Medical Education Partnership Initiative in Zimbabwe: partnerships for transformation
Authors: James G Hakim, Michele Barry, Jonathan Matenga, Frances Cowan, Thomas B Campbell
Journal: The Lancet Global Health (2017)

The considerable health workforce challenges in sub-Saharan Africa demand robust and transformative interventions. Between 2010 and 2015, the US President's Emergency Plan for AIDS Relief (PEPFAR) and the US National Institutes of Health (NIH) sponsored the Medical Education Partnership Initiative (MEPI)—a grant-awarding programme aimed at enhancing the quantity and quality of education and research in African universities.1Collins FS Glass RI Whitescarver J Wakefield M Goosby E Developing health workforce capacity in Africa.Science. 2010; 330: 1324-1325Crossref PubMed Scopus (61) Google Scholar Through MEPI, 13 medical schools in sub-Saharan Africa were competitively awarded grants to work with existing and new partners to develop bold and innovative programmes.2Mullan F Frehywot S Omaswa F et al.The Medical Education Partnership Initiative: PEPFAR's effort to boost health worker education to strengthen health systems.Health Aff (Millwood). 2012; 31: 1561-1572Crossref PubMed Scopus (66) Google Scholar Here we present the achievements of the University of Zimbabwe College of Health Sciences (UZCHS) under the MEPI programme. After a decade of political and economic crisis between 1999 and 2010, health education in Zimbabwe was in a desperate state and required a major overhaul. UZCHS reported a 60% decrease in medical student enrolment, a 61% faculty vacancy rate, a 50% increase in failure rate, and the specialist training pipeline had virtually dried up.3Ndhlovu C Nathoo K Borok M et al.Innovations to enhance the quality of health professions education at the University of Zimbabwe College of Health Sciences—NECTAR program.Acad Med. 2014; 89: S88-S92Crossref PubMed Scopus (13) Google Scholar Moreover, the curriculum of UZCHS had not been revised since 1992 and the information communication technology infrastructure and services needed urgent expansion and improvement. Dedicated academics at UZCHS and the Ministries of Health and Tertiary/Higher Education, in collaboration with long-standing partners from the University of Colorado Denver, Stanford University, University College London, Kings College London, and the University of Cape Town, seized the MEPI opportunity to establish a medical education and research training programme that changed the face of medical training at UZCHS. Through the Zimbabwe MEPI award, the Novel Education Clinical Trainees and Researchers programme, and two linked awards addressing cardiovascular and mental health research capacity, established a modular programme, which collectively made considerable progress to improve medical training across Zimbabwe. The programmes that were implemented included advanced faculty development; a mentored scholars' programme; information technology improvements; research methodology and administration training; and clinical, knowledge-based, and technical skills training in cardiology, neurology, and mental health. During MEPI implementation, 106 visiting professors made 211 visits to UZCHS, to help drive many of these programmes. Besides partnership with research-rich countries, MEPI provided a tremendous opportunity for South-to-South interaction and learning. Up to 40 institutions from sub-Saharan Africa and 20 from the USA and UK collaborated in the MEPI network.4Olapade-Olaopa EO Oluwabunumi E Baird S Kiguli-Malwadde E Kolars J Growing partnerships: leveraging the power of collaboration through the Medical Education Partnership Initiative.Acad Med. 2014; 89: S19-S23Crossref PubMed Scopus (41) Google Scholar Several activities synergistically improved training capacities at UZCHS and other sub-Saharan African institutions, including annual MEPI symposia held in various countries on a rotational basis, site visits across grantee schools, and technical working groups promoting key training areas.4Olapade-Olaopa EO Oluwabunumi E Baird S Kiguli-Malwadde E Kolars J Growing partnerships: leveraging the power of collaboration through the Medical Education Partnership Initiative.Acad Med. 2014; 89: S19-S23Crossref PubMed Scopus (41) Google Scholar The MEPI Principal Investigators Council was established to oversee the implementation of MEPI activities. This council has proved to be a very successful innovation and is set to sustain the implementation of MEPI innovations in the future and broaden the scope of medical training across Africa. MEPI has resulted in a great transformation in medical education and training at UZCHS. Important programmes such as faculty development and research capacity strengthening have been institutionalised in a newly created Department of Health Professions Education and a new Research Support Centre. Furthermore, MEPI made a major contribution to other programmes that UZCHS implemented to improve the circumstances of the college. Staff retention increased, with the faculty growing by 36% (from 122 to 166 staff). Enrolment of undergraduate students increased by 59%, and enrolment of postgraduate students also increased by 61%. University of Colorado Denver, Stanford University, and University College London have continued to support and enhance important aspects of the MEPI Zimbabwe programme beyond the period of MEPI funding. Bidirectional resident and visiting professors programmes are being implemented with support from the University of Colorado Denver and Stanford University. University College London has continued to collaborate with the Department of Psychiatry through a mentoring relationship and implementation of a Wellcome Trust Research Excellence and Leadership Award. Partners are supporting UZCHS in the implementation of a recent NIH/Fogarty award designed to train junior faculty to become competent and independent high-level researchers. In conclusion, the opportunity afforded by the MEPI programme has transformed the training of the health-care workforce in Zimbabwe. The role of partners has been synergistic and sustained, and was key to these achievements. JGH, reports grants from the National Intitutes of Health (NIH)/Fogarty during the conduct of the study. TBC and JM reports grants the NIH during the conduct of the study. TBC reports personal fees from Gilead Sciences outside the submitted work. MB and FC declare no competing interests.