Tanzania Field Epidemiology and Laboratory Training Program

Program overview

The Tanzania Field Epidemiology and Laboratory Training Program (TFELTP) is a two-year competency-based training program that was established in 2008. The program is anchored within the Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) and collaborates with Muhimbili University of Health and Allied Sciences (MUHAS) and the National Institute for Medical Research. In addition, TFELTP receives support from various partners including the U.S. Centers for Disease Control and Prevention (CDC), the African Field Epidemiology Network (AFENET), the United States Agency for International Development (USAID), and the World Health Organization (WHO). Being a competency-based training program, trainees spend 25 percent of their time in class (didactic session) and the rest at their field placement, learning by providing services. To build critical mass of epidemiology, TFELTP adopted a three-tiered pyramid model in 2016 by introducing two new levels of the program—frontline and intermediate. The goal of this model is to address the need to improve the surveillance, epidemiology, response, and scientific communication skills of public health workers at each level of the health system (district, regional and national levels). Frontline training lasts three months, while the intermediate course lasts six. Both focus on detection of and response to disease or events of public health importance. The advanced TFELTP course originates from various regions of the country. After training, most of the trainees return to these regions, though a few have been relocated to other departments, units and organizations that either directly or indirect work on public health surveillance. The presence, coverage, and distribution of FELTP trainees has facilitated communication within the country and throughout the region, strengthened the capacity to respond to public health emergencies, improved early detection and notification of events, and enabled the surveillance and research of priority public health problems.

Achievements

The program has invested in building epidemiological capacity in the country. Over the years, the program has concentrated on hands-on training where residents have attained skills and competencies geared towards addressing public health challenges. Efficient communication of crucial information has improved, and the MoHCDGEC now utilizes evidence-based methods to establish health priority. Alumni and residents have been able to detect and respond to a number of outbreaks, emergencies, and threats in several parts of the country. They have also disseminated research findings in local and international conferences and meetings, as well as in peer-reviewed journals. This database of research has established a strong public health surveillance system in the country. The residents conduct studies that reflect the diversity of public health issues. In doing so, they identify research questions, design the studies, and gather critical data. Some of the work done through this program has resulted in policy changes. Currently, four senior positions in the MoHCDGEC are headed by graduates of the TFELTP. These include the Director of Health Quality Assurance, the Assistant Director of Epidemiology (who is also the Director of the Tanzania Field Epidemiology Training Program), the Director of National Health Laboratory Quality Assurance and Training, and the Strategic Information Coordinator of Integrated HIV, TB and Leprosy. Other graduates of the program are in national disease programs, hospitals, district and regional health management teams, and even non-governmental organizations. Graduates of FELTP started an alumni association called Tanzania Field and Laboratory Epidemiologists Association (TANFLEA). The mission and vision of the association is to support, promote, and defend the fundamental human rights of all people, irrespective of their status, gender, sex, nationality, or religious or political belief, to access healthcare. To date, there have been nine cohorts and 114 alumni. As of 2019, trainees have conducted six outbreak investigations and one disaster assessment in Kagera region. Trainees have conducted surveillance systems evaluations and data quality assessments in 10 regions. Additionally, trainees have conducted group operational studies to evaluate HIV programs in 10 regions.