CapacityPlus supported more than 50 health professional schools in 12 African countries to strengthen health workforce education and school management, contributing to over 9,000 new health workers and building the capacity of these schools to continue scaling-up production of graduates and improving the efficiency and quality of their programs.

Background
Given the global health workforce shortage, it is clear that more health workers must be educated and trained—especially in Africa where the health needs are greatest. In addition, preservice education (PSE) institutions must ensure that graduates develop the competencies needed to address local health needs, particularly in underserved areas. Preservice education determines who will become a health worker (e.g., man or woman, rural background or urban), what skills and behaviors they will learn (e.g., respectful, high-quality care), and how adaptable they will be to different practice environments (e.g., district hospitals or rural clinics without electricity or running water). The one to six years of PSE health workers receive have a profound impact on the subsequent 30 to 40 years that they practice and represent the best investment countries can make to ensure that health workers with the right skills are practicing in the right communities. Development assistance to health professional schools has often focused on curriculum improvement and faculty support; however, dramatic improvements in the efficiency of these schools are also needed to strengthen and scale up the production of health workers required to realize the goals of priority US Government and global initiatives such as AIDS-Free Generation, Ending Preventable Child and Maternal Deaths, and enabling 120 million more women and girls to use contraceptives by 2020.

Strategy and Approaches
In collaboration with global, regional, and national stakeholders in the public and private sectors, CapacityPlus provided leadership in developing, testing, and building capacity in the use of innovative approaches and tools to address common challenges in scaling up and transforming health workforce education and training. As a first step, the project developed the Bottlenecks and Best Buys Approach, which has been adapted and applied in more than 30 nursing, midwifery, medical, health assistant, and community health worker schools in seven African countries. This tool allows stakeholders inside or external to a school to consider a range of issues that might impede the school’s ability to increase the number or skills of its graduates, and identify and prioritize actions that can efficiently address those issues.

A comprehensive Guide and Tools for Strengthening School Management, tested in Ghana and South Africa, builds the capacity of school leaders to use existing resources more efficiently and effectively. This package guides school leaders—who often have limited formal education in facility or budgetary management—through a cyclical process of assessment, planning, and improvement in key management areas. The tools allow leaders to consider their own organizations’ performance in the context of evidence-informed good practices in nine management dimensions: leadership and governance; strategic planning; external relations; financial resources; personnel; students; equipment and materials; facilities and infrastructure; and evaluation and knowledge management. CapacityPlus’s school management package includes the Dean’s Dashboard, an open source software application that can be customized according to schools’ needs to track progress in areas such as infrastructure management, student academic progress, and faculty productivity.
 
CapacityPlus also developed tools and approaches in response to schools’ more specialized needs. These include the Preservice Education Costing Methodology and Instruments, finalized after applications at diverse schools in Ethiopia and South Africa, which allows schools to estimate the unit cost of producing a graduate to guide investments for increasing the number and/or quality of graduates; and a technical brief, report, and advocacy tool that highlight interventions to eliminate gender discrimination and promote equal opportunity and gender equality in health professional education. In addition, the project collaborated with PEPFAR’s Medical and Nursing Education Partnership Initiatives—MEPI and NEPI—to build capacity and develop approaches and tools for eLearning, community-based education, and graduate tracking now in use among MEPI-supported medical schools in 12 African countries. CapacityPlus supported school leaders as they developed and implemented eLearning strategies; assisted them to create the evaluation plans and tools they needed to better understand the effects of community-based educational programs; and created MEPI Connect—an open source software application being used by schools to track and connect with alumni.