title: Training tomorrow's leaders in global health: impact of the Afya Bora Consortium Fellowship on the careers of its alumni.
abstract: BACKGROUND
  Effective leadership is a cornerstone of successful healthcare delivery in resource limited settings throughout the world. However, few programs in Africa prepare healthcare professionals with the leadership skills vital to the success of the healthcare systems in which they work. One such program, the Afya Bora Consortium Fellowship in Global Health Leadership, has been training health professionals since 2011. The purpose of this study was to assess what career changes, if any, the Afya Bora Fellowship's alumni have experienced since completing the fellowship, and to describe those changes.
  
  
  METHODS
  The Afya Bora Fellowship is a multidisciplinary, one-year training program that teaches health professionals leadership skills through didactic and experiential learning in four African countries. Between January 2011 and June 2013 the consortium trained 42 nurses and doctors. In November 2013, an electronic survey was sent to all alumni to assess their performance in the workplace post-fellowship.
  
  
  RESULTS
  Thirty-one (74 %) of 42 alumni completed surveys. Twenty-one (68 %) reported changes to their position at work; of those, sixteen (76 %) believed the change was due to participation in the fellowship. All alumni reported improved performance at work, and cited the application of a wide range of fellowship skills, including leadership, research, communication, and mentoring. Twenty-six (84 %) alumni spearheaded improvements in their workplaces and almost all (97 %) remained in contact with colleagues from the fellowship. Among the respondents there were five publications, nine manuscripts in preparation, and three international conference presentations.
  
  
  CONCLUSIONS
  Afya Bora alumni overwhelmingly reported that the one year fellowship positively influenced both their work and career trajectory. Training health professionals in leadership skills through didactic modules with the opportunity to apply learned skills at attachment sites in the Afya Bora Fellowship has an impact on performance in the workplace and the potential to improve long-term institutional capacity.
authors.affiliation: Departments of Medicine and Global Health, University of Washington, 325 Ninth Avenue, Box 359909, Seattle, WA, 98104-2499, USA. alizamw@u.washington.edu.
authors.forename: Aliza
authors.initials: A
authors.lastname: Monroe-Wise
authors.affiliation: Department of Medicine, University of Botswana, Gaborone, Botswana.
authors.forename: Yohana
authors.initials: Y
authors.lastname: Mashalla
authors.affiliation: Department of Global Health, University of Washington, Seattle, WA, USA.
authors.forename: Gabrielle
authors.initials: G
authors.lastname: O'Malley
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Neal
authors.initials: N
authors.lastname: Nathanson
authors.affiliation: School of Nursing, University of Botswana, Gaborone, Botswana.
authors.forename: Esther
authors.initials: E
authors.lastname: Seloilwe
authors.affiliation: Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya.
authors.forename: Onesmus
authors.initials: O
authors.lastname: Gachuno
authors.affiliation: School of Nursing Sciences, University of Nairobi, Nairobi, Kenya.
authors.forename: Theresa
authors.initials: T
authors.lastname: Odero
authors.affiliation: Department of Internal Medicine, Makerere University, Kampala, Uganda.
authors.forename: Damalie
authors.initials: D
authors.lastname: Nakanjako
authors.affiliation: College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Nelson
authors.initials: N
authors.lastname: Sewankambo
authors.affiliation: Department of Nursing Management, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
authors.forename: Edith
authors.initials: E
authors.lastname: Tarimo
authors.affiliation: Department of Community Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
authors.forename: David
authors.initials: D
authors.lastname: Urassa
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Yukari C
authors.initials: YC
authors.lastname: Manabe
authors.affiliation: Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, CA, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Chapman
authors.affiliation: School of Nursing, University of Washington, Seattle, WA, USA.
authors.forename: Joachim G
authors.initials: JG
authors.lastname: Voss
authors.affiliation: Departments of Medicine and Global Health, University of Washington, 325 Ninth Avenue, Box 359909, Seattle, WA, 98104-2499, USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Wasserheit
authors.affiliation: Departments of Medicine, Global Health, and Epidemiology, University of Washington, Seattle, WA, USA.
authors.forename: Carey
authors.initials: C
authors.lastname: Farquhar
mesh_terms: D000349:Africa; D002322:Career Mobility; D005257:Fellowships and Scholarships; D014943:Global Health / Q000193:education*; D006282:Health Personnel / Q000193:education*; D006801:Humans; D007857:Leadership
keywords: Africa; Interprofessional; Leadership training; Transformative leadership; Transprofessional