Background

Global research shows that the burden of disease (BoD) is high in countries that have little resources as the case with most African Regions. Empirical evidence also indicates that despite hearing impairment ranking third on the list of nonfatal disabling conditions in low- and middle-income countries, Ear, Nose, and Throat (ENT) disorders are not specifically coded for within the framework governing global BOD estimates. In addition, health discourses have historically neglected non-communicable diseases where health challenges are discussed. They receive very little attention or mere secondary considerations. This is despite the fact that ENT disorders greatly militates against the quality of life of children and adults. As a response mechanism to the neglected services, most developing communities resorted to indigenous knowledge systems where traditional interventions are practiced. The increased reliance on traditional practices results in the growth of cases requiring surgical management. The situation is exacerbated by the acute shortage of trained professionals in the field of ENT and audiology. WHO (2018) statistics have highlighted that over 466 million persons in the world live with disabling hearing loss, which relates to 6.1% of the world’s population. The number of people with disabling hearing loss will grow over the years up to 630 million by 2030 and over 900 million in 2050 (WHO, 2018). There is still a very significant gap between the current situation and available skilled manpower to attend to the prevailing problems.

The Ministry of Health and Child Care in relationship with CBM and WizEar supported by BMZ has initiated a partnership with Stanford University in the United States of America to conduct a Reverse Fellowship program. To date one ENT surgeon has so far undergone a fellowship program. These fellowship programs have proven very vital to ENT service delivery and as such, this project would like to have more doctors to undergo the same program. For the fellows, the essential learning activity is interaction with patients under the guidance and supervision of faculty members who give value, context and meaning to those interactions. To this end three cadres will be identified to undergo a reverse fellowship program for one year. The otology fellowship consists of a comprehensive course of study and surgical apprenticeship with inpatient and outpatient experience. The training program will be based at Parirenyatwa Hospital and Sally Mugabe Central Hospital.

Available funds for the program

The three-year program has a budget which comprises training fees, flights and training materials and this will be spread over three years. The total amount also includes flight and hotel costs for other professors coming in to support the program. All other expenses are to be included in the financial proposal such as communications, travel and subsistence costs for Consultant (s) (if applicable).

Methodology of the program

The reverse fellowship will be conducted under consistent supervision by the consultant of the fellow. The consultant will also provide one on one tutorship and observation especially during surgery. Observation reports will be generated monthly showing accumulative hours conducted as well as the activity done.

Objectives

The objectives of this fellowship program are as follows: To train through supervision, three ENT specialists into Fellows by end of 2023; To start a Fellowship Program in Zimbabwe which will form the basis of all ENT Fellowship Programs in Zimbabwe; To generate an ENT Fellowship program curriculum that is nested in the Zimbabwean context.

Scope of work

The Consultant(s) undertake(s) to perform the services with the highest standards of professional and ethical competence and integrity. The Consultant(s) is/are strongly encouraged to develop highly interactive and practical outputs for this consultancy. The Consultant(s) is/are required to perform the following functions at minimum: 280 accumulative hours of service by the fellow student for both surgical and non-surgical ENT related issues through provision of a conducive environment; Ability to undertake ENT related surgeries with very minimum supervision and assistance by the student. These are regularly cases like nosebleeds, adenoidectomies, infected mastoids, tonsillectomies, and sinusitis; Ability by the fellow students to undertake expected service delivery as per designed curriculum; Writing a structured and concise training report; The consultant will also coordinate with MOHCC, WizEar and CBM through periodic feedback; The local faculty consultant should work very closely with the Stanford University faculty through organising their flights, accommodation and supervision program

Deliverables and timelines

Development of a one-year training curriculum to be approved by the project team and University of Zimbabwe; All Presentations and support training material to be copied on a CD, memory stick or hardcopies for distribution to participants; 280 accumulative hours of supervision of the Fellow student as per designed program; Drawing a list of the needed measuring instruments to conduct the program; A detailed progress report for the supervision that is produced quarterly; Quarterly reports on student progress and capacities, abilities and challenges generated and shared.

Roles and responsibilities

The Consultant (s) role and responsibilities will cover the following: Generating a work plan for the program consultancy team and share this with MOHCC and WizEar; Conducting supervision of fellows and generating reports; Mentorship of ENT registrars in terms of ENT related services.

Qualifications

Groups or Individuals interested in this consultancy must have the following qualifications:

A recognised post graduate MMed; Be a qualified ENT surgeon; Be a holder of a Reverse Fellowship qualification from a recognisable University; Demonstrated experience and success in delivering same courses; Good administration and interpersonal skills; Good computer skills.

Expected start date

This reverse fellowship program is expected to start in July 2021. The program will be based in Zimbabwe. This will be followed by return visits by professors from Stanford who will come to conduct observations prior to awarding the qualification.