Creating a Sustainable Foundation for IR Services and Training in Sub-Saharan Africa: 5-Year Update on the Road2IR Initiative

Abstract

Purpose: To evaluate the growth and quality of an interventional radiology (IR) training model designed for resource-constrained settings and implemented in Tanzania as well as its overall potential to increase access to minimally invasive procedures across the region. Materials and Methods: IR training in Tanzania began in October 2018 through monthly deployment of visiting teaching teams for hands-on training combined with in-person and remote lectures. A competency-based 2-year Master of Science in IR curriculum was inaugurated at the nation's main teaching hospital in October 2019, with the first 2 classes graduating in 2021 and 2022. Procedural data, demographics, and clinical outcomes were collected and analyzed throughout the duration of this program. Results: From October 2018 to July 2022, 1,595 procedures were performed in Tanzania: 1,236 nonvascular and 359 vascular, all with local fellows as primary interventional radiologists. Of these, 97.2% were technically successful, 95.2% were without adverse events, and 28.9% were performed independently by Tanzanian fellows and faculty with no difference in adverse event and technical success rates (P = .63 and P = .90, respectively), irrespective of procedural class. Ten IR physicians graduated from this program during the study period, followed by another 3 per year going forward. Partner training programs in Uganda and Rwanda mirroring this model commenced in 2023 and 2024, respectively. Conclusions: The reported training model offers a practical and effective solution to meet many of the challenges associated with the lack of access to IR in sub-Saharan Africa.