COMMUNITY BASED EDUCATION &

SERVICE(COBES)

By:

Andrew Mwanika

BACKGROUND

• Decentralisation

• Feasibility study.

• Curriculum change.

COBES

• What its not.

• A tool or learning strategy.

AS TOOL/STRATEGY

• Authentic learning context.

• Service Provision.

• Civic responsibility

• Strategic partnerships for Health

OBJECTIVES

• Prepare students for Rural Practice.

• Integrate Priority Health Programs into Training.

• Acclimatize students to rural districts

• Align training to Health needs.• Focus on households.

AUTHENTIC LEARNING CONTEXT

• Life is unstructured.

• COBES Motto: • “train Health workers in the communities they

will serve”

• Experiential learning.

• Assessment- Portfolio.

SERVICE PROVISION

• Primary health care & Family medicine

• Access to Health.

• Quality time.

• Service Penetration.

ACHEIVEMENTS

• Presence in 43 districts in all regions.

• High Level of acceptance.

• Community Based Health Projects.

• Effective learning.

• Partnerships.

Benefits of COBES to communities cont’d

• Kalisizo students’ project implementation report, January 2007 page iv, “We visited 22 Households in Nininzi village, installed 17 hand washing facilities in 17 households, increased availability of sanitary facilities in households of Nninzi, held a health information seminar and pioneered creation of a MODEL village in Kalisizo Town Council”

• Wakiso Project implementation report, November 2007, Page 5, “Successful de-worming of all people over 14 years who visited the out-patients department during the implementation period. De-worming of students and staff at selected schools was also accomplished successfully. Total coverage was 1,942 individuals. 800 were students and 1142 were people who had come to attend Out Patients department”.

Benefits of COBES to communities cont’d

Improving the life of thecommunities they are placed:

One of the householdmembers using the handwashing facility installedby the 4th year students ofKalisizo

Benefits of COBES to communities cont’d

Health Education:

One of the 4th year studentsat Wakiso Health Centergiving a health talk beforede-worming at the outpatient unit

Benefits of COBES to communities cont’d

Iganga students’ sanitation project visited 25 households in Nakavule village. We joined the towncouncil in a sanitation drive to clean the town. We got involved in cleaning of the town; sweepingthe reads and collection of rubbish”. (Students in red undergraduate coats)

A table showing students’ COBES projects proposed and implemented in 2007

Name of site Title of projects proposed by 3rd year students

Iganga Hospital Improving sanitation in Iganga Town Council

Kayunga Hospital A community project on Latrine covers and Hand washing facilities

Gombe Hospital Home-Based HIV Counselling and Testing in Gombe Community

Nkozi Hospital Increasing awareness of STIs other than HIV/AIDS among sexually active age group (15-49 years) in Nkozi sub county

Kiruddu Health Center

Assessment of the Nutritional status of children under 5 years in Makindye Division

Kawolo Hospital To reduce the morbidity and mortality due to malaria in Kawolo hospital catchments area

St. Stephen’s Hospital, Mpererwe

Reduction of HIV Prevalence among the youth in Mpererwe parish, Kawempe Division

Ndejje Health Center

Assessing the knowledge, attitudes and practice of alternative and conventional medicine in Ndejje community

Kumi Hospital Improving sexual and Reproductive Health in Ongino sub county, Kumi district

Kinoni Health Center

Assessment of the determining factors for the high burden of Malaria in Kinoni Health Sub County

A table cont’dName of site

Title of projects proposed by 3rd year students

Buluba Hospital

Home based water disinfections and safe storage

Lira Hospital Reduction of Malaria morbidity and Mortality among children below 5 years in Adekokwoki sub county, Lira district

Kiyeyi HC Improving adolescent health and contraceptive use in Kiyeyi Health Center III catchment area, Tororo

Rugazi HC Reduction of Malaria prevalence among pregnant women in Ryeru sub county, Bushenyi District

Kalisizo Hospital

Oral Health promotion among school going children aged between 6-12 years in Kalisizo

Wakiso HC Improving the human excreta disposal through health education in Bongole zone, Makindye Sabagabo sub county, Wakiso District

Projects Implemented by 4th year students

Wakiso HC Intestinal Worm Control in Wakiso Town Council

Kalisizo Hospital

To Promote personal and environmental sanitation and hygiene in Kalisizo community so as to reduce the disease burden thus ensuring an improved quality of life.

Kayunga Hospital

Diarrhoeal disease control in Children under five years in Kayunga Town Council

A table cont’d

Name of site

Kawolo Hospital

To increase awareness on sanitation among the community in Kinyoro Village

Kinoni HC Prevention of Malaria among under 5 Year old children in Kyabashukura village; Rwampara sub country, Mbarara District

Hoima Hospital

Information, Communication and Education about HIV/AIDS and STIs among adolescents in Hoima Town Council

Kawolo Hospital

Interventions geared towards the reduction of Malaria morbidity and mortality in Kawolo Hospital catchement area

Kiyeyi Health Center

Improving adolescent health and contraceptive use in Kiyeyi Health Center III catchment area, Tororo

Kalisizo Hospital

Promoting reduction of malaria prevalence in Kalisizo town Council

CHALLENGES

• Access to Learning Materials.

• Supervision.

• Student Welfare

• Sustainability.

POSSIBLE SOLUTIONS

• District resource centres.

• Family Medicine/ Portfolio

• District budgets, Fees, Transport

• National Policy, National budget, Partnerships.

CONCLUSION

• High Potential:

• Skill Shortage.

• H.R.H.crisis.

• Roll out to all tertiary institutions.

• National service.