The Prepared for Practice project

Context and Problem

The Prepared for Practice project (2017-2021) aimed to strengthen Somaliland’s health workforce by improving the quality of higher education for medical, nursing, and midwifery students. This initiative aimed to solve various issues, including inadequate clinical training, limited faculty expertise, poor regulation, and high mortality rate. It was led by King’s Global Health Partnerships (KGHP) in collaboration with the Tropical Health Education Trust (THET), MedicineAfrica, and three Somaliland universities: Amoud University, University of Hargeisa, and Edna Adan University.

Solution

The project worked on three main workstreams. First, undergraduate workstream. This included clinical training where students got funded clinical supervision positions with hands-on learning opportunities in real-world settings, supplementary online learning, where courses were delivered to address gaps in local curricula and fostering diagnostic and clinical reasoning skills, and standardized assessments, that included introducing evidence-based final year examinations for medical, nursing, and midwifery students. Second, institutional workstream, which included Health Professions Education Course, which included designing and delivering postgraduate certificates, diplomas, and master’s programs in health professions education to over 90 faculty members, capacity building through establishing Educational Development Centres to support continuous professional development for teaching staff, and policy integration, by developing institutional policies and procedures to standardize teaching and assessments across partner universities. Third, policy and regulation workstream, that focused on establishing national medical education policy, national curriculum and standards, and ensuring stakeholder coordination during this process.

Impact

100% of participating faculty reported making changes to their teaching and assessment practices. Moreover, students benefitted from structured clinical supervision and community health visits, national curriculum was adopted by all medical schools in Somaliland, monitored data revealed improved performance among students at partner universities compared to non-partner institutions, and the national medical education policy led to reforms in oversight, regulation, and assessment of medical schools, driving systemic improvements across Somaliland.

The co-designed partnership model, with its emphasis on evidence-based teaching and standardized curricula, offers a replicable framework for other low-resource settings facing similar challenges. Sustainability is ensured through the integration of Educational Development Centres and standardized assessments, now independently managed by partner universities. The co-design approach fostered local ownership, reducing reliance on external support. Additionally, government support, including co-funding of clinical supervisor salaries by the Ministry of Health Development and universities, further strengthens the program's long-term viability.