Browsing by Author "Cancedda, Corrado"

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Coordinating Between Medical Professions’ Tasks to Optimize Sub-Saharan Health Systems: A Response to Recent Commentaries
(Kerman Univ Medical Sciences , Jahad Blvd, Kerman, Iran, 7619813159, 2017) Eyal, Nir; Cancedda, Corrado; Hurst, Samia A.; Kyamanywa, Patrick
We are grateful that our perspective received commentary from leading experts on African human resources for health. All endorse and several quote our central suggestion that the “development in [non-physician clinician] deployment should unfold in parallel with strategic rethinking of the role of physicians and with critical innovations in physicians’ education and inservice training.
Enhancing Formal Educational and In-service Training Programs in Rural Rwanda: A Partnership Among the Public Sector, a Nongovernmental Organization, and Academia
(Lippincott Williams & Wilkins , Two Commerce Sq, 2001 Market St, Philadelphia, Usa, Pa, 19103, 2014) Cancedda, Corrado; Farmer, E. Paul; Kyamanywa, Patrick; Riviello, Robert; Rhatigan, Joseph; Wagner, Claire M; Ngabo, Fidele; Manzi, Anatole; Drobac, Peter C; Mpunga, Tharcisse; Nutt, Cameron T; Kakoma, Jean Baptiste; Mukherjee, Joia; Cortas, Chadi; Condo, Jeanine; Ntaganda, Fabien; Bukhman, Gene; Binagwaho, Agnes
Global disparities in the distribution, specialization, diversity, and competency of the health workforce are striking. Countries with fewer health professionals have poorer health outcomes compared with countries that have more. Despite major gains in health indicators, Rwanda still suffers from a severe shortage of health professionals.This article describes a partnership launched in 2005 by Rwanda's Ministry of Health with the U.S. nongovernmental organization Partners In Health and with Harvard Medical School and Brigham and Women's Hospital. The partnership has expanded to include the Faculty of Medicine and the School of Public Health at the National University of Rwanda and other Harvard-affiliated academic medical centers. The partnership prioritizes local ownership and-with the ultimate goals of strengthening health service delivery and achieving health equity for poor and underserved populations-it has helped establish new or strengthen existing formal educational programs (conferring advanced degrees) and in-service training programs (fostering continuing professional development) targeting the local health workforce. Harvard Medical School and Brigham and Women's Hospital have also benefited from the partnership, expanding the opportunities for training and research in global health available to their faculty and trainees.The partnership has enabled Rwandan health professionals at partnership-supported district hospitals to acquire new competencies and deliver better health services to rural and underserved populations by leveraging resources, expertise, and growing interest in global health within the participating U.S. academic institutions. Best practices implemented during the partnership's first nine years can inform similar formal educational and in-service training programs in other low-income countries.
Health Professional Training and Capacity Strengthening Through International Academic Partnerships: The First Five Years of the Human Resources for Health Program in Rwanda
(Kerman Univ Medical Sciences , Jahad Blvd, Kerman, Iran, 7619813159, 2018) Cancedda, Corrado; Cotton, Phil; Shema, Joseph; Rulisa, Stephen; Riviello, Robert; Adams, Lisa V; Farmer, Paul E; Kagwiza, Jeanne N; Kyamanywa, Patrick; Mukamana, Donatilla; Mumena, Chrispinus; Tumusiime, David K; Mukashyaka, Lydie; Ndenga, Esperance; Twagirumugabe, Theogene; Mukara, Kaitesi B; Dusabejambo, Vincent; Walker, Timothy D; Nkusi, Emmy; Bazzett-Matabele, Lisa; Butera, Alex; Rugwizangoga, Belson; Kabayiza, Jean Claude; Kanyandekwe, Simon; Kalisa, Louise; Ntirenganya, Faustin; Dixson, Jeffrey; Rogo, Tanya; McCall, Natalie; Corden, Mark; Wong, Rex; Mukeshimana, Madeleine; Gatarayiha, Agnes; Ntagungira, Egide Kayonga; Yaman, Attila; Musabeyezu, Juliet; Sliney, Anne; Nuthulaganti, Tej; Kernan, Meredith; Okwi, Peter; Rhatigan, Joseph; Barrow, Jane; Wilson, Kim; Levine, Adam C; Reece, Rebecca; Koster, Michael; Moresky, Rachel T; O’flaherty, Jennifer E; Palumbo, Paul E; Ginwalla, Rashna; Binanay, Cynthia A; Thielman, Nathan; Relf, Michael; Wright, Rodney; Hill, Mary; Chyun, Deborah; Klar, Robin T; McCreary, Linda L; Hughes, Tonda L; Moen, Marik; Meeks, Valli; Barrows, Beth; Durieux, Marcel E; McClain, Craig D; Bunts, Amy; Calland, Forrest J; Hedt-Gauthier, Bethany; Milner, Danny; Raviola, Giusappe; Smith, Stacy E; Tuteja, Meenu; Magriples, Urania; Rastegar, Asghar; Arnold, Linda; Magaziner, Ira; Binagwaho, Agnes
Background: The Rwanda Human Resources for Health Program (HRH Program) is a 7-year (2012-2019) health professional training initiative led by the Government of Rwanda with the goals of training a large, diverse, and competent health workforce and strengthening the capacity of academic institutions in Rwanda. Methods: The data for this organizational case study was collected through official reports from the Rwanda Ministry of Health (MoH) and 22 participating US academic institutions, databases from the MoH and the College of Medicine and Health Sciences (CMHS) in Rwanda, and surveys completed by the co-authors. Results: In the first 5 years of the HRH Program, a consortium of US academic institutions has deployed an average of 99 visiting faculty per year to support 22 training programs, which are on track to graduate almost 4600 students by 2019. The HRH Program has also built capacity within the CMHS by promoting the recruitment of Rwandan faculty and the establishment of additional partnerships and collaborations with the US academic institutions. Conclusion: The milestones achieved by the HRH Program have been substantial although some challenges persist. These challenges include adequately supporting the visiting faculty; pairing them with Rwandan faculty (twinning); ensuring strong communication and coordination among stakeholders; addressing mismatches in priorities between donors and implementers; the execution of a sustainability strategy; and the decision by one of the donors not to renew funding beyond March 2017. Over the next 2 academic years, it is critical for the sustainability of the 22 training programs supported by the HRH Program that the health-related Schools at the CMHS significantly scale up recruitment of new Rwandan faculty. The HRH Program can serve as a model for other training initiatives implemented in countries affected by a severe shortage of health professionals.
The human resources for health program in Rwanda—a new partnership
(Massachusetts Medical Society, 2013) Binagwaho, Agnes; Kyamanywa, Patrick; Farmer, E. Paul; Nuthulaganti, Tej; Umubyeyi, Benoite; Nyemazi, Jean Pierre; Mugeni, Soline Dusabeyesu; Asiimwe, Anita; Ndagijimana, Uzziel; McPherson, Helen Lamphere; Ngirabega, Jean de Dieu; Sliney, Anne; Uwayezu, Agnes; Rusanganwa, Vincent; Wagner, Claire M; Nutt, Cameron T; Eldon-Edington, Mark; Cancedda, Corrado; Magaziner, Ira C; Goosby, Eric
The authors discuss the Human Resources for Health Program, which is working to improve the quality and quantity of health professionals in Rwanda by means of sustained collaborations with U.S. schools of medicine, nursing, dentistry, and public health. A global shortage of 4.3 million health professionals poses a major bottleneck to poor people worldwide with regard to benefiting from the fruits of modern medicine.(1) Among existing health professionals, there are also staggering inequities in skill levels and geographic distribution.(2)-(4) Unsurprisingly, the deepest national gaps in human resources for health run parallel to poor population-level health outcomes.(1) Sub-Saharan Africa bears 24% of the global burden of disease(5) but is served by only 4% of the global health workforce.(1) The health graduate schools in the region face overwhelming financial, infrastructural, and personnel constraints, limiting their ability to address the ...
Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians
(Kerman Univ Medical Sciences , Jahad Blvd, Kerman, Iran, 7619813159, 2016) Eyal, Nir; Cancedda, Corrado; Kyamanywa, Patrick; Hurst, Samia A.
Responding to critical shortages of physicians, most sub-Saharan countries have scaled up training of nonphysician clinicians (NPCs), resulting in a gradual but decisive shift to NPCs as the cornerstone of healthcare delivery. This development should unfold in parallel with strategic rethinking about the role of physicians and with innovations in physician education and in-service training. In important ways, a growing number of NPCs only renders physicians more necessary – for example, as specialized healthcare providers and as leaders, managers, mentors, and public health administrators. Physicians in sub-Saharan Africa ought to be trained in all of these capacities. This evolution in the role of physicians may also help address known challenges to the successful integration of NPCs in the health system.
Rwanda 20 Years on: Investing in Life
(Elsevier Science Inc , Ste 800, 230 Park Ave, New York, Usa, Ny, 10169, 2014) Binagwaho, Agnes; Farmer, E. Paul; Nsanzimana, Sabin; Karema, Corine; Gasana, Michel; Ngirabega, Jean de Dieu; Ngabo, Fidele; Wagner, Claire M; Nutt, Cameron T; Nyatanyi, Thierry; Gatera, Maurice; Kayiteshonga, Yvonne; Mugeni, Cathy; Mugwaneza, Placidie; Shema, Joseph; Uwaliraye, Parfait; Gaju, Erick; Muhimpundu, Marie Aimee; Dushime, Theophile; Senyana, Florent; Mazarati, Jean Baptiste; Gaju, Cesla Muzayire; Tuyisenge, Lisine; Mutabazi, Vincent; Kyamanywa, Patrick; Rusanganwa, Vincent; Nyemazi, Jean Pierre; Umutoni, Agathe; Kankindi, Ida; Ntizimira, Christian; Ruton, Hinda; Mugume, Nathan; Nkunda, Denis; Ndenga, Espérance; Mubiligi, Joel M; Kakoma, Jean Baptiste; Karita, Etienne; Sekabaraga, Claude; Rusingiza, Emmanuel; Rich, Michael L; Mukherjee, Joia S; Rhatigan, Joseph; Cancedda, Corrado; Bertrand-Farmer, Didi; Bukhman, Gene; Stulac, Sara N; Tapela, Neo M; Holstein, Cassia van der Hoof; Shulman, Lawrence N; Habinshuti, Antoinette; Bonds, Matthew H; Wilkes, Michael S; Lu, Chunling; Smith-Fawzi, Mary C; Swain, JaBaris D; Murphy, Michael P; Ricks, Alan; Kerry, Vanessa B; Bush, Barbara P; Siegler, Richard W; Stern, Cori S; Sliney, Anne; Nuthulaganti, Tej; Karangwa, Injonge; Pegurri, Elisabetta; Dahl, Ophelia; Drobac, Peter C
Two decades ago, the genocide against the Tutsis in Rwanda led to the deaths of 1 million people, and the displacement of millions more. Injury and trauma were followed by the effects of a devastated health system and economy. In the years that followed, a new course set by a new government set into motion equity-oriented national policies focusing on social cohesion and people-centred development. Premature mortality rates have fallen precipitously in recent years, and life expectancy has doubled since the mid-1990s. Here we reflect on the lessons learned in rebuilding Rwanda’s health sector during the past two decades, as the country now prepares itself to take on new challenges in health-care delivery.