Paediatric haematology/oncology workforce and training programmes for Africa: a regional analysis

Abstract

Graduate medical education programmes in paediatric haematology/oncology (PHO) are necessary to train specialists to provide high-quality care for children and adolescents with cancer and haematologic diseases. In this study, we used the Education Program Assessment Tool (EPAT). The study consisted of three components: (1) mapping the PHO workforce and training programmes in Africa; (2) using the EPAT to evaluate the current PHO programmes in Africa and (3) using a design-thinking approach to develop priority interventions to expand PHO training capacity in Africa through a collaborative co-design process. There were 236 fellowship-trained paediatric haematologists/oncologists in 37 countries in Africa. 17 countries (32%), with a total population of 42 million under 14 years of age, had no paediatric haematologists/oncologists. The continent has an average of 205 new paediatric cancer cases per specialist. 22 PHO training programmes completed the EPAT. The average score was 72% (SD 9%). Programmes showed varying strengths in the elements of comprehensive training, with the highest EPAT scores in experiential learning domains. A priority-setting exercise established interventions to strengthen PHO training in Africa, including a PHO curriculum, a leadership skill development process and a path for the creation of exchange opportunities. The PHO workforce and training capacity are highly variable in Africa. Through international collaboration and a systematic evaluation of workforce density and training programme strengths, alignment on key regional priorities and the creation of a shared model of cooperation to enhance training programmes for Africa can be achieved.

Keywords: Cancer; Child health; Health systems.

Figure 1. Study approach and components. EPAT, Education Program Assessment Tool; PHO, paediatric haematology/oncology.

Figure 2. (A) The paediatric haematology/oncology workforce density per million children under 18 years of age in Africa. (B) Sites of paediatric haematology/oncology training programmes according to World Bank income classification, disciplines of the training programmes and the hospital type.

Figure 3. (A) Average Education Program Assessment Tool (EPAT) scores of the 22 responding programmes. (B) Scatter plot showing the EPAT domain scores of the 22 responding programmes.

Figure 4. Results of the Education Program Assessment Tool design-thinking discussion and prioritisation. SWOT, strengths, weaknesses, opportunities and threats.