JG Hakim, FRCP On Behalf of NECTAR, CHRIS, IMHERZ Team

1. NECTARNovel Education Clinical Trainees And Researchers ProgramAnd Linked-Awards: CHRIS, IMHERZ JG Hakim, FRCP On Behalf of NECTAR, CHRIS, IMHERZ Team University of Zimbabwe College of Health Sciences

2. NECTAR, CHRIS, IMHERZ • NECTAR • Novel Education Clinical Trainees And Researchers Program • CHRIS • Cerebrovascular Heart Failure, RHD Interventions Strategy • IMHERZ • Improving Mental Health Education & Research in Zimbabwe NECTAR CHRIS IMHERZ

3. University of ZimbabweHistory • University of Zimbabwe • First intake 1952 • Oldest & Largest University in Zimbabwe • 10 faculties • Accredited through the National Council of Higher Education (Min of Higher & Tertiary Education) • College of Health Sciences • First intake 1963 • 23 Departments • 5 “Schools” • Medical school • Public health • Nursing • Pharmacy • Rehabilitation

4. UZ-College of Health Sciences • 4 teaching zones • Pre-clinical Depts • Main campus • Parirenyatwa Hospital Campus • Harare Central Hospital • Field Attachment-district hospitals Pre-clinical Departments ParirenyatwaHospital UZCHS New Health Science Building Harare Hospital

5. Training & Service Challenges • Increasing no. of graduates… • In 2010 only 39% (122 of 314) of faculty positions were filled • In 2009 only 33% of MO posts in MOH were filled Loss of Faculty: Impact on students • 2009-only 19% of internal medicine • MMedpositions were filled.

6. Current MBChB Enrolment • Year 1 - 139 • Year 2 - 111 • Year 3 - 140 • Year 4 - 175 • Year 5 - 146 • TOTAL - 711

7. Postgraduate & Faculty • Postgraduate • Diploma • 30 students • MMed-17 courses • 220 students • PhD • 10 candidates • Faculty • 147 in post • Greatest shortage in Preclinical subjects • Clinical instruction • assistance from government consultants

8. Mission Statement In alignment with the mission of the Medical Education Partnership Initiative (MEPI), NECTAR and its two linked award programs -- CHRIS and IMHERZ -- will support medical education and research capacity development in Zimbabwe. The programs will coordinate to increase the quantity, quality, and retention of graduates with specific skills to address the healthcare needs of the population of Zimbabwe

9. Through collaboration, the programs will: • Modernize the curricula, pedagogy, and instructional technology at the UZCHS in local healthcare priorities; • Establish ongoing professional development for current faculty and support for the development of future medical educators; • Increase UZCHS students’ skills, resources, and opportunities to engage in regionally relevant research; • Support and focus research efforts on local healthcare priorities; • Facilitate long-term collaboration between Zimbabwe and US/UK/SA doctors in medical research to improve the health of the population.

10. In-Country Collaborations • Ministries • Health/Child Welfare • Higher/Tertiary Education • ICT • US Agencies • PEPFAR, CDC, USAID • Others • BRTI, NIHR, AiBST • Workshop • 9th April 2010 • Preparation for MEPI application • Solicit ideas and support • 3rd-5th Feb 2011 • Presentation of award & implementation plan to stakeholders • Solicitation of further support

11. Increasing Capacity • Faculty Development • FAIMER training • 48 faculty members to be trained in 5 years • MCSP • Mentored Clinical Scholars Program • 63 specially mentored student/postgraduate scholars as substrate for additional faculty • Increase UZCHS intake • Increase to 200/year at 5 years

12. Improving Retention • Retention of Faculty • Special training as educators • Create a scholarly environment • Enhance teaching skills and opportunities through a College Teaching and Learning Centre • Improve research capacity & competitiveness • Retention of Medical Personnel • Enrich field attachment experience • Impart life-long learning skills

13. Conduct Country Relevant Research • Strengthen research skills at all levels • Undergraduate, Postgraduate, Faculty • Training and skills development courses • Establish a Research Support Centre • Track research opportunities • Train and support skills in research: • Identification, application, conduct, ethics, monitoring, publication • Train and make available grants management skills

14. NECTAR Strategy • To create an academically stimulating environment • To enable collaborative partnerships to foster cutting-edge research and innovative teaching • To provide partners to share the work-load of teaching and clinical care until faculty numbers increase

15. NECTAR Summary Enhanced & innovative curriculum focused on TB, HIV, & Malaria NECTAR Mentored Clinical Scholars Program NECTAR Mentored Research Scholars Program Create academic environment enabling UZCHS faculty to become leading medical educators, investigators, & mentors Monitor impact of NECTAR on medical education, research & practice RESULT: Increased clinical & research competency and retention of Zimbabwean healthcare professionals

16. CHRIS • Enhance existing curriculum in CVD for all students • Clinical, Echocardiography, ECG • Implement a cardiovascular scholars program for promising students/postgraduates • Engage UZCHS students, PGs & faculty in scholarly activities related to CVD • Identify & initiate training of faculty through an exchange program with UCD and UCT

17. CHRIS Content AreasTreatment and Prevention • Cerebrovascular Disease • Community-based epidemiology of hypertension • Harare • Rural attachments • Community-based Stroke rehabilitation • Heart Failure • Hospital-based registry of patients, treatments, outcomes • Rheumatic Heart Disease • Registry of clinical characteristics and outcomes using ASAP registry. • Primary and secondary education campaign

18. IMHERZ • Increase expertise & retention of UZCHS psychiatry faculty • Strengthen existing post-graduate curriculum • Mentoring, short courses and visiting lecturers • Capacitate MMedsto be competent educators • Master classes, Exchange program • IMHERZ mentored fellowships for strong candidates

19. Undergraduate Mental Health • Curriculum review; modernized education • Communication skills, family function • Recognition and country-relevant treatment of priority conditions • Link with WHO ‘MHGap’ intervention guide • Teach medical students to be competent educators in mental health including for nurses and lay workers

20. Building Research Expertise in Mental Health • Strengthen research capacity • PhD opportunities for suitable applicants • Training opportunities in Public Mental Health • Research courses in psychiatric epidemiology, mental health economics • Use current research projects as platform for training, especially interventions for common mental disorders in general health care • IMHERZ research fellowship-exchange program

21. NECTAR, CHRIS, IMHERZ ORGANIZATIONAL STRUCTURE

22. PARTNERSHIPS CHRIS NECTAR IMHERZ UZCHS-University of Zimbabwe College of Health Sciences UCD-University of Colorado, Denver SU-Stanford University UCL- University College London; IoP-Institute of Psychiatry UCT-University of Cape Town

23. NCI Workshop 3rd-5th Feb 2011 Second NECTAR/CHRIS/IMHERZ Workshop, Harare, Zimbabwe-3rd-5th Feb 2011 Attendees: Partner representatives-Univ of Colorado, Denver, Stanford Univ, Univ of Cape Town, Institute of Psychiatry, University College London, Bristol Univ; Representatives of MoH, MoHTE, MoICT, NCHE, NAC UZ Faculty, District MOs, Teaching Hospital Leaders, Stakeholders-CDC, USAID

24. Role of NECTAR Partners To assist UZ faculty with design and implementation of: • Competency-based medical curricula for post-graduate and undergraduate students • A Mentored Clinical Scholars Program that will provide mentorship and advanced instruction in teaching and educational techniques to UZ postgraduate students • Faculty development education programs with emphasis on engaging and training district medical officers at field attachment sites to provide better clinical education experiences for medical students • Evaluations of the impact of NECTAR programs on medical education and health care in Zimbabwe

25. Role of CHRIS Partners • To assist UZCHS to expand teaching, research and scholarly activities in CVD • Mentoring of CCSP scholars • Assist in training of specialists in CVD-related disciplines-cardiology, neurology, public health, rehabilitation • Develop & implement evidence-based management guidelines • Assist in conduct of survey methods & establishment of disease registries

26. Role of IMHERZ Partners • IMHERZ Partners • IoP-King’s College London, UCL, Bristol, Harvard, Stanford • Only implement change that fits with an agreed need for UZCHS and is likely to lead to a sustainable action • Assist in gathering & implementation of best practices from elsewhere in Africa • Ensure most faculty development occurs within Zimbabwe • Support existing faculty to improve teaching skills • Capacitate medical students and MMeds to be competent mental health educators • Education abroad should be contextualised and integrated when the scholars return to Zimbabwe

27. Project Outcome ForecastIncreasing No. of Health Care workers

28. Project Outcome ForecastRetention

29. Project Outcome ForecastInvesting in Regionally Relevant Research

30. NECTAR Picture Gallery

31. Challenges & Future Direction • NECTAR-Upgrade of ICT • Better internet services-beyond current plans • Improved access for students & faculty-Wi-fi, computers, laptops • Extend curriculum development to other cadres-nurses, pharmacists, dentists, rehabilitation specialists, etc • CHRIS-More intense clinical and epidemiological focus • A comprehensive program to prevent rheumatic heart disease • IMHERZ • Comprehensive initiative to train large numbers of non-doctor mental health cadres

32. Acknowledgements • University of Zimbabwe • Prof L Nyagura-Vice Chancellor • UZCHS • Prof M Chidzonga-Dean • Mr W Chitiyo-Deputy Registrar • NECTAR/CHRIS/IMHERZ Executive • Peter Mason • Thomas Campbell • Michele Barry • Edward Havranek • Frances Cowan • Melanie Abas • Sekai Nhiwatiwa • UCD & UZ Evaluations Centre • Bonnie Walters • Simbarashe Rusakaniko • NECTAR Secretariat • Information Communication Tech • Tungamirai Simbini • Curriculum Committee Co-chairs • Godfrey Muguti • Christopher Samkange • Eva Aagaard • Bonnie Maldonado • Mentored Clinical Scholars Program • Kusum Nathoo • Margaret Borok • Nancy Madinger • Mentored Research Scholars Program • Mike Chirenje • Tsungai Chipato • David Katzenstein • Faculty Development Program • Midion Chidzonga • Lucy Bradley-Springer • Visiting Professors • Jonathan Matenga • Rangarirai Masanganise • Lucy Bradley-Springer

33. Thank You