Ghana Physician Assistant Education
Background
Starting in 2007 the University of Utah Physician Assistant Program began its collaboration with the Ghana Ministry of Health and Kintampo Rural Health Training School.
The school had been training Medical Assistants or MAs (the local PA analog) in Ghana for 40 years, and desired a partnership that would enhance both midlevel professions. The initial focus was to develop a clinical service elective to enable PA students to be a part of the global focus on midlevel health care providers in rural and underserved settings, and to build capacity within the Ghanaian MA in its training and profession.
Clinical Perspective
MAs in Ghana provide over 70% of the population’s primary health care. "Educating for Service” is the motto for the Rural Health Training School in Kintampo and its graduates live by it. MAs are trained there. On average they care for 90-150 patients per day, primarily in rural clinic settings, but also in large regional hospitals.
The Challenge
Sub-Saharan Africa holds 10% of the world population, with 25% of burden of disease, 3% of healthcare resources and 1% of health care workers. In contrast, North America has 5% of world population 3% burden if disease, 25% of healthcare resources and 30% of health workers.
Ghana is a West African country that, although more economically and politically stable than many other African countries, has dire health care needs. Ghana has only 2,000 physicians and 500 MAs for the care of its 22 million people. This very limited supply of health care providers contributes to poor access to care and population health in the country.
The Experience
During this elective, US PA students and residents actively see patients along with Ghanaian health care providers, in primary care and hospital settings.
The sustainable service focus is taught at continuing medical education seminars for the MAs in Ghana by Ghanaian and University of Utah School of Medicine faculty.
PA students and Residents gain an understanding of the health care system of Ghana through their clinical rotations, while serving at all levels of the health care system. They are directly paired with Ghanaian health care providers and see patients under the direction of the clinicians there. This provides a rich and unique exposure to the organization, functions and interrelationships between the different parts of a system of health care designed to serve a developing country. The US learners are in rural clinics, municipal hospitals as well as the regional hospital for the Brong Ahafo region. . The clinical exposure is broad, providing care for diabetes, hypertension, sickle cell disease, HIV/AIDS, out patient, inpatient, as well as pediatric patients and working with obstetrics, surgery, orthopedics, emergency room, and ophthalmology patients -to name a few.
International Seminar
As there is no internet access for the majority of the people of Ghana, and medical journals and literature are not readily available there, continuing medical education is a challenge for the clinicians to obtain. To address this need, the International Seminar was created under the direction of the Director of the Kintampo Rural Health Training School, as the only continuing medical education offering for MAs.
The US PA students and residents are a part of the teaching team for the International Seminar. In so doing, the learners see that ‘service’ is best offered not by foreign clinicians coming to this country primarily to see patients, but by providing education to local clinicians and teachers, empowering change and growth from within.
The Seminar has grown from an attendance of 150 to over 500 per year, and has been guided by the requests of the Ghanaian health care providers on its topics. Faculty from the University of Utah School of Medicine, as well as clinicians from around the US, join the teaching team as well.
Current Projects
In partnership with the Kintampo Rural Health Training School:
- Ghana Women’s Health Initiative – cervical cancer and breast cancer screening training
- Curriculum and clinical development: trauma, dermatology
Program Director
nminiclier [at] upap [dot] utah [dot] edu (Nadia Miniclier) MS, PA-C, is the Director of the Ghana Clinical Medicine rotation for the University of Utah Physician Assistant Program, thru the Department of Family and Preventive Medicine at the University of Utah School of Medicine. Her work comes through shared vision with her partners in Ghana and the US. She holds adjunct faculty status both at the Kintampo Rural Health Training School and KNUST. Her focus is clinical training in a service-oriented manner. While furthering collaborations with the Ghana Ministry of Health, the Rural Health Training School and the University of Utah she feels honored to lead learners and clinicians on this rotation.
