207539 Feasibility and effectiveness of a continuous medical education program for primary care providers in a war-torn state

Wednesday, November 11, 2009

Ramin Asgary, MD, MPH , Dept of Preventive Medicine, and the Center of Global Health, The Mount Sinai School of Medicine, New York, NY

Economical and social collapse and civil war after breakdown of former Soviet States significantly impacted their health care system and delivery. In Abkhazia with close to one-million population and where medical supplies are limited, there were no refreshing medical education for medical providers, and no medical books and journals. Lack of proper ongoing training contributed to inefficient use of limited resources, trends toward symptomatic therapies, and poor compliance with population-based guidelines.


To improve quality and ensure proper use of limited supplies, during a humanitarian medical program we introduced a novel continuous medical education program providing relevant and up-to-date information for more than 100 generalists and pediatricians. Based on epidemiology of common illnesses after a systematic assessment, and with the collaboration of local health professionals we accordingly developed and offered seminars, on-site workshops, and ongoing medical letters which included WHO's guidelines in diagnosis and management of diseases. Over a 6-month period, these regular on-site interactive bi-weekly workshops, and one-page medical letters with subsequent questionnaires, delivered through regular visits (no postal services), further provided more insights into barriers to health care delivery, public health challenges, and nature of medical practices. Local health authorities and medical professionals were partners and significantly involved in all levels. We subsequently transferred the complete programmatic responsibility to local health authorities.


Practitioners were very enthusiastic and welcoming. They found the program very useful in improving their overall efficiency and satisfaction when adapted to the epidemiology of diseases they encountered. Follow up assessment documented improved quality of clinical practices.


This program demonstrated that evaluation and subsequent ongoing training programs for practitioners are not only necessary to ensure efficient utilization of scarce resources but also feasible and effective in a post-war/post-conflict setting.

Learning Objectives:
To recognize the necessity, feasibility, and impact of continuous training programs for medical and health providers even in a post-conflict setting To describe the pillars of a novel training program for practitioners in a collapsed health system

Keywords: Training, International Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been working with international humanitarian organizations since 1997. I have developed training curricula and offered training for medical doctors and medical assistants to manage common diseases and public health challenges during humanitarian situations. As a teaching faculty in clinical medicine and global public health I have also developed global health curricula and trained many physicians in the United States to be prepared for working in humanitarian situations. I have designed, initiated and performed this program.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.