U-M OB/GYN training programs continue to take hold in Africa

Cameroon is the latest nation where a University of Michigan-developed OB/GYN training program has taken root, part of broader effort to confront maternal and infant mortality across Sub-Saharan Africa.

Dr. Frank Anderson

The University of Beau will launch its first OB/GYN residency this year. The training is being done in partnership with the University of Arizona, Phoenix College of Medicine, but is part of a larger program called the 1,000+ OB/GYN Project, an OB/GYN post-graduate training initiative that takes U-M’s proven partnership model and makes it freely available to teaching hospitals across Africa and their US-based collaborators. What started as a small experiment to improve women’s health in Ghana has turned into something of a movement, according to Frank Anderson, MD, MPH, a Professor of Obstetrics & Gynecology who launched the 1,000+ OB/GYN Project with the help of UMMS colleagues in 2014.

“We’ve had schools in Malawi, Sierra Leone, Liberia, Ethiopia, and now Cameroon adopt this model, using curriculum examples, textbooks, lab materials, videos – all brought together by U-M,” said Dr. Anderson, who visited the University of Beau to consult on their new program last year. “We have the materials and proven approach, why not share those resources to help jumpstart programs in other countries?”

UMMS’ OB/GYN Department first partnered with the University of Ghana and Kwame Nkrumah University in the 1980s develop a sustainable, in-country training model for Ghanaian OB/GYN physicians. Seeing the success those partnerships – at last count, all but 1 of the 142 trained doctors were still practicing in Ghana – the team sought to replicate the success through the 1,000+ OB/GYN Project. The initial goal, as the title implies, was to establish enough in-country capacity to train 1,000 new OB/GYN doctors across Sub-Saharan Africa within 10 years, a target the project is on track to exceed easily.

“I think we may have to rename the project to the 10,000+ OB/GYN project. Ethiopia alone has the stated goal of 800 new physicians, and that is only one program,” said Dr. Anderson, who is traveling to Ghana this summer with medical students to survey program graduates again for updated results in that country’s programs.

The new residency in Cameroon will welcome its initial cohort of students this October. The program will start modestly with five residents but, like its sister programs, is expected to grow exponentially over time as those who complete the training in turn become teachers for future residents. Dr. Anderson and his team also hope to accelerate the progress by transitioning from the current model, which simply makes the curriculum and resources available, toward a more hands-on approach, introducing administrative and implementation resources into each African partner school and institution. They are currently seeking funding to do just that.

The World Health Organization aims to reduce maternal mortality worldwide to less than 70 per 100,000 live births by 2030. It’s a lofty goal; while maternal mortality has fallen by nearly 50 percent since 1990, the mortality ratio among women in low- to middle-incoming countries remains 14 times higher than in developed regions, where only half of the women receive the recommended amount of prenatal care they need.

To meet that goal, Dr. Anderson believes, countries need to adopt broad educational approaches that produce well-rounded OB/GYN physicians, rather than training that focuses on individual diseases or pregnancy complications as many programs currently do.

“I’m gratified that more institutions continue to adopt and implement these resources. Women, whether they live in a city center or in a rural area, deserve access to advanced care with fully trained OB/GYN doctors,” he said. “That’s the only way we’re going to reach the WHO target goal. I believe it’s possible. Although there is a lot of work to do, the progress being made across Sub-Saharan Africa is encouraging.”