Building Public Health Capacity: Field Epidemiology Training Program (FETPs)

1. Building Public Health Capacity: Field Epidemiology Training Program (FETPs)

2. CDC's Global Health Goals Healthy People in a Healthy World:People around the world will live safer, healthier, & longer lives through • Health Promotion: Global health will improve by sharing knowledge, tools & other resources with people & partners around the world  • Health Protection: Americans at home & abroad will be protected from health threats through a transnational prevention, detection, & response network  • Health Diplomacy: CDC & the United States Government will be a trusted & effective resource for health development & health protection around the globe

3. Mission • Work with Ministries of Health • and public health partners to: • Strengthen public health systems • Develop the workforce to build sustainable capacity

4. Strategy Work with partners & MOHs in these areas: • Applied Epidemiology:strengthen countries’ epidemiology workforce through residency-based applied epidemiology program • Surveillance Systems:strengthen countries’ PH surveillance & response systems for priority disease conditions • Public Health Management:improve public health management capacity in developing countries

5. Field Epidemiology(and Laboratory) Training Program (FETP/FELTP)

6. FETP Overview • Modeled after CDC’s Epidemic Intelligence Service • Two-year, full-time postgraduate training program • Supervised, on-the-job, competency-based training • About 25% class work, 75% field placement • Assigned to positions that provide epidemiologic service to MOH • Graduates may receive a certificate or degree

7. FE(L)TP • FETP that also trains laboratory scientists • Fosters linkage between epidemiologists & laboratory scientists • Enhance communication • Lab-based Surveillance • Build quality laboratory networks • Examples: Kenya, Central Asia, Pakistan, South Africa

8. Field Epidemiology Training Programs

10. Team Approach to Plan & Provide Technical Assistance CDC Resident Advisor(in-country) Country FETP Field MOH Provinces & districts Atlanta Non-communicable disease Infectious Diseases Epidemiologist PH Advisor DGPHCD US CDC Partners Instructional Designer Program Analyst Other Technical Environmental

11. FETP Timeline • First contact by MOH to CDC • 1−2 years: * In-country assessment * Country plan development * Funding awarded * Resident advisor placed * Curriculum developed * First cohort recruited • 2 years: First graduates • 5−7 years: Transition for resident advisor departure

12. Country (MOH) Participation • Provide access to surveillance systems & data • Identify priority areas for planned investigations • Provide support for investigations • Clearly delineate trainee duties • Provide administrative facilitation • Provide counterpart with dedicated time • Develop career structure for graduates

13. CDC Contribution • Expertise in • Applied epidemiology program development & implementation • Curriculum development • Training • Evaluation • Technical assistance from a multidisciplinary team • Resident advisor placed in country for 4 to 6 years • Linkages to other CDC experts in country’s disease priority areas • Facilitate networking with other FETPs around the world

14. FE(L)TP Services to MOH • Detect & respond to PH emergencies (i.e., outbreaks, disasters, emerging infections) • Enhance disease surveillance systems • Analyze routinely collected data • Conduct surveys, field studies, & evaluations • Develop new or strengthen existing systems • Communicate PH findings & recommendations • Oral presentations & written publications • Publish epidemiologic bulletin • Conduct seminars & training for others

15. FE(L)TP Key Features • Country ownership of program • Program tailored to country needs & priorities • Resident advisor for first implementation phase • Plan for sustainability • Partnership enables additional collaborations with CDC & others

16. FE(L)TP Training Competencies & Curriculum

17. Competency Development Process Formal Instruction Achieving competency in field epidemiologyBlended learning & measurable results • OUTPUTS • Outbreak report • Surveillance evaluation report • Data analysis report • Study protocol • Thesis • Abstract • Conference presentation • Seminar • Bulletin article • Scientific manuscript • Dataset • Teaching summary report • Project statement & work plan - Epidemiologic methods - Biostatistics - Surveillance - Lab & biosafety - Communications - Computer technology - Management & leadership - Prevention effectiveness - Teaching mentoring - Epidemiology of disease & injury Field Activities Mentoring

18. Critical Outcomes • Robust surveillance system established & used effectively • PH events detected, investigated, & responded to quickly & effectively • Human capacity developed in applied epidemiology & PH laboratory management • PH program decisions based on scientific data

19. Sponsors & Partners FETPs & other programs funded by • GDD • USAID • World Bank • Dept. of State • GAP • Gates Foundation

20. Different Modelsof FE(L)TPs

21. Different Models • FE(L)TPs • Certificate or degree • Multi-country or regional programs • Laboratory Component • Other components • Short courses and/or DDM • Priority diseases - Infectious diseases - Chronic diseases • Emphasis on surveillance systems development

22. Field Epidemiology Networks TEPHINET & AFENET

23. TEPHINET Training Programs in Epidemiology & PHInterventions NETwork (www.tephinet.org) • Global network of FETPs & similar programs, supported by CDC, WHO, & Foundation Merieux • Incorporated in 1999 • Goals • Support & strengthen existing FETPs • Support development of new FETPs • Enhance applied PH research in field-based programs • Link professionals in field epidemiology to organizations responding to PH situations

24. African Field Epidemiology Network (AFENET) Leadership for the Region

25. AFENET is Born In August 2005, at the 2nd African FETP directors’ meeting, AFENET was established to: • Share expertise/best practices with member programs • Promote & support applied public health research activities • Advocate for better health for Africa • Mobilize resources for member programs • Promote the establishment of new FELTPs in Africa • Link public health professionals with organizations seeking competency in field epidemiology

26. Accomplishments • Support member countries to conduct assessments for new programs in West Africa, Nigeria, & Tanzania • Provide technical assistance & supplies for the response to disease outbreaks in the region (eg, avian flu, rift valley fever & Ebola) • Pilots new training materials that will be used in the region • AFENET/USAID/CDC Immunization projects (US$ 5000 grants to 5 trainees in the member programs • Website and Newsletter

27. Conclusions • FETPs are Ministry of Health programs • FETPs are not just training programs • emphasize building public health systems • FETP programs are diverse   • in various stages of development; tailored to the needs of the country, with unique components • FETP Regional Networks can support development of applied epidemiology and laboratory capacity

28. How do FETPs relate to One Health • Close partnerships with the government • Close human-animal relationships • High density populations • Live animal markets • Cross-border issues • Train the workforce to respond via joint-investigations  • FETPs can foster regional collaboration through network and inter-governmental knowledge share • CDC technical assistance

30. Other Programs DDM, IDSR, Others

31. Data for Decision Making (DDM) Goals • Increase ability of decision-makers to use data appropriately for making & implementing PH decisions • Enhance capacity of technical staff to provide needed information to decision-makers • Strengthen health information systems at local, regional, & national levels

32. DDM Training Program Design Target audience Experienced mid-level managers or PH officers Program design • On-the-job training • Combination of didactic & project • 4–6 weeks of didactic training over 8–12 months • Supervised application of skills between workshops

33. DDM Training Program Design (cont.) Didactic training Surveillance, epidemiology, data analysis, information technology, management, communication, & PH economics For project Participants select existing PH problem of significance from their area or district: describe health problem, identify existing data, collect & analyze data, determine causes & appropriate interventions, develop implementation plan & budget

34. Other DGPHCD-supported Programs • Other programs • Africa Integrated Disease Surveillance & Response • Sudan Health Transformation Project • Amazon River Basin Surveillance • Avian influenza projects • Field staff in South Sudan, & Brazil • FETPs & other programs funded by GDD, USAID, World Bank, Ellison Foundation, NTI