What specific problems in Ethiopia is TAAAC addressing?
Currently, there are very few specialist and subspecialist medical education, Masters and PhD programs in Ethiopia. Professionals who want or require additional education are forced by this circumstance to leave Ethiopia to pursue their goals. Only a small percentage of these now highly trained professionals return to Ethiopia. TAAAC is working with Ethiopian colleagues to develop, strengthen and expand the educational infrastructure of required advanced programs at Addis Ababa University, so that professionals can continue living and working in Ethiopia as they augment their educations and professional qualifications. By working to develop post graduate training capacity and sustainability Ethiopia can train the professionals she needs to solve the problems that continue to haunt the country.
The Psychiatrists trained in country in the TAAPP partnership have a 95% retention rate – contrasted against an 80% migration rate of other physicians and health care workers either out of the country or out of the public health system. We hope that TAAAC by co-developing and strengthening Ethiopian training programs, will act to mitigate the brain-drain!
Ethiopia is expanding the number of medical schools from 3 to 12; the number of medical students per year is going to increase from 100 to 400. Medical faculty are urgently needed to staff and teach these new cohorts of potential doctors and specialists.
Health is not a result of development; it is a key prerequisite for development. Working to promote and enable Ethiopian capacity and sustainability in local post graduate trainings will strengthen the health care system of Ethiopia which can be anticipated to support development over multiple sectors.
How many volunteers travel to teach in Addis every year?
Approximately 90 volunteers travel and teach in Addis each year.
Why build educational capacity in Ethiopia?
Ethiopia has an urgent need for qualified health care professionals at every level of the health system in order to improve the health of the population which has some of the worst health statistics in Africa.
In 2004, the World Health Organization (WHO) and World Federation of Medical Education (WFME) recognized the importance of strengthening health professional education in order to increase the personnel available, to teach others and expand the capacity of health systems. Health worker shortages interfere with efforts to achieve global health-related millennium development goals. According to the WHO 2006, while the African continent bears 24% of the global burden of disease it has only 3% of the world's health workforce and less than 1% of the world's financial resources for health.
About 80% of the population live in rural Ethiopia, and only half have access to primary health care. Shortages of physicians, nurses and other health care staff at all levels have fostered a weak health care infrastructure unable to cope with emergent and lingering health issues. With a population of over 80 million, the lack of health services, weak infrastructure and limited numbers and capacity of health staff have played a major role in shaping current poor health indicators in Ethiopia. In 2003, there was a total of only 56,269 health workers (including just over 14,000 nurses and 11,000 midwives, 26,000 community health and 1800 physicians). The significant “brain drain” of 73.2% of physicians out of country leaves a physician population ration of 1:118,00 a 74% deficit according to WHO minimum doctor to population ratio.
A unique and valuable scheme to provide preventative care at the grass roots level is the recent training of thousands of Health Extension Workers – grade 12 students who roll out prevention packages and keep statistics in the villages. But change happens more easily from the top down, rather than the bottom up – specialists are desperately needed to ensure a pyramidal health system and to establish an important plank in developing and sustaining a comprehensive health care system that will also allow expansion and support of the complementary and allied health care professions including Ethiopia’s community and health extension workers Ethiopia also greatly needs engineers and other academics to work in the developing public education system and on expanding infrastructure for transportation and water supply, to support business and to enhance agriculture and food production, to develop export markets and to staff the new universities.
How does TAAAC benefit U of T?
The Ethiopian teaching project will greatly increase the credibility of the University and the Faculty as important players and contributors to international health and global development. It will help establish the University of Toronto as a leader in these fields. This will open many doors and provide many other benefits and opportunities.
How does TAAAC work?
For each new educational partnership a point person is identified who works to gain an in-depth understanding of the needs of the sister AAU Department. The point person recruits and briefs appropriate volunteer UofT faculty for each program who collaborate on curriculum development and implementation with colleagues at AAU. Small teams of specialists with a senior student travel to AAU to block teach most usually for one month, three times per year, over a period of 3-5 years to complete the training of a cohort of residents or graduate students at AAU. As these students become fully qualified they are able to join the AAU faculty, making it possible to continue training more specialists and reducing the dependence on visiting faculty from western universities. As well, there are opportunities for the AAU and U of T scientists to collaborate on research projects, to the benefit of both institutions.
The following Faculties have Departments and Divisions which are developing TAAAC programs:
How long does it take for an Ethiopian to train as a medical subspecialist or graduate with a PhD?
Just as in Canada, different programs require different amounts of time. A PhD typically takes between 2-5 years. For most medical specialties a residency program takes 3-4 years to graduation. Additional faculty development and research is often required for a year or more, to prepare graduates to teach the area of specialization to others. Sub-specialties may require another two years, following the residency program.
What are the medium-term practical goals of TAAAC?
In the 5-10 year time frame, we expect a significant increase in the number and quality of advanced education programs available at AAU. These will be PhD and Master’s programs and medical specialty and sub-subspecialties. Our shared goal is to co-develop a cohort of Ethiopian-trained post-graduates with the ability and qualifications to be hired as teaching faculty into their programs so that the programs develop independence and function without the need for external support. In turn, these academics and health professionals will be able to expand the training available for practitioners and mid-level professionals in health and technical fields.
How are cultural differences accounted for in the program?
It isn’t just cultural differences that need to be accounted for – there are also differences in work conditions and available resources. The approach is one which honours and respects different cultures from the outset, and actively works to incorporate understanding into each phase of the work being done. The conscious aim is to exchange and adapt knowledge, adjusted to Ethiopian realities. For example, co-teaching by UofT and AAU faculty is a collaboration that relies on Ethiopian partners to adapt the material to local knowledge and custom that reflect local conditions and resources.
What language is the teaching done in?
All teaching is conducted in English.
What is TAAAC?
TAAAC started in 2008 as an extension of the successful Toronto Addis Ababa Academic Psychiatry Project (TAAPP), and at the request of senior Ethiopian faculty at Addis Ababa University (AAU). TAAAC is the umbrella organization housing all the new educational partnerships between Departments and Divisions in six Faculties at the University of Toronto in Canada and AAU in Ethiopia. TAAAC’s purpose is to facilitate small, well organized groups of volunteer faculty and an accompanying senior student, who travel to AAU for a month to teach, mentor and collaborate with AAU faculty. The programs build on the work of each group of outgoing faculty so that together we work to enhance and expand medical residencies and subspecialty training in medicine, and to strengthen Masters and PhD programming in other post graduate academic programs.
What does TAAAC stand for?
Toronto Addis Ababa Academic Collaboration
What is TAAPP?
The Toronto Addis Ababa Psychiatry Project (TAAPP) is an educational collaboration between the Department of Psychiatry, University of Toronto and the Department of Psychiatry, Addis Ababa University (AAU). It started in 2003 at the invitation of the two Ethiopian psychiatrists on faculty at AAU, Dr Atalay Alem and DR Mesfin Araya in order to assist build and sustain the first psychiatry residency program in Ethiopia. It is an ongoing program and to date we have together graduated 30 AAU Ethiopian psychiatrists swelling the number of psychiatrists from 11 to 41. It provided the template on which TAAAC is modeled and is now housed under TAAAC although the psychiatry partnership between the two universities continues to be called TAAPP! www.utoronto.ca/ethiopia