Building the Public Health Workforce

An intermediate FETP resident takes a participant’s blood glucose level during the

An intermediate FETP resident takes a participant’s blood glucose level during the "Prevalence and risk factors of Diabetes type 2 among adults 25 to 79 years old" survey at Jérémie, Haiti, July 2017.

Building the Public Health Workforce: CDC works closely with the Haitian Ministry of Health (MOH) and partners to build the capacity of the local public health workforce through the Field Epidemiology Training Program (FETP). CDC introduced FETP-Haiti in 2011 in collaboration with the MOH to improve the country’s ability to better prevent, detect and respond to public health threats. Before the introduction of FETP, there was limited epidemiology capacity at the MOH and no structured and field-focused training in-country. As of 2018, CDC has trained over 300* doctors, nurses, computer scientists, statisticians, laboratory technicians, and veterinarians to be disease detectives. Nearly all FETP-Haiti graduates remain in the government system providing services to the MOH and reinforcing the country’s public health system.

FETP-Haiti includes a combination of in-class (25%) and on-the-job (75%) instruction. FETP residents spend the majority of their time in the field investigating outbreaks, conducting studies, and training other health professionals. FETP-Haiti originally included three “tiers”—a three-month basic course, a nine-month intermediate level training, and a two-year advanced-level course – however, the advanced-level course concluded in 2015. In 2017 CDC collaborated with the Training Program in Epidemiology and Public Health Interventions Network (TEPHINET) to launch a Frontline training program designed to strengthen surveillance and epidemiology capacity at the primary level of the country’s health system. The Frontline training officially replaced the Basic course in 2018. FETP-Haiti currently offers the three-month Frontline course and follow-on Intermediate training.

The 60 graduates of the Frontline and Intermediate FETP cohorts pose with U.S. Ambassador, Michele Sison; Director General of the Ministry of Health, Dr. Lauré Adrien; and CDC Haiti Country Director, Dr. David Fitter at the July 2018 graduation ceremony.

The 60 graduates of the Frontline and Intermediate FETP cohorts pose with U.S. Ambassador, Michele Sison; Director General of the Ministry of Health, Dr. Lauré Adrien; and CDC Haiti Country Director, Dr. David Fitter at the July 2018 graduation ceremony.

The FETP-Haiti training curriculum is contextualized to meet the needs of Haiti’s population. The Frontline training focuses on the fundamentals of disease surveillance, understanding case definitions, disease screening and notification, data synthesis and analysis, conducting case investigations, and responding to epidemiological outbreaks. The intermediate training expands on the frontline course and also includes additional modules on designing and conducting public health research and collecting and analyzing data using Epi Info.

FETP residents conduct a field investigation during the 2016 Hurricane Matthew response in Jérémie, Haiti.

FETP residents conduct a field investigation during the 2016 Hurricane Matthew response in Jérémie, Haiti.

FETP-Haiti Impact: FETP-Haiti graduates are a vital component of Haiti’s health workforce and promote health security throughout all levels of Haiti’s public health system. Graduates serve in leadership roles as departmental health directors, work in the field collecting and analyzing surveillance data, and provide crucial epidemiological expertise during emergencies. FETP-Haiti residents and graduates were among the first to confirm the existence of the Zika virus in Haiti after planning and conducting active case finding; they were also on the ground after the passage of Hurricane Matthew in October 2016 to help curb the spread of diseases, including cholera. Additionally, they have contributed to the overall enhancement of disease surveillance and reporting in the country. A recent assessment of FETP-Haiti noted that surveillance data quality has improved since the program’s introduction and that an increasing number of outbreaks are being documented and properly investigated.

FETP is also a critical driver of public health research in Haiti. FETP-Haiti residents and graduates have carried out numerous epidemiological surveys and investigations that are building the evidence base for public health programming in Haiti. They also participate in project research conducted by the MOH, such as the National Nutritional Survey using the Standardized Monitoring and Assessment of Relief and Transitions (SMART) methodology, and share the findings of their research at international fora. Since 2012, FETP-Haiti residents and graduates have presented research at over 15 scientific conferences including the annual TEPHINET Global Scientific Conference, TEPHINET Regional Scientific Conference of the Americas, the American Society of Tropical Medicine and Hygiene annual meeting, the annual Epidemic Intelligence Service Conference, and the European Scientific Conference on Applied Infectious Disease Epidemiology.

CDC and the MOH plan to train two Frontline and one Intermediate cohorts in fiscal year 2019. For more up-to-date information on the FETP-Haiti program, please read the FETP-Haiti newsletter Boots on the Ground.

Page last reviewed: October 5, 2018
Content source: Global Health