Defining the elements of a self and peer assessment system for academic institutions of public health in Africa as a precursor to accreditation: A study protocol

TL;DR

This study aims to create a self and peer assessment tool for public health institutions in Africa to improve education quality and support global health goals.

Contribution

The study introduces a new assessment tool for African public health institutions to enhance education quality in the absence of formal accreditation.

Findings

The study will produce agreed standards for quality postgraduate public health education in Africa.

The tool will help institutions monitor educational goals aligned with local health needs and global SDG and UHC objectives.

Findings will be shared with stakeholders to support capacity development and accreditation efforts.

Abstract

Current challenges facing the overburdened health systems in Africa, warrant a review of the public health training and development of the health workforce for the attainment of the envisioned global goal of universal health coverage (UHC) and the United Nations Sustainable Development Goals (SDG). The integral components informing the relevance of public health education in the context of UHC comprise the academic workforce, curricula and the capacity of the academic institutions of public health. This study aims to assess the quality improvement strategies of academic institutions of public health with respect to the curriculum and the academic faculty staff within the WHO African region, in order to develop an institutional self- and peer-assessment tool to ensure the quality of public health education.

This study will be a three-phase, multicentre sequential mixed-methods design within the WHO African region, targeting 52 ASPHA (Association of Schools of Public Health in Africa)-affiliated institutions. Phase 1 will comprise a cross-sectional survey to determine the current programme assessment standards. Phase 2 will employ a modified Delphi method to reach consensus on these standards that will comprise a newly developed assessment tool. Phase 3 will pilot the tool through institutional self-assessment. MPH coordinators and department heads will participate. Convenience sampling and electronic questionnaires will be used. Quantitative data will be analysed using STATA 18, and ATLAS.ti for qualitative data.

The study findings are envisaged to result in a set of agreed standards reflecting the institutional arrangements to ensure quality postgraduate public health education in Africa. These standards, in the absence of regulation or formal accreditation, will be the basis of a self- and peer-assessment tool to enable the African academic institutions of public health to advance capacity development and monitor progressive educational goals suitable for local health needs, within the global context of the SDG and UHC implementation. Thus, laying the ground for a uniquely African accreditation system. The findings will be shared with the relevant stakeholders; ASPHA, the academic institutions of public health, and the scientific community at conferences and published in accredited journals.

Figures

Diagram illustrating the various phases and objectives of the study.

A map showing the 52 ASPHA member institutions across 19 African countries and the number of academic institutions per country (Reprinted from ASPHA under a CC BY license, with permission from ASPHA, original copyright 2024) (Fig2.tif).

Full text

Introduction

The 2030 Agenda for Sustainable Development, adopted by all United Nations Member States in 2015, provides the common blueprint for health as defined by the World Health Organization (WHO). According to the WHO, health is defined as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” [1]. The current United Nations (UN) Sustainable Development Goals (SDG) serve as a global partnership for a single health goal to, “Ensure healthy lives and promote well-being for all at all ages” [2]. Despite the continuing challenges (including major communicable and non-communicable diseases, poor access to essential health services, and major financial constraints), notable progress has been made with overall reduction in morbidity and mortality, and increased life expectancy. Concerted efforts by all the relevant stakeholders are required to address the continuing challenges to achieve Universal Health Coverage (UHC) – meaning that people will receive health services they need without suffering financial hardship [1–3].

Therefore, a well-trained public health workforce in adequate numbers is essential to provide integrated, people-centred health services to meet the population health needs, and is thus central to the achievement of UHC and of SDG3 (which aims to ensure healthy lives and promote well-being for all at all ages) [2]. This being a central component of the global and national Human Resources for Health (HRH) strategies [3,4]. Although the HRH strategy highlights the need to upscale the number of public health professionals, the African health systems remain burdened and curatively-oriented [3,5–7]. Therefore, the training of such a workforce needs to be reviewed and evaluated regularly to ensure good practice and quality education [8–13].

Public health competencies

The core disciplines of public health, epidemiology and biostatistics, are cross-cutting and provide the tools for describing the patterns and trends, finding causal linkages and evaluating the effectiveness of health services and programmes [8,10,14,15]. The assessment of how well the current education training frameworks are responsive to (and linked with) major societal and scientific shifts involves macro trends. These are defined as a set of competencies and recommendations for epidemiologic and public health training to address the changing landscape. A competency is defined as a cluster of related knowledge, attitudes, and skills which are important for the performance of a job activity and can be measured against well-accepted standards [8,9,16,17].

Standards are levels of quality or attainment, norms or model in comparative evaluations [9]. Macro trends are often considered in strategic planning processes and involve some combination of changing demographics, economic factors, technological changes, and legal, political, or social conditions [10,16]. Public health practitioners should demonstrate skills and competencies in leadership, systems thinking, policy development, critical and analytical thinking, as well as teamwork and communication skills in order to improve the performance of the health system and population health outcomes [18–21]. While some regions such as Africa, are starting to focus on globally relevant, region-specific core competencies [22], other regions (Europe and North America) are already advanced [18,23,24]. Therefore the developing regions have an opportunity to learn from those that have already pioneered in this regard [25].

Public health workforce capacity and training in Africa

The training and development of the health workforce, including the public health workforce, is vital to their productivity, performance, distribution, and retention; and the selection and education of the health workforce is closely related to the broader social and economic development [3,26]. As one of the building blocks of health system strengthening, the health workforce impacts the overall health goals and health outcomes [27,28]. The various strategies and commissions which reiterate the need for approaches trailblazer and partnerships to close the existing sectoral gaps include, the Global Strategy on Human Resources for Health [29], the report of the Commission on Health Employment and Economic Growth [26]; and the Lancet Commission on transformative learning and education [21]. The pursuit of these being to enable the scaling up of transformative, quality education and fostering life-long learning. Additionally, they emphasise the reforms which are necessary for health workforce competencies that are best suited to equitably meet the population needs and health labour market needs for strengthened health systems [21,30].

The current challenges in public health reform are partly attributable to the non-responsive postgraduate public health education curricula in relation to the quantity and pertinence of training which are not appropriately aligned with the population health needs [5,13,29]. The corresponding correction is required to envisage the strengthening of health systems in order to improve health service provision and health outcomes, which require highly skilled public health personnel with expertise and knowledge [27].

Public health training: Role of academic institutions in Africa

The role of the academic institutions in training health professionals in the discipline of public health is crucial to ensure the successful implementation of the UHC [31]. Public health education and training takes place at undergraduate and postgraduate levels. It is most often included in the undergraduate health disciplines such as medicine or dentistry; although not exclusively [32]. Postgraduate programmes include: the Master of Public Health (MPH) which targets professionals from varied health and social science disciplines; and a medical specialisation only for medical doctors, the Master of Medicine in Public Health Medicine (MMed PHM) [32,33].

The main aim of the programmes is to equip health professionals from a variety of disciplines with key public health competencies and collaborative strategies to address population level risk factors contributing to the national and global burden of disease [5,7]. In addition, the programmes equip practitioners to become pioneering and innovative professionals with an emphasis on multidisciplinary approaches that utilise the advanced evidence-based scientific knowledge [5–7]. Postgraduate programmes in public health are generally recognised professional postgraduate qualifications for leadership positions within the health sector [5,34–36].

Licensing and accreditation

Licencing (or licensure) is a process by which governmental authority grants permission to an individual or organisation to operate or engage in an occupation [24,37]. These regulatory processes include the establishment of education standards, quality assurance of education programmes, establishment of codes of conduct, identification of scopes of practice, systems for licensure, maintenance of registers of those fit to practice, and systems to ensure continuing professional development and appropriate disciplinary measures. Many of these attributes are determined by the interaction between the market forces, political benefits, and health workforce regulation [38–40].

An accreditation system is an essential element to determine whether a programme meets minimum quality standards [41]. Accreditation in higher education is a voluntary process which is based on self- and peer-assessment for the purpose of assuring and improving education quality and accountability [42].

Examples of accreditation systems in established to monitor and assure the quality of public health capacity and education include, the Council on Education for Public Health (CEPH) in the United States of America (USA) [42]; Ahpra, a Canadian regulatory agency; the Health and Care Professions Council (HCPC) in the United Kingdom (UK Faculty of Public Health or Pubic Health England); European Agency for Accreditation in Public Health Education (APHEA) in Europe and the National Registration and Accreditation Scheme in Australia [24,25,41].

However, no such system exists in the African region. A South African study highlighted the desire expressed by the MPH coordinators for the need of an association or quality assurance body for the establishment of quality standards to ensure benchmarking and standardization across the various programmes [5].

Although the cumulative number of MPH graduates over a 5-year period can be considerable exceeding 800 for one country [5], it is concerning to note that the programme is not regulated by any council, or accredited by any professional body in Africa. The capacities of the African academic institutions, to assess their own capacity to implement the training of the necessary health workforce in response to UHC, cannot be clearly determined due to the lack of the established standards of public health education, practice or regulatory framework [25,38,43].

Rationale for the study

Problem statement.

The practice of public health is becoming more prominent globally, particularly in low-to-middle income (LMIC) countries, as a result of constrained financial and human resources amidst a disproportionate burden of disease [33]. Most of the countries in sub-Sahara Africa (SSA) face a mixed burden of disease [44]; and subsequently, public health (also known as, public health medicine, community medicine, or preventive medicine) has been identified as a strategic approach by some of the National Ministries/ Departments of health to reduce the burden of disease and reduce dependence on hospital-based and specialist services [33].

The current challenges, as well as the need to address both the SDGs and UHC within the context of overburdened health systems warrant a review of public health education within the African region. There is an urgent need for evidence to enable informed decision-making to ensure proper alignment with the production and development of the public health workforce, who should be trained to derive fitting solutions for the African health challenges [11,12,22].

This study is thus in response to and aligned with the six of the seven resolutions undertaken at the 2019 ASPHA (Association of Schools of Public Health in Africa) held in Kampala, Uganda; to support a sustainable health workforce development initiative by increasing the quantity and the quality of the public health workforce in Africa [45]. This research will focus on the institutional capacity, including the academic workforce and curriculum renewal processes of academic institutions of public health in Africa, but will not revise curriculum content as that is the focus of another project by Opare et al [11].

The Association of Schools of Public Health in Africa (ASPHA) mainly functions as a forum to serve the collective needs of the member institutions in the education and training of public health professionals by building capacity to maximize and excel in academic training and advocacy for public health policy. Additionally, the association serves as a medium for sharing innovative ideas to advance scientific knowledge led by the regional experts, as well as to provide a strong unified voice for promoting regional public health development and practices in Africa [17].

The integral components of the ASPHA projects will determine the relevance of public health education in the African region and comprise the curriculum (process), the academic workforce (people), and the academic institutions of public health (places). Thus, the results of this research will contribute to pursuit of developing an accreditation system in the region and professionalisation of the field. This shift towards professionalisation of public health has been reiterated by Mansholt et al. at the European Union Public Health Association (EUPHA) Health Workforce Research Conference held in June 2020, as well as the 16^th^ World Congress on Public Health (WCPH) held in October 2020 [25,46,47]. The emphasis is that the health professional regulatory processes remain central to ensuring health workforce quality and sustainability to address priority health systems concerns, as well as associated capacity constraints, which the COVID-19 pandemic has highlighted [40].

Significance of the research

The significance of the proposed research is to establish the first tools and processes needed for an accreditation system for academic institutions of public health in Africa. It is envisaged that the outcomes of this research will be of critical academic and practical value to the academic institutions, as well as to the region and professionalisation of public health as a whole. Furthermore, this research could provide essential information that can guide academic institutions of public health in strengthening their capacity and collaboration. Regional and global collaborations have the potential to foster partnerships, as well as regional public health workforce development [48,49].

The absence of regulatory bodies for public health can be overcome by a voluntary system of accreditation, which has proven to be very successful in establishing and maintaining the capacity of institutions to provide quality public health education in other regions such as Europe and North America [24,42]. This research will therefore focus on determining the elements needed for self- and peer assessment which is the hallmark of accreditation systems. Given the varied country experiences in health professional regulation and the absence of a regional accreditation system, it will be essential to understand what works best for differing settings, and how to maintain and improve the quality of the public health education, in particular the MPH programme [39,47].

Research questions

What is the current capacity status of academic institutions of public health in Africa, as it relates to the academic workforce (people), the curriculum (process) and the academic institutions (place)?

Are the African academic institutions of public health able to prepare MPH graduates for UHC?

Aim and objectives

Study aim

The aim of the study is to assess the quality improvement strategies of academic institutions of public health with respect to the curriculum and the academic faculty staff within the WHO African region, in order to develop an institutional self- and peer-assessment tool to ensure the quality of public health education.

Study objectives

PHASE 1: Exploration of the current status of the academic institutions of public health in Africa

Objective 1: To describe the internal strategies for quality assurance of the teaching, learning methods/practices and curriculum renewal

Objective 2: To describe the characteristics of academic staff and (internal) strategies used to develop academic staff.

Objective 3: To determine the interest and need of an accreditation system for academic institutions of public health.

PHASE 2: Development of standards and assessment tool

Objective 4: To develop public health teaching and learning quality standards.

Objective 5: To develop an institutional self- and peer-assessment tool to monitor and evaluate progress and ensure continual adherence to the public health teaching and learning quality standards.

PHASE 3: Piloting of the developed tool

Objective 6: To pilot the newly developed self- and peer-assessment tool for public health education in Africa through institutional self-assessment and develop a recommended implementation framework.

Methods

This study will be a three-phase, multicentre embedded sequential mixed-methods design [50] within the WHO African region, targeting 52 ASPHA (Association of Schools of Public Health in Africa)-affiliated institutions (Fig 1). The quantitative component will include an analytical cross-sectional study design to assess the relationships between different study variables, and the qualitative data analysis of open-ended questions will include thematic analysis of the emerging themes and sub-themes [14,51].

Diagram illustrating the various phases and objectives of the study.

PHASE 1 is currently ongoing and will conclude at the end of May 2025. This cross-sectional online survey (quantitative/ qualitative) will ascertain the current status of the academic institutions of public health and to determine which items should be included as standards for the assessment tool. PHASE 2, will commence from August 2025 until September 2025, and will comprise a modified Delphi method (qualitative) to reach consensus on the standards to be included in the tool. PHASE 3, (post-PhD ~ 2026/ 2027) will comprise the piloting of the tool by willing institutions (quantitative/ qualitative) and to recommend the implementation framework.

The following components will be common for the first two phases: study setting and study population/participants.

Study setting

The study setting will be at the 52 ASPHA-affiliated academic institutions of public health in the Anglophone countries (where English is the official language), the Lusophone countries (where Portuguese is the official language) and the Francophone countries (where French is the official language) in the WHO African Region (Table 1) [52].

Table 1: Number of ASPHA-affiliated academic institutions of public health in Africa by sub-region and language [17].

Study Population and Participants

The study population and participants comprise the MPH programme coordinators at 52 public health academic institutions across 19 countries affiliated with the Association of Schools of Public Health in Africa (ASPHA), and recruited through the ASPHA (Fig 2) [14].

A map showing the 52 ASPHA member institutions across 19 African countries and the number of academic institutions per country (Reprinted from ASPHA under a CC BY license, with permission from ASPHA, original copyright 2024) (Fig2.tif).

Phase 1: Exploration of the current status of the academic institutions of public health

Study design: An analytical cross-sectional study design will be used for Phase 1 [14].

Methodology: The total population sampling method will be used where all the 52 academic institutions of public health affiliated with ASPHA will be recruited to participate [14,53]. A list of the academic institutions of public health will be obtained from the ASPHA database [17]. All the institutions will be forwarded an email to explain the nature and purpose of the study and to obtain consent before taking part.

Phase 2: Development of standards and assessment tool

Study design: A descriptive cross-sectional study will be utilised for this phase [14].

Methodology: The modified Delphi method will be used in Phase 2 of the study. This research method was developed by the RAND (Research and Development) Corporation in a military setting around 1948, and was initially used for classified research [54]. The Delphi technique can be used in research for different reasons, such as to build consensus on a topic in a situation of uncertainty, or where there is a lack of empirical evidence to make predictions in order to better understand possible future scenarios, and to choose strategies for action, such as with military interventions and education methods/practices [51,54–57].

A Delphi study is therefore ideal to achieve consensus on the standards needed for a tool that can be used for self- and peer-review. Since the Delphi technique is exploratory in nature, it enables the best management of group dynamics by reaching an agreement among experts while preventing possible derailments due to opposing views. This technique achieves results through consecutive stages of data collection regarding consensus, which usually involves working through three distinctive rounds of expert consultation [51,54–56].

For this study, the Delphi survey will be developed informed by the relevant literature, and the results from Phase 1. It will be administered electronically (using Qualtrics® software [58]; https://pretoria.eu.qualtrics.com/), and will consist of three rounds to ensure good response rates. The Delphi panel will comprise the participants (MPH coordinators) from the academic institutions. The duration for the participants’ response will be exactly one month, from the initial invitation with reminders.

After completion of the first round, an updated survey will be compiled and sent to the panellists, and this will constitute the second round. The updated survey will include the descriptive statistics on the repeated statements (for which there was no consensus) to provide insight on other participants’ responses as they engage with the survey again; but will exclude the statements on which there was consensus in the first round. Depending on the consensus results of the second round, the third round will be instituted [54–56,59].

Measurements

Measurement instruments

The measurement instruments will be developed for each phase of the study. The measurement instruments will be available in the three languages (English, French, Portuguese) to enable the participants to choose their most proficient language.

Phase 1: Exploration of the current status of the academic institutions of public health

An electronic survey using a self-administered questionnaire is being employed for this Phase using the Qualtrics® software [58] (https://pretoria.eu.qualtrics.com/) to measure the study variables shown in Table 2. The section headings will include; characteristics of the academic institutions, quality assurance of teaching and learning methods strategies, MPH programme design and curriculum renewal strategies, professional development of academic faculty and assessing the need and acceptability of a regional accreditation body for the academic institutions of public health. Since the study will not use a validated questionnaire, Cronbach’s alpha will be calculated to ensure internal consistency, an objective measure of reliability used to overcome measurement error [60].

Table 2: Phase 1 study variables to be measured. (Adapted from BME WFME 2020 [64] Standards and HPCSA Guidelines [38]).

The necessary privacy and safety requirements will continually be ensured. All the research data will be recorded and stored securely for analysis purposes. A password-protected database will be used, which will be backed-up regularly, and will only be accessible to the primary researcher and the research supervisors. Ethical approval has been obtained (Ref. no. 2352021) from the Faculty of Health Sciences Research Ethics Committee at the University of Pretoria [61–63].

Phase 2: Development of standards and assessment tool

The measurement instrument will comprise an electronic self-administered questionnaire using Qualtrics® software [58] (https://pretoria.eu.qualtrics.com/), to be administered to the participants utilising the Delphi technique. The results of Phase 1 will be summarised as possible standards for consideration and these draft standards will form the basis of the Delphi survey. The five-point Likert scale online surveys will be used to obtain data from the participants. After completion of the first round, an updated survey will be compiled and sent to the panellists, and this will constitute the second round. The updated survey will include the descriptive statistics on the repeated statements (for which there was no consensus) to provide insight on other participants’ responses as they engage with the survey again; but will exclude the statements (greyed-out) on which there was consensus in the first round. Depending on the consensus results of the second round, the third round will be instituted. The proportions for each of the Delphi survey items will be derived. Consensus will be defined as the combination of participants who agree and strongly agree to the statements. Non-consensus will be defined as a combination of disagree and strongly disagree as well as neutral/ do not know responses [54–57,59,65].

Data management and analysis plan

The collected data will only be accessible to the principal researcher and the research supervisors. The data will be kept private and treated with the strictest confidence. The data will be downloaded from the Qualtrics® platform [58] into a password-protected database (with continuous backing up), and will be exported to Stata version 18 for analysis after each round.

All statistical analyses will be conducted by the principal researcher and consultation with a biostatistician will be sought, if required. The data analysis will be performed in accordance with the three phases of the study.

Phase 1: Exploration of the current status of the academic institutions of public health

Data analysis

Data analyses will comprise the following

Quantitative data analysis: Firstly, the data will be declared as survey design (command: svyset), since the sampling method for this phase will be multi-stage. This will include stratification and sampling weights (probability weights or pweights) will be necessary as the participants may have different probabilities of selection where others may be oversampled due to the uneven distribution of the academic institutions within the sub-regions [14,66].

Descriptive statistics (means, modes and range [including interquartile range: IQR]) will be used to summarise categorical variables, and frequency distributions (proportions and percentages) [14,59]. Reliability and coherence between questionnaire items will be tested using the Cronbach alpha coefficient [60]. Factor analysis and sensitivity analysis of the questionnaire items will be conducted. Logistic regression will be performed to determine the associations between the study variables [67,68].

All quantitative data analyses will be done using STATA version 18 (Stata Corp., College Station, TX, USA) [69].

Qualitative data analysis: Thematic analysis of the qualitative data derived from open-ended questions will be done using ATLAS.ti, in accordance with the study objectives. The responses will be categorised into predetermined themes based on the sections of the questionnaire [51].

Phase 2: Development of standards and assessment tool

Data Analysis Plan.

Data analyses will comprise the following:

Quantitative data analysis: Descriptive statistics (means, modes and range [including interquartile range: IQR]) will be used to summarise categorical variables, and frequency distributions (proportions and percentages) will be described for participants’ responses measured on the five-point Likert scale (“strongly agree”, “agree”, “neutral/ don’t know”, “disagree”, “strongly disagree”) [14,54,56,59]. Reliability and coherence between questionnaire items will be tested using the Cronbach alpha coefficient. Logistic regression will be performed to determine the associations between the study variables [67,68]. All quantitative data analyses will be done using STATA version 18 (Stata Corp., College Station, TX, USA) [69].

Qualitative data analysis: Thematic analysis of the qualitative data derived from open-ended questions will be done using ATLAS.ti, in accordance with the study objectives. The responses will be categorised into predetermined themes based on the sections of the questionnaire [51].

Error minimising processes

Every research undertaking has an inherent risk of bias. Selection bias will be minimised through using the total population sampling method [53] where the entire study population will be included in the study. Information bias will be minimised through the upholding of the ethical principles to reassure the study participants of anonymity, privacy and confidentiality of the information provided. Since the study will not use a validated questionnaire, Cronbach’s alpha will be calculated to ensure internal consistency, an objective measure of reliability used to overcome measurement error [60].

Application of the criteria for a good quality Delphi study: specifying the planned number of rounds, specifying the stopping criteria, repeatability criteria used for the selection of study participants, and criteria used to drop off items after each specified round [54,59].

The master questionnaire will be in English and translated using the inbuilt function of Qualtrics® software [58] (https://pretoria.eu.qualtrics.com/). The translation will be validated by the French and Portuguese language experts from the Department of Ancient and Modern Languages and Culture in the Faculty of Humanities, at the University of Pretoria or translation service providers. Various techniques will be used for qualitative data management and analysis to ensure quality criteria of credibility, transferability, dependability and confirmability. These include, (1) iterative data analysis through continuous examining of the data based on the themes and sub-themes emerging from the analysis, (2) audit trail (record-keeping of all the research processes and amendments, if any), and (3) peer debriefing to discuss the process and findings with experts and peers [51,59].

Ethical considerations

Ethical approval to conduct the study was obtained from the Faculty of Health Sciences Research Ethics Committee at the University of Pretoria (Ref. no. 2352021). The ethical principles for biomedical research (autonomy, beneficence, non-maleficence and distributive justice) will be upheld throughout the tenure of the research project. The participant information and informed consent document will be administered electronically via the Qualtrics platform, before participants can commence with responses. The document provides details on the nature of the study and what is expected from the study participants (including, the duration), their right to refuse or withdraw without any penalty, as well as the contact details of the Research Ethics Committee [61–63].

The participants’ (institutional) details will be de-identified to maintain privacy and confidentiality. There are no anticipated risks during the study. Although the study benefits may not be direct for the research participants, the study findings will benefit the MPH programmes and the institutions within which they work, for the overall benefit of capacity development and quality assurance of the MPH programme as well as the overall quality and training of public health education within the African region. The research stakeholders will be informed of the research findings [61–63].

All the data will be managed by the primary researcher and stored on a password-protected database with backup after downloading from Qualtrics® platform [58]; and only accessible to the research team. All the research data will be stored at the School of Health Systems and Public in the Faculty of Health Sciences for 10 years in accordance with the University of Pretoria Data Management Policy.

Discussion

Dissemination plans

The findings of the study will be disseminated through various platforms. The Phase 1 and 2 findings will be submitted as part of a thesis in partial fulfilment of the Doctor of Philosophy in Public Health (PhD Public Health) degree at the School of Health Systems and Public Health in the Faculty of Health Sciences at the University of Pretoria, South Africa.

The developed assessment tool after Phase 2 will be foundational and piloted among willing participants (institutions) and will comprise Phase 3 of the study (post-PhD).

All the study findings will be shared with all the relevant stakeholders, including the study participants through ASPHA as well as the Council for Higher Education (or equivalent). Journal manuscripts will also be submitted to accredited peer-reviewed journals.

The findings will also be presented at national conferences (SAAHE and PHASA), regional (ASPHA) and international conferences (WCPH). The proposed study has been presented at the 17^th^ World Congress on Public Health (WCPH) in Rome, Italy in May 2023 [70].

Conclusion

The study findings will provide evidence to inform the relevant decision-makers regarding the need for an accreditation system for the MPH programme in Africa. In addition, they will foster long-term networks and partnerships; and further inform the curriculum reform of the academic institutions of public health in Africa to appropriately respond and align to the health needs within the African region in pursuit of realising the United Nations 2030 Agenda of Sustainable Development Goals.