CARPHA in partnership with Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET) rolled out Frontline FETP as a pilot training initiative in response to the Regional Zika epidemic of 2016. Frontline FETP is a 3-month training programme that targets public health staff working in sentinel surveillance sites (on the Frontline), who have had little or no formal training in surveillance and emergency response. Trainees learn the importance of timely, accurate and complete data collection, which supports surveillance and public health decision making; basic analysis and interpretation of surveillance data; and how to develop scientific reports and presentations to communicate public health importance. Trainees also learn to apply basic outbreak investigation skills and how to carry out problem analyses using cause and effect models. Four countries were involved in this pilot, Trinidad and Tobago and Grenada (Phase 1), as well as Jamaica and St. Vincent and the Grenadines (Phase 2). Monitoring of graduates for post training effectiveness, demonstrates that within local working environments, graduates are submitting more accurate and complete surveillance reports in a timely fashion, improving the response time to unusual and emergency public health events and stimulating behavioural change within their work environments by advocating improved surveillance practices among co-workers.


  • Level I is intended as an introduction to the core competencies for integrated field and laboratory epidemiologic practice, for health professionals from diverse backgrounds, working in regional or national health organizations in participating countries.
  • Level I include approximately 15-20 days of face-to-face training, over a 20-week (5 month) period.
  • After each training module of 3-5 working days, Trainees return to their usual work locations.
  • As part of the 'field' component of Level I of the CR-FELTP, each Trainee is required to complete four assignments, described below. Trainees are expected to work on the products when they are back at their jobs between training courses.

Level I Training Topics

In consultation with regional partners, nine core domains for CR-FELTP Level I training were identified:

  • 1. Epidemiological Methods
  • 2. Biostatistics
  • 3. Public Health Surveillance
  • 4. Laboratory and Biosafety
  • 5. Computer Technology
  • 6. Management and Leadership
  • 7. Communication
  • 8. Emergency Preparedness and Response
  • 9. Epidemiology of Priority Diseases, Threats and Injuries

Field Assignments

Field assignments are 'competency products' which demonstrate that Trainees are able to apply their new knowledge and skills. The four competency products for Level I are:

  • 1. Outbreak Investigation Report
  • 2. Health Surveillance Analysis Report
  • 3. Oral presentation
  • 4. Two written briefs/memos


Level II or Intermediate training promotes the development and application of more in-depth field epidemiology skills. Advanced topics are taught under the nine core domains from Level I and an additional domain, “Teaching and Mentoring” is introduced at Level II to promote programme sustainability. Graduates from this level are expected to be future programme mentors.

In terms of field competency products, graduates are expected to undertake outbreak investigation and surveillance reports using analytical statistics, as well as, conduct a health system evaluation and design a study protocol. The field work required to produce these products should be initiated at the commencement of the programme, and participants are expected to work on the products when they are back at their jobs between training courses. Intermediate training takes place over a year and involves both classroom training (20%) and fieldwork (80% on the Job).

Level II involves 28 days of face-to-face training or online/blended didactic sessions, over a 12-month period (48 Weeks). If the face-to-face modality is solely used there are 4 training modules lasting 6 working days, a one-day field trip and a 3-day field assignment review workshop. The four primary training modules are held two months apart. In between training modules, trainees return to their usual work locations, and carry out fieldwork assignments in addition to their routine job responsibilities.


Level III or Advanced training is expected to train graduates to operate at a level commensurate with that of a National Epidemiologist. As such, the curriculum would build on the previous levels of training in applied epidemiology and public health laboratory skills and should be benchmarked against other international programmes. The proposed 2-year programme, however, is expected to maintain a focus on fieldwork and application of competencies. The didactic component, which forms 20% of the length of the Level III programme, is to be delivered in a combination of face to face and virtual training (blended approach). Fieldwork placements would be made by CARPHA in conjunction with the individual and the country Ministry of Health, which would be based on the objectives of the field experience. The participant may work in their country with specific parameters or it may be a combination where the person is placed regionally or internationally.