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Where are Africa’s field epidemiology graduates?

In 2020, data from field epidemiology training programs showed 1,995 advanced, 4,951 frontline, and 248 intermediate graduates. This number is bound to go up as more countries join the African Field Epidemiology Network. 

Available data from all the cohorts of graduates also show that ministries of health in sub-Saharan Africa are absorbing FETP graduates to help countries develop and implement dynamic cost-effective public health strategies to improve and strengthen their health systems and infrastructure.

A panel discussion at the 6 – 10 June 2022 AFENET Technical Retreat, stirred a discussion on the whereabout of FETP graduates and their role in their countries. 

Panelists including Dr. Donne Ameme – Regional Technical Coordinator, Anglophone West Africa, Dr. Lazarus Kuonza – Program Director, South Africa FETP, Dr. Cynthia Sema – Program Director Mozambique FELTP, and Dr. Shakir Bolugun – Resident Advisor Nigeria FETP led an open discussion on where the graduates are and what are they doing to support their countries. Other issues discussed were the sustainability of the graduates in the countries, despite financial limitations to absorb all graduates in the AFENET system. Despite many being deployed to support numerous outbreaks and investigations, graduates cannot be fully employed by AFENET or the health ministries. Some have gone into private practice and some moved overseas, it emerged. 

Program directors, resident advisors, and project coordinators across the room gave an overview of the situation in their countries and gave strategies to engage governments and partners on how to engage more FETP graduates and residents in their programs. 

Trainees on the advanced tier spend 25-30% of the 2-year long program mastering content through didactic classes and 75% of the remainder of the time is spent gaining hands-on experience through  field placement. Field epidemiology training programs that have a laboratory component, send residents to work in the state and national laboratories and boost their efficiency. Today more countries have introduced the front line and intermediate training tiers to ensure all levels of health workers benefit from these skills. 

Mali and Togo were the first Francophone FELTP in Africa, today AFENET is reaching more francophone countries across Central Africa, West Africa, and the Indian Ocean Region. Dr Etoundi Alain – Program Director Cameroon, said, “We have to celebrate what has been done and it was done on the basis of those who were together and out to put AFENET on the right track. Francophone has recently discovered AFENET and is now understanding the importance of epidemiology and how it helps our health system. Through our network, we are now taking a new position as a francophone region to improve our health systems and ministries of health.”

The success and achievements of FETPs and FELTPs have attracted trainees from more countries in Africa. This demand has led to a desire by many African countries to start their own FETPs or FELTPs. Chad, Bostwana, and Peru (the latter outside Africa) have expressed interest in beginning their own programs.

Graduates play a central role in public health surveillance, disease control, and in the design, implementation, and evaluation of various public health programs in malaria, tuberculosis, and HIV/AIDS, immunization programs among others, and outbreak investigation and control. 

The growth in FETPs and FELTPs recorded in the region has been a result of a deliberate effort by programs to see a change in their countries.