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RCSI-COSECSA Collaboration Programme
Surgical Training in Africa Collaboration Programme
Royal College of Surgeons in Ireland (RCSI)
College of Surgeons of East, Central and Southern Africa (COSECSA)
Supported by Irish Aid
The Surgical Care Crisis in Africa
Current estimates suggest that 11% of the global disease burden is due to conditions amenable by surgery. Sub-Saharan Africa has the highest ratio of surgical Disability Adjusted Life Years (DALYs), a measure of the overall disease burden, and the highest rate of obstetrical complications in the world. Africa has approximately 25% of the burden of the world's diseases but only 1.3% of the world health workforce.
Until recently, surgery has not been considered as part of a health strategy in low-income countries because it has been considered to be unaffordable. This has now changed: surgery is increasingly being recognised as an integral part of primary healthcare, a preventive strategy and a cost effective response to numerous health challenges in resource-poor settings. Moreover, surgical care is now considered critical in the tackling of the WHO-declared health workforce crisis.
The College of Surgeons of East, Central & Southern Africa (COSECSA)
COSECSA was formed in 1999 to advance education, training, examinations standards, research and practice in surgical care by increasing the number of appropriately trained, well qualified surgeons and surgically trained general medical officers. It is an independent body that provides standardised surgical training in nine countries: Ethiopia, Kenya, Malawi, Mozambique, Rwanda, Tanzania, Uganda, Zambia and Zimbabwe.
The RCSI-COSECSA Collaboration Programme
In 2007, RCSI, COSECSA and Irish Aid signed a Memorandum of Understanding that initiated a partnership programme designed to advance COSECSA's mandate and improve its current operating capacity. Irish Aid granted start up funding and RCSI provides staff time and resources including curricula, education tools, skills training, examinations, accreditation and quality assurance processes.
The Programme's goal is to increase the provision of quality, essential surgical and emergency care in the COSECSA mandate region, particularly at district level. The goal will help to achieve the UN MDGs in child and maternal health and contribute to relevant national health priorities.
Selected Programme Activities
- Delivery of Train the Trainers courses to all COSECSA trainers in Ethiopia, Kenya, Rwanda, Tanzania, Zambia and Zimbabwe, with Burundi, Mozambique, Malawi and Uganda to follow in 2013.
- Ongoing training of 27 surgeons as Basic Science Faculty.
- Syllabus and qualification development completed for non-physician surgical training courses in Zambia and Malawi and a successful funding application to EU was submitted with RCSI Dept of Epidemiology to fund clinical officer training initiatives in these countries.
- Supervision, support and benchmarking of COSECSA examinations from 2009 to present, exam exchange visits, faculty exchange visits, pre-exam seminars and a exam question writing seminar.
- Provision of a professional volunteer in COSECSA secretariat Arusha,Tanzania.
- 25 ICT labs established and equipped in 9 countries. A unique, Africa-centric surgical training e-learning platform SchoolForSurgeons jointly developed with COSECSA. Launched with a mandatory online training programme.
- Joint development of other IT tools: website, online database of members and fellows and education management software.
- Design and provision of training and promotional material.
- Ongoing faculty and student engagement resulting in increased numbers of trainee and examination candidates.
- International promotion of COSECSA: International conference held in London May 2011, and meeting in San Diego held November 2011 bringing together international stakeholders in surgical training in East Africa. Facilitation of COSECSA cooperation with other international partners.
- Development of monitoring and evaluation tools for COSECSA.
- Training, recruitment and funding of COSECSA staff.
- Funding of specific activities and events, successful engagement of other donors and partners.
Significant increase in trainee numbers: from 26 (2008) to 184 (June 2013).
Qualification recognition obtained in eight of the nine countries.
Increase in COSECSA’s capacity to train, conduct research and engage trainees and fellows.
Standardisation of training across the region
Successful “blending” of e-learning academic element into trainee experience.
Substantial increase in COSECSA revenue, putting COSECSA on path towards financial sustainability.