The introduction of genetic counseling in Ethiopia: Results of a training workshop and lessons learned.
Shane C Quinonez, Bridget C O'Connor, Michelle F Jacobs, Atnafu Mekonnen Tekleab, Ayalew Marye, Delayehu Bekele, Beverly M Yashar, Erika Hanson, Abate Yeshidinber, Getahun Wedaje
Author Information
Shane C Quinonez: Division of Pediatric Genetics, Metabolism and Genomic Medicine, Department of Pediatrics, Michigan Medicine, Ann Arbor, Michigan, United States of America. ORCID
Bridget C O'Connor: Division of Pediatric Genetics, Metabolism and Genomic Medicine, Department of Pediatrics, Michigan Medicine, Ann Arbor, Michigan, United States of America.
Michelle F Jacobs: Division of Genetic Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States of America. ORCID
Atnafu Mekonnen Tekleab: Department of Pediatrics, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Ayalew Marye: Department of Obstetrics and Gynecology, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Delayehu Bekele: Department of Obstetrics and Gynecology, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Beverly M Yashar: Department of Human Genetics, University of Michigan, Ann Arbor, Michigan, United States of America.
Erika Hanson: Division of Genetic Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States of America.
Abate Yeshidinber: Department of Pediatrics, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Getahun Wedaje: Department of Pediatrics, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
BACKGROUND: Over the past two decades non-communicable diseases (NCDs) have steadily increased as a cause of worldwide disability and mortality with a concomitant decrease in disease burden from communicable, maternal, neonatal and nutritional conditions. Congenital anomalies, the most common NCD affecting children, have recently become the fifth leading cause of under-five mortality worldwide, ahead of other conditions such as malaria, neonatal sepsis and malnutrition. Genetic counseling has been shown to be an effective method to decrease the impact of congenital anomalies and genetic conditions but is absent in almost all sub-Saharan Africa countries. To address this need for counseling services we designed and implemented the first broad-based genetic counseling curriculum in Ethiopia, launching it at St. Paul's Millennium Medical College (SPHMMC) in Addis Ababa, Ethiopia. METHODS: The curriculum, created by Michigan Medicine and SPHMMC specialists, consisted of medical knowledge and genetic counseling content and was delivered to two cohorts of nurses. Curriculum evaluation consisted of satisfaction surveys and pre- and post-assessments covering medical knowledge and genetic counseling content. Following Cohort 1 training, the curriculum was modified to increase the medical knowledge material and decrease Western genetic counseling principles material. RESULTS: Both cohorts reported high levels of satisfaction but felt the workshop was too short. No significant improvements in assessment scores were seen for Cohort 1 in terms of total scores and medical knowledge and genetic counseling-specific questions. Following curriculum modification, improvements were seen in Cohort 2 with an increase in total assessment scores from 63% to 73% (p = 0.043), with medical knowledge-specific questions increasing from 57% to 79% (p = 0.01) with no significant change in genetic counseling-specific scores. Multiple logistic, financial, cultural and systems-specific barriers were identified with recommendations for their consideration presented. CONCLUSION: Genetics medical knowledge of Ethiopian nurses increased significantly following curriculum delivery though difficulty was encountered with Western genetic counseling material.
