从 4 人到 384 人不等。73% 的受访者 (n = 64) 在过去五年中增加了第一年的入学人数。据报道，平均有 26% 的受访者毕业生在毕业后五年内移居国外（n = 68）。据报道，增加毕业生数量和提高质量的最重要障碍分别与基础设施和师资限制有关。过去五年中，实施增加教师工资和奖金的学校与降低教师流失率的学校之间存在显着相关性（P = 0.018）；加强机构研究工具（P = 0.00015）并资助教师研究时间（P = 0.045）以及更多教师参与研究；和国家义务服务要求 (P = 0.039)、中等数量 (1-5) 的研究生医学教育课程 (P = 0.016) 和法语学校 (P = 0.016) 以及毕业后更多的农村全科医生。结论：SAMSS 调查结果提高了撒哈拉以南非洲医学院的数据水平和了解水平。该数据可作为该地区医疗保健劳动力未来研究、政策和投资的基线，这对于改善健康状况是必要的。
Background: Sub-Saharan Africa suffers a disproportionate share of the world's burden of disease while having some of the world's greatest health care workforce shortages. Doctors are an important component of any high functioning health care system. However, efforts to strengthen the doctor workforce in the region have been limited by a small number of medical schools with limited enrolments, international migration of graduates, poor geographic distribution of doctors, and insufficient data on medical schools. The goal of the Sub-Saharan African Medical Schools Study (SAMSS) is to increase the level of understanding and expand the baseline data on medical schools in the region.Methods: The SAMSS survey is a descriptive survey study of Sub-Saharan African medical schools. The survey instrument included quantitative and qualitative questions focused on institutional characteristics, student profiles, curricula, post-graduate medical education, teaching staff, resources, barriers to capacity expansion, educational innovations, and external relationships with government and non-governmental organizations. Surveys were sent via e-mail to medical school deans or officials designated by the dean. Analysis is both descriptive and multivariable.Results: Surveys were distributed to 146 medical schools in 40 of 48 Sub-Saharan African countries. One hundred and five responses were received (72% response rate). An additional 23 schools were identified after the close of the survey period. Fifty-eight respondents have been founded since 1990, including 22 private schools. Enrolments for medical schools range from 2 to 1800 and graduates range from 4 to 384. Seventy-three percent of respondents (n = 64) increased first year enrolments in the past five years. On average, 26% of respondents' graduates were reported to migrate out of the country within five years of graduation (n = 68). The most significant reported barriers to increasing the number of graduates, and improving quality, related to infrastructure and faculty limitations, respectively. Significant correlations were seen between schools implementing increased faculty salaries and bonuses, and lower percentage loss of faculty over the previous five years (P = 0.018); strengthened institutional research tools (P = 0.00015) and funded faculty research time (P = 0.045) and greater faculty involvement in research; and country compulsory service requirements (P = 0.039), a moderate number (1-5) of post-graduate medical education programs (P = 0.016) and francophone schools (P = 0.016) and greater rural general practice after graduation.Conclusions: The results of the SAMSS survey increases the level of data and understanding of medical schools in Sub-Saharan Africa. This data serves as a baseline for future research, policies and investment in the health care workforce in the region which will be necessary for improving health.