Care onderzoekers in de landelijke pers - Nphf

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Ccarré | jaargang 15 | nr 51 | maart 2010 bulletin van de netherlands school of primary care research ◄ terUg Naar INHOUD MUNDO’s approach to support higher education institutes in the South in developing their capacities 38 Heinz Greijn, Project Manager MUNDO Since it was founded in 1997, the maastricht University Centre for International Cooperation in academic Development (mUnDO) has implemented dozens of projects supporting the capacity development of higher education institutes in developing countries and Eastern Europe. We are a small unit within maastricht University with twelve staff members. Seven staff members, including the director, are project managers who operate as knowledge brokers connecting teams of experts from maastricht University with teams of experts from the partner institute. In this article I will explain how mUnDO operates. using the case of a project we support in Ethiopia. Since 2006 mUnDO has been implementing a nUFFIC/nPt project with the objective to improve the quality and relevance of medical education at two young Universities in mekelle and Hawassa. through this project with a project budget of 1,6 million euros, we aim to contribute to improved health of the people in Ethiopia. The health situation in Ethiopia to understand the relevance it is important to picture how this project is embedded in its wider context. the health indicators show a distressing situation in Ethiopia. One in six children will not see their fifth birthday. nearly 1 out of 100 pregnant women die from causes related to child bearing. 1.5 million people are living with HIV/ aIDS and the number is rising, preventable and treatable diseases cause death because four out of every 10 people have no access to health care. Ethiopia has only 22,000 health workers on a po- �
� bulletin van de netherlands school of primary care research ◄ terUg Naar INHOUD 39 carré | jaargang 15 | nr 51 | maart 2010 pulation of 73 million people. It is estimated that only 2500 and 4000 are doctors and the remaining are health officers, nurses and midwives. this amounts to 0.3 1 health worker per 1000 people, which is extremely low even compared to neighboring countries. One of the problems Ethiopia is struggling with is the massive brain drain of medical doctors abroad. according to some reports there are more Ethiopian medical doctors working in the EU and the US than at home. Hence there is a need to boost Ethiopia’s capacity to train medical doctors. The medical faculties of Hawassa and Mekelle In view of shortage of doctors all medical faculties in Ethiopia are expected to dramatically increase their capacity. For the period 2006-09 the medical faculties of Hawassa and mekelle planned to increase enrolment from 172 students to 345 and from 230 students to 440 respectively. at the same time the faculties wanted to improve quality and relevance and adopt a student centered approach. In 2006 the management of the institutes had only vague ideas about the nature of this student centered approach, the Dean of mekelle referring to his own education through traditional rote learning in large auditoria said to me: ”We want to teach our students in a different way than we have been taught ourselves”. When starting a project we are always very cautious about the setting of targets. this aspect is often underestimated. Expectations on the donor side (in this case nUFFIC) and the recipient side are often very high whereas the budget and scope of a project is usually modest compared to higher level objectives. In this particular case of Ethiopia 1.6 million Euros may seem a lot of money, but it is by far not enough to increase the student intake capacity of both institutes to the levels mentioned above and to introduce a student centered curriculum as well. Furthermore, the success of a project depends on many other factors that are beyond the control of the faculties and the project management. For example, stepping up the capacity to train medical doctors will be futile if no measures are taken to stop the brain drain. another factor that influenced the project outcome was the fact that in the early stages of the project the central government decided how many students the medical faculties were supposed to register with little consideration whether the faculties were able to take on these students. In such a situation it is very difficult to improve quality. It is important to map out and assess such uncertain external factors as early as possible in order to make a list of interventions that are effective and that make sense against the back drop of the bigger picture dynamics. taking into consideration such factors we agreed with the partners which interventions would make a good contribution to meeting their strategic objectives. Out of the many interventions we agreed on I will describe two interventions that involved exchange of expertise between maastricht University and the partner institutes 2 . A student centered approach to education With the aim of introducing a more student centered approach to teaching, two experts from maastricht University visited the faculties in Ethiopia to conduct a workshop discussing with staff the various options. Vice versa Ethiopian staff members came to the netherlands to see how student centered education works at maastricht University. maastricht champions the problem based learning approach (PBL). In PBL students are stimulated to be curious and creative in solving problems that are very similar to what they will encounter in practice in their future careers. the project was forced to go slow in deciding on a particular student centered approach, because the Ethiopian Ministries of Education and Health were in the process of developing a basic curriculum for medical education in Ethiopia. For as long as this policy was still in the pipeline, it was very difficult to know how much room for manoeuvre there was for the faculties to shape their own student centered approach to education. In order to learn from other institutes, the �
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