Dr. Cancedda is associate physician, Divisions of Global Health Equity and Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, instructor of medicine, Harvard Medical School, Boston, Massachusetts, and former director of medical education and training, Partners In Health Rwanda/Inshuti Mu Buzima, Rwinkwavu, Rwanda. Dr. Farmer is associate physician and division chief, Divisions of Global Health Equity and Infectious Diseases, Brigham and Women's Hospital, professor of medicine and department chair, Department of Global Health and Social Medicine, Harvard Medical School, and cofounder, Partners In Health, Boston, Massachusetts. Dr. Kyamanywa is dean and associate professor, School of Medicine, University of Rwanda, College of Medicine and Health Sciences, Butare, Rwanda. Dr. Riviello is director, Global Surgery Programs, Brigham and Women's Hospital, Center for Surgery and Public Health, instructor in surgery, Harvard Medical School, and director, Global Surgery Programs, Partners In Health, Boston, Massachusetts. Dr. Rhatigan is associate physician and associate division chief, Division of Global Health Equity, Brigham and Women's Hospital, instructor in medicine, Harvard Medical School, and director, Global Health Delivery Partnership, Partners In Health, Boston, Massachusetts. Ms. Wagner is research fellow, Global Health Delivery Partnership, Harvard Medical School, Boston, Massachusetts. Dr. Ngabo is director, Division of Maternal and Child Health, Ministry of Health, Kigali, Rwanda. Mr. Anatole is program director, Mentoring and Enhanced Supervision-Quality Improvement Program, Partners In Health Rwanda/Inshuti Mu Buzima, Rwinkwavu, Rwanda. Dr. Drobac is associate physician, Divisions of Global Health Equity and Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, instructor in medicine, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, executive director, Partners In Health
Acad Med. 2014 Aug;89(8):1117-24. doi: 10.1097/ACM.0000000000000376.
Global disparities in the distribution, specialization, diversity, and competency of the health workforce are striking. Countries with fewer health professionals have poorer health outcomes compared with countries that have more. Despite major gains in health indicators, Rwanda still suffers from a severe shortage of health professionals.This article describes a partnership launched in 2005 by Rwanda's Ministry of Health with the U.S. nongovernmental organization Partners In Health and with Harvard Medical School and Brigham and Women's Hospital. The partnership has expanded to include the Faculty of Medicine and the School of Public Health at the National University of Rwanda and other Harvard-affiliated academic medical centers. The partnership prioritizes local ownership and-with the ultimate goals of strengthening health service delivery and achieving health equity for poor and underserved populations-it has helped establish new or strengthen existing formal educational programs (conferring advanced degrees) and in-service training programs (fostering continuing professional development) targeting the local health workforce. Harvard Medical School and Brigham and Women's Hospital have also benefited from the partnership, expanding the opportunities for training and research in global health available to their faculty and trainees.The partnership has enabled Rwandan health professionals at partnership-supported district hospitals to acquire new competencies and deliver better health services to rural and underserved populations by leveraging resources, expertise, and growing interest in global health within the participating U.S. academic institutions. Best practices implemented during the partnership's first nine years can inform similar formal educational and in-service training programs in other low-income countries.
全球卫生人力的分布、专业化、多样性和能力存在显著差异。与卫生人力较多的国家相比,卫生人力较少的国家的健康结果更差。尽管在卫生指标方面取得了重大进展,但卢旺达仍面临严重的卫生专业人员短缺问题。本文介绍了卢旺达卫生部 2005 年与美国非政府组织“健康伙伴”、哈佛医学院和布莱根妇女医院发起的一项伙伴关系。该伙伴关系已扩大到包括卢旺达国立大学医学院和公共卫生学院以及其他与哈佛有关的学术医疗中心。该伙伴关系优先考虑地方所有权,并以加强卫生服务提供和实现贫困和服务不足人群健康公平为最终目标,帮助建立新的或加强现有的针对当地卫生人力的正规教育计划(授予高级学位)和在职培训计划(促进继续专业发展)。哈佛医学院和布莱根妇女医院也从伙伴关系中受益,为其教师和学员提供了更多的全球卫生培训和研究机会。该伙伴关系使在伙伴关系支持下的地区医院的卢旺达卫生专业人员通过利用资源、专业知识以及参与的美国学术机构对全球健康日益增长的兴趣,获得了新的能力,并为农村和服务不足的人群提供了更好的卫生服务。在伙伴关系的头九年实施的最佳做法可以为其他低收入国家的类似正规教育和在职培训计划提供信息。