Building a framework for the design and implementation of One Health curricula in East and Central Africa: OHCEAs One Health Training Modules Development Process
Hellen Amugunia, Winnie Bikaakob, Irene Naigagab, William Bazeyo
Tufts University, Cummings School of Veterinary Medicine, 200 Westboro Road, North Grafton, USA
One Health Central and Eastern Africa (OHCEA), P.O. Box 7072, Kampala, Unit 4, Ekobo Avenue, Kololo, Uganda
Finance and Administration, Makerere University and Principal Investigator, One Health Central and Eastern Africa(OHCEA) Network. P.O. Box 7072, Kampala, Unit 4,
Ekobo Avenue, Kololo, Uganda
Over the past decade, Africa and the world have faced severe public health threats, ranging from infectious disease outbreaks such as the Ebola outbreak in West Africa to environmental disruptions like the devastating effects of hurricane Matthew in Haiti. Recent outbreaks of emerging infectious diseases have captured global attention with their significant impact on health systems and economies. Boundaries between humans, animals and our environment are undergoing rapid changes . Novel diseases are emerging and not just in humans. It is estimated that three out of four new infectious diseases occurring in humans are of animal origin . The complexity of the issues: global movement of people, animals and disease-causing pathogens, cross border exchanges, increased human population, shrinking wildlife habitats, illegal wildlife trade, rapid globalization, pollution, loss of biodiversity, antimicrobial resistance and changes in environment and land use demand that we apply a systems thinking interdisciplinary approach to solve complex health challenges at the human animal and environmental interface.
Experiences from the fight against Ebola and the highly pathogenic avian influenza demonstrated the effectiveness of multi-sectoral, multi-agency approaches that are not limited by national or regional borders in dealing with public health threats . One of the key approaches to achieve global health security is by building a multidisciplinary public health workforce that is well trained and fully equipped to counter infectious disease threats and that eliminate the current global barriers that exist because of disciplinary silos.
In response to this challenge, the One Health approach is advocated as the global framework for strengthening collaboration and capacities of the sectors and actors involved in health service delivery . The One Health paradigm emerged from the recognition that the wellbeing of humans, animals and ecosystems are interrelated and interdependent, and there is need for more systematic and cross-sectoral approaches to identifying and responding to global public health emergencies and other health threats arising at the human-animal ecosystem interface . The One Health concept is a growing global strategy for expanding interdisciplinary collaborations and communications in all aspects of health care for humans, animals and the environment that calls for a paradigm shift in developing, implementing and sustaining health policies .
Key to the implementation of One Health strategies is the redesign of a more integrative and dynamic educational system to better match the public health needs and produce a workforce that can effectively and efficiently respond to complex health challenges. Mismatch between present siloed professional competencies and the requirements of an increasingly multidisciplinary complex world means that overhauling public health education is imperative. In 2010, the commission on education for health professionals for the 21st century was launched. This independent initiative with a global outlook sought to advance health by recommending instructional and institutional innovations to develop a new generation of health professionals who would be better equipped to handle present and future complex health challenges in an era of rapid globalization . Yet many professional training programs are still very traditional, producing graduates who are ill equipped to handle current challenges. One Health is a conceptual challenge to conventional public health training and practice because it addresses public health threats from a multidisciplinary collaborative perspective.
One Health Central and Eastern Africa (OHCEA) is a network of universities in Central, West and Eastern Africa which are collaborating to build One Health capacity and academic partnerships in the region. OHCEA membership includes twenty-four Central, West and Eastern Africa Schools of Public Health, Veterinary Medicine and Environmental Science; and US partner institutions: University of Minnesota (UMN) and Tufts University. The current OHCEA membership spans eight countries: Kenya, Uganda, Tanzania, Rwanda, Ethiopia, Democratic Republic of Congo, Cameroon, and Senegal , working together to strengthen public health education, systems, emergency preparedness and response.
OHCEA seeks to expand the human resource base needed to detect and respond to potential pandemic disease outbreaks, and increase integration of animal, wildlife and human disease surveillance and outbreak response systems using a One Health approach . To do this effectively requires engagement of multidisciplinary groups of professionals with the right intellectual competencies and knowledge, capable of collaborating with each other. What type of training and preparation will provide public health professionals with the skills and competencies needed to combat such emerging public health threats?
The OHCEA network and its partner institutions, have developed One Health Core Competencies and modules that are key to delivering knowledge and skills to a multidisciplinary workforce and building a framework on which One Health curricula can be designed and implemented. A total of sixteen modules have been developed including One Health soft skills such communication, collaboration and partnership, culture, leadership, gender, policy and advocacy, systems thinking as well as core technical skills including ecosystem health, risk analysis, infectious disease epidemiology, One Health concepts and outbreak investigation and response. These modules are being used at both preservice and in-service levels. by faculty and students across OHCEA's eight countries and institutions in East and Central Africa, and by various government and private industry in these countries-deliberately focusing on building cross sectoral collaborative skills and technical competencies that prepare them to efficiently respond to any emerging public health threats. They are designed to fill the cross sectoral and technical skill gap caused by the changes in public health practice. The skills provided combine human and animal health sciences with the principles of ecology and environmental health while at the same time considering the social, economic, cultural and environmental impacts and effects on global health security. In this manuscript, we provide a detailed description of the module development process.
Producing Interdisciplinary Competent Professionals: Integrating One Health Core Competencies into the Veterinary Curriculum at the University of Rwanda
Hellen J. Amuguni n Melissa Mazan n Robert Kibuuka
Infectious diseases of grave concern to human health are emerging from wildlife and livestock populations in multiple regions of the world. Responding effectively to these emerging pandemics requires engagement of multidisciplinary groups of professionals. Using a One Health approach, One Health Central and Eastern Africa (OHCEA), a network of seven schools of public health and seven veterinary schools, with the support of the United States Agency for International Development (USAID), has engaged in curriculum review with the aim of building the skills of multidisciplinary groups of professionals to improve their capacity to respond to emerging infectious diseases. Through stakeholder analysis and curriculum development workshops, the University of Rwanda’s School of Veterinary Medicine, in association with Tufts University, revised its curriculum to incorporate One Health competencies to be better prepared to respond to any infectious disease outbreak in Africa. The revised curriculum aimed to build cross-sectoral skills and knowledge; transform students’ ways of thinking about infectious disease outbreak response; link human, veterinary, and wildlife health training opportunities; and strengthen community front-line responder training. Eight different disciplines engaged in the curriculum review process: Veterinary Medicine, Livestock Production, Wildlife and Aquatic Resources, Environmental Health and Epidemiology, Communication Technology, Engineering, Agriculture, and Public Health. One Health competencies such as communication, collaboration, leadership, and advocacy were added to the new curriculum, helping ensure that each professional be appropriately equipped with skills to recognize and respond effectively to any emerging infections.
Key words: curriculum, educational methods, One Health, infectious diseases
Implementing One Health as an integrated approach to health in Rwanda
It is increasingly clear that resolution of complex global health problems requires interdisciplinary, intersectoral expertise and cooperation from governmental, nongovernmental and educational agencies. ‘One Health’ refers to the collaboration of multiple disciplines and sectors working locally, nationally and globally to attain optimal health for people, animals and the environment. One Health offers the opportunity to acknowledge shared interests, set common goals, and drive toward team work to benefit the overall health of a nation. As in most countries, the health of Rwanda’s people and economy are highly dependent on the health of the environment. Recently, Rwanda has developed a One Health strategic plan to meet its human, animal and environmental health challenges. This approach drives innovations that are important to solve both acute and chronic health problems and offers synergy across systems, resulting in improved communication, evidence-based solutions, development of a new generation of systems-thinkers, improved surveillance, decreased lag time in response, and improved health and economic savings. Several factors have enabled the One Health movement in Rwanda including an elaborate network of community health workers, existing rapid response teams, international academic partnerships willing to look more broadly than at a single disease or population, and relative equity between female and male health professionals. Barriers to implementing this strategy include competition over budget, poor communication, and the need for improved technology. Given the interconnectedness of our global community, it may be time for countries and their neighbours to follow Rwanda’s lead and consider incorporating One Health principles into their national strategic health plans.
One Health capacity building in sub-Saharan Africa
Innocent B. Rwego, BVM, MSc, PhD,1,7,* Olutayo Olajide Babalobi, DVM, MPVM, PhD,2 Protus Musotsi, BSc,3 Serge Nzietchueng, DVM, MSc,1,4 Christian Keambo Tiambo, BSc, PhD,5,6 John David Kabasa, BVM, MSc, PhD,7 Irene Naigaga, BVM, MSc, PhD,8 Gladys Kalema-Zikusoka, BVetMed, MRCVS,9 and Katherine Pelican, DVM, PhD1
Africa of late has been faced with challenges that require a multidisciplinary and multisectoral approach to address them, and academic and non-academic institutions have played a key role in training and conducting research that would promote the One Health approach.
The objective of this review was to document networks and organizations conducting One Health training, research, and outreach in Africa, as one of a series of articles around the world.
Data for this review were collected from organizations through key contacts of the authors and their knowledge of networks they have worked with. Web searches were conducted using One Health, training, and research as key words for work done in Africa.
Africa has major networks involved in One Health training, research, and outreach, with participation of both academic and non-academic institutions. This review highlights an effort in Africa to form networks to conduct multidisciplinary training and research. The main networks include Afrique One, Southern African Centre for Infectious Disease Surveillance (SACIDS), and One Health Central and Eastern Africa (OHCEA).
Both academic and non-academic institutions and organizations have shown an interest to conduct multidisciplinary training and research in Africa for managing challenges that Africa is facing currently, especially the outbreak of infectious diseases.
The full text article available here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5131459/
One Health Central and Eastern Africa: Historical and Future Perspectives
One Health Central and Eastern Africa (OHCEA) is a network of schools of public health and veterinary higher education institutions that are located in countries of the Eastern and Central Africa region, a region that includes the Congo Basin commonly considered to be one of the ‘hot spots’ for emerging and reemerging infectious diseases. The vision of the OHCEA network is to be a global leader in One Health, promoting sustainable health for prosperous communities, productive animals, and balanced ecosystems.
• Hot spots;
• One Health Central and Eastern Africa (OHCEA);
• United States Agency for International Development (USAID);
• World Health Organization (WHO);
• Food and Agriculture Organization (FAO);
• World Organization for Animal Health (OIE);
• One Health, Emerging Pandemic Threats
See details about the publication: http://www.sciencedirect.com/science/article/pii/B9780128036785005129
Seroprevalence of Coxiella burnetii in sheep, goats and impalas at the Amboseli Park corridor, Kenya Bilha Njeri Nguro, George Karuoya Gitau & Andrew Gitau Thaiyah Department of Clinical Studies, Faculty of Veterinary Medicine, University of Nairobi, Kenya.
Coxiella burnetii is an obligate intracellular bacterium that is the causative agent of Q fever, an important zoonotic. Domestic ruminants, mainly goats and sheep, are the main source of Q fever outbreaks in humans. Very scant information is available on the role and status of Q fever in wildlife in Kenya. This seroepidemiological survey was conducted to investigate the seroprevalence and associated factors of coxiellosis in sheep, goats and impalas at the Amboseli National Park wildlife-livestock corridor in Kenya. 5 ml whole blood was collected through jugular venepuncture from 300 sheep, 200 goats and 20 impalas. Sera were then collected and tested for antibodies against Coxiella burnetii using ELISA CHEKIT Q fever test kit. The seroprevalence at 95% confidence interval in sheep was 6% (2.7%, 9.3%), 21.7% (17%, 26.4%) in goats and 25% (6%, 44%) in impalas. The study also concluded that species and sex were significant risk factors. A semi-structured questionnaire was also administered in all the households to gather general household data and assess pastoralist knowledge on Q fever, none of the respondents had ever heard of the disease. These findings demonstrate that Q fever could be circulating among the wildlife, livestock and humans in the study area and further investigation is required. http://ijirk.com/archive_v2i10_paper_pdf/IJIRK-2.10.03.pdf