Strategies for change These strategies for change include: Building international and regional networks of “change agents” united by a shared vision for equitable and sustainable health systems Promoting effective partnerships between different stakeholders Assisting partners with development and adaptation of locally relevant health training materials Promoting local capacity in community based primary health care by training trainers in needs assessment, program development and evaluation. Helping partners in developing countries obtain external funding for model initiatives.

	A Reciprocal Transfer of Innovations In Kenya we have less than 5000 medical doctors for a country of 32 million people. We need to educate more doctors, doctors that will not leave Kenya to work abroad. The first students arrived at Moi medical school in 1990. Since then we have graduated over 350 doctors, 80% of whom stayed in Kenya. And out of 71 districts in Kenya, more than 50% have health officers that are students graduated from Moi University. Why did so many make the decision to stay? There are several reasons. First, we use community-based education in the training of our students (something that we have shared with like-minded institutions as Makerere University in Uganda and the Catholic University of Mozambique). This approach has made our students socially more accountable to the Kenyan communities. What also influenced many of our students were the electives abroad. After experiencing healthcare systems – and life in general – elsewhere, they were able to compare and choose; many of them chose Kenya. Of course we also encounter problems, as any medical school does. Our university hospital is one example: with 500 beds it is too small for us to teach our students. We are tackling this problem together with the Kenyan Government and our international partners (e.g. from Indiana, USA and Maastricht, the Netherlands); we have now two new teaching laboratories, a new intensive care unit, facilities for 15 health centres in western Kenya, and plans for a new maternity and newborn unit. Staff recruitment was another hurdle we encountered when starting Moi medical school; it was difficult, because we are far away from the capital city. We solved this problem not only by hiring professors from outside Kenya, but also by recruiting and training our former graduates. Linköping University (Sweden) and Maastricht University (the Netherlands) were a big help in faculty development. We have been able to sustain and improve our programme in the past 15 years, thanks to our programmes, and to our international collaborations. Simeon Mining / Senior Lecturer, Faculty of Medicine, Moi University, Eldoret, Kenya E-mail