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Challenges with Continuing Professional Development for Health Professionals in Africa – Focus on Nigeria

By Abdullahi Tsanni

Globally, medicine is a rapidly growing field producing tons of research findings and information daily. New drugs and vaccines, new clinical procedures and techniques, and new equipment and technology are continually being introduced. These advancements require physicians, nurses, and other healthcare workers to improve their knowledge and skills through continuing professional development (CPD) throughout their careers.

Continuing Professional Development is an ongoing learning process that, in addition to formal undergraduate and postgraduate training, allows health professionals to maintain and improve medical practice standards.

Through the development of knowledge, skills, attitudes, and behaviors, CPD improves clinical and procedural skills and enhances medical knowledge. Continuing professional development keeps health professionals abreast of the latest trends and developments in research, thereby facilitating quality patient care and improving clinical practice.

While CPD clearly plays an essential role in maintaining healthcare systems worldwide, many health professionals practicing in Africa continue to face challenges accessing continuing medical education — an essential part of CPD. These challenges include financial constraints, lack of motivation and support, lack of learning resources, non- release by employers, and poor or slow internet connectivity. A 2017 online survey examined the experiences and perceptions of CPD among 2,299 clinicians from across 13 countries in sub-Saharan Africa. Among the findings, a slow internet connection was a significant barrier to online CPD program participation.

Dr. Ifeanyi Nsofor is the CEO of EpiAFRIC, a health consultancy group based in Abuja, Nigeria. EpiAFRIC is focused on improving population health through research and data analysis, health communication, advocacy, and training in sub-Saharan Africa. Dr. Nsofor strongly believes that lifelong learning among health professionals is no longer an option but a necessity.

Dr. Ifeanyi Nsofor (2nd from Right), CEO of EpiAFRIC, believes that continuing professional development for health professionals in Africa is necessary.

Citing the immense benefits to the skills and competencies of health professionals, Dr. Nsofor feels that we cannot overemphasize the importance of CPD for health professionals in Africa. However, Dr. Nsofor notes that difficulty in taking time off from work to engage in training activities hinders health professionals from participating in professional development courses since they have to leave their paid jobs to take further studies. Thus, Dr. Nsofor’s organization is working to provide various online CPD courses for health professionals across African countries, including Nigeria, Ghana, Kenya, and South Africa. “Health professionals can no longer depend on what they were taught in school — because lots of information from research findings and scientific publications are now generated daily, and fast. The future belongs to [health professionals] who recognize and respond to developments in the fields of health and medicine, [and have] knowledge of trends and advancements that impact patient care,” said Dr. Nsofor. “If you’re a clinician, for instance, some medical procedures might have been modified since the last time you learned about them. So, if you don’t update your knowledge, you could end up providing poor health services to your patients,” he said.

In Nigeria, Africa’s most populous nation, CPD is mandatory for all medical and dental practitioners. At least 20 CPD points are required for licensure renewal, according to the Medical and Dental Council of Nigeria (MDCN). The MDCN is the regulatory body for medicine, dentistry, and alternative medicine in Nigeria. Since 2007, the body has 3 promoted CPD “to improve, renew, and update the skills and ability of medical professionals to ensure that appropriate and high-quality health services were being rendered to patients.”

The scope and curriculum of the CPD program in Nigeria cover basic medical, dental, and clinical sciences, including different specialties such as anesthesia, public health, family medicine, internal medicine, pharmacology, and psychiatry. Health professionals take part in CPD programs to address various needs, including license renewal, developing proficiencies necessary to meet patients’ expectations, and updating their current medical knowledge and skills.

A study in Nigeria, however, revealed the barriers to CPD faced by nurses at the University of Nigeria Teaching Hospital, Enugu in southeastern Nigeria, which included: lack of support to fund or attend scheduled CPD courses, competing for work priorities, and lack of employer cooperation to attend CPD outside the workplace. Other barriers to CPD were family and childcare responsibilities and colleagues’ reluctance to provide coverage during training absences. Similar findings were reported in another study conducted in Calabar, Cross River State, Nigeria.

Advancements in the field of medicine require health professionals to update their skills and medical knowledge continuously.

Continuing professional development is self-paced. Dr. Tunji Akintade, a physician and chairman of the Association of General and Private Medical Practitioners of Nigeria (AGPMPN) in Lagos, Nigeria, said that CPD was central to improving medical practitioners’ knowledge and skills, which, in turn, improves their professional status and patient care and health outcomes. He noted that there is a need for effective monitoring, regulation, and enforcement of CPD. In Nigeria, “there are organizations that provide continuing medical education and professional development for health professionals, but the regulator [Medical and Dental Council of Nigeria] has to enforce it and look at the quality of courses provided. Also, the total number of [CPD] points needs to be increased to make it better,” said Dr. Akintade.

Dr. Nsofor agrees. He urged that organizations ensure that their staff regularly update their knowledge and skills by providing the enabling environment for their professional development, including adequate funding and time to engage in CPD.

“Ultimately, health professionals must be willing to learn new things and update their knowledge. What I have found is that once you begin to search for learning opportunities, you’ll find them,” said Dr. Nsofor. “So, you must be willing to improve yourself because it will make you a better healthcare provider, competitive, and someone that organizations will be interested in employing,” he added.

Continuing professional development provides the opportunity to keep up to date with medical knowledge and clinical skills and develop personal and professional qualities. Medical professionals who do not continuously update their knowledge through CPD cannot apply current evidence to their clinical practice, leading to suboptimal patient care and health outcomes.

Looking for Online CPD Courses?

The Missing Link to Improved Health Outcomes (MiLHO) Initiative provides online CME courses that recognize and consider Africa’s unique medical practice environment by developing evidence-based and relevant content. The initiative aims to expand opportunities for CME to assist healthcare practitioners in staying current with evidence supporting patient care in their local setting. Courses are certified by the CPD Certification Service. Visit the MiLHO Initiative to learn more.