G-I-N spotlight July 2011
"Twinning" in Africa: a tale of two stories
Clinical Practice Guidelines (CPGs) are instruments to improve care all over the world. Even though they are most intensively used in developed countries, other realities are also eager to take full advantage of this as a basis for clinical practice. Ever since we helped found G-I-N (and Ibero-GPC - Iberoamericana de Guias para la Calidad) we, at the Center for EBM at the University of Lisbon School of Medicine, have always been concerned with the possibility that Portuguese speaking countries in Africa would be interested in participating in scientific activities around designing, disseminating and implementing CPGs. But how could we identify people or organizations within these countries that would be interested in joining G-I-N?
This is a story of “twinning” between a European and two African countries, both interested in improving clinical care within their national health systems. It shows the problems and rewards of establishing mutual relationships, and getting them to become G-I-N members.
Over the last decades, Portugal has maintained very close ties with all its former colonies in Africa: Angola, Mozambique, Cabo Verde, S. Tomé e Principe and Guiné. By close ties I mean permanent bilateral projects in public health, medical teaching, clinical research, etc. conducted by several governmental departments in my country, exclusively devoted to improving bilateral exchanges.
So our first step was to identify, in these departments, people that were knowledgeable about the realities of the health systems in each Portuguese speaking country (PALOP) so they could help us to identify the right people that would lead the process there. Once we obtained this information, we mailed, called and e-mailed all of them and, from that point on, we could identify the most enthusiastic individuals that could be interested in leading the process in Africa.
Soon two countries emerged as the most promising: Cabo Verde and Mozambique. Here we could establish immediate relationships and start looking for ways to get them into being G-I-N members.
In Cabo Verde a local doctor - a leader at the biggest hospital in the country – was identified, and we could meet him in Lisbon and get to know his needs and views on how he thought G-I-N could help the health system there. We then pursued our contacts by inviting him to the G-I-N Conference in Lisbon in 2009 and, from then on, we could establish a regular professional relationship that culminated in me going to Cabo Verde and formally proposing that he and his hospital join G-I-N afterwards. At this time I also had the opportunity of meeting local health authorities and explaining what G-I-N is and does. The formal acceptance of Cabo Verde as a G-I-N member followed.
In Mozambique we had a different approach: we got in touch with the President of the Medical Association (MMA) and invited him to attend the Lisbon Conference. While here, we had the opportunity to discuss with him the needs of his health system and present G-I-N and its initiatives. Over the months we got the chance to understand what we could do for this country in terms of high quality medical information, and – answering his request - we ended up sponsoring the MMA as a G-I-N member.
So, out of the five PALOPs we already have 2 as G-I-N members. So far, so good…
Should you, as a G-I-N member, be interested in “twinning”?
My answer is a strong yes, but bear in mind that there are some problems: firstly, the communications are not always easy, either due to telephone or internet problems. Secondly, you need to be very active in pursuing the relationship with the local stakeholders. Thirdly, you need to have a long term plan with your partners there. Finally, you need to have resources to sponsor G-I-N membership of these institutions.
But it is worthwhile, believe me! These experiences were extraordinary enriching for me, giving me the opportunity to meet wonderful people and helping to set up an information system responding to the needs of our African brothers.
António Vaz Carneiro, MD, PhD, FACP
Center for EBM, University of Lisbon School of Medicine, Lisbon, Portugal
Members and non-members are invited to participate in a focus group organised by G-I-N Membership Committee and scheduled during the G-I-N conference in Seoul, Korea
By sharing with us your thoughts, experiences and ideas you will help us in shaping the future of the Network. The outcomes of the session will be shared with the G-I-N Board and will direct G-I-N strategies to ensure that the Network is evolving to face the challenges and issues of organisations and individuals working in the field of guidelines.
We are looking forward to having participants from around the globe -- G-I-N individual members, G-I-N organisational members and non members.
Here is the agenda:
- Welcome and general introduction
- Subgroup discussions on
- What is G-I-N doing well?
- What should G-I-N be improving?
- What are you expecting from G-I-N?
- Which strategic directions would you like to see G-I-N take?
- Summary of subgroup discussions by moderators
- Discussion and wrap up
The session will be held on Tuesday August the 30th, 2011 and is scheduled to last between 1 hour and 1,5 hour at lunch time (meals will be provided).
Interested? Please contact Magali Remy-Stockinger: firstname.lastname@example.org