Research e-Mentorship for early-career family physicians in sub-Saharan Africa: evaluation of a pilot programme
Authors: Maame Araba E Buadu, Alexandra van Waes, Kenneth Yakubu, Pius Ameh, Bolatito B Fatusin, Hithaishini Kodicherla, Brian W Jack, Nancy A Scott, Chelsea M McGuire
Journal: The Lancet Global Health (2021)

BackgroundMany family physicians in sub-Saharan Africa are not active in research, partly due to the lack of available mentorship. The professional society for early-career family physicians in sub-Saharan Africa, AfriWon Renaissance, is well-positioned to address this gap. Here, we describe the AfriWon Research Collaborative (ARC), an online research mentorship and training programme for AfriWon Renaissance members in Africa that aims to increase research activity through an e-learning community. This online initiative for physicians in low-resource settings is significant as more medical education moves online due to the COVID-19 pandemic.MethodsARC provided research training via Google classroom over a six-month core programme period. Participants from sub-Saharan Africa were matched with both peer and faculty mentors from sub-Saharan Africa, Europe, and the USA. We used a tiered mentorship structure focused on peer support for participants as they designed primary-care research proposals. A six-month post-programme period consisted of monthly online research work-in-progress meetings. We used an adapted RE-AIM framework to guide a mixed-methods evaluation of the feasibility, acceptability, and effectiveness of ARC. Data from several sources, including programme logs and surveys, were triangulated to conduct both process and outcome evaluations. We conducted post-programme semi-structured individual interviews with participants and mentors stratified by low, medium, and high levels of engagement. We analysed data using descriptive statistics and mixed inductive/deductive qualitative analysis.FindingsThe programme included 25 family physicians and family medicine trainees who were placed into five mentorship teams, each consisting of two participants, one peer mentor and two faculty mentors. Participants were from Botswana, Democratic Republic of Congo, Ghana, Nigeria and Sierra Leone and mentors were from 11 countries across three continents. Of the 25 individuals, 19 (76%), continued their mentorship relationships into the post-programme phase. Six of 10 participants completed a full research proposal by the end of the post-programme period, with several mentors reporting increased confidence and competence of their mentees. Surveys and post-programme interviews showed increases in confidence in conducting and understanding of research and a positive research culture amongst active participants. One participant noted: "all of a sudden I'm finding myself asking questions; what can I do to try and improve this? And for me it's a sign that going forward, research will definitely be part of what I do". Work-in-progress meetings facilitated continued research activity. Barriers to engagement with the ARC program included poor network connectivity, time limitations, confusion over mentorship structure and role, and personal life challenges. Over half of the participants who responded to the outcome survey reported internet connectivity as a barrier and 86% also reported time limitations.InterpretationOnline research training and mentorship is feasible and acceptable for early-career sub-Saharan family physicians. Further work is needed to determine optimum implementation strategies and scalability. Global health educators can learn from ARC's tiered e-mentorship approach and benefit from lessons learned, including the need for flexible, clearly organised structures for mentee-mentor engagement.FundingConsortium of University of Global Health (CUGH) Tom Hall grant.