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Mubuuke AG, Nawagi F, Nalugo-Mbalinda S, Musoke D, Nekaka R. Development of a mentorship framework guide to promote the acquisition of interprofessional education and collaborative practice competencies during undergraduate training: a mini-Delphi cross-sectional study. RESEARCH SQUARE 2024:rs.3.rs-3923664. [PMID: 38464128 PMCID: PMC10925446 DOI: 10.21203/rs.3.rs-3923664/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Background The current global burden of disease which includes emerging and re-emerging diseases calls for interprofessional partnerships and team work to work collaboratively to solve community health problems. Inter-professional collaboration needs to start with training whereby learners are mentored in inter-professional teams and collaborative care. Many guidelines do exist in teaching and learning but faculty often do not have guidelines on how to mentor learners to acquire the needed inter-professional competencies. This study aimed at developing a mentorship guide for faculty to enable them to ably mentor learners in the acquisition of interprofessional competencies. Methods It was a cross-sectional study involving both students and faculty mentors. Questionnaires were distributed to undergraduate students and the mentors at Makerere University College of Health Sciences and Busitema University Faculty of Health Sciences. Data from the participants was used alongside literature to develop the interprofessional education mentorship guide for faculty mentors. The guide was validated by a panel of experts. Results From this study, students reported limited knowledge of the IPE core competencies and the faculty mentors corroborated this finding. Mentors did not directly give any feedback specifically targeting the IPE core competencies, though some of them unknowingly talked about some of the IPE competencies. The key challenges identified from students and faculty included limited training IPE and IPE core competencies and lack of guidelines for faculty mentors which they can follow to mentors students adequately across all the expected IPE competencies. Conclusion There was limited mentorship in IPE competencies. Findings from this study alongside literature and expert validation, a framework guide for mentors in relation to IPE competencies has been proposed.
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Awasthi KR, Jancey J, Clements ACA, Rai R, Leavy JE. Community engagement approaches for malaria prevention, control and elimination: a scoping review. BMJ Open 2024; 14:e081982. [PMID: 38365295 PMCID: PMC10875526 DOI: 10.1136/bmjopen-2023-081982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 01/25/2024] [Indexed: 02/18/2024] Open
Abstract
INTRODUCTION Globally malaria programmes have adopted approaches to community engagement (ACE) to design and deliver malaria interventions. This scoping review aimed to understand, map, and synthesise intervention activities guided by ACE and implemented by countries worldwide for the prevention, control and elimination of malaria. METHODS Three databases (Web of Science, Proquest, and Medline) were searched for peer-reviewed, primary studies, published in English between 1 January 2000 and 31 December 2022. Advanced Google was used to search for grey literature. The five levels of the International Association for Public Participation were used to categorise ACE - (1) Inform, (2) Consult, (3) involve, (4) Collaborate, and (5) Co-lead. Intervention activities were categorised as health education (HE), and/or health services (HS), and/or environmental management (EM). Outcomes were collected as knowledge, attitude, behaviour, help-seeking, health and HS and environment. Enablers and barriers were identified. Malaria intervention phases were categorised as (1) prevention (P), or (2) control (C), or (3) prevention and control (PC) or prevention, control and elimination (PCE). RESULTS Seventy-five studies were included in the review. Based on ACE levels, most studies were at the inform (n=37) and involve (n=26) level. HE (n=66) and HS (n=43) were the common intervention activities. HE informed communities about malaria, its prevention and vector control. EM activities were effective when complemented by HE. Community-based HS using locally recruited health workers was well-accepted by the community. Involvement of local leaders and collaboration with local stakeholders can be enablers for malaria intervention activities. CONCLUSION Involving local leaders and community groups in all stages of malaria prevention programmes is vital for successful interventions. Key elements of successful ACE, that is, consult, collaborate, and co-lead were under-represented in the literature and require attention. National programes must consult and collaborate with community stakeholders to develop ownership of the interventions and eventually co-lead them.
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Affiliation(s)
- Kiran Raj Awasthi
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Jonine Jancey
- Western Australian Centre for Health Promotion Research, School of Public Health, Curtin University, Perth, Western Australia, Australia
| | | | - Rajni Rai
- School of Population Health, Curtin University, Perth, Western Australia, Australia
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Nawagi F, Munabi IG, Vyt A, Kiguli S, Rabin T, Waggie F, Mubuuke AG. Using the modified Delphi technique to develop a framework for interprofessional education during international electives in health professions training institutions in Sub-Saharan Africa. Front Med (Lausanne) 2023; 10:1225475. [PMID: 37920599 PMCID: PMC10618419 DOI: 10.3389/fmed.2023.1225475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/06/2023] [Indexed: 11/04/2023] Open
Abstract
Background International electives provide a learning platform where interprofessional education and collaborative practice (IPECP) skills can be cultivated. However, hardly any frameworks to guide the implementation of interprofessional education (IPE) during international electives, especially in the context of low-income settings have been published. To address this gap, this study used the modified Delphi approach to develop an IPE framework guide for international electives to be used by health professions training institutions in Sub-Saharan Africa. Methods A rapid literature review and a study among students and faculty in four African health professional training institutions were done to inform the process. This was followed by the modified Delphi technique that used three Delphi rounds with a panel of eight experts to build consensus on the final framework for IPE during international electives. The level of consensus was set at ≥70% on each of the statements in all rounds. Results Out of the 52 statements in round 1 (n = 37, 71%) reached consensus while (n = 15, 29%) of the statements did not reach consensus and were discussed in round 2. Round 2 led to 42 statements to be utilized for round 3. In round 3, all statements (42) reached a consensus and an IPE framework to guide the implementation of international electives was developed. The framework consists of three sections. Section one highlights the various IPECP competencies to be gained by learners in the areas of teamwork, interprofessional communication, roles and responsibilities of interprofessional collaborative practice, values and ethics of interprofessional collaboration, and reflection and evaluation of oneself and the team. Section two gives guidance on the structuring of the IPE international electives in health professional training institutions. This includes subsections on operational/institutional needs, acculturation considerations, teaching strategies, assessment strategies, mode of delivery, and public health considerations. Section three consists of the various practical guides and approaches that health professional training institutions could use according to what works best in their setting. Conclusion The modified Delphi technique was an adequate approach to aid the development of an IPE framework to guide implementation during international electives in various health professional training institutions.
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Affiliation(s)
- Faith Nawagi
- School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Ian Guyton Munabi
- School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda
| | - Andre Vyt
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Sarah Kiguli
- School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Tracy Rabin
- School of Medicine, Yale University, New Haven, CT, United States
| | - Firdouza Waggie
- Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa
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Nawagi F, Munabi IG, Vyt A, Kiguli S, Mubuuke AG. Interprofessional education during international electives: Perceptions of health professions students from selected institutions in Africa. J Interprof Care 2023:1-8. [PMID: 36739590 DOI: 10.1080/13561820.2023.2172387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Although international electives provide important opportunities for the development of interprofessional education and collaboration practice skills, there is limited literature that describes students' perceptions in various training institutions in Africa. This study aimed to address this gap by establishing the student's perceptions of interprofessional education during international electives from four African health professional training universities. This was a cross-sectional quantitative study. Data were collected online using the Readiness for Interprofessional Learning Scale from 135 student participants. Linear regression and multilinear regression were used to establish relationships between socio-demographic characteristics and the student's perception of interprofessional education during international electives. There was a high overall positive perception (76 SD± 8.1) among the student participants of interprofessional education during international electives. Almost all the students (88.9% n = 120) thought interprofessional education during international electives would help them become better team workers during future practice and enhance their communication skills. There were high mean scores regarding positive perceptions of teamwork and collaboration (39.5 SD± 4.9), positive professional identity 17.6 (SD± 2.6), and understanding roles and responsibilities (7.4 SD± 2.0). There is a generally positive perception of interprofessional education during international electives among health professions students from various African university institutions.
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Affiliation(s)
- Faith Nawagi
- School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Ian Guyton Munabi
- School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda
| | - Andre Vyt
- Faculty of Medicine and Health Sciences, University of Ghent, Gent, Belgium
| | - Sarah Kiguli
- School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
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Relational experiences of community members participating in a rural health initiative with interprofessional students. AFRICAN JOURNAL OF HEALTH PROFESSIONS EDUCATION 2022. [DOI: 10.7196/ajhpe.2022.v14i2.1531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background. A South African faculty of health sciences created a forum for the community to voice their relational experiences with interprofessional students through visual projections. No other studies that explore such experiences using the Mmogo method could be located.
Objective. To gain an understanding of the relational experiences of community members participating in Lifestyle-groups as part of a rural health initiative with interprofessional student groups.
Methods. The Mmogo method is a qualitative, structured, observation technique. Participants constructed visual projections representing specific relationships. Thereafter, during a group discussion, participants explained the meaning of their projections. The visual data were analysed according to their literal presentation and subjective, symbolic meaning. A thematic analysis was used for the transcribed data.
Results. Thirteen of the 24 visual projections were of a quality that allowed visual analysis; all 24 members participated in the discussions. Light was identified as an overarching theme to represent the community-student interaction. Sub-themes and categories associated with light were healthier lifestyles (knowledge sharing, lifestyle transformation, improved health outcomes), solidarity (reciprocity, collaboration, person centredness, multidimensional approach) and affirmation (gratitude and acceptance).
Conclusion. Though some statements by participants related to health education as opposed to health dialogue highlighted areas requiring improvement, the findings correlated with the outcomes prescribed for students by this rural health initiative. Emotional connections in relational experiences could facilitate higher levels of self-efficacy in communities. The question is whether a stronger emphasis on health dialogue can be a catalyst for improved self-efficacy.
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Buregyeya E, Atusingwize E, Nsamba P, Nalwadda C, Osuret J, Kalibala P, Nuwamanya R, Okech S, Ssekamatte T, Nitumusiima S, Wakabi T, Bikaako W, Yawe A, Naigaga I, Kagarama J, Kabasa JD, Bazeyo W. Lessons from a community based interdisciplinary learning exposure: benefits for both students and communities in Uganda. BMC MEDICAL EDUCATION 2021; 21:5. [PMID: 33397353 PMCID: PMC7784318 DOI: 10.1186/s12909-020-02429-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 12/07/2020] [Indexed: 05/04/2023]
Abstract
BACKGROUND Makerere University implemented a One Health Institute (OHI) in 2016 involving undergraduate students selected from different disciplines. The students were first taken through theoretical principles of One Health followed by a field attachment in communities. The field attachment aimed to expose students to experiential educational opportunities in the communities in a One Health approach. In this paper, we present students' experiences and their contributions to the communities of attachment. METHODS This was a cross-sectional study, utilizing qualitative data collection methods. The study involved students who participated in the OHI field attachment and community members in a One Health demonstration site-Western Uganda. Four focus group discussions (FGDs) and four in-depths interviews (IDIs) were conducted among the students, while four FGDs and twelve IDIs were conducted among community members. All interviews were audio-recorded, transcribed and analysed manually. RESULTS The four themes that emerged are: students' understanding and appreciation of One Health concept, their experiences and gains from the multi-disciplinary field attachment, students' contributions to the community, and challenges faced by the students. Students had good knowledge of One Health. They appreciated that health cannot be achieved by one discipline or sector and thus the need to collaborate across sectors. Regarding experiences and gains during the multi-disciplinary field attachment, the students appreciated that each discipline had a role to play in achieving health in the community. They appreciated the training citing skills gained in communication, team work and collaboration. They also reported a feeling of gratitude and accomplishment because they felt they made a positive change to the community by putting in place interventions to address some of the community challenges. Similarly, the communities appreciated the students' contribution in solving their health challenges, ranging from conducting health education to improving sanitation and hygiene. CONCLUSIONS Through the OHI, students gained One Health competencies including communication, teamwork, and collaboration. Adopting an interdisciplinary model in university teaching system especially during field placement would strengthen skills of collaboration, team work and communication which are critical for a multi-disciplinary approach which is needed among the future workforce in order to solve the current health challenges.
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Affiliation(s)
| | | | - Peninah Nsamba
- Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | | | - Jimmy Osuret
- Makerere University School of Public Health, Kampala, Uganda
| | - Patrick Kalibala
- Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | - Ronald Nuwamanya
- Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | - Samuel Okech
- Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | | | | | - Timothy Wakabi
- One Health Central and Eastern Africa (OHCEA), Kampala, Uganda
| | - Winnie Bikaako
- One Health Central and Eastern Africa (OHCEA), Kampala, Uganda
| | - Agnes Yawe
- One Health Central and Eastern Africa (OHCEA), Kampala, Uganda
| | - Irene Naigaga
- Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
- One Health Central and Eastern Africa (OHCEA), Kampala, Uganda
| | | | - John David Kabasa
- Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
- One Health Central and Eastern Africa (OHCEA), Kampala, Uganda
| | - William Bazeyo
- Makerere University School of Public Health, Kampala, Uganda
- One Health Central and Eastern Africa (OHCEA), Kampala, Uganda
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van Schalkwyk S, Couper I, Blitz J, Kent A, de Villiers M. Twelve tips for distributed health professions training. MEDICAL TEACHER 2020; 42:30-35. [PMID: 30696315 DOI: 10.1080/0142159x.2018.1542121] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Increasing numbers of health professions students are being trained in healthcare facilities that are geographically removed from central academic hospitals. Consequently, studies have evaluated this distributed training, assessed the impact that it has on student learning as well as on the facilities where the training occurs, and explored factors that enable and constrain successful clinical training at such sites. The 12 tips presented in this article have been developed from a longitudinal project that has focused on developing a framework for effective distributed health professions training through an extensive review of the literature and a national consultative process. These 12 tips should, therefore, have applicability across multiple contexts. The purpose of this article is to assist people in implementing, adapting, upscaling, maintaining, and evaluating the distributed training of students in the health professions.
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Affiliation(s)
- Susan van Schalkwyk
- Centre for Health Professions Education, Stellenbosch University, Cape Town, South Africa
| | - Ian Couper
- Ukwanda Centre for Rural Health, Stellenbosch University, Cape Town, South Africa
| | - Julia Blitz
- Centre for Health Professions Education, Stellenbosch University, Cape Town, South Africa
| | - Athol Kent
- Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa
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Mogodi MS, Kebaetse MB, Molwantwa MC, Prozesky DR, Griffiths D. Using a virtue ethics lens to develop a socially accountable community placement programme for medical students. BMC MEDICAL EDUCATION 2019; 19:246. [PMID: 31277629 PMCID: PMC6612096 DOI: 10.1186/s12909-019-1679-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 06/19/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Community-based education (CBE) involves educating the head (cognitive), heart (affective), and the hand (practical) by utilizing tools that enable us to broaden and interrogate our value systems. This article reports on the use of virtue ethics (VE) theory for understanding the principles that create, maintain and sustain a socially accountable community placement programme for undergraduate medical students. Our research questions driving this secondary analysis were; what are the goods which are internal to the successful practice of CBE in medicine, and what are the virtues that are likely to promote and sustain them? METHODS We conducted a secondary theoretically informed thematic analysis of the primary data based on MacIntyre's virtue ethics theory as the conceptual framework. RESULTS Virtue ethics is an ethical approach that emphasizes the role of character and virtue in shaping moral behavior; when individuals engage in practices (such as CBE), goods internal to those practices (such as a collaborative attitude) strengthen the practices themselves, but also augment those individuals' virtues, and that of their community (such as empathy). We identified several goods that are internal to the practice of CBE and accompanying virtues as important for the development, implementation and sustainability of a socially accountable community placement programme. A service-oriented mind-set, a deep understanding of community needs, a transformed mind, and a collaborative approach emerged as goods internal to the practice of a socially accountable CBE. The virtues needed to sustain the identified internal goods included empathy and compassion, connectedness, accountability, engagement [sustained relationship], cooperation, perseverance, and willingness to be an agent of change. CONCLUSION This study found that MacIntyre's virtue ethics theory provided a useful theoretical lens for understanding the principles that create, maintain and sustain CBE practice.
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Affiliation(s)
- Mpho S. Mogodi
- Department of Medical Education, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Masego B. Kebaetse
- Department of Medical Education, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Mmoloki C. Molwantwa
- Department of Medical Education, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Detlef R. Prozesky
- Department of Medical Education, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Dominic Griffiths
- Division of Studies in Education, Wits School of Education, University of the Witwatersrand, Johannesburg, South Africa
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van Schalkwyk S, Blitz J, Couper I, de Villiers M, Lourens G, Muller J, van Heerden B. Consequences, conditions and caveats: a qualitative exploration of the influence of undergraduate health professions students at distributed clinical training sites. BMC MEDICAL EDUCATION 2018; 18:311. [PMID: 30567523 PMCID: PMC6299970 DOI: 10.1186/s12909-018-1412-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 11/29/2018] [Indexed: 05/22/2023]
Abstract
BACKGROUND Traditionally, the clinical training of health professionals has been located in central academic hospitals. This is changing. As academic institutions explore ways to produce a health workforce that meets the needs of both the health system and the communities it serves, the placement of students in these communities is becoming increasingly common. While there is a growing literature on the student experience at such distributed sites, we know less about how the presence of students influences the site itself. We therefore set out to elicit insights from key role-players at a number of distributed health service-based training sites about the contribution that students make and the influence their presence has on that site. METHODS This interpretivist study analysed qualitative data generated during twenty-four semi-structured interviews with facility managers, clinical supervisors and other clinicians working at eight distributed sites. A sampling grid was used to select sites that proportionally represented location, level of care and mix of health professions students. Transcribed data were subjected to thematic analysis. Following an iterative process, initial analyses and code lists were discussed and compared between team members after which the data were coded systematically across the entire data set. RESULTS The clustering and categorising of codes led to the generation of three over-arching themes: influence on the facility (culturally and materially); on patient care and community (contribution to service; improved patient outcomes); and on supervisors (enriched work experience, attitude towards teaching role). A subsequent stratified analysis of emergent events identified some consequences of taking clinical training to distributed sites. These consequences occurred when certain conditions were present. Further critical reflection pointed to a set of caveats that modulated the nature of these conditions, emphasising the complexity inherent in this context. CONCLUSIONS The move towards training health professions students at distributed sites potentially offers many affordances for the facilities where the training takes places, for those responsible for student supervision, and for the patients and communities that these facilities serve. In establishing and maintaining relationships with the facilities, academic institutions will need to be mindful of the conditions and caveats that can influence these affordances.
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Affiliation(s)
- Susan van Schalkwyk
- Centre for Health Professions Education, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Julia Blitz
- Centre for Health Professions Education, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Ian Couper
- Ukwanda Centre for Rural Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Marietjie de Villiers
- Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Guin Lourens
- Ukwanda Centre for Rural Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Jana Muller
- Ukwanda Centre for Rural Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Ben van Heerden
- MB,ChB Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
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Obol JH, Akera P, Ochola PA, Arubaku W, Oria H, Moi KL, Arony DA, Felix K. Community-based training of medical students is associated with malaria prevention and treatment seeking behaviour for children under 5 years in Uganda: a study of MESAU-MEPI COBERS in Uganda. BMC MEDICAL EDUCATION 2018; 18:131. [PMID: 29884160 PMCID: PMC5994002 DOI: 10.1186/s12909-018-1250-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 06/01/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Four university medical training institutions in Uganda have trained students at off-site health facilities under community-based education and Research Service (COBERS) programme for over 5 years. One of the major components of COBERS placement is for the students to provide health education in the communities about malaria as a major public health disease in Uganda. This study seeks to assess if targeted community-based medical education programme is associated with better prevention and treatment seeking behaviours in the management of malaria, a leading cause of morbidity and mortality of children under five in Uganda. METHODS A cross-sectional survey was done to compare communities around health facilities where medical students were placed at COBERS sites with communities around similar health facilities where medical students were not placed (non-COBERS sites). We randomly selected two villages near each health facility and consecutively selected 10 households per village for interviews using nearest-neighbour method. We used a structured questionnaire to interview household heads on malaria prevention and treatment seeking behaviour for children under 5 years. We performed univariate analysis to determine site and demographic characteristics and performed a multivariate logistic regression to assess association between dependant and independent variables. RESULTS Five hundred twenty-three (66.8%) of the children under 5 years in COBERS communities slept under Insecticide Treated Nets (ITNs) the night before survey compared with 1451 (57.8%) in non-COBERS communities (AOR = 0.66, p = 0.017). 100 (60.0%) of children under 5 years in COBERS communities sought care for fever within 24 h of onset compared with 268 (47.0%) in non-COBERS communities (AOR = 0.71, P = 0.009). CONCLUSION The presence of COBERS in communities is associated with improved malaria prevention and treatment-seeking behaviour for parents of children under 5 years. Further study needs to be done to determine the long-term impact of COBERS training program on malaria control and prevention in Uganda, along with other effects of COBERS.
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Affiliation(s)
- James Henry Obol
- Department of Public Health, Faculty of Medicine, Gulu University, P.O Box 166, Gulu, Uganda
| | - Peter Akera
- Department of Public Health, Faculty of Medicine, Gulu University, P.O Box 166, Gulu, Uganda
| | - Pamela Atim Ochola
- Department of Public Health, Faculty of Medicine, Gulu University, P.O Box 166, Gulu, Uganda
| | - Wilfred Arubaku
- Deaprtment of Dental Surgery, Faculty of Medicine Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Uganda
| | - Hussein Oria
- Department of Pharmacy, School of health Sciences Makerere University, P.O Box 7072, Kampala, Uganda
| | - Kenneth Luryama Moi
- Department of Medical Microbiology & Immunology, Faculty of Medicine, Gulu University, P.O Box 166, Gulu, Uganda
| | - Denis Anywar Arony
- Department of Biochemistry, Faculty of Medicine, Gulu University, P.O Box 166, Gulu, Uganda
| | - Kaducu Felix
- Department of Public Health, Faculty of Medicine, Gulu University, P.O Box 166, Gulu, Uganda
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Amalba A, Abantanga FA, Scherpbier AJJA, van Mook WNKA. Community-based education: The influence of role modeling on career choice and practice location. MEDICAL TEACHER 2017; 39:174-180. [PMID: 27841070 DOI: 10.1080/0142159x.2016.1246711] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
INTRODUCTION Research findings in medical education support the importance of positive role models in enhancing learning and influencing the career path of medical students and graduates. The authors explored the characteristics of positive and negative role models during Community-Based Education and Service (COBES), as well as their effect on trainees' career paths. METHOD A cross-sectional survey was conducted by means of a questionnaire among medical students to explore the characteristics of positive and negative role models during COBES. Associations between gender, choice of specialty, and practice location were assessed using the chi-square test. All qualitative data analysis was performed using the principles of primary, secondary, and tertiary coding. RESULT The majority of the students indicated that role modeling during COBES will affect their choice of specialty and practice location with a significant gender difference in terms of practice location (p < 0.005). Qualitative data supported the finding that positive role modeling during COBES may influence graduates willingness to work in rural area. CONCLUSION The desire and willingness to work in a rural community combined with good communication and excellent interpersonal skills as well as good leadership skills are attributes of good role modeling that could influence medical students' career choice during COBES.
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Affiliation(s)
- A Amalba
- a School of Medicine and Health Sciences (SMHS) , University for Development Studies (UDS) , Tamale , Ghana
| | - F A Abantanga
- a School of Medicine and Health Sciences (SMHS) , University for Development Studies (UDS) , Tamale , Ghana
| | - A J J A Scherpbier
- b Faculty of Health, Medicine, and Life Sciences, School of Health Professions Education , Maastricht University , Maastricht , The Netherlands
| | - W N K A van Mook
- b Faculty of Health, Medicine, and Life Sciences, School of Health Professions Education , Maastricht University , Maastricht , The Netherlands
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Amalba A, van Mook WNKA, Mogre V, Scherpbier AJJA. The perceived usefulness of community based education and service (COBES) regarding students' rural workplace choices. BMC MEDICAL EDUCATION 2016; 16:130. [PMID: 27129683 PMCID: PMC4850666 DOI: 10.1186/s12909-016-0650-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Accepted: 04/22/2016] [Indexed: 05/17/2023]
Abstract
BACKGROUND Community Based Education and Service (COBES) are those learning activities that make use of the community as a learning environment. COBES exposes students to the public and primary health care needs of rural communities. The purpose of this study was to investigate students' perceived usefulness of COBES and its potential effect on their choice of career specialty and willingness to work in rural areas. METHOD A mixed method cross sectional study design using semi-structured interviews, questionnaires, and focus group discussions were used for health facility staff, faculty and students and community members. RESULTS One hundred and seventy questionnaires were administered to students and 134 were returned (78.8% response rate). The majority (59.7%) of students were male. Almost 45% of the students indicated that COBES will have an influence on their choice of career specialty. An almost equal number (44%) said COBES will not have an influence on their choice of career specialty. However, 60.3% of the students perceived that COBES could influence their practice location. More males (64.7%, n = 44) than females (57.8%, n = 26) were likely to indicate that COBES will influence their practice location but the differences were statistically insignificant (p = 0.553). The majority of students, who stated that COBES could influence their practice location, said that COBES may influence them to choose to practice in the rural area and that exposure to different disease conditions among different population groups may influence them in their career choice. Other stakeholders held similar views. Qualitative data supported the finding that COBES could influence medical students' choice of specialty and their practice location. CONCLUSION Medical students' 'perceptions of the influence of COBES on their choice of career specialty were varied. However, most of the students felt that COBES could influence them to practice in rural locations.
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Affiliation(s)
- A Amalba
- Department of Health Professions Education and Innovative Learning School of Medicine and Health Sciences, University for Development Studies, P. O. Box 1883, Tamale, Ghana.
| | - W N K A van Mook
- School of Health Professions Education, University of Maastricht, Maastricht, The Netherlands
| | - V Mogre
- Department of Health Professions Education and Innovative Learning School of Medicine and Health Sciences, University for Development Studies, P. O. Box 1883, Tamale, Ghana
| | - A J J A Scherpbier
- School of Health Professions Education, University of Maastricht, Maastricht, The Netherlands
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Atuyambe LM, Baingana RK, Kibira SPS, Katahoire A, Okello E, Mafigiri DK, Ayebare F, Oboke H, Acio C, Muggaga K, Mbalinda S, Nabaggala R, Ruzaaza G, Arubaku W, Mary S, Akera P, Tumwine JK, Peters DH, Sewankambo NK. Undergraduate students' contributions to health service delivery through community-based education: A qualitative study by the MESAU Consortium in Uganda. BMC MEDICAL EDUCATION 2016; 16:123. [PMID: 27114073 PMCID: PMC4843200 DOI: 10.1186/s12909-016-0626-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 04/05/2016] [Indexed: 05/22/2023]
Abstract
BACKGROUND It has been realised that there is need to have medical training closer to communities where the majority of the population lives in order to orient the trainees' attitudes towards future practice in such communities. Although community based education (CBE) has increasingly been integrated into health professions curricula since the 1990s, the contribution students make to service delivery during CBE remains largely undocumented. In this study, we examined undergraduate health professions students' contribution to primary health care during their CBE placements. METHODS This was a qualitative study involving the Medical Education for Equitable Services to All Ugandans consortium (MESAU). Overall, we conducted 36 Focus Group Discussions (FGDs): one each with youth, men and women at each of 12 CBE sites. Additionally, we interviewed 64 community key-informants. All data were audio-recorded, transcribed and analysed using qualitative data analysis software Atlas.ti Ver7. RESULTS Two themes emerged: students' contribution at health facility level and students' contribution at community level. Under theme one, we established that students were not only learning; they also contributed to delivery of health services at the facilities. Their contribution was highly appreciated especially by community members. Students were described as caring and compassionate, available on time and anytime, and as participating in patient care. They were willing to share their knowledge and skills, and stimulated discussion on work ethics. Under the second theme, students were reported to have participated in water, sanitation, and hygiene education in the community. Students contributed to maintenance of safe water sources, educated communities on drinking safe water and on good sanitation practices (hand washing and proper waste disposal). Hygiene promotion was done at household level (food hygiene, hand washing, cleanliness) and to the public. Public health education was extended to institutions. School pupils were sensitised on various health-related issues including sexuality and sexual health. CONCLUSION Health professions students at the MESAU institutions contribute meaningfully to primary health care delivery. We recommend CBE to all health training programs in sub-Saharan Africa.
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Affiliation(s)
- Lynn M. Atuyambe
- />Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, College of Health Sciences, New Mulago Hospital Complex-School of Public Health Building Suite nr 307, P.O. Box 7072, Kampala, Uganda
| | - Rhona K. Baingana
- />School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda
| | - Simon P. S. Kibira
- />Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, College of Health Sciences, New Mulago Hospital Complex-School of Public Health Building Suite nr 307, P.O. Box 7072, Kampala, Uganda
| | - Anne Katahoire
- />School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Elialilia Okello
- />School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - David K. Mafigiri
- />School of Social Sciences, Makerere University College of Humanities and Social Sciences, Kampala, Uganda
| | - Florence Ayebare
- />Office of the Principal, Makerere University College of Health Sciences, Kampala, Uganda
| | - Henry Oboke
- />Faculty of Medicine, Gulu University, Kampala, Uganda
| | - Christine Acio
- />Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- />School of Health Sciences, Kampala International University Western Campus, Bushenyi, Uganda
| | - Kintu Muggaga
- />Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- />School of Health Sciences, Kampala International University Western Campus, Bushenyi, Uganda
| | - Scovia Mbalinda
- />School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Ruth Nabaggala
- />Office of the Principal, Makerere University College of Health Sciences, Kampala, Uganda
| | - Gad Ruzaaza
- />Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Wilfred Arubaku
- />Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Samantha Mary
- />Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Peter Akera
- />Faculty of Medicine, Gulu University, Kampala, Uganda
| | - James K. Tumwine
- />School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - David H. Peters
- />Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Nelson K. Sewankambo
- />Office of the Principal, Makerere University College of Health Sciences, Kampala, Uganda
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Mubuuke AG, Oria H, Dhabangi A, Kiguli S, Sewankambo NK. An exploration of undergraduate medical students' satisfaction with faculty support supervision during community placements in Uganda. Rural Remote Health 2015; 15:3591. [PMID: 26626014 PMCID: PMC4710616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
INTRODUCTION To produce health professionals who are oriented towards addressing community priority health needs, the training in medical schools has been transformed to include a component of community-based training. During this period, students spend a part of their training in the communities they are likely to serve upon graduation. They engage and empower local people in the communities to address their health needs during their placements, and at the same time learn from the people. During the community-based component, students are constantly supervised by faculty from the university to ensure that the intended objectives are achieved. The purpose of the present study was to explore student experiences of support supervision from university faculty during their community-based education, research and service (COBERS placements) and to identify ways in which the student learning can be improved through improved faculty supervision. METHODS This was a cross-sectional study involving students at the College of Health Sciences, Makerere University, Uganda, who had a community-based component during their training. Data were collected using both questionnaires and focus group discussions. Quantitative data were analyzed using statistical software and thematic approaches were used for the analysis of qualitative data. RESULTS Most students reported satisfaction with the COBERS supervision; however, junior students were less satisfied with the supervision than the more senior students with more experience of community-based training. Although many supervisors assisted students before departure to COBERS sites, a significant number of supervisors made little follow-up while students were in the community. Incorporating the use of information technology avenues such as emails and skype sessions was suggested as a potential way of enhancing supervision amidst resource constraints without faculty physically visiting the sites. CONCLUSIONS Although many students were satisfied with COBERS supervision, there are still some challenges, mostly seen with the more junior students. Using information technology could be a solution to some of these challenges.
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Affiliation(s)
| | - Hussein Oria
- Makerere University, College of Health Sciences, Kampala, Uganda.
| | - Aggrey Dhabangi
- Makerere University, College of Health Sciences, Kampala, Uganda.
| | - Sarah Kiguli
- Makerere University, College of Health Sciences, Kampala, Uganda.
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Communities’ views, attitudes and recommendations on community-based education of undergraduate Health Sciences students in South Africa: A qualitative study. Afr J Prim Health Care Fam Med 2013. [PMCID: PMC4565441 DOI: 10.4102/phcfm.v5i1.456] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Medical and Health Sciences students in South Africa undertake community-based education (CBE). Health professionals based at host sites are jointly responsible for training of these students in conjunction with university staff. This study explored the communities’ views, attitudes and recommendations regarding CBE undertaken by these students, in order to improve the quality of community support for these programmes. Method A qualitative descriptive study was conducted at CBE placement sites of students from the Faculties of Health Sciences of the University of Limpopo (UL), University of KwaZulu-Natal (UKZN) and University of the Western Cape (UWC) during 2010 and 2011. Focus group discussions were held with site facilitators, community leaders and patients, and interviews were audio recorded, transcribed and translated into English where necessary. Data were analysed using NVivo (version 9). Findings CBE was seen to benefit communities, students and host institutions as there was perceived improvement of service delivery, better referral to hospitals and reduction of workloads on site staff. CBE was also seen as having potential for recruiting professionals who have better orientation to the area, and for motivating school pupils for a career in health sciences. Students acquired practical skills and gained confidence and experience. Challenges included poor communication between universities and host sites, burden of student teaching on site facilitators, cultural and religious sensitivity of students and language barriers. Conclusion The study revealed that communities have an important role to play in the CBE of future health care professionals. CBE activities could be better organised and managed through formalised partnerships.
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Talib ZM, Baingana RK, Sagay AS, Van Schalkwyk SC, Mehtsun S, Kiguli-Malwadde E. Investing in community-based education to improve the quality, quantity, and retention of physicians in three African countries. EDUCATION FOR HEALTH (ABINGDON, ENGLAND) 2013; 26:109-14. [PMID: 24200732 PMCID: PMC4156792 DOI: 10.4103/1357-6283.120703] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
CONTEXT The Medical Education Partnership Initiative (MEPI) is a $US 130 million program funded by the United States government supporting 13 African medical schools to increase the quantity, quality, and retention of physicians in underserved areas. This paper examines how community-based education (CBE) is evolving at MEPI schools to achieve these goals. METHODS We utilized data from the first two years of site visits and surveys to characterize CBE efforts across the MEPI network and provide detailed descriptions of three models of CBE among the MEPI programs. RESULTS There is widespread investment in CBE, with considerable diversity in the goals and characteristics of training activities among MEPI schools. Three examples described here show how schools are strengthening and evaluating different models of CBE to achieve MEPI goals. In Nigeria, students are being sent for clinical rotations to community hospitals to offload the tertiary hospital. In Uganda, the consistency and quality of teaching in CBE is being strengthened by adopting a competency-based curriculum and developing criteria for community sites. At Stellenbosch University in South Africa, students are now offered an elective year-long comprehensive rural immersion experience. Despite the diversity in CBE models, all schools are investing in e-learning and faculty development. Extensive evaluations are planned to examine the impact of CBE strategies on the health workforce and health services. DISCUSSION The MEPI program is stimulating an evolution in CBE among African medical schools to improve the quality, quantity, and retention of physicians. Identifying the strategies within CBE that are reproducible, scalable and optimize outcomes will be instructive for health professions training programs across the continent.
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Affiliation(s)
| | | | | | | | - Sinit Mehtsun
- The George Washington University, Washington DC, USA
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Diab P, Flack P. Benefits of community-based education to the community in South African health science facilities. Afr J Prim Health Care Fam Med 2013. [PMCID: PMC4709640 DOI: 10.4102/phcfm.v5i1.474] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Community-based education (CBE) is utilised by health science faculties worldwide to provide a relevant primary care experience for students and a service to underserved communities and, hopefully, to affect student career choices. The benefits to training institutions and students are well documented, but it may well be that communities, too, will be able to benefit from a more balanced partnership, where they are consulted in the planning of such training programmes. Method An exploratory qualitative study was undertaken by three South African universities in the provinces of Limpopo, KwaZulu-Natal and the Western Cape. Focus group interviews were conducted in their local languages with groups of community leaders, patients and supervisors at community sites involved in CBE training. A thematic analysis of their views was undertaken with the aid of NVivo (version 9). Ethics approval was obtained from the respective universities and health care training sites. Results Benefits to the community could be categorised into short-term and long-term benefits. Short-term benefits included improved service delivery, reduction in hospital referrals, home visits and community orientated primary health care, improved communication with patients and enhanced professionalism of the health care practitioner. Long-term benefits included improved teaching through a relationship with an academic institution and student familiarity with the health care system. Students also became involved in community upliftment projects, thereby acting as agents of change in these communities. Conclusion Communities can certainly benefit from well-planned CBE programmes involving a training site - community site partnership.
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Affiliation(s)
- Paula Diab
- Department of Rural Health, College of Nursing & Public Health, Howard College Campus, University of KwaZulu-Natal, South Africa
| | - Penny Flack
- Discipline of Speech Language Pathology, College of Health Sciences, Westville Campus, University of KwaZulu-Natal, South Africa
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Pariyo G, Serwadda D, Sewankambo NK, Groves S, Bollinger RC, Peters DH. A grander challenge: the case of how Makerere University College of Health Sciences (MakCHS) contributes to health outcomes in Africa. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2011; 11 Suppl 1:S2. [PMID: 21411002 PMCID: PMC3059474 DOI: 10.1186/1472-698x-11-s1-s2] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND "Grand challenges" in global health have focused on discovery and development of technologies to save lives. The "grander challenge" involves building institutions, systems, capacity and demand to effectively deliver strategies to improve health. In 2008, Makerere University began a radical institutional change to bring together four schools under one College of Health Sciences. This paper's objective is to demonstrate how its leadership in training, research, and services can improve health in Uganda and internationally, which lies at the core of the College's vision. METHODS A comprehensive needs assessment involved five task forces that identified MakCHS's contribution to the Ugandan government health priorities. Data were collected through analysis of key documents; systematic review of MakCHS publications and grants; surveys of patients, students and faculty; and key informant interviews of the College's major stakeholders. Four pilot projects were conducted to demonstrate how the College can translate research into policy and practice, extend integrated outreach community-based education and service, and work with communities and key stakeholders to address their priority health problems. RESULTS MakCHS inputs to the health sector include more than 600 health professionals graduating per year through 23 degree programs, many of whom assume leadership positions. MakCHS contributions to processes include strengthened approaches to engaging communities, standardized clinical care procedures, and evidence-informed policy development. Outputs include the largest number of outpatients and inpatient admissions in Uganda. From 2005-2009, MakCHS also produced 837 peer-reviewed research publications (67% in priority areas). Outcomes include an expanded knowledge pool, and contributions to coverage of health services and healthy behaviors. Impacts include discovery and applications of global significance, such as the use of nevirapine to prevent HIV transmission in childbirth and male circumcision for HIV prevention. Pilot projects have applied innovative demand and supply incentives to create a rapid increase in safe deliveries (3-fold increase after 3 months), and increased quality and use of HIV services with positive collateral improvements on non-HIV health services at community clinics. CONCLUSION MakCHS has made substantial contributions to improving health in Uganda, and shows great potential to enhance this in its new transformational role - a model for other Universities.
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Affiliation(s)
- George Pariyo
- HQ/HWA Global Health Workforce Alliance, World Health Organization, Geneva, Switzerland
| | - David Serwadda
- College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Sara Groves
- Johns Hopkins School of Nursing, Baltimore, Maryland 21205, USA
| | | | - David H Peters
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA
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Kaye D, Mwanika A, Burnham G, Chang LW, Mbalinda SN, Okullo I, Nabirye RC, Muhwezi W, Oria H, Kijjambu S, Atuyambe L, Aryeija W. The organization and implementation of community-based education programs for health worker training institutions in Uganda. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2011; 11 Suppl 1:S4. [PMID: 21411004 PMCID: PMC3059476 DOI: 10.1186/1472-698x-11-s1-s4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Community-based education (CBE) is part of the training curriculum for most health workers in Uganda. Most programs have a stated purpose of strengthening clinical skills, medical knowledge, communication skills, community orientation of graduates, and encouragement of graduates to work in rural areas. This study was undertaken to assess the scope and nature of community-based education for various health worker cadres in Uganda. Methods Curricula and other materials on CBE programs in Uganda were reviewed to assess nature, purpose, intended outcomes and evaluation methods used by CBE programs. In-depth and key informant interviews were conducted with people involved in managing CBE in twenty-two selected training institutions, as well as stakeholders from the community, Ministry of Health, Ministry of Education, civil society organizations and local government. Visits were made to selected sites where CBE training was conducted to assess infrastructure and learning resources being provided. Results The CBE curriculum is implemented in the majority of health training institutions in Uganda. CBE is a core course in most health disciplines at various levels – certificate, diploma and degree and for a range of health professionals. The CBE curriculum is systematically planned and implemented with major similarities among institutions. Organization, delivery, managerial strategies, and evaluation methods are also largely similar. Strengths recognized included providing hands-on experience, knowledge and skills generation and the linking learners to the communities. Almost all CBE implementing institutions cited human resource, financial, and material constraints. Conclusions The CBE curriculum is a widely used instructional model in Uganda for providing trainee health workers with the knowledge and skills relevant to meet community needs. Strategies to improve curricula and implementation concerns need further development. It is still uncertain whether this approach is increasing the number graduates seeking careers in rural health service, one of the stated program goals, an outcome which requires further study.
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Affiliation(s)
- Dan Kaye
- Johns Hopkins School of Public Health, Baltimore, Maryland, 21205, USA.
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Mwanika A, Okullo I, Kaye DK, Muhwezi W, Atuyambe L, Nabirye RC, Groves S, Mbalinda S, Burnham G, Chang LW, Oria H, Sewankambo N. Perception and valuations of community-based education and service by alumni at Makerere University College of Health Sciences. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2011; 11 Suppl 1:S5. [PMID: 21411005 PMCID: PMC3059477 DOI: 10.1186/1472-698x-11-s1-s5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background Training of health professionals can be deliberately structured to enhance rural recruitment by exposing the trainees to the realities of rural life and practice through Community-Based Education and Service (COBE) programs. Few studies have surveyed the alumni of these programs to establish their post-university views and whether the positive impact of COBE programs endures into the post-university life. This study surveyed the alumni of COBE at Makerere to obtain their perceptions of the management and administration of COBE and whether COBE had helped develop their confidence as health workers, competence in primary health care and willingness and ability to work in rural communities. Objectives • To assess the efficiency of the management and administration of COBES. • To obtain the views of the impact of COBES on its alumni. Methods A mixed qualitative and quantitative study was conducted using focus group discussions (FGD) and a telephone administered questionnaire. From a total of 300 COBES alumni 150 were contacted. Twenty four Alumni (13 females and 11 males) were purposefully selected by discipline, gender and place of work, and invited for the focus group discussion. The discussions were transcribed and analyzed using a manifest content analysis table. The thematic issues from the FGDs were used to develop a structured questionnaire which was administered by telephone by the authors. The data were entered into Microsoft excel template and exported to Stata for analysis. The findings of the telephone survey were used to cross-match the views expressed during the focus group discussions. Results The alumni almost unanimously agree that the initial three years of COBES were very successful in terms of administration and coordination. COBES was credited for contributing to development of confidence as health workers, team work, communication skills, competence in primary health care and willingness to work in rural areas. The COBES alumni also identified various challenges associated with administration and coordination of COBES at Makerere. Conclusions This study has established that the positive impact of COBES endures with the alumni of the program. Health planners should take advantage of the impact of COBES and provide it with more support.
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Affiliation(s)
- Andrew Mwanika
- College of Health Sciences, Makerere University, Kampala, Uganda.
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