Abstract
BackgroundIt 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.MethodsThis 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.ResultsTwo 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.ConclusionHealth 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.
Highlights
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
Our results show that students were learning; they were contributing to health service delivery
This study provides evidence that students contribute to health service delivery at health facility and community levels
Summary
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. 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. Community-based education (CBE) involves the integration of education and practice in the community within the learning process [1]. Three of the principles of CBE are key to this study: (i) CBE is a standard, integral, and continuing part of the educational process, program and curriculum, not a peripheral or casual experience; (ii) the community must be actively involved in the educational program and there must be clear benefits to both the student and the community; (iii) the students’ work during training must be “real work” that is related to their educational needs, and forms part of the requirements for qualification [1]. The competencies should describe the student’s ability to apply basic and other skills in situations that are commonly encountered in everyday health professional practice
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