An ongoing challenge in medical/health education and training in developing countries is building and maintaining the quality of these efforts. Regulation of health professions education helps to ensure that physicians, nurses, midwives, pharmacists and other allied health providers receive a quality education, are certified or licensed upon entry to professional practice and maintain competency throughout their active clinical careers. Accreditation is the part of the regulatory system that helps to improve and sustain quality of educational institutions. As a process, accreditation consists of a thorough review of the capabilities of an organization to consistently deliver reliable quality outputs or achieve desired results. One this institutional level, accreditation says that the institution has the capacity to produce health professionals who have the knowledge, skills and attitudes they need to provide quality services upon deployment—whereas licensure/registration verifies the individual’s competencies.

Accreditation helps to achieve the following on the educational institutional level:

  • Improves quality of education
  • Promotes uniformity across institutions
  • Establishes clear, explicit expectations for teachers and students
  • Helps to lay the foundation for regulation
  • Improves success on national licensing exams
  • Moves health professions in developing countries toward international equivalence

To work toward establishing a foundation and ultimately a mechanism for accreditation, a range of activities must be undertaken on two levels—one focusing on the educational institutions, teacher and students (the microenvironment); the other focusing on

Microenvironment activities include creating or ensuring:

  • Competency-based curricula that are up-to-date and evidence-based
  • Appropriate focus on standardized, state-of-the-art student assessment
  • Supportive teaching materials
  • Teacher training:
    • Clinical skills
    • Teaching skill

Macroenvironment activities include creating or ensuring:

  • Appropriate national educational/training strategy, which includes regulatory mechanism
  • National clinical guidelines that are up-to-date and evidence-based
  • Clear job descriptions for different health professions
  • Performance and quality improvement programs at teaching hospitals
  • Formation of professional associations
  • Development of health professions education policy