Functions, challenges and opportunities of health professions education units in Africa: a qualitative study across Eastern, Southern and Western regions

Teaching in Health Professions Education (HPE) is complex, with educators balancing teaching, clinical, and scholarly responsibilities. Medical, nursing, and other health professional schools have created units to move HPE forward. However, little is known about how these units have evolved over the past 15 years. This study explored the landscape of HPE units in Eastern, Southern, and Western Africa, their evolution, functions, challenges, and opportunities for continued growth. This exploratory qualitative study used purposive sampling to recruit HPE professionals from educational institutions across ESWA. Recruitment methods included self-identification on a survey, snowball sampling, and direct outreach by the research team which included HPE professionals from ESWA. This team co-developed a semi-structured interview guide and conducted interviews via Zoom. This project used a content analysis approach to understand the functions, challenges and opportunities of these units. Transcripts were coded in Dedoose and exported by code for review, discussion, and categorization. We conducted 22 interviews from 21 institutions in 9 countries. Most units are approximately 20 years old. Units sit in various locations within institutions, for example at a faculty-level, within the Dean’s office, or as a stand-alone department. There is also heterogeneity in funding sources and staff size. The most common activities are Faculty development; Research in health professions education; Curriculum development, review, renewal, and implementation; and Teaching and training. Noted challenges HPE units face are human resource issues due to lack of adequately trained faculty and the inability to hire them; tension between clinical and educator identities; and institutional incentives that are not aligned to quality teaching. Despite these challenges, units are experiencing major successes such as reshaping perspectives on thinking and learning within their institutions, influencing curricula, and creating graduate programs in HPE. The charge of HPE units in ESWA remains much the same as it was in prior studies with similar functions, challenges and opportunities. This study adds important context around these activities, helping to understand opportunities for growth, such as establishing and entrenching an HPE professional identity and promoting collaborations as ways to strengthen and accelerate HPE units in ESWA.