PROJECT : LAO PDR Collaborations / Partnerships.

VISION STATEMENT

The importance of continued medical education (CME) based on solid scientific evidence is now well recognised yet not widely implemented, and thus reducing the possible impact on health services in developing countries. The immediate consequences are stagnation of the quality of service delivery and ill health of the population. This applies particularly to developing countries and countries in economic transition. Some ways to develop a better health system are to promote research relevant to problems in the field, to strengthen the human and material resources for this research and to create a mechanism, which would assist countries to address their own research needs. Development of appropriate technologies and training of personnel in various fields of medicine and public health, and research are essential components of such a mechanism.

MISSION STATEMENT

The Mission of the Geneva Foundation for Medical Education and Research (GFMER) The mission of GFMER is to furnish health education and research programmes that can be applied by developing countries, and countries in economic transition, and to establish collaboration between entities from the public and private sectors through different direct or indirect types of actions. Laotian approach The Local Partners are Ministry of Health, Faculty of Medical Sciences, National Institute for Public Health and his Institut de la Francophonie pour la Médecine Tropicale (IFMT) and all institutions involved in the Health Domain.

VIENTIANE IS ON THE WAY TO BECOME THE CENTER OF COLLABORATIONS INITIATIVES FOR SOUTH-EAST ASIA AND MEKONG REGION

AS COLLABORATION FACILITIES, GFMER IS DEVELOPING STATE-OF-THE-ART INFORMATION TECHNOLOGY TOOLS, ‘ONLINE LEARNING SYSTEM ,’ TELECONFERENCING’, ONLINE-TOOLS

To achieve this mission, the GFEMR adhere to the following principles:

1. Participative process for projects objectives definition.

2. High Level Information Technology tools, Media and Network.

3. Intensive coordination and follow-up of projects.

4. Reviewing collaborators competence and confidence.

5. Exhaustive Documentation and Reporting and complete transparency.

FUNDRAISING:

GFMER receives funding from different public and private institutions.

GFMER Past Projects:

The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organisation established in 2002. GFMER has initiated programmes in Africa, Asia (China, Indonesia), South America and Eastern Europa (23 countries.) Currently, Reproductive Health and Sexual Health, Campaign to end obstetric fistula, Oncologic and Urologic Laparoscopy, and Prevention of mother-to-child transmission of Hepatitis B programmes are in development (Vietnam).

WHO Collaborating Centre Mandate:

- To provide postgraduate training in research methodology in RH

- To develop and conduct research and research synthesis activities

- To assist partner institutions for postgrade medical education

- To collaborate with WHO on e-learning activities

- To provide expertise to WHO centers and network requesting collaboration in research and training.

CONTACT PERSONS:

GFMER Director: Prof. Aldo CAMPANA

GFMER Project Manager : Yanick-M.EBINGER

ADDRESS:

Fondation Genevoise pour la Formation et la Recherche Médicales

5, Chemin Edouard-Tavan 1206 Genève – Suisse Phone +41 (0)22 3467716 Fax +41 (0)22 3467834

E-mail : aldo.campana@gfmer.org

Web site http://www.gfmer.ch

E-mail : yanick.ebinger@gfmer.org

Web site http://www.gfmer.ch/laos

SUMMARY PROJECT DESCRIPTION:

The focus of this proposal for funding is to develop and sustain the Collaboration / Partnership with local partners in Vientiane, Laos. Furthermore to develop the dissemination of GFMER Continued Medical Education programmes in South-east Asia.

• Extension of the Postgraduate and CME Research Training Programmes

• Development of internet tools for long distance training programmes

• Initiation of training programmes for developing countries in collaboration with WHO.

• Development of new and follow-up of ongoing research and research synthesis projects

• Preparation for postgraduate and CME training courses in Research.

• Translation of postgraduate and CME training courses.

The GFMER already invested CHF 100'000 to set up the programme for 2007-2008.

The budget is calculated as CHF 691’000 over an initial period of 3 years.

OBJECTIVES

The overall objectives are to:

• Furnish health education programmes and research support

• Establish collaboration between entities from the public and private sectors

• Develop international partnerships and twinning programmes with collaborating institutions and develop a programme for staff exchange

The specific objectives are to :

• Promote the clinical, educational, and scientific collaboration between health professionals working in order to create centers of excellence in different medical domains

• Offer and provide easy access and exchange to relevant, high-quality, up-to-date information through the already existing Web facilities of partners.

• Reinforce and mobilize useful expertise so as to anticipate better public health problems

• Conduct together systematic reviews to identify areas of research and support the development of clinical practical guidelines

• Develop a network of individuals and institutions to coordinate research synthesis activities, including Cochrane systematic reviews

• Develop Continuing Medical Education (CME) structural and technical guidelines and certification procedures adapted to the health needs of the country

• Create a CME body for research and implement a training programme in research synthesis as basis for clinical decision-making

• Identify research needs and assist health professionals in the conduct of relevant research activities

• Develop clinical training programmes at both national and international levels

• Respond to specific requests from partners, developing countries and countries in economic transition and assist in the identification of clinical and research needs and address these needs with adequate training and research programmes.

JUSTIFICATION SUMMARY :

The Public Health is a major problem in Lao PDR and south-east Asia. The way to develop a better health system is to promote research relevant to problems in the field, to strengthen the human and material resources for this research and to create a mechanism, which would assist countries to address their own research needs.

Development of appropriate technologies and training of personnel in various fields of medicine and public health, and research are essential components of such a mechanism. The project will prioritise improvement of the quality of health personnel at graduate level with an emphasis on technical, scientific, administrative, and behavioural skills. The dissemination of medical information and knowledge on Internet will allow developing

Long Distance Learning Programme, to open the access to a continued medical education based on solid scientific evidence.

The Partners and GFMER missions and approach are identified to work towards same objectives in the same way of doing.

• The long distance training project is extremely cost-effective.

• The Geneva-based courses are well established and provides high-quality formation for researchers who will become future teachers in the partner institutions (training-of-trainers approach);

• Some training programme, including curriculum and lecture material already exists and is revised and updated annually;

• The technical set-up and support for dissemination are in place;

• The institutional back-up is locally available; The local institutions and local researchers are key elements for the success of this project, as they are able to provide adequate scientific and management support to the project and take on local training and research programme responsibilities at the country level.

PROJECT DESCRIPTION:

BACKGROUND :

To introduce Lao PDR as an example for the South_east Asia, Lao PDR is a small, sparsely populated, landlocked country with extensive natural resources. With a population estimated at 5.9 million in 2005. Lao PDR is characterized by a rich cultural and ethnic diversity where almost half of the population belongs to minority groups concentrated in the upland areas.

Covering an area of 236,800 square km in the center of the dynamic Mekong region, Lao PDR shares borders with Thailand, Vietnam, China, Cambodia, and Myanmar (Burma). Although infrastructure (roads, telecom, water and electricity) is underdeveloped, the country is rich in water resources, tropical forests and minerals. A large majority of the population relies for its livelihood on agriculture. Urbanization is low, at 20 percent. Gross National Income (GNI) per capita stands at around US$390 (2004). External support to the budget remains high and external Bilateral and NGO’s programs account for 37 percent of total public expenditures.

The major public health problems are:

- Malaria and diarrhea are the two main causes of mortality and morbidity.

- Infectious diseases (dengue, hepatitis, ARI, sexually transmitted diseases).

- Injury from Unexploded Ordnance (UXO).

Although some significant achievements occurred in the health sector, maternal mortality and infant mortality rates, mortality and morbidity remain very high, especially among the rural population. Malaria and diarrhea are the two main causes of mortality and morbidity.

• Utilization of health care services is very low (0.1 annual patient visits per person in some rural districts). Less than 30 percent of people in need of medical services turn to the health system for help.

• For those who do seek treatment, the quality of curative services is extremely poor: treatment guidelines are outdated and often not followed; skilled human resources are scarce, facilities are in poor condition and lack basic equipment.

• Financial resources are scarce and inequitably distributed.

• Capacity of health sector workers, administrators and managers is very low. This health situation panorama can be transposed to the South-east Asia rural areas in Vietnam, Cambodia, Myanmar (Burma).

The GFMER collaboration project will increase the accessibility of stat- of-the-art relevant domain of post graduate medical knowledge, in terms of training, research support, knowledge bases (methodology and data) and scientific information availability and dissemination.

The Reproductive Health and Mother-and-Child-Health domains are the first priority for South-east Asia developing countries.

PROJECT ACTIVITIES

PHASE-1 :

o Classification of the relevant domains where the needs are identified.

o Budget evaluation and breakdown.

o WHO collaboration to identify strategic aspects.

o Meetings with interested partners o Planning, design and project management.

PHASE-2 :

o Organization of a Reproductive Health training course in Geneva.

o Design of the E-learning part for specific project in reproductive health.

o Organisation of Training Course in Research in Reproductive Health/Sexual Health in Lao PDR.

o Development of research projects and Conduct of systematic reviews and research synthesis activities

These activities are directly related with the FGMER mandates and objectives :

” Furnish health education programmes and research support” with the emphasis to develop a better health system and to promote research relevant to problems in the field, to strengthen the human and material resources for this research and to create a mechanism, which would assist countries to address their own research needs.

EXPECTED OUTPUTS

1) To continue providing medical research training via the Geneva course as the core activity to support the satellite courses and to expand the network of collaborating scientists.

2) To develop research and research synthesis projects within this network.

3) To continue the dissemination of the research training course by engaging local, Geneva-trained lecturers and by using E-learning tools.

FOLLOW-UP AND MONITORING

The Programme is under the direct supervision of the GFMER. The Foundation will provide the necessary technical and managerial support to local project managers and coordinators. The project will be monitored with the help of local counterparts and an monthly evaluation in the initialization phase. The formal evaluation of the project will be done on a yearly basis.

Regular feedback from local partners and facilitators.

Regular feedback from the trainees regarding relevancy of knowledge and skills achieved from the training to their everyday practice in teaching and in the community/district hospital level.

Group discussion of all stakeholders i.e. Ministry of Public Health (MOH), Ministry of Education (MOE), Training Institutions, Communities, etc…

TARGETS GROUPS :

According the vision of the collaboration, the beneficiaries will be the partner institutions and the countries in the developing world, their researchers, scientists and clinical practitioners and ultimately the consumers who will receive appropriate treatment.

The partners’ projects in term of strengthens of the knowledge base, data access, services and scientific support and enlargement of regional collaborations.

BENEFICIARY INVOLVMENT

GFMER will discuss the concept and specific plan with the board of the partners, medical staff, as well as with the governments’ authorities.

They have to agree to participate and provide adequate support for the collaboration and will be closely involved in the collaboration design.

Partners are aware that collaborations and networking are inevitable for the future.

PROJECT DURATION (Phase-1 : Initiation) :

SUSTAINABILITY:

-The founding continuity is the main constrains for the sustainability of the project.
-The functional aspects are already well knows and reliable.
-The training and research activities of this proposal have already been implemented in Geneva under the auspices  of WHO Collaborating Centre, Geneva.

A niche for these activities was found some 10 years ago and has been kept intact. No other actors have presented themselves to address the need to expand these activities through dissemination, on CD-ROM or via Internet.

Therefore, this proposal offers a unique platform of already tested activities as well as new and innovative ones.

PROJECT STAFF

The core project staff in Geneva consists of:

                       Programme Director: Prof. Aldo Campana, MD
                       Project Manager: Yanick-M.Ebinger
                       Scientific Management, Informatics: Shawn Koppenhoefer, PhD

Vientiane Coordinator :

Dr Khamsay Chanthavysouk, MD MSc TM
Mother and Child Health Hospital
Email: khamsay2000@yahoo.com

COLLABORATORS :

The main actors of this project are:

Geneva

• Geneva Foundation for Medical Education and Research (GFMER)
• The World Health Organization (WHO)
• The International Association for Maternal and Neonatal Health (IAMANEH)
• The Fonds Universitaire Maurice Chalumeau
• UNFPA

Partners at the Lao PDR level

• Lao PDR Ministry of Health
• Vientiane University of Medical Sciences.
• National Institute for Public Health, Vientiane (NIOPH)
• Institut de la Francophonie pour la Médecine Tropicale (IFMT)
• Mother ans Child Health Hospital, Vientiane (MCHH)

Partners with interest for Collaboration Programme initiative

• Faculty of Medicine, University of Indonesia
• Thainguyen Faculty of Medicine (Vietnam)

Writed by Y.-M.Ebinger, Project Manager, June 2007, December 2007.

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