Part I. The Emergence of Degree-Granting Biomedical Engineering Programs in Sub-Saharan Africa

Annals of Biomedical Engineering, Aug 2017

Brittany Ploss, William Reichert

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Part I. The Emergence of Degree-Granting Biomedical Engineering Programs in Sub-Saharan Africa

Part I. The Emergence of Degree-Granting Biomedical Engineering Programs in Sub-Saharan Africa The disability-adjusted life-year (DALY) is defined as the overall health and life expectancy of different countries expressed as the number of years of life lost due to ill health, disability or early death. An excellent interactive 2012 world map of each country's DALY expressed in years lost per 100,000 population is available from the World Health Organization (WHO).7 Canada, the U.S. and Mexico, respectively, had DALYs in 2012 of 18,838 (15th), 22,775 (33rd) and 26,763 (50th) years lost. The global average in 2012 was 38,780, essentially the same as Iraq (108th) and Bangladesh (109th). In contrast, not one country in continental Sub-Saharan Africa had a DALY in 2012 of less than the global average, and all of the countries that had DALYs of greater than 60,000 years lost were Sub-Saharan except for Afghanistan and Haiti. While there has been a reduction of the relative Sub-Saharan DALY numbers and some shifting in the rankings since the original 2000 WHO census,7 the overall global DALY picture for SubSaharan Africa remains the most challenging. Characteristic of Sub-Saharan medical clinics is the accumulation of mostly routine instrumentation that lies unused or in disrepair due to a lack of a skilled workforce and/or readily available spare parts.2,4 Correcting this situation is largely the role of the biomedical engineer (BME). According to the 2016 WHO comprehensive report Human Resources for Medical Devices: The Role of Biomedical Engineers, again the U.S., Mexico and Canada, respectively, have 49, 24 and 18 BMEs per 1 M people; whereas Botswana is the only Sub-Saharan country with greater than 10 BMEs per 1 M people.9 In fact, 68% of Sub-Saharan countries have one or less BMEs per 1 M people, and many countries have none at all.9 In a promising trend, several Sub-Saharan universities have responded to this disparity by starting BME programs and coalescing into professional BME societies. The above referenced 2016 WHO report, a must read for those interested in increasing BME capacity in low- and middle-income countries (LMICs),9 is a comprehensive description of the BME context in the six WHO global regions. Appendix 2 of the report lists 52 Sub-Saharan institutions that have self-reported as offering BME programs starting in the early 2000s. Seventeen of these programs list bachelor's degrees in BME, and six list graduate BME degrees. Another 24 programs only listed ''other'', which is commonly a two-year or less biomedical technology degree program, similar to an associates degree or certificate in the U.S. However, verifying the existence of these programs and learning about their curriculum can be frustrating to an individual or institution interested in establishing a partnership with a Sub-Saharan BME program. This manuscript is the first of two editorials that apprises the U.S. biomedical engineering (BME) community of the growing presence of BME programs in Sub-Saharan Africa (Part I) by providing verified referencing of viable BME programs. The second editorial (Part II) encourages U.S. BME programs to get involved in their emergence through collaborative educational partnering. - INTRODUCTION SUB-SAHARAN BME PROGRAMS The WHO Global BME Survey lists all self-reported BME educational programs in 2015.8 Twentytwo of these programs were housed in Sub-Saharan universities that use English as the language of instruction. Generic Internet searches were conducted to learn more about the characteristics of these programs. Table 1 lists the bachelor’s and graduate degree granting BME programs that could be verified through this search. Programs without Internet evidence of existence were not included. Note: Five of the BME programs in Table 1 did not self-report for the WHO survey, but were included as they became known to the authors. Note: the composition of web site addresses can be quite fluid; this table designates them as of 2017. PROFESSIONAL SUB-SAHARAN BME SOCIETIES The need for regular equipment procurement, management and repair (EPMR) of medical equip2017 Biomedical Engineering Society g , 8ll.:)rraecveyobouuESSBHGOMW itfssebeao0217EBMW ii.t// iilii/r-cngegneenaoedm j/t/ i./ lit.cschademm iit.sxed?pdeph= iiilittrrcssssyoued_eagpendopaogpegudd471===&&&m i/ iiilii./ ilii/.t..ttt://t/r-rkcscedeapaupneedaegnneengwwwmmm lii// /t/rr-rrr-r-ssageo9epuaddnegapo1gae825mmmm iiilliilf.t---r-rcccscbeoedaenoaheonegneenghmm ii./ lliif/ iill./trrrrxsvsephdpp?aneuadndegaegaabeogae=APmm lliil./.t.ftt:///t/.cscnguhoodoeupeahodeaphpSBwwwHm iiit/-rnugnngnee iii/ .t./ i./ iilii/r-cngeegnneaoedm liiiii-r--cccengneenadeobene0gm t../t..ftt://t/cssaugabouapuwwwm t/trneepam iliiiiftt---r--rccscsedaebooenepaenadnengenengmm iilift,,tfrrrsssssyngneengoeaaeohoophEEPPMMMM in h b h h a h in a h h h h u b h h h u h h e h h h b h s h d d ce a n e M i ( c S f o s r e t s a M S M , y g o l o n h c e T f o r o l e h c a B T B , e c n e i c S f o r o l e h c a B S B , g n i r e e n i g n E f o r o l e h c a B E B , e t a . c e ifi re t r g e e C ld ,aC trao om co l D p i ed S S - M b E , u in n t o n it ia a a p r c o g o i h e L t e r S n i s m a r g o r P E M B g g e D e t a u d a r G d n a l e v e L r o l e h c a B D h P , P T B M , , S S E B B , D D M , , S D h P , D D S S h h M M P P M S S S S S , , S B B B B B B C C B B D B B B M M B B B B S , E T S S S S S S a c i ca fr ir A a f c A th i fr th ou A u S h o f t S o u f o o ilc S c b f il u o b p a a n E i a a , p h n ab io G ah a th , G b E a A , ud i,s a ir a s i d m fo m d im o u A J K K a a y n n a a a e y n h K n a G , e h , a K G n s , ,ra tan a i b b o c e m ir c d o a A A M N i ira ia licub epuR ,rgeR anda ndaa g g i w w la la a a e re ep ,n u a M ir ig ig M , e b U U N N ,R ow se l,a ,a l,yoo tryne i,gN i,rre ,so itroa eT ann pam rraa h la ta w ag re ap oh a b T B O O L P C J K M y g o l o n h ceT icnh , d c y n te g a ly y lo e o g o c P lo n n o h ie e n c c h h e T c T i r r e w O d n n ra ow rs S fS i, e f f ia T te o itrsyo laawM itfyoT itrsyeo sagLo trreoP paeC itawW iitrvsye itrsye ive fo rse ivn fo fo fo fo nU ivn U ilnaUw iitrsyve illvsnU lradeU iitrsyve iitrsyve iitrsyve iitrsyve rrkeee rraaa a n e e n n n n a b y g o l o n h c e T d n a e c n e i c D P e it s b e W e m a n y t e i c o S n o it a i c o s s A iitcona iltssgoo o n ssgA cheT n g ie in r e r in ee ng ign licaE lnaE ed icd m e o m iB io ianpo iabBm i th a E G y r t n u o C s e c n e i c S Part I. The Emergence of Degree-Granting Biomedical Engineering Program g r o . e h m a n u . w w w / / : p t t h l a it p s o H d n a l a c i d e M r o f n o it a i c o s s A l a n o i taN irng gandaU iengenE ment in a clinical setting is substantial in Sub-Saharan Africa, and thus the current and primary emphasis of most Sub-Saharan BME programs. Consequently, many Sub-Saharan undergraduates pursuing a bachelors degree in BME see EPMR as their likely career path.5,6 However, focusing solely on EPMR and just increasing the pool of Sub-Saharan BMEs alone will not necessary lead to increased employment opportunity without proper in-country vision and leadership. Another encouraging trend is the growth of SubSaharan BME societies that connect professionals and students of mutual interests. Table 2 lists the BME societies in Sub-Saharan Africa according to the WHO Global BME Survey for which viable web sites were identified. Also included are two Pan-Africa collaboratives and some additional societies known to the authors, but not listed by the WHO BME survey.8 Like the Biomedical Engineering Society (BMES) and the American Institute for Medical and Biological Engineering (AIMBE) in the U.S., Sub-Saharan BME societies are able to advocate for curricular priorities, funding, regulation, and intellectual property policies that foster modern training and health technology innovation. The existence of BME student organizations is also an important professional leveraging activity, such as the Makerere University Biomedical Student Association and Engineering World Health (EWH) chapters at Makerere University and the University of Ghana.1,3 CONCLUSION The current manuscript, Part I, provides a verified listing of degree granting Sub-Saharan BME programs that is also limited to English-speaking institutions to match the U.S. language of instruction. These programs and the associated societies provide an opportunity for U.S. BME programs to partner with BME programs in Sub-Saharan Africa, thus broadening curricular capabilities and professional expectations. BME institutions in resource-limited environments are often seeking opportunities for more up to date content, expansion of course coverage, and obtaining collaborations that lead to additional training and research support. These are opportunities that U.S. BME programs are well positioned to provide. Part II presents illustrative examples of U.S. BME programs that have established collaborative partnerships mainly in Malawi, Nigeria, Ghana and Uganda, as well as specific recommendations to consider when planning an education partnership with a Sub-Saharan BME program. 1 EWH. Overview & Locations: List of Active Chapters . Engineering World Health, 2017 . ( university-chapters/chp-overview). 2Howitt, P. , A. Darzi , G. Z. Yang , H. Ashrafian , R. Atun , J. Technologies for global health . Lancet 380 : 507 - 535 , 2012 . 3Makerere University Biomedical Engineering Students' Association - mubesa. Facebook (https://www.facebook. 4Malkin, R. A. Design of health care technologies for the developing world . Annu Rev Biomed Eng 9 : 567 - 587 , 2007 . 5Mohedas , I. , E. E. Kaufmann , S. R. Daly , and K. H. Sienko . Ghanaian undergraduate biomedical engineering students' perceptions of their discipline and career opportunities . Glob J Eng Educ 17 : 34 - 41 , 2015 . 6Mullally, S. , and M. Frize . Survey of clinical engineering effectiveness in developing world hospitals: equipment resources, procurement and donations . Conf Proc IEEE Eng Med Biol Soc 4499 - 4502 : 2008 , 2008 . 7WHO. Age-standardized disability adjusted life year: DALY: rates (per 100,000 population ), 2012 . World Health Organization, 2014 ( burden_disease/countries/situation_trends_dalys/en/). 8WHO. BME Global Survey . 2015 ( medical_devices/support/en/). 9WHO. Human resources for medical devices: the role of biomedical engineers . In: WHO Medical device technical series . Geneva: World Health Organization, 2017 ( dev_bio-engineers/en/).

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Brittany Ploss, William Reichert. Part I. The Emergence of Degree-Granting Biomedical Engineering Programs in Sub-Saharan Africa, Annals of Biomedical Engineering, 2017, 1-4, DOI: 10.1007/s10439-017-1897-2