Kenyan medical students are learning through a community outreach model

Kenyan medical and public health students provide healthcare to communities. Reuters/Katy Migiro

This is a time of unprecedented change in medical education globally. Medical schools, postgraduate bodies and other organisations are responding to rapid advances in medicine and changes in health care delivery.

New education approaches are being adopted to exchange information. This enables the institutions to produce relevant health professionals.

There are a number of innovations and models that are being explored to improve the learning of students studying medicine and public health. And institutions are learning from each other by sharing experiences on overcoming challenges they have faced during medical training.

For example, a Kenyan case study shows that partnerships between the higher education institution and the community are working. The way the partnership worked is featured in the Routledge International Handbook of Medical Education . It gives an account of the Moi University community programme that uses adaptive instruction for health trainees in the schools of medicine and public health.

Adaptive instruction is a student centred approach where they are given real life cases to solve health problems theoretically as tutorial cases.

This discussion, with the guidance of a tutor, promotes active learning.

The model – built an inter professional collaboration that benefits the community – is recognised globally because it encourages active learner participation in the provision of health services.

The experiential model

An early relationship with Linköping Universityin Sweden led to this unique staff and student exchange programme.

The aim of the Community Based Education and Service programme when it was set up at Moi University in 1989 was to give both students and teachers a chance to form partnerships with the community early in their careers.

The programme introduces the students to a community health framework where they work in rural health facilities as part of their continuous assessment. It means that graduates entering the profession are able to apply and practise knowledge and skills beyond the theoretical knowledge learnt at the university.

It has shaped the careers of its health graduates. It has also encouraged the promotion of health and health services in communities.

The program serves residents in the three former provinces, before devolution to counties – Rift Valley , Western and Nyanza.

The trainees are posted in:

  • 22 rural health centres within 11 districts, and

  • 19 urban health centres within 19 districts.

The activities are theoretical as well as practical so that students can be engaged fully in applying learnt principles.

From these experiences they are expected to handle community health programmes by providing preventive, promotive and curative care.

The students diagnose issues affecting the local community, develop a research proposal, work with district health management teams and implement activities. They conduct surveillance and monitor diseases and in the event of an epidemic, they are expected to respond effectively.

The students also master the principles of how rural health facilities are run.

How it works

The six week model is designed to produce students with competency in community health.

It begins with an introduction to community health and developing research proposals on issues affecting their placement stations.

The first two weeks are dedicated to teaching research methodology and community entry, followed by three weeks of attachment and a final week of presentation of the field attachment research findings.

The programme is divided into five phases:

  • Introduction to the community

  • Community diagnosis

  • Writing a research proposal

  • Investigation executing the research plan

  • District health service attachment

The research projects designed and implemented in phase three and four have produced fascinating reports with research topics that address issues affecting the communities.

Examples of popular projects include those that recognise women’s self help groups as change agents in alleviating malnutrition among children under five years.

There have also been initiatives that create awareness on hygienic food handling among kiosk food vendors in Eldoret.

Eldoret is the fifth largest town north west of Kenya with 500,000 residents. It hosts Moi University with a 30,000 student population.

The benefits of the teaching model

This is a unique niche for our graduates as it takes 20% to 30% of curriculum content and it makes the graduand socially responsible and accountable team players in health care delivery.

The students are responsive to community needs and the experience prepares them to work in rural practice and primary health care.

It has produced health professionals who have locally relevant skills to work in community service on completion of their training having been exposed to the realities of working in a health care set up in remote and rural areas.

The students gain experience on appropriate responses to how they can improve the health of rural communities where they are posted. They also learn about how they can be leaders that embrace the servant leadership model.

The way forward in medical education

Sharing our experience in the book was a useful resource for Moi University and other tertiary institutions that train health care professionals.

We hope that other tutors in Kenya, Eastern Africa and beyond the continent will benefit from this model.

The experience provides tutorial guidance towards building a resilient and experienced crop of health professionals at par with global health training standards.

This a bold step in moulding well rounded health professionals.

Professor Simeon Mining contributed a chapter “Community Development of Interprofessional practice in Kenya. He was one of the 199 authors from 26 countries who contributed to the compiled instructional book titled, ‘The Routledge International Handbook of Medical Education’