TY - JOUR
T1 - Undergraduate students' contributions to health service delivery through community-based education
T2 - A qualitative study by the MESAU Consortium in Uganda
AU - Atuyambe, Lynn M.
AU - Baingana, Rhona K.
AU - Kibira, Simon P.S.
AU - Katahoire, Anne
AU - Okello, Elialilia
AU - Mafigiri, David K.
AU - Ayebare, Florence
AU - Oboke, Henry
AU - Acio, Christine
AU - Muggaga, Kintu
AU - Mbalinda, Scovia
AU - Nabaggala, Ruth
AU - Ruzaaza, Gad
AU - Arubaku, Wilfred
AU - Mary, Samantha
AU - Akera, Peter
AU - Tumwine, James K.
AU - Peters, David H.
AU - Sewankambo, Nelson K.
N1 - Funding Information:
This work was made possible by MEPI grant number 5R24TW008886 from the Office of Global AIDS Coordinator and the U. S. Department of Health and Human Services, Health Resources and Services Administration and National Institutes of Health. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the US government.
Funding Information:
Uganda currently has 6 pre-service medical training institutions. In 2010, five of them: Makerere University College of Health Sciences (MakCHS), Gulu University (GU), Mbarara University of Science and Technology (MUST), Kampala International University (KIU) and Busitema University (BU) came together to form Medical Education for Equitable Services to All Ugandans consortium (MESAU) with funding from the US Government-supported Medical Education Partnership Initiative (MEPI) and technical support from Johns Hopkins University [12, 13]. MESAU is the first nation-wide consortium approach to addressing medical education in Uganda with the overall aim of standardising medical education and developing the partner institutions as centres of excellence for medical education, research and service that address local and national needs to improve health in Uganda. One of MESAU’s objectives is to improve the quality and relevance of medical education in order to produce health workers with the competencies and motivation to deliver locally relevant services. Each of the MESAU institutions has implemented CBE as an integral part of their respective curricula for varying lengths of time since 1989. Community-based education, research and service (COBERS), the MESAU model of CBE, is a key performance area for the consortium institutions. Although the MESAU institutions place their students for community exposure in different years of study [14], they have common goals and site selection criteria for COBERS. Before students go to the sites, they are briefed and are given overview lectures that introduce them to community health, PHC and what to expect during their COBERS attachment.
Publisher Copyright:
© 2016 Atuyambe et al.
PY - 2016/4/25
Y1 - 2016/4/25
N2 - 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.
AB - 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.
KW - Community-based education
KW - Contribution
KW - Health service
KW - MESAU
KW - Qualitative
KW - Uganda
KW - Undergraduate students
UR - http://www.scopus.com/inward/record.url?scp=84964529074&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84964529074&partnerID=8YFLogxK
U2 - 10.1186/s12909-016-0626-0
DO - 10.1186/s12909-016-0626-0
M3 - Article
C2 - 27114073
AN - SCOPUS:84964529074
SN - 1472-6920
VL - 16
JO - BMC medical education
JF - BMC medical education
IS - 1
M1 - 123
ER -