Involvement of the health sciences students in the Community Health Development through Community

Based Learning

Dr. Biraj KarmacharyaDhulikhel Hospital Kathmandu University Teaching Hospital,

Nepal

Nepal

NepalGeneral statistics..

Average life expectancy: 63.7

Crude birth rate: 29.2/1000

Crude death rate: 8.5/1000

Total fertility rate: 3.1/woman

Infant mortality rate: 48/1000

Under 5 mortality rate: 61/1000

Births attended by skilled health staff: 18.7%

Population: per doctor: 18439; per hospital bed: 2349

Health Sciences education in Nepal

– In 1990: 1 medical college (Capacity of producing 40 doctors/year) for almost previous 15 years.

– In 2008: About 14 medical colleges (Capacity of producing about 1400 doctors/ year)

– Still more in pipeline..

– Similar growth in other allied health sciences field..

After the restoration of democracy in 1990 and liberal policies in the field of education and health sector, tremendous boom in the health sciences education in Nepal.

• Less addressed issues:– Dichotomy between

government health system and the private sector initiatives

– Poor integration of the health sciences institutions with the national health system

Health Sciences education in Nepal

Community Based Learning

• Principles– The setting in which the

students of health sciences get education does not always reflect the situation of the country in a broader sense.

– The need is to develop not just medicos but also leaders in their concerned fields.

– Real life exposure is essential

– Holistic approach to health

Institutional Objective of the medical program of KUSMS

Technically competent and socially responsible physicians to meet the existing emerging health needs

Community Based Learning

• Activities– Stay with the community– First understand the problems– Discuss on the problems– Plan interventions– Arrange for continuity of the

activities by the community– Different activities as per

different disciplines

Community Based Learning

• Experience so far….

– The extent of CBL is different in different institutions

– Dhulikhel Hospital Kathmandu University Teaching Hospital is a community based organization.

– Network of its own different community based outreaches in rural areas

– Platform for CBL activities for a holistic care

Community Based Learning

• Benefits– Change in perspective

– Unexpected situation/ challenges

– Real-life exposure to the different health related issues

– Sense of satisfaction because of reaching to the people who would have otherwise remained away from the services

– Less cost incurred for a greater volume of activities

– Encouragement for newer things

– Newer insights

Community Based Learning• Limitations

– Rather difficult in adjusting to new places and with new people.

– Worse attitude towards the challenges (Discouraging effects)

NOT ALWAYS !!

Community Based Learning

• Opportunities– Every community acts

differently– Activities can be

different– More systematic and

scientific approach necessary

– Involvement of foreign students

Community Based Learning

• Challenges

– Trend of technology driven health sciences education

– More financial drive/ glamour

– Brain-drain

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