There is a severe health care workforce shortage in Africa. The solution is not to build a western-style system, rather we need to leverage new technologies and low-cost alternatives to build an African-style medical education system that will help train and retain providers and bridge gaps in access to care.
The first is to invest in tele-education given the scant resources. There are many tele-education programs in the West and there is even a trend to expand these services to developing countries. Having been a part of such a program where US health professionas teach remotely I would suggest that these models are not ideal. The best model of tele-education would be one that is based in the host country itself. Fore example, a tele-education program for East Africa could be based in Nairobi, building local capacity to teach to more remote areas of Africa. While daunting to set up, this would help build even supporting infrastructure such as IT support.
The second solution is to train more paraprofessionals. A recent McKinsey report nicely summarizes the benefits of such a model. This will minimize the brain drain, provide more providers in less time and cost less. The model of the community health volunteer has worked in so many countries – this model needs to be scaled up so that they can refer to mid-level providers who ultimately refer to secondary and tertiary centers that are staffed by physicians. These paraprofessionals would complement not replace much needed physicians and nurses.
Lastly, medical education in developing countries needs to capitalize on mHealth. In the next few years over 90% of Africa will have a cell phone. It makes perfect sense to use this technology to bridge gaps in access and knowledge. For example, geographically isolated providers could complete modules on their cell phone on topics that are relevant to their patient population e.g. HIV, TB, NTDs.
While I’m sure the solution to the health care workforce shortage is much more complicated, I do feel these three areas are worth prioritizing and funding in these areas should be scaled up.