**3. Centers of excellence**

Every country should strive to establish their own cardiac centres. These dedicated Centers of Excellence (COE) would provide clinical, educational, training, research, and administrative support to the services and the programs within the country in addition to their role in providing patient care [5].

These COEs would lead the service development and be a centre for data gathering, research and development and may serve as a hub for medical missions [11]. The COEs can also lead and coordinate the partnership with global cardiovascular organizations and forums; such partnership can help enormously in establishing cardiac services for children in LICs [9].

If appropriately organized, COEs are economically and financially efficient and can save resources especially if their patient volume is large [5].

The cost of these centres may be shared with the adult cardiology programs to save the resources. The COEs would provide the greatly needed training. They also provide *Management of Congenital Heart Disease in Low-Income Countries: The Challenges and the… DOI: http://dx.doi.org/10.5772/intechopen.104830*

a hub for visiting humanitarian missions [29] which may promote high standards of practice and training.

COEs may have a major role in education and training of the local teams while visiting teams will train the pediatric cardiac personnel including surgeons, physicians, anesthetists, Intensivists, perfusionists, and nurses. For sustaining the skills, the local team's training may have to be augmented by training abroad. However, training abroad is expensive, and the trainee may not get good hands-on training. Recently, there is a move toward long-term embedding projects, where experienced cardiologists and/or surgeons spend one to 12 months in host programs. This has great value both medically and financially [30, 31].
