Health care worker training programmes: Sharing the Kenyan experience
Despite what seems to be a significant burden of rheumatic diseases in East Africa, huge deficiencies in education and training of health professionals exist. World health organization recommends that there should be at least one rheumatologist per 100,000 people. However in sub-Saharan Africa(excluding south Africa), there are less than 20 rheumatologists for over 8000 million people and only four for a population of over 100 million in East Africa. Appropriate training of suitably qualified staff could help rectify this. Unfortunately, a lack of well -developed curricula for teaching rheumatology in East Africa has resulted in inadequate teaching in medical schools. Primary care physicians, internists and middle-level care medical carers such as nurses and clinical officers in Kenya currently play a major role in managing these patients .Despite inadequate training, they have to recognize, diagnose and treat patients with MSK conditions. With few functioning rheumatology clinics, patient management is haphazard and without guidelines or adequate intervention strategies. Bridging the gap between patients and rheumatologists can be achieved by giving basic training to the nurses, clinical officers and primary care physicians who are often the first point of contact for patients. this method is already being used for managing diabetic patients in Kenya and has been successful.