Assessing community perspectives of the community based education and service model at Makerere University, Uganda: a qualitative evaluation

Abstract

BackgroundCommunity partnerships are defined as groups working together with shared goals, responsibilities, and power to improve the community. There is growing evidence that these partnerships contribute to the success and sustainability of community-based education and service programs (COBES), facilitating change in community actions and attitudes. Makerere University College of Health Sciences (MakCHS) is forging itself as a transformational institution in Uganda and the region. The College is motivated to improve the health of Ugandans through innovative responsive teaching, provision of service, and community partnerships. Evaluating the COBES program from the community perspective can assist the College in refining an innovative and useful model that has potential to improve the health of Ugandans.MethodsA stratified random sample of 11 COBES sites was selected to examine the community’s perception of the program. Key Informant Interviews of 11 site tutors and 33 community members were completed. The data was manually analyzed and themes developed.ResultsCommunities stated the students consistently engaged with them with culturally appropriate behaviour. They rated the student’s communication as very good even though translators were frequently needed. Half the community stated they received some feedback from the students, but some communities interpreted any contact after the initial visit as feedback. Communities confirmed and appreciated that the students provided a number of interventions and saw positive changes in health and health seeking behaviours. The community reflected that some programs were more sustainable than others; the projects that needed money to implement were least sustainable. The major challenges from the community included community fatigue, and poor motivation of community leaders to continue to take students without compensation.ConclusionsCommunities hosting Makerere students valued the students’ interventions and the COBES model. They reported witnessing health benefits of fewer cases of disease, increased health seeking behavior and sustainable healthcare programs. The evidence suggests that efforts to standardize objectives, implement structural adjustments, and invest in development of the program would yield even more productive community interactions and a healthcare workforce with public health skills needed to work in rural communities.

Home-based rehabilitation: Physiotherapy student and client perspectives

“…Therefore, agreeing with Prose et al, [8] the possibility of a more timely course, which also promotes cultural competence, should be investigated. We agree with Mbalinda et al [6] that a translator, who could also aid cultural understanding, can be a valuable communica tion tool. Although an interpreter accompanied the participants in this study on their home visits, there was still a barrier in communication with the client.…”

“…[2,4,6] The students stated that being proficient in isiXhosa would have helped in HBR to minimise the verbal communication barrier. They reported that an introductory isiXhosa course in their 1st year seemed irrelevant to them at the time.…”

“…As noted in a study on educa tion in a community, collaboration with peers in the form of more comprehensive handover is necessary to build on what previous students achieved. [6] Early exposure to the clinical environment as part of an integrated curriculum has been shown to increase student motivation and lead to deeper learning. [3,4] Students suggested that earlier exposure may assist in overcoming the initial 'culture shock' .…”

“…Students report feeling overwhelmed when witnessing the realities of life in poor households. [4][5][6] Factors such as diverse socioeconomic, racial, language and cultural backgrounds may affect healthcare interventions. Developing cultural competency, i.e.…”

Community-based pedagogy of nursing in developing countries: An integrative review

“…The theme revealed positive outcomes based on several factors, including collaborative partnership, impact to student learning, [12,36,[45][46][47][48][49][50] community academic partnership, [51,52] cultural competence, [6,41,42] faculty-student relationship [20] and access to funding and developing a relationship between the university and community. [6,8,36,53] Linda et al [8] used an interpretive existentialistphenomenological approach to describe a community-based education program.…”