title: Building mental health workforce capacity through training and retention of psychiatrists in Zimbabwe.
abstract: Despite the need to improve the quantity and quality of psychiatry training in sub-Saharan Africa (SSA), very little is known about the experiences of psychiatric trainees in the region. This is the first study examining psychiatric trainees in a low-income country in SSA. It was carried out as part of the needs assessment for a unique Medical Education Partnership Initiative (MEPI) programme to find African solutions for medical shortages in Africa. We approached all doctors who had trained in post-graduate psychiatry in Zimbabwe in 2010 and conducted in-depth qualitative interviews with all except one (n = 6). We analysed the data using constant comparison and thematic analysis. Trainees described the apprenticeship model as the programme's primary strength, through providing clinical exposure and role models. Programme weaknesses included shortages in information sources, trainee salaries, trainers, public health education, and in the mental health service. Most respondents were, however, eager to continue practising psychiatry in Zimbabwe, motivated by family ties, national commitment and helping vulnerable, stigmatized individuals. Respondents called for sub-speciality training and for infrastructure and training to do research. Resources need to be made available for psychiatric trainees in more SSA settings to develop public health competencies. However, investment in psychiatry training programmes must balance service provision with trainees' educational needs. Directing investment towards needs identified by trainees may be a cost-effective, context-sensitive way to increase retention and learning outcomes.
authors.affiliation: IoPPN, King's College London , UK.
authors.forename: Melanie A
authors.initials: MA
authors.lastname: Abas
authors.forename: Sekai M
authors.initials: SM
authors.lastname: Nhiwatiwa
authors.forename: Walter
authors.initials: W
authors.lastname: Mangezi
authors.forename: Helen
authors.initials: H
authors.lastname: Jack
authors.forename: Angharad
authors.initials: A
authors.lastname: Piette
authors.forename: Frances M
authors.initials: FM
authors.lastname: Cowan
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barley
authors.forename: Alfred
authors.initials: A
authors.lastname: Chingono
authors.forename: Amy
authors.initials: A
authors.lastname: Iversen
authors.forename: Dixon
authors.initials: D
authors.lastname: Chibanda
mesh_terms: D057191:Capacity Building / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services; D011570:Psychiatry / Q000193:education; D000078329:Workforce; D015030:Zimbabwe / Q000453:epidemiology