Field Epidemiology Training Programs FETP MODELS Presented by Ken Johnson August 8, 2011 Resident Advisor Orientation

FETP Models Field Epidemiology Training Programs (FETPs) Two–year full time competency-based training and service programs in applied epidemiology and public health that contribute to building public health system capacity in the countries in which they are implemented by: Strengthening response to acute problems such as outbreaks Strengthening the scientific basis for program and policy decisions Strengthening surveillance systems Strengthening the communication of epidemiologic information Several practices distinguish FETPs-

FETP Models Field Epidemiology Training Programs (FETPs) Providing service: Both the residents as individuals and the FETP as a program are expected to provide service to the Ministry of Health (MOH) and to improve the health of the population. Implementing competency-based training: Graduates of each program are expected to demonstrate proficiency in a defined set of competencies. In most programs around 75% of the training period is devoted to practicing epidemiology in the field under the guidance of a mentor. Building systems capacity: Takes place in the host country and is sponsored or co-sponsored by the MOH. CDC or other partners may participate in implementing the program, but the programs are intended to become self-sustaining programs within the host country’s public health system.

FETP Models Field Epidemiology Training Programs (FETPs) FETP Operation Locus Ideally FETP should be imbedded w/in MOH Have a position in MOH’s org chart Positioned w/in MOH section that handles epidemiology, surveillance, outbreaks (communicable disease) Some are based/located/housed elsewhere University, Public Health Institutions, others Should still provide service to MOH

FETP Models Field Epidemiology Training Programs (FETPs) FETP Recruitment Ideally FETP recruits from current MOH staff (federal/state/provincial/district) Depends upon needs of country & MOH structure Physicians; laboratorians, veterinarians, dentists, pharmacists, nurses, and microbiologists Other qualifications may apply (age, length of time w/ MOH) May come from specific programs Some organizations may have negotiated slots

FETP Models Field Epidemiology Training Programs (FETPs) Proportion of time spent in classroom (≈25%) Amount of time spent in formal training activities, usually in a classroom, ranges from 2 to 10 months. Programs affiliated with a university and result in a degree may require a greater amount of time in the classroom

FETP Models Field Epidemiology & Laboratory Training Programs (FELTPs) Same as FETP with a separate laboratory track; Trains public health laboratory scientists also Focus: strengthening laboratory infrastructure and leadership Competency-based curriculum: laboratory-based surveillance, outbreak response, analysis, pathogen identification, and disease monitoring Fosters understanding and communication linkages between epidemiologists and laboratory scientists Improve outbreak response and control w/ consistent, high-quality laboratory testing, rapid dissemination of laboratory information to assist in identification and understanding Build quality laboratory networks; support laboratory improvement and regulation

FETP Models Field Epidemiology & Laboratory Training Programs (FELTPs) w/ Veterinary Track Same as FETP with a separate veterinary track; usually provides service to Ministry of Agriculture or other related Ministry Trains veterinary scientists also; Identifying and evaluating microbiological hazards to human health of animal origin Competency-based curriculum: veterinary-based surveillance, outbreak response, investigating the impact of zoonotic disease on the health, disseminating relevant information to experts in public health, veterinary science and other scientific disciplines, Fosters a One Health approach & links between epidemiologists, laboratory scientists, and veterinarians to improve the health of people, animals, and environment

FETP Models Field Epidemiology & Laboratory Training Programs (FELTPs) w/ Concentrations Same as FETP or FELTP with distinct coursework and activities geared toward one particular disease Focus generally takes place outside of the inclusive didactic sessions May only involve a small percentage of the total resident cohort May be referred to as a “track” also by others

FETP Models Field Epidemiology & Laboratory Training Programs Tracks vs. Concentrations Public health discipline and/or closely related field (Epidemiology/Laboratory/ Veterinary) All residents learn during didactic sessions CONCENTRATION Specific disease or field of study (Influenza, TB, Malaria, HIV, Cancer) Subset of residents learn specific aspects during field sessions; additional lectures may be involved Core public health disciplines: Biostatistics, Environmental Health Sciences, Epidemiology, Health Policy Management, and Social and Behavioral Sciences, Emergency Medical Services, International/Global Health , Maternal and Child Health, Nutrition, Public Health Laboratory Practice, Public Health Practice

FETP Models Field Epidemiology & Laboratory Training Programs (FELTPs) w/ degrees or certifications Involves an additional partnership w/ an in-country university to offer a Master level degree for graduates; Some programs offer other certifications or diplomas Curriculum developed in conjunction with universities and involved ministries University usually will play a role in providing some lectures and mentorship Involvement of university improves chances of sustainability

FETP Models Field Epidemiology & Laboratory Training Programs Regional Approach FETP or FELTP with more than one country involved Collaboration and participation by each country involved One country serves as the “hub” where didactic work occurs Residents may return to respective country for field work or may conduct field work in “hub” country Steering Committee and/or funding will decide how many residents come from each country

FETP Models Pyramid Model

FETP Models Pyramid Model N=12 graduates N=154 graduates N=946 graduates Distribution of Graduates and Trainees Guatemala, 2001-2010

FETP Models Short Courses Any number of shorter duration courses that are a compliment to the FETP; increases awareness of the importance of epidemiology and surveillance Provided for a different audience of public health professionals than FELTP residents Allow you to train a larger number of public health professionals in a shorter period of time Curriculum developed in conjunction with involved ministries ; customized based on a country’s public health priorities and infrastructure

FETP Models Short Courses Many names, models, and time durations exist ; not to be confused w/ FETP seminars Helps establish a network of healthcare professionals that are speak same language as FETP Helps to further develop and enhance skills within the ministries especially in provinces/states/regions; Can serve as a huge advocacy tool in-country, especially prior to starting the FELTP Can be used as a screening tool for FETP