Promotion of a primary healthcare philosophy in a community-based nursing education programme from the students’ perspective

Abstract

The traditional teaching approach has been criticised for not equipping health professionals with the necessary knowledge and skills to work in rural, remote and under-resourced communities. [1,2] The conventional approach focuses on hospital-based, curative-focused teaching, which relies on sophisticated technology. Furthermore, upon graduation, many nurses are reluctant to work in rural, underprivileged areas, where resources are scant and the focus is on healthcare and prevention. [2] This instructional approach hinders the equal distribution of health professionals in South Africa (SA) and therefore the quality of services provided to its citizens. This, in turn, impedes the promotion of primary healthcare (PHC). The World Health Organization (WHO) defines PHC as 'essential healthcare based on practical scientifically sound and socially sound acceptable method and technology, universally accessible to all in the community through their full participation; at an affordable cost, and geared toward self-reliance and self-determination'. [3] PHC is therefore an approach to healthcare that promotes the attainment by all people of a level of health that will permit them to live socially and economically productive lives. Healthcare is essential, practical, socially and scientifically sound (evidence based), ethical, accessible, equitable, affordable, and accountable to the community. Furthermore, PHC is more than primary medical or curative care or a package of low-cost medical interventions for the poor and marginalised. To address these challenges, the WHO, International Council of Nurses (ICN) and South African Nursing Council (SANC) recommended the implementation of a community-based education (CBE) programme as part of the teaching curriculum in the training of nurses. [2,4-6] CBE refers to learning activities that take place in a particular setting, i.e. the community setting. [7] Students are allocated to different communities (urban, peri-urban and rural or semi-rural) to undertake activities relevant to community health needs and that address community health-related needs. CBE may contribute to solve the inequity in service delivery by producing healthcare professionals who are willing and able to work in underserved areas, particularly rural communities. [8,9] CBE also offers opportunities for students to learn in situations similar to those in which they might work later in their professional lives. It may equip students with transferable core competencies that they would not learn otherwise, such as leadership skills, the ability to work in teams, and the capability to interact with the community. The South African Department of Education (DoE) and the Council on Higher Education (CHE) endorse the implementation of CBE as a responsive educational method. [10] Furthermore, the Department of Health (DoH) (SA), in the 1997 White Paper on the Transformation of the Health System, highlighted that in order to align nursing education with PHC the curriculum should be based on community needs and linked to PHC...

A case study: Promoting interprofessional community-based learning opportunities for health sciences students at the University of KwaZulu-Natal, Durban, South Africa

“…It also demonstrates application of PHC principles, specifically to identify needs through community participation and implementing interventions using available resources to address these health issues. This is further supported by Ndateba et al, [12] who claim that the approach of first identifying healthcare problems and validating the needs of communities through appropriate interventions in line with PHC philosophy. In this initiative, students put into practice the theory of PHC principles learnt.…”

Assessing community members’ knowledge and attitude towards Community-Based Education practices in Southern Ethiopia

“…The main reason behind this was the encouragements of primary and secondary school students on the program practices mostly during the time of university health students working on CBE practices were searching to find and solve problems of the school environment. Learners tend to share their knowledge and doing peer review in many subjects, including CBE program (Michaels et al, 2017), managing (Kruger et al, 2015), making evaluation on it (Bailey et al, 2016), and even finding the solution for the issues arise (Dreyer et al, 2016;Ndateba et al, 2015). Therefore, it makes sense that students tend to have better knowledge in CBE practices.…”

‘We thought we would just be following the district nurse around’: Innovation in Australian student nursing placements in rural primary health care.

“…Conventional placement approaches are often health service based, where the focus is on treatment and management rather than contextually relevant promotion and early intervention as recognized in primary health care (Lewis & Kelly, 2018;McInnes et al, 88| JPNEP Volume 1, Issue 2 Reid et al 2015; Ndateba et al, 2015). A comprehensive primary health care approach is a whole-ofsociety strategy that seeks to equitably maximize the level and distribution of people's health and wellbeing needs and preferences (Irwin & Scali, 2005;Wilkinson & Marmot, 2003).…”

“…The placement model sought to provide a learning experience of rural primary health care as a social model of health where service provision connects to the needs of the community (Ndateba et al, 2015). It was important for the placement to increase student nurses' understanding of the social determinants of health within everyday contexts (Golden et al, 2015).…”