本科生通过社区教育对卫生服务提供的贡献：乌干达MESAU联盟的定性研究
Undergraduate students' contributions to health service delivery through community-based education: A qualitative study by the MESAU Consortium in Uganda.
作者信息
Atuyambe Lynn M, Baingana Rhona K, Kibira Simon P S, Katahoire Anne, Okello Elialilia, Mafigiri David K, Ayebare Florence, Oboke Henry, Acio Christine, Muggaga Kintu, Mbalinda Scovia, Nabaggala Ruth, Ruzaaza Gad, Arubaku Wilfred, Mary Samantha, Akera Peter, Tumwine James K, Peters David H, Sewankambo Nelson K
机构信息
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.
School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda.
出版信息
BMC Med Educ. 2016 Apr 25;16:123. doi: 10.1186/s12909-016-0626-0.
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.
背景
人们已经意识到，有必要在大多数人口居住的社区附近开展医学培训，以便使受训人员对在这些社区的未来实践形成正确态度。自20世纪90年代以来，基于社区的教育（CBE）越来越多地被纳入卫生专业课程，但学生在CBE期间对服务提供的贡献在很大程度上仍未得到记录。在本研究中，我们调查了本科卫生专业学生在CBE实习期间对初级卫生保健的贡献。
方法
这是一项定性研究，涉及为所有乌干达人提供公平服务的医学教育联盟（MESAU）。总体而言，我们进行了36次焦点小组讨论（FGD）：在12个CBE地点，分别与青年、男性和女性各进行一次讨论。此外，我们采访了64名社区关键信息提供者。所有数据都进行了录音、转录，并使用定性数据分析软件Atlas.ti Ver7进行了分析。
结果
出现了两个主题：学生在医疗机构层面的贡献和学生在社区层面的贡献。在第一个主题下，我们发现学生不仅在学习；他们还在医疗机构为卫生服务的提供做出了贡献。他们的贡献尤其受到社区成员的高度赞赏。学生被描述为有爱心、有同情心，随时可及，并且参与患者护理。他们愿意分享自己的知识和技能，并激发了关于职业道德的讨论。在第二个主题下，据报告学生参与了社区的水、环境卫生和个人卫生教育。学生为维护安全水源做出了贡献，向社区宣传饮用安全水和良好的卫生习惯（洗手和正确处理废物）。个人卫生促进在家庭层面（食品卫生、洗手、清洁）和公众层面进行。公共卫生教育扩展到了机构。在校学生对包括性和性健康在内的各种健康相关问题有了更多认识。
结论
MESAU机构的卫生专业学生对初级卫生保健的提供做出了有意义的贡献。我们建议撒哈拉以南非洲的所有卫生培训项目采用CBE。
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