School of Medicine, Ateneo de Zamboanga University, Zamboanga, Philippines.
Research and Extension, Zamboanga State College of Marine Sciences and Technology, Zamboanga, Philippines.
Front Public Health. 2021 Apr 29;9:612035. doi: 10.3389/fpubh.2021.612035. eCollection 2021.
Universal Health Care requires equal distribution of a health workforce equipped with competencies appropriate for local population needs. While health inequities persist in the Philippines, the Ateneo de Zamboanga University School of Medicine (ADZU-SOM) in Zamboanga Peninsula - an impoverished and underserved region - has demonstrated significant success retaining graduates and improving local health statistics. This study describes the qualitative evidence of ADZU-SOM students and graduates having positive impacts on local health services and communities, and the contextual factors associated with the school's socially-accountable mission and curriculum that contribute to these impacts. This qualitative study involved 41 one-on-one or group interviews conducted across seven participant groups (faculty, graduates, final-year students, health professionals, health workers, community members, community leaders). Gale et al's method for analyzing qualitative data in multi-disciplinary health research, WHO's "6 Building Blocks for quality health systems" framework and THEnet's social-accountability framework were used to organize and interpret data. Local community members, community leaders, and health staff consistently reported examples of ADZU-SOM students and graduate doctors developing health infrastructure and providing health education, health promotion, and disease prevention activities accessible to all population groups. Students and graduates suggested these impacts were due to a number of factors, including how ADZU-SOM's sandwich model of longitudinal community-engagement culminating in 10-months continuous community placement in the final year helped them develop a strong motivation for community service, the teachings and curriculum activities that focused on public health and the social determinants of health, and faculty's commitment and ability to operationalize ADZU-SOM's mission and values. Staff also reported impacts were driven by integration of regional and national health priorities as core curriculum, and involving local stakeholders in curriculum development. This study provides qualitative evidence that ADZU-SOM's curriculum content and immersive community placements are training a medical workforce that is strengthening local health systems and health infrastructure across all 6 WHO "Building Blocks for quality health systems." These findings suggest ADZU-SOM has managed to evolve a consciousness toward community service among final year students and graduates, adding evidence to the assertion it is a fully socially-accountable health professions institution.
全民医疗保健需要公平分配具备适合当地人口需求的能力的卫生人力。虽然菲律宾仍然存在卫生不公平现象，但在棉兰老岛的三宝颜雅典耀大学医学院（ADZU-SOM）——一个贫困和服务不足的地区——已经证明在留住毕业生和改善当地卫生统计数据方面取得了重大成功。本研究描述了 ADZU-SOM 学生和毕业生对当地卫生服务和社区产生积极影响的定性证据，以及与学校社会问责使命和课程相关的背景因素，这些因素促成了这些影响。这项定性研究涉及在七个参与者群体（教师、毕业生、应届毕业生、卫生专业人员、卫生工作者、社区成员、社区领导）中进行的 41 次一对一或小组访谈。Gale 等人用于分析多学科健康研究中的定性数据的方法、世界卫生组织的“6 个质量健康系统建设模块”框架和 THEnet 的社会问责框架用于组织和解释数据。当地社区成员、社区领导和卫生工作人员一致报告了 ADZU-SOM 学生和毕业医生为所有人开发卫生基础设施和提供健康教育、促进健康和疾病预防活动的例子。学生和毕业生认为这些影响归因于许多因素，包括 ADZU-SOM 的纵向社区参与三明治模式如何最终在最后一年进行 10 个月的连续社区安置，帮助他们对社区服务产生强烈的动机，专注于公共卫生和健康的社会决定因素的教学和课程活动，以及教师对 ADZU-SOM 使命和价值观的承诺和实施能力。工作人员还报告说，影响是由将区域和国家卫生重点作为核心课程纳入以及让当地利益攸关方参与课程开发推动的。本研究提供了定性证据，表明 ADZU-SOM 的课程内容和沉浸式社区安置正在培训一支医疗劳动力，这支劳动力正在加强所有 6 个世界卫生组织“质量健康系统建设模块”的当地卫生系统和卫生基础设施。这些发现表明，ADZU-SOM 已经成功地在最后一年的学生和毕业生中培养了一种社区服务意识，为其是一个完全具有社会责任感的卫生专业机构的说法增添了证据。
