Background
Ethiopia has a population of 100 million people. Although it is one of the fastest growing economies in Africa, it is also one of the poorest, with a per capita income of US$660. The healthcare system currently in place is unable to provide services for more than half the population. Ethiopia struggles from a shortage of healthcare workers including specialized medical doctors. The total number of hospital beds in Ethiopia is 11,685, which means that there is only one bed for a population of 4,900. The physician per population ratio is one per 48,000. To put these numbers into perspective, the US has 29 hospital beds per 10,000 people, and 24.5 physicians per 10,000 people – the UK 27.9 and Slovenia 25.2. Using traditional medical education, it will take more than 25 years for Ethiopia to reach an agreed minimum standard health worker population ratio of 100 trained health workers per 100,000 population. With both the population and economy growing, the need for healthcare access is increasing as more of the population move to urban centers.
Situation
There are approximately 160 radiologists in Ethiopia serving a local population of 100 million. The US has approximately 35,000 radiologists for a population of 320 million. Most of the radiologists in Ethiopia are generalists who have not received formal subspecialty training. Over the years most of the attempts the government and medical schools made to formally train the generalists to become subspecialized did not produce meaningful results. Many of the medical students who left for overseas training did not return to Ethiopia. Establishing local subspecialty programs hasn’t been any easier since it is difficult to convince foreign educators and subspecialist physicians to relocate to Ethiopia.
In 2014, representatives from an Ethiopian government hospital, SPHMMC, approached Ver2 Digital Medicine requesting us to develop an innovative two-year specialization program and train their radiologists in four subspecialties locally in Ethiopia while taking into consideration the aforementioned challenges.
Task
Introducing innovative telemedical education services in Africa and the Middle East had been a part of Ver2’s strategic business plan to complement the digital health platform offerings. It was important for Ver2 to win this mandate and execute flawlessly to build investor confidence, gain exposure, and set a footprint in African markets which could potentially lead to additional business opportunities. Ver2 had a capable team with the required skills to develop the program and execute, but it lacked some integral components: educational material, technology platform, and the backing of a renowned medical institution to support Ver2 with its educational expertise and program completion certificates.
Action
- Built a project team consisting of Ver2 and Johns Hopkins Medicine which would complement the Ver2 team and provide the missing integral components for the project.
- The SPHMMC project team tailored a two-year subspecialty program using a combination of prerecorded and live lectures, in addition to interactive case reviews with specialist physicians based out of Johns Hopkins Medicine in Baltimore, USA.
- Selected and customized existing technology solutions to enable seamless educational experience between the trainees in Ethiopia and educators in the US.
- Made all necessary arrangements, preparations, and training for the project team on the ground in Ethiopia to ensure the program proceeds according to schedule.
- Put together contingency plans in the event the project encounters difficulties due to the uncertain political climate and unstable infrastructure.
- Developed a trainee evaluation method and periodically evaluated them to measure the efficacy and outcome of the program.
- Gathered constant feedback from trainees in Ethiopia and educators in the US to tweak and improve the program.
Result
Despite the technical and political challenges arising in Ethiopia and disrupting the program every now and then, the project team collaborated to successfully execute the subspecialty training program as planned and under budget. The program concluded in October 2017 with Johns Hopkins doctors and educators flying to Ethiopia to present the 10 radiologists with their program completion certificates.
Award
Ver2 won the Dubai Expo2020 Innovation Impact Grant from among 400 submissions and secured funds to expand the SPHMMC subspecialty education program and make it sustainable. The add-on program would train select Ethiopian radiologists from the subspecialty program to become educators for future specialists.