Toronto Addis Ababa Academic Collaboration in Family Medicine: an overview of the dawn of family medicine in Ethiopia through an inter-institutional model

: 1.045_MDG Toronto Addis Ababa Academic Collaboration in Family Medicine: an overview of the dawn of family medicine in Ethiopia through an inter-institutional model D. Wondimagegn, B. Cornelson, K. Rouleau, P. Janakiram, A. Ghavam-Rassoul, J. Rodas, D. Zemenfes; Addis Ababa University, College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia, East Calgary Family Care Centre, Calgary, Alberta, Canada, University of Toronto, Department of Family & Community Medicine, Toronto, Ontario, Canada Program Purpose: TheWHO2008Report “PrimaryHealthCare: Now more than ever” and increasing evidence support the development of robust primary care as a central pillar of health systems. The transition from Millennium Development Goals into the SustainableDevelopmentGoals beyond 2015 presents an opportunity for innovation in effective health service models, with significant contribution from family medicine. In 2013, Addis Ababa University (AAU), with an inter-institutional model of collaboration, launched the first family medicine residency program in Ethiopia. Structure: AAU’s family medicine residency program was inaugurated in collaboration with the Department of Family and Community Medicine, University of Toronto and the Department of Family Medicine at University of Wisconsin through the Medical Education Project Initiative (MEPI). The program has benefited from the generous contributions and participation of many expatriate faculty over the past three years. The launch of the program followed a series of strategic discussions, needs assessments, international collaborations, and faculty development events held between 2008 and 2013. The program aims to train family physicians for Ethiopia and to cultivate future faculty and program offerings encouraging sustainability through capacity building. Outcomes: The program has achieved significant milestones, highlighted by the upcoming graduation in 2016 of the first seven family physicians in Ethiopia from their AAU residency. Ethiopia’s Federal Ministry of Health (FMOH) has embraced family medicine as a key element of its health system and recently announced the upcoming establishment of two additional training programs in Gondar and Jimma in 2016. Going Forward: Ongoing challenges exist, including undefined roles and career opportunities for this new cadre of family physicians in the health care system, a shortage of Ethiopian faculty, and the need to expand the number of training programs to produce enough family physicians for the population. The program’s sustainability will be contingent on the ongoing support of Ethiopian leaders, local champions, reduced reliance on expatriate faculty, commitment from long-term partners, and support for expansion sites. Funding: The Toronto Addis Ababa Academic Collaboration in Family Medicine (TAAAC-FM) is supported by external donors in partnership with the Department of Family of Community Medicine at the University of Toronto. Abstract #: 1.046_MDG: 1.046_MDG Evaluation of the presence of clinically significant hemolytic disease of the fetus and newborn due to RhD antibodies in multi-ethnic Suriname R. Zonneveld, H. Schonewille, A. Brand, H.H.H. Kanhai, C.W.R. Zijlmans; Scientific Research Center Suriname, Academic Hospital Paramaribo, Suriname, Department of Pediatrics, Academic Hospital Paramaribo, Suriname, Department of Research, Sanquin Blood Supply, Amsterdam, The Netherlands, Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands, Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands, Department of Pediatrics, Diakonessen Hospital, Paramaribo, Suriname Background: Hemolytic Disease of the Fetus and Newborn (HDFN) is a major cause of fetal and neonatal morbidity and mortality. Maternal Rhesus D (RhD) negativity and the formation of RhD antibodies during pregnancy is the primary cause of HDFN. In western countries RhD immunoglobulin (RhD-Ig) prophylaxis has reduced incidence of HDFN to 0,2%. In low resource countries RhD-Ig is rarely applied and data on impact of HDFN is scarce. In these countries, HDFN may still be a common cause of death. In a pilot study a 4,3% overall RhD negativity amongst 8686 multi-ethnic Surinamese pregnant women was found, ranging from 0,0% in Amerindian, 3,4% in Hindustani to 7,2% in African women. The current study further investigates multi-ethnic RhD negativity and antibodies in pregnant women and presence and severity of HDFN in their offspring. Methods: InMay 2015 a detailed prospective study was initiated in 4 Surinamese hospitals to follow RhD negative pregnant women during their pregnancy and their offspring for development of HDFN. After informed consent, obstetric history and current pregnancy was documented, and maternal and neonatal blood samples for antibody identification and RhD phenotyping and genotyping obtained. Findings: So far 108 (85 (78,7%) multiparae) mothers and their offspring were included. Only 16 (14,8%) mothers ever received

Program Purpose: The WHO 2008 Report "Primary Health Care: Now more than ever" and increasing evidence support the development of robust primary care as a central pillar of health systems. The transition from Millennium Development Goals into the Sustainable Development Goals beyond 2015 presents an opportunity for innovation in effective health service models, with significant contribution from family medicine. In 2013, Addis Ababa University (AAU), with an inter-institutional model of collaboration, launched the first family medicine residency program in Ethiopia.
Structure: AAU's family medicine residency program was inaugurated in collaboration with the Department of Family and Community Medicine, University of Toronto and the Department of Family Medicine at University of Wisconsin through the Medical Education Project Initiative (MEPI). The program has benefited from the generous contributions and participation of many expatriate faculty over the past three years. The launch of the program followed a series of strategic discussions, needs assessments, international collaborations, and faculty development events held between 2008 and 2013. The program aims to train family physicians for Ethiopia and to cultivate future faculty and program offerings encouraging sustainability through capacity building.
Outcomes: The program has achieved significant milestones, highlighted by the upcoming graduation in 2016 of the first seven family physicians in Ethiopia from their AAU residency. Ethiopia's Federal Ministry of Health (FMOH) has embraced family medicine as a key element of its health system and recently announced the upcoming establishment of two additional training programs in Gondar and Jimma in 2016.
Going Forward: Ongoing challenges exist, including undefined roles and career opportunities for this new cadre of family physicians in the health care system, a shortage of Ethiopian faculty, and the need to expand the number of training programs to produce enough family physicians for the population. The program's sustainability will be contingent on the ongoing support of Ethiopian leaders, local champions, reduced reliance on expatriate faculty, commitment from long-term partners, and support for expansion sites. Background: Hemolytic Disease of the Fetus and Newborn (HDFN) is a major cause of fetal and neonatal morbidity and mortality. Maternal Rhesus D (RhD) negativity and the formation of RhD antibodies during pregnancy is the primary cause of HDFN. In western countries RhD immunoglobulin (RhD-Ig) prophylaxis has reduced incidence of HDFN to 0,2%. In low resource countries RhD-Ig is rarely applied and data on impact of HDFN is scarce. In these countries, HDFN may still be a common cause of death. In a pilot study a 4,3% overall RhD negativity amongst 8686 multi-ethnic Surinamese pregnant women was found, ranging from 0,0% in Amerindian, 3,4% in Hindustani to 7,2% in African women. The current study further investigates multi-ethnic RhD negativity and antibodies in pregnant women and presence and severity of HDFN in their offspring.
Methods: In May 2015 a detailed prospective study was initiated in 4 Surinamese hospitals to follow RhD negative pregnant women during their pregnancy and their offspring for development of HDFN. After informed consent, obstetric history and current pregnancy was documented, and maternal and neonatal blood samples for antibody identification and RhD phenotyping and genotyping obtained. MDGs and SDGs M a y eJ u n e 2 0 1 6 : 3 7 5 -3 9 6