IMPACT Trains a New Generation of Leaders to Bolster Public Health Efforts in Bangladesh and Kenya

Building on the success of its Field Epidemiology Training Program (FETP) model in forming a strong public health workforce to protect the globe, the Centers for Disease Control and Prevention (CDC) launched the Improving Public Health Management for Action (IMPACT) program in 2016. TEPHINET has been providing operational support to the implementation of IMPACT in Bangladesh and Kenya—the first two countries chosen to pilot this program—since 2015, helping the CDC and partner institutions in-country gear up to launch IMPACT and run the program successfully afterwards.

In general, TEPHINET co-sponsors training workshops (along with other funding partners) and manages contracts with the programs’ administrative staff and key contractors who provide services including classroom space and training materials. In both countries, an evaluation consultant, supported through a contract with TEPHINET, assesses the effectiveness of the trainings.

In January 2018, fellows from both programs convened in Atlanta for a five-day IMPACT symposium for which TEPHINET provided logistics and travel support. Fellows gave presentations about their work and participated in specialized training and case study sessions throughout the week.

“This program is vital because the world needs strong management to coordinate increasingly complex global public health efforts,” says Lesley Guyot, MPH. Guyot is a project manager with TEPHINET and oversees its work with IMPACT.

IMPACT aims to build a cadre of highly skilled public health managers to lead these efforts, from prevention to outbreak response, and to work alongside scientists to translate research into effective interventions. As in the FETP model, IMPACT fellows receive hands-on training—mostly at field sites across their countries—and are overseen by supervisors and guided by mentors.

IMPACT trains fellows in eight key domains:

  1. Program planning and management
  2. Communication
  3. Community partnership development
  4. Analysis and assessment
  5. Organizational leadership and systems awareness
  6. Basic public health sciences and practices
  7. Budget and financial planning
  8. Emergency planning, preparedness, and response

The Bangladesh and Kenya IMPACT programs each feature two tracks: a two-year traditional fellowship for entry- to mid-level health professionals leading to a master’s degree and a six-month Distinguished Fellows Program (DFP) for senior-level managers. Another similarity to FETP is that DFP graduates often return to supervise or mentor fellows in the traditional track.

To date, Bangladesh IMPACT has hosted one cohort of the traditional two-year program (with four participants) and two cohorts of DFP (with 44 total participants). The program in Kenya has hosted three cohorts of the two-year program (with 24 total participants) and three cohorts of DFP (with 44 total participants). All participants have been ministry of health employees in their respective countries.

In March 2019, TEPHINET and Africa-based healthcare non-profit Amref Health Africa co-sponsored nine Kenya IMPACT fellows’ attendance at the 2019 Africa Health Agenda International Conference in Kigali, Rwanda. The fellows’ conference presentations contribute to the completion of their fellowship degree requirements.

“Confidence to speak in public?” says one Kenya IMPACT fellow in response to an anonymous survey. “No, I was horrible. I was not confident. Now I have presented at a major African Union meeting. I can’t believe I did it. IMPACT enabled us to present in front of our peers. I presented at the FELTP dissemination. IMPACT has improved my confidence.”

In Kenya, the Field Epidemiology and Laboratory Training Program (FELTP), hosted by the Ministry of Health, houses the IMPACT program. The FELTP has established the infrastructure for the program to exist, from developing the fellows’ recruitment method to processing paperwork to promoting the program within the government. The FELTP also provides technical support to fellows during their two-year fellowship and guidance during the selection processes for both the DFP participants and two-year fellows.

In addition, the FELTP coordinates relationships with partner institutions such as the Kenya School of Government and Kenyatta University. The Kenya School of Government provides classroom space and logistics for DFP, while Kenyatta University provides instruction, research support, classroom space, and ultimately a degree for the two-year fellows. CDC’s country offices in Kenya and Bangladesh provide additional mentorship for the fellows and assist in program coordination.

In Bangladesh, the Institute of Epidemiology, Disease Control and Research (IEDCR), based in Dhaka, is the host institution of the Bangladesh FETP and also organizes the IMPACT program. Fellows in Bangladesh have had the opportunity to work with Rohingya refugees in Cox’s Bazar, conducting situational analysis and using the Incident Command System to learn how to manage a health workforce in an emergency situation.

CDC is now implementing new IMPACT programs in Cambodia and Nigeria. Both programs will receive evaluation support from a TEPHINET consultant. Evaluation results from Bangladesh and Kenya have been positive, with self-assessments showing improvements in fellows’ knowledge and skills.

“Most of the time, you're not thinking about how you go and sit in the class,” explains Kenya IMPACT DFP graduate Bonaya Adano. “Most of the time, you are going to think, even when your teacher is there, how you are going to apply [knowledge] starting immediately when you leave that class.”