ADVANCING GLOBAL HEALTH NEPHROLOGY EDUCATION: A US – KENYA COLLABORATIVE EXPERIENCE

Introduction:

Chronic Kidney Disease (CKD) is a major cause of morbidity in Sub-Saharan Africa. Kenya has a low nephrologist/million population ratio (0.7 versus a global median of 11.8). Until recently, there were few nephrology education efforts in western Kenya. To address this gap, collaboration between Moi University (MU-Kenya) and Brown University (BU-USA) was initiated in 2018. The goal was to enhance nephrology education in the region. To share the experience in building this international collaboration, we describe the initial phase, outline perceived education needs and improvements among the target population, and present future directions for the program.

Methods:

A description of the relationship-building and common goal setting is shared. An initial survey was carried out in September 2019 targeting clinicians to understand local nephrology education needs. Thereafter, a series of interventions were rolled-out to address arising needs. A follow-up survey was then carried out among MU internal medicine residents in April 2023 assessing perceived benefit from the program. Finally, the future direction for the program is delineated.

Results:

The BU team accepted an invitation to visit Eldoret in 2018. Key stakeholder meetings were held with the Dean MU School of Medicine, the head of the teaching hospital, and the Kenya Renal Association to ensure alignment. (Figure 1 shows key milestones in the Moi/Brown University nephrology collaboration.) The initial survey in 2019 included 45 clinicians involved in kidney disease care. Only 9% felt confident managing nephrology patients, and just 26% had attended a nephrology education session in the last three years. However, 83% preferred case-based future education sessions. Consequently, several interventions were introduced. In 2019, biweekly case-based nephrology conferences began for MU internal medicine residents and were also open to BU fellows. In October 2022, MU residents were invited to attend BU's weekly case-based nephrology conferences and biweekly journal club meetings. The annual West Kenya nephrology conference has become a regular event to share nephrology knowledge among local clinicians. Of the 30 respondents in the 2023 follow-up survey, 96.6% reported confidence in managing general kidney disease patients. However, only 10% were confident in caring for transplant patients, and 53.3% in treating glomerular diseases. Moving forward, the annual conference and case-based discussions will focus on transplant and glomerular disease care. Efforts are underway to support care in the local community to enhance early diagnosis and timely management of CKD. Additionally, plans are advancing to establish the first nephrology fellowship program in western Kenya.

Figure 1: Key milestones in the Moi/Brown University nephrology education collaboration

Conclusions:

This experience illustrates in-person relationship building and common goal setting for a global health partnership in nephrology. The program may have led to improved confidence in managing kidney disease. Still, post-renal transplant care and glomerular disease remain areas of need. In a globalized world, the MU/BU experience could be valuable for other institutions seeking to build sustainable international nephrology education partnerships.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.