INNOVATIVE COMMUNITY-BASED POSTGRADUATE TRAINING FOR OBSTETRICS AND GYNECOLOGY IN WEST-AFRICA

Objective: To describe a unique international effort to develop a trai ning program in West Africa that would be of similar quality to any ot her in the world (but with sensitivity to cross-cultural needs) and wo uld retain physicians in West Africa to improve women's health in that part of the world. Methods: Step-by-step formulation of a program inc luded initial trainee recruitment, the inclusion of foreign guest facu lty, and the establishment of institutional libraries. This was follow ed by a phase of curriculum development, recruitment of West African f aculty, and organization of an innovative, community-based fourth year . Results: Between ten and 12 postgraduates will have completed the pr ogram by January 1996, and will be placed in Ghana. More than 60% of G hanaian postgraduates have passed the relevant regional examinations, compared with less than 25% of candidates from other countries. Nine G hanaian specialists have returned to Ghana to become faculty members i n the program. Over 20 published peer-reviewed articles have resulted from this program since 1989. The number of residents being trained ha s increased from three to 28. Seven new residents joined the program i n, 1994. An early reduction in maternal mortality from 9.9 deaths per 1000 births in 1991 to 4.2 deaths per 1000 births in 1992 was noted wh en senior postgraduates took over labor and delivery at the teaching h ospital in Accra, Ghana, where approximately 10,000 deliveries occur p er year. Conclusion: Specialty training in obstetrics and gynecology t hat is specifically aimed al meeting the needs of West Africa has been initiated successfully. Long-range success will require support from regional governments and continued long-term commitments from the inte rnational community of obstetricians and gynecologists.