Transformative Education
for Health Professionals

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Summary of the evidence

Accreditation is defined as a process of review and approval by which an institution or programme is granted time-limited recognition of having met certain established standards (Uys and Coetze, 2012). Accreditation, if properly used, is a key tool for quality management of professional education and for ensuring that graduates have the competencies that correspond to accepted professional standards and to the needs of the population. The alignment of accreditation with health goals is one of the four enabling actions that contribute to scaling up the education of health professionals (Frenk, et al., 2010). Accreditation is particularly important at a time when private health professional education is proliferating, often in an unregulated environment.

There is no systematic assessment of accreditation practices worldwide; there is variation in its utilization and, in some countries, it is absent or exists only on paper. Accreditation mechanisms “exist in three quarters of Eastern Mediterranean countries, just under half of the countries in Southeast Asia, and only about a third of African countries” (Frenk, et al., 2010:29). Even in an integrated economic region such as the European Union (EU), there are important variations in how accreditation is conducted (Frenk, et al., 2010). There does not seem to be a relationship between the Gross National Income (GNI) level of countries and whether or not they have accreditation systems (Uys and Coetze, 2012). Also, private schools are less likely to undergo accreditation procedures (Frenk, et al., 2010).

In some countries, accreditation is performed by the government, in others it is the responsibility of professional councils or associations, or even private agencies (Uys and Coetze, 2012). Accreditation may target specific programmes or whole institutions. There is limited literature on the respective advantages and disadvantages of each modality, or on the impact of accreditation on quality improvement.

Nevertheless, it is generally understood that accreditation can have a significant positive effect on the quality and relevance of the health workforce in that it can guide professional education in addressing the priority health concerns of the community. A global strategy that incorporates the best of all practices with clear targets and outputs could encourage regions to create and reinforce national accreditation systems.

In order to be effective, such a global system should be based on standards developed and accepted by all stakeholders. The process of accreditation should be independent and transparent so as to be a stamp of quality (Baumann and Blythe 2008). Accreditation status should be time-limited, and the accreditation system itself should be periodically evaluated.