Physicians post-graduate training in reproductive health

Special PES covers the period 9/76-l0/80 and is based on site visits, briefings at AID/W and project headquarters, and interviews with A.I.D. staff and with project and government personnel in the four countries visited. The Johns Hopkins University Program for International Education in Gynecology and Obstetrics (JHPIEGO) is successfully improving reproductive health in LDC"s; about half of eligible medical schools have been reached. The major change has been the shift from U.S.-based to in-country training, now in place in 14 countries. Political and technical problems have interfered with this institutionalization process in several important countries (e.g., India and Ethiopia), but in most it is proceeding as planned. When current overseas training is completed, at least 4,000 professionals will have been trained; a new 5-year project (l982-86) which is awaiting A.I.D. approval calls for training at least l0,000 more. In Korea, Colombia, and Thailand, reduced maternal and infant mortality rates and a sharp drop in birth rates can be at least partly attributed to JHPIEGO programs. Although unexpected, the project has also been accepted in very conservative countries (i.e., Mauritania, Morocco, and Burma). JHPIEGO has already implemented five recommendations made in a previous evaluation. Specifically, these recommendations called on JHPIEGO to: (1) initiate courses to improve the skills of LDC graduate nurses; (2) include experts in nurse and physician training and in educational materials development in its International Council; (3) sponsor in-country or regional meetings involving medical school deans and professors of obstetrics and gynecology to help introduce reproductive health into medical school curricula; (4) incorporate demographic information and contraceptive technology in all courses; and (5) become a resource center on reproductive health information and education materials.