hey welcome everybody to this session and then this session is about the future scenarios and a novel approach to produce more health workers in Kenya my name is dai I am a chief technical officer at the intra health international I would like to intro ask janet and then start to introduce themselves yes good afternoon good morning and good evening my name is dr janet mariuki I’m the country director of intra-health in Kenya and also the program lead for the human resources for health Kenya mechanism glad to glad that you're able to join our session today thank you great good morning and good evening everyone my name is suspicion daba I work for the USAID funded human resources for health care mechanism I serve as a training manager it's a pleasure to be with you and looking forward to a fruitful discussion on the future of health workforce in the country great so today's session is a combination of the two session ideas one was that my area of the work which is to look at the future but then what's really critical is then if you we imagine the future how we're going to address that so that's where that the janet and then hospitals work is going to come in and what they have been working on around the health workers so the session design is that I’m going to first talk through and then about the future discussions and then that will go to the Kenya's cases of the their efforts in increasing the health workers so I will just jump in so what we did in 2019 to 2020 is to started to look at various factors like environmental factors political factors technological factors social demographic factors and economic factors and then try to understand what would be the larger external forces that will reshape our work or health work in Africa if you remember year 2000 20 years before there was no global fund that there was a time that the gabi was just announced pepfar wasn't there and then 20 years can do a lot of big difference make the big difference so what we wanted to do was to think about what would be the future look like for that what kind of the health workers are there what kind of health where do those health care are provided and then also who are those health workers and then where that they provide those skills how their provider else works so that that's sort of like a is that that expanding our imaginations and then the boundaries in order for us to prepare for the future was that the part of the work that I was working on just to give some of the external factors that we identified one is a this is a 2019 Africa venture capital reports and then indeed in Africa there are more than two billion dollars has been invested for a start-up of the to develop their own indigenous technologies especially places like Kenya where the the janet is located Nigeria south Africa and then Egypt is beating and then also but then also that the Uganda and then other countries started to see a that increased investment into the startup of the technology so that the Africa-based technological evolution is really on the horizon and it's really becoming a rapidly active activated another issues that are coming up again and again is the climate risks and then we all go through this and if you this is one of the data from the bbc but if we look at the issues that bigger cities in Africa these red dogs tended to be much more vulnerable and then also the populations that are going to face a the climate risks so finally like that we cannot really ignore that we kind of knew that someday that pandemic may happen but then who knew that was going to happen in 2020 and then going into that 2021 I remember in march 2020 that the talking with our office was closed down in north Carolina and I was talking with my colleague that oh no this is just going to be like a two or three months and then we still have not going back to the office so it's very difficult for us to predict the future in that forecasting way because what we know today and then what it's not necessarily reflect to the future of the predicting the future so what we are trying to do is to understand what would be the other factors may change how we think about the health work and then considering all those different uncertainties and then try to envision that the different futures that that may become real and then also that how we're going to think about our health workers and then prepare and work with that African government to for the future was on this project so one of there are two major factors that through our research came out one is how the health workers power structures are going to look like in the future what do I mean by what I mean by this is that is the current international power structure of the donors and then international agencies like the wh show setting the norms and then even within the countries there are doctors having a holding on to the power and the nurses and the midwives and then community health workers and then also that the private facilities of private sector providers are these kind of power structure going to be preserved or there will be some major transition happen and then and then the power structure is going to be different or transformed for the future so the one factor that we have to think about is that who are the leadership who will have the political and financial power in determining that the health care is going to be a one huge hacker do we have to think about another factor that came out again in our research was ability of your health systems to harness or take advantage of the benefits of the technologies technology could be the digital technologies or in health or digital health or could it be a new diagnostics or medicines or vaccines but then ability of the health systems both including the public sector services and also private sector systems how much of those systems will be able to take advantage of those the upcoming technologies and then able to offer or is this going to be really patchy and then some people get it and some people may not get it you know how this is going to look like is also going to be shaping the future so from this analysis that we came up with a three scenarios of that how the future going to look like the first scenario is called the father together this is really like Africa will have a the younger leadership the thinking about the health care more as in the shape of the wellness or going back to this definition of the health in a more broader times improving the mental health and then also that the pandemic addressing the pandemic and then increase the regional and then also kind of African corporations so maybe this is the future that we're going to see in this case is that the power structure will be newly transformed and the new leader imagines and then also that the system will be able to harness these upcoming technologies another way to look at the future is that there may be some degree that harnessing the technologies will happen but then the power structure will be maintained so this is going to be a for example like in 2035 who and then all the government declare the universal health coverage is achieved but when you really look at the carefully within the populations there will be a some patchy inequity may still exist and then also that because of the new technologies being introduced that the new shape and format of that inequity started to come into the play so this is more like we will incrementally improve there will still be a doctors and they'll still be a nurses and then they may hold on to the professional power and then and then we will be modeling through to the progress but then it's a slow and then painful that the process another way to we looked at is a is like a maybe that the power will transform and then private sectors and communities and then patients themselves will start to have much more power but then in a way that the totally disorganized and then also that the benefits of the technology will be really up to the grads for the private companies or governments or individuals or like a direct sellers and then others and this will really create a we not takes all cyberpunk kind of chaos that for the future so these are the three scenarios that we came up with the technology calls the shots the winner takes all societies there will be a lot of technology boom but then there will also be a harvesting of the data from the populations or patients privacy is going to be challenged and then some people take a lot of benefits maybe that the father together will imagine whether the universal health coverage is redefined new leadership and then Africa is really becoming a leadership place for the new generat the thinking about the collaborations and the healthcare and then the third one is more that the status for business as usual and then we will be really dragging through for the future is the three scenarios have a panca Africa there will be a health data harvesters of the health walker there will be more like an uber and then kind of like gig workers are going to be there and providing the part-time supports other health workers and the patient themselves becomes a using that the smartphone and the technologies and they themselves take the patient will diagnose themselves and get the medications in some cases it would be amplify the capacity within the ai assisted tools would be there and then frequently learning and relearning skills because technology were constantly changing and the help and then health worker needs to be really equipped to think about those privacies and then how they're going to take out advantage of it and then it's a really a highly fluid health labor market with like just like a economy and then taxi changed just like a transportation that totally change health economy is going to be hugely different in this cyber Africa sense so your privacy but it's all about my profit world mothering material I have already talked about the existing tiers of licensed professional would have the power maintain they will be able to maintain a task shifting and then community health workers may or may not get some of the credentials and then and then the specialty clinics and then care providers started to emerge in the sun the wealthy areas and then there may be a more ncd work but there will be much more fragmented and then the similar cares today with the more technological tools but they're not really a huge transformation would be that and then the accelerated public and private bifurcation will start to happen and an inequity next to continue so in this case that the university of first cover is really declared on the paper but then are you really sure that that's what where we are finally that the last one last scenario is powder together this is really expanded set of the health and well-being workers it's not just going to be the care providers in the traditional sense but then people think about those diseases and then predict predicting that the what kind of like a preventive measure has to be there people will think about the mental health assisted by the technologies and then there are a lot of enablers to support that expanded services other health workers in this world and then the more prevented by the social work is going to be integrated and then multi-sexual services becomes a norm and then the condition will be a emergency of the new health leadership and the technological systems and then the stronger governance there so these are the three major scenarios and then how we are going to make sure that the you your organizations are government or health system and then also helps workers going to be keep themselves relevant and then being useful and then be able to contribute the health impact is going to be a strategy that your organizations and yourself have to think about this is my last slide before handing over to janet just and then the software to think about that how then we will be able to address that the current issue will help workers that we need that more competent high quality health workers we desperately need that the health workforce or the health care needs to be provided and then also in the way of that the patient send that away but then what kind of health workers do we need do we want to maintain the current status and then also that the current job descriptions do we re do we also how do we want to move our interventions and then what kind of interventions or like strategies are needed on the ground and then work and then for the government so that the future we want is going to be a brighter and also a much healthier and an equitable so that's a really a critical thinking that we have to do now and then I’m going to stop my slides and then we'll take that the questions later once that we finished all the presentations and then I will hand over to janet and then to talk about the work in Kenya so I will yes thank you very much dave for that introduction so welcome I think we are going to take you over to Kenya and want to share our Kenyan experience and this really aligns to the presentation that dai has has already started with really how do you want to look at the workforce so here in Kenya we have been looking at an approach in which more health workers can be churned out from our medical training institution next uh so we have this product this is the afia limo fund the an earlier limousine started in 2013. this product is a joint collaboration between the ministry of health the ministry of education through the higher education loans board we also have donors such as USAID who have continued to support this for the last seven years we also have brought in the private sector funds players the banks are foundations who have been instrumental in Kenya we also do have a divorce system of health with the national and county governments and we have been engaging with county governments to also putting resources into this fund so the affair limo fund is really a low interest loan that is provided to the mid tertiary level of education and it is for students who would want to pursue health courses they would either want to be nurses clinical officers nutritionists health records officers but this kind of traditionally because they get diploma they undertake diploma courses as their entry into the job market and support the health sector have not been really been provided with that opportunity to access a sustainable way of educating themselves so this is where the earlier affiliate fund comes in we have also had high dropout rates of traditionally of students at medical training colleges and this was up to about 25 percent of the students who drop off when enrolled because they lack the resources to pay the annual school fees which is about two thousand two thousand five hundred dollars every year so what have we managed to do we have managed as intra-health with the support of the ministry of health and ministry of education through the higher education salons board to have a us id you have at least about 35 895 students benefit from this fund of those 11 878 have actually graduated they're in the job market currently employed is close to about four thousand five hundred of these students who are supporting health services under uhc and they're in such service areas like hiv reproductive maternal child health malaria amongst others and then we have those students as soon as they graduate they usually do get a one year grace period subsequent to that the higher education loans would mandates through an act of parliament that the students need to start beginning to repay their loans and the loan repayment could be as low as five dollars per month and today so far the students have been able to repay those who have graduated I mean have been able to repay close to 1.8 million us dollars and this really helps provide additional resources that can continue supporting other needy students towards their medical education and this really aligns well with USAID's journey to self-reliance next this is the evolution of the afghan limousine since inception you can see we began that journey as I shared in 2013 2014 the blue indicates the resources that were mobilized at that time and that was about 1.1 us million us dollars and the students that are benefiting at that initial stage were about 1942 so over the years with fundraising from the private sector and we have a board within the private sector about six partners especially the banks foundations that have really putting resources into this some of the banks through their foundation had a target for example they were looking at issues of blindness and they were willing to support students who were doing courses such as ophthalmology or clinical medicine very targeted and this is because some of our arid and semi-arid areas in Kenya do suffer from quite a bit of traucoma and other eye infections so they were targeted in that they had there was a need because these are neglected diseases in some of these regions and they is a workforce that is required to support eye services in this arid and semi-arid areas of Kenya so through such initiatives very tailor-made over the year we have been able to raise at least 25.8 million us dollars towards the students and this has supported the 35 plus students
we have already mentioned on next so there's been that evolution and what has that meant who are the students who have been being supported these are nurses both at the diploma and also at the certificate level we have a clinical officers these are really like doctor assistants just a slightly step down from the doctors we've also supported them we also have our health records and really to cater for the issues of data science within our hospital systems the record-keeping we have public health pharmacists and pharmacy technicians and technologists the lab systems the medical laboratory technicians and technologists and not nutritionists and we really would want to do more and I think this is where this would tie to what are the other cuddles and we're looking at community health yeah we call them community health assistants I think this is an opportunity really to also ensure at the community level that level one that these adequate there's an adequate workforce that can supervise the community health volunteers and ensure quality of services for the local communities next this is one of our success stories this is a young man who is in rural Kenya and a village in nyamira county he has been a beneficiary of the afia elimu fund over the years and his story is really that his father fell ill he could not continue providing for this young man in terms of paying for his medical education he became desperate because he knew if he did not get a way out he would have to drop out from his um from his studies and along the way with engagement of at his institution of a coordinator who was dealing with the affiliate mufon he was able to get to know about the fund he was supported to enroll because we had educated the coordinators on how to support students in the enrollment process and within a couple of months after the advertisement had been run he was able to receive his first graphically more fund loan dispersed to him and over the years subsequent applications he was successful and he was able to complete his medical education as a clinical officer in yamira this young man to date actually owns his own private clinic in rural nyamira and he's able to employ other health workers so this is a difference he's making just by getting that opportunity to be educated he's able to make a change in his community by setting up his own clinic and even hire other health workers to support him in provisional services in the in his community so this is really one of our achievements and there are many others that would share but really in view of time this is one of the few we wanted to showcase today that there is an entrepreneurial spirit that can come out from this and it's not just about health workers going to work in government facilities next so I want to hand it over to my colleagues peter just to pick up further on this discussion thank you for your attention great thank you janet and thank you for that exhaustive aspect of the af so basically I’ll be touching a bit on what is required to build a sustainable financial resource base to support health workforce training especially in context of universal health coverage so in context of affair limo fund the first will be a policy that to support resource mobilization for increasing the health workforce training it's worth noting that health workforce training is a resource intensive undertaking for example you're looking at the figures that have been discussed earlier you're looking at around 25 million u.s dollars currently being used up for training of around 35 000 of these health workers over the last seven years so in context of aef fund resource mobilization is indeed one of the key cornerstone of the program sustainability plans my colleague has talked about the us USAID plans of journey to self-reliance which essentially looks at how we can add value to the local entities and strengthen them to take up three responsibilities that are being undertaken by foreign entities so it's worth noting that as we speak the demand for the fund really outweighs the resources currently available before the start of the fund in the year 2012 the Kenya medical training college which is the main college for training of diploma level health workers had received over 35 000 applications but only 4 500 were enrolled and this really justified why we needed to come up with this initiative so for us how we approaching the resource mobilization for the fund is through an oversight committee that we formed and this committee is made up of the government entity that is responsible for implementation of the fund and this entity is known as the higher education loss board including other partners including us intra health and other banks and donors that are playing a big role in in mobilizing resources and this oversight committee essentially looks at various ways we can mobilize resources especially with the exit of several of the donors including USAID and this will ensure that the sustainability we're going forward of the funding second will be to determine the kardash to be supported based on a training needs assessment and it's worth noting also that any training intervention should be essentially be preceded by a robust training needs assessment so that we ensure that the resources are located for the cutters or for the trainings are for the most critical cadas especially in context of universal health coverage for example in context of our country Kenya the nurses and especially the diploma level nurses they play a big role in both primary and also specialized health care and in fact as you speak there is a huge gap that is currently existing on our training of specialized nurses due to an upsurge in the numbers of patients with cancer cases and most importantly currently with the advent of covid19 we have really seen a need for training of most specialized nurses especially at the critical care departments to deal with these upsarge numbers so it's very important as you're coming up with such a fund to be able to really understand and determine scientifically which coders are to be funded to what to be prioritized because not all coders are play the same role in the health sector especially in universal health coverage the third would be to determine the beneficiaries eligible by use of a main testing instrument and how we do this is by looking at various criteria and for us the criteria we are using is to ensure that there is equity in this opportunities especially for those who live in the far-flung areas the marginalized and disenfranchised areas of the country and how we look at this is through the governance structures that i've talked about we have the affiliate fund oversight committee that i've talked about earlier and this is the committee that is responsible in ensuring that we have a criteria to ensure that there's a proper eligibility for access to this fund and how we look at this is through a criteria that looks at family income that is a key priority for us offend status we look at gender we looked at we look at disability status and also the county of our region as my colleague has talked about the counties in Kenya play a big role in health provision in our country the health sector is a bit different from other countries the health sector in Kenya is highly decentralized to local entities that are known as counties so we have to look at the counties of origin to ensure that there's equity especially in distribution of these beneficiaries across the country so that we have a universal health coverage that is covering basically looking at the whole country in totality the next would be to establish a framework for revolving of the fund and this to us has been one of the key lessons learned it's worth noting that when we initiated the fund in the year 2013 it was in form of a scholarship and as you know scholarships are one-off payments and the beneficiaries essentially are not supposed to required rather to refund the money however we realized over time that the scholarship schemes are not sustainable especially when you have the exit of the donors and they also indeed do create a culture of dependency so with this in mind we changed the framework from a scholarship to a revolving fund which my colleague has talked about with a minimum interest of four percent annual which is much lower than the commercial interest charged on loans in Kenya that go as high up to as high as 14 percent so currently affiliate fund graduates have paid over the last seven years an amount equivalent to 1.8 million us dollars which we are now turning back to the fund to enhance the sustainability and to benefit other beneficiaries the fifth uh requirement to be to put up a model for public private partnership and for us this has also been one of the lessons learned and a key success story that these public-private partnerships amongst working with the government entity known as a higher education lawsuit have really benefited the loan because this pp public private approach has gradually exposed the higher education lawsuit to increasing level of private sector participation in a way to ensure transfer of skills and this goes hand in hand with the mantra of our donor usage where we are looking at how do we empower the local entities to take up this responsibility going forward especially with the exit of several donors so this ppp approach for us has been a way to transfer this knowledge base to the government entity to be able to prudently manage the fund the sixth requirement to be growing the fund where health disprints disciplines are funded including master's level so as alluded earlier one of the lessons learnt is that we need to grow the fund further from funding of diploma level graduates to even special specialized trainings because of the changing dynamics in the health sector and also changing dynamics in the disease patterns once again covid19 has exposed the challenges that we face as a country especially in specialized healthcare and we have now realized that we need more nurses we need more clinic officers to specialize in critical care we need even more nurses to specialize in Renault Renault disciplines and also oncology so we are hoping that going forward this fund is going to be not only transformative in terms of the basic aspects of health care but also specialized care which we have found as a key gap going forward over the last seven years finally you need to develop a framework for employment of af graduates unfortunately this has been a challenge we have realized that there's a mismatch between the numbers of graduates and the absorption capability of the health sector and this is partly because of what I said earlier our health system is developed and the local entities have what I would call semi-autonomous or rather autonomous ability to hire health workers so it's for us we're finding it as a challenge to ensure that there's 100 percent absorption due to disparities amongst these counties many of them have not come up with very good strategic plans many of them are grappling with issues of governance issues of corruption which have really led to less and less finances for absorption of these graduates so going forward and I think as a way of sustaining the fund is to ensure that now we have a framework that will ensure once we have graduated these beneficiaries they're able to be employed in the counties and indeed one of the success stories is to have the counties also come up with their own funds or chipping into the affiliate fund and once the graduates have finalized their training they're able to be bonded and they give back to the counties in in form of service delivery so this is what we have in terms of what is required to build a sustainable health workforce training program and back to you thank you so much great thanks I think that that we will be able to take questions and then from the floor the first question is have any specific strategies being defined for implementation of health care worker training programs associated with this funding mechanisms or funding mechanisms you know that sorry I had so I think that's what's been covered in that last slide by sauce peter these are the strategies we have actually put in place at the moment and by just having that policy for resource mobilization we have a tool that is able to identify the students appropriately so that you actually are catering for the very needy the country also has a national training policy we have one here in Kenya and the suspicion did allude to that it does define the different types of training how a county should have even a training selection committee our trainings based on needs I think that's critical as anybody is being called upon to undertake training both short term and long term so there is power in the training needs assessment and having training projections because those will actually guide budgets around some of those areas and then affair limo fund itself has become that model so that's the strategy on public private partnership with regards to the various disciplines being trained I think that has also been alluded to quite well by so spita and then employment I think that's the last huddle that we really have to look at we have tried this in terms of having forums where the employers come into the into the meetings dialogue have an interaction one-on-one with the students themselves with the principles and able to actually look at how can these students therefore be benefit we've looked at employment by advertising for opportunities we since we are actively engaged with the counties we do have access we gain access to their job advertisements and we post that to our students and encourage them to take up those employment opportunities in the public sector but as I shared their successes of self-employment and I think we do not want to restrict our students to just the government sector but how can they themselves also be entrepreneurs and open up their their own clinics yeah thank you I hope that is a response to that question thanks janet and then second question is are continuing medical education required and then and then for the different health cutters in Kenya and then if you know the other countries that's also great about other countries that would be great yes thank you chair yes could continuous medical education is is actually a cornerstone of education for the in the for the health sector especially for nurses and clinic officers we have what you call health professional associations that really do encourage the health workers to undertake this continuous medical education and once they do this they gain what we call continuous professional development points cpds which are also linked to their licensure so we have the regulatory bodies that are working closely with these health professional associations to ensure that the health workers do indeed continue gaining expertise in different areas and once they do not reach several quite a number of these professional points they lose their registration so this is encouraged in all cadas we have this going on for the nurses for the clinic officers for the doctors and the key cards that are required for universal head coverage great thanks is john anything to add to that or uh I think sausage has adequately addressed that question thank you dave I have actually questions to both of you that this is really interesting and great success stories and then it's very amazing that now you have 25 million dollar the assets there and then my question is if the other countries wants to start similar kind of program what do we recommend and where should they start um yes thank you dave that's a good question I have to say that affiliate mufund has been a journey and has evolved over the last seven years I started working with intra health when this product was actually a scholarship and it took a bit of lobbying to actually have stakeholders convinced that this was the right time for a loans product and especially at a diploma level I think in Kenya and even globally student loans have mainly targeted degree programs so what's the value out of this I this is what our stakeholders came back asking us and we say that scholarships have a good place that means you're able to educate somebody but once they're employed how do they give back how do you also keep that how do you sustain will you get people especially philanthropists foundations corporates giving money every year but there is nothing left on the table for the future generations so that's where now the loan comes about and I think this was really transformative but we had to talk to the ministry we had to talk to the higher education sloan sport because they were like diploma students when they graduate they will get employment they will repay and I think we have proven them wrong that it's easier for a student who has graduated from a health course to get employment easily as compared to the other courses either we looked at engineering or accounting somehow the uptick into employment is better for health oriented students so because there is a need there's a big gap here in Kenya we're still below the who standards for employment we so there's a huge gap and even now with covid I mean the health workers are overstretched and they still need they need to put more health workers to support uhc and also the specialized services as suspicious has alluded to we're in a crisis where carders like critical care nurses doctors uh are really wanted in view of the pandemic so I think that stakeholder buying is critical the other thing was the private sector we had to sit down with them and engage luckily within the then usid funded project were able to get on board a partner drawn from the private sector who showed us the ropes really on how to do resource mobilization it needed somebody who's trusted for purposes of getting that goodwill of the ceos the the managing directors and going even to individual philanthropists really to bring in those open their wallets and bringing the resources into the fund we also did this with the county government I i really want to acknowledge one that's our caca mega county the governor there had a dream during his first time of appointment he put he's been building a hospital and he realized this hospital is going to require human resource to manage and also provide services so as the hospital was being constructed he put in resources through his department of education and department of health into the afer limousine and within a year or so that hospital is actually going to be opening and the health workers whom he has supported from his county actually going to be available now to provide those services so I think you need people who are visionary in doing this so we hope other countries can learn from that look at your infrastructure what is needed in three or four years what's a human capital required to manage that infrastructure so I think those are some of the pointers I would share with other countries on how to make this fund a reality and I think lastly is working with also a state agency that can actually go out there and collect debt because I cannot go out there and do that neither can intra help neither can us id neither can the ministry of of health but working with a state agency that already has been mandated to give loans and to go and collect them once our students have graduated I think that was also uh it changed the thinking around the affair limo fund and that's where the recovery is as it stands at 1.81 million so yes thank you I wish all the other countries all the best if they on this journey but they are welcome to learn from us here in Kenya that's a great story thanks and then so do you have any additions like you from your perspective like what kind of advice would you give to the other places or organizations that wants to start similar kind of program oh thank you dai I think just to add to what janet has said I think for us what worked for us would be the justification and why we needed to do this it was a huge injustice to have 80 percent of those who work in the health sector especially dealing with both promoting and preventive health care are not included in a government loans board for higher education so for us we had a huge justification to ensure that we have the buy-in not only from the government but also from the private sector and in retrospect this has worked very well because this loans product from the feedback we have received from the government it has it's been one of the best performing because we there there's a huge gap and there's a huge demand for the health workers who we are turning out as beneficiaries so many of them are getting more employment these are the other products that are for bachelors or undergraduate or masters who are still seeking employment especially in their humanities who are really seeking employment and struggling so this this fund for us has been a life-changing fund for many students and we are hoping that going forward we are going to not only expand it to look at specialties but also link up with the counties to ensure that it's sustainable beyond the donor funding great thanks and then I’m so glad that the janet mentioned the kakamega because kakadu county is where I worked about a year and then that was still there so I’m just so touched there's a lot of questions that thank you for your presentations and how was the training program affected by the pandemic and you know the relationship between the loan program and also the how the schools and the students be able to go to the education is there any kind of like additional challenges that you have experienced yes indeed and I think the pandemic in terms of the training has been like a double-edged wood for us we have learnt many lessons especially on how to institutionalize virtual training it's worth noting that the main training college for middle level healthcare workers is known as the Kenya medical training college we have work together with them not only to ensure that their virtual trainings are in shape but also to include covered 19 content in their training curricula so for us there are many lessons we have learned as per the pandemic since we started off last year in march but most importantly is known is what noting that there has been an effect especially not only in training but also an uptick of of these health workers in the public health sector there have been huge demands for the beneficiaries but in the private sector due to reduced traffic partly because of the stigma that was associated with covet 19 many of them lost their jobs so we found it interesting that there was a movement from a private sector to the public sector which has been the inverse in previous years so there are quite a number of lessons we have learnt from the pandemic but as we speak right now we have stabilized and many of these colleges the middle level colleges are using virtual training to continue with the training of the earth workforce anything else from janet uh yes I i think I could add something to what um sauspita has so eloquently shared I think the other thing that plays out in this period and it would align very well to the future together is how the government and the technology companies could work together this is a time when content conversion of a lot of our curriculums have an opportunity to be undertaken it's pivotal at this particular time so I think that collaboration is something that they would look at we have seen one of our our providers that we work with for the education sector even come ahead and negotiate with the telecom companies for discounted rates for faculty we have seen discounted rates also for the students where they buy the air time the data bundles much cheaper and that is in recognition that this time round lessons have to be held virtually so I think that's the power that kavit has brought on the table yes the disease is there but they are also the good sides of this experience so content conver conversion is key what we think I think we need to really bring out is when universities and colleges are training on in medical education this I think it's an area that they need to give more attention to ensure that the educators are churned out technology serving we also need to look at ensuring that the infrastructure is well laid out not all colleges and universities have the fiber connection that internet connection so I think this is the time to actually put that so private sector I think come cross over to the health sector let's work together in this production of the workforce and also at the hospital level there's a lot more at play to bring about this as a lasting change not just reactive here in Africa when it comes to health thank you that's a great point janet and I really appreciate that we are about like seven eight minutes to the top of the hour but then I think that we just finished all the questions and then I really appreciate everybody who came to our sessions and then also janet and then we really had a great discussion and I appreciate everybody thanks
2021-09-05