Background/Purpose:

Musculoskeletal conditions (MSC) are common in Kenya yet the training of primary care physicians in MSC is minimal and there are only 2 full time rheumatologists for a population of 41 million. The aim of this project, supported by ILAR, is to enable early access to appropriate health care for MSC in Kenyan communities. In a collaboration between colleagues in Kenya, UK and Sweden an innovative sustainable training programme has been developed to raise the knowledge and skills of health professionals working in the community in the early detection, diagnosis and management of MSC.

Methods:

A programme was developed to train a cohort of mid-grade physicians and patients as trainers in musculoskeletal health. These trainers teach health providers that are the first point of contact for patients in the community e.g. clinical officers. The training emphasises history and examination to identify the musculoskeletal syndrome; the use of basic investigations, diagnosis, management and referral. The trainers work as a physician/patient team with the patients playing a key role in teaching history taking and examination skills and in making health providers aware of the impact of MSC on patient’s lives.

Results:

A train the trainer session was held in March 2012. 10 physicians and 9 patients were trained to become trainers in a 2.5 day session followed by a one-day demonstration training session which was videoed as a resource for the trainers. The trainers have gone on to deliver training to 150 first contact providers in 4 regions across Kenya. The content and delivery of the trainer and health provider courses were rated by participants as very good or excellent. After the first round of health provider training 75% of participants felt they were well prepared to use the skills in MSC diagnosis and 68% felt they were well prepared to use the skills in MSC management in their daily work. A 6 month post training evaluation is to be completed.

Training patients to be educators has started empowering them in advocacy and self-management. The project recognises the need to work with patients to develop an appropriate self management programme for Kenya and plans to address this in the future.

Conclusion:

This sustainable programme has developed a system and resources for delivering effective and appropriate musculoskeletal health care training to first contact health providers across Kenya. It has also raised the level of knowledge and competency of mid-grade physicians so they can fill the gap between first contact providers and hospital specialists. Should the project evaluation show it to be effective in changing practice and improving care for MSC this may provide a template for a programme of MSC training which could be implemented in other low income countries globally.

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« Back to 2012 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/initiating-an-innovative-training-programme-to-improve-access-to-musculoskeletal-health-care-in-kenya/