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




                         Dr. Biraj Karmacharya
      Dhulikhel Hospital Kathmandu University Teaching Hospital,
                                  Nepal
Nepal
Nepal
                     General 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
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.

 – 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..
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
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
             Institutional Objective of the medical program of KUSMS
   – Holistic approach competent and socially responsible
          Technically to health
       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
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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GHF presentation

  • 1.
  • 2. Involvement of the health sciences students in the Community Health Development through Community Based Learning Dr. Biraj Karmacharya Dhulikhel Hospital Kathmandu University Teaching Hospital, Nepal
  • 4. Nepal General 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
  • 5. Health Sciences education in Nepal 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. – 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..
  • 6. 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
  • 7. 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 Institutional Objective of the medical program of KUSMS – Holistic approach competent and socially responsible Technically to health physicians to meet the existing emerging health needs
  • 8. 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
  • 9.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18. 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
  • 19. 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
  • 20. Community Based Learning • Limitations – Rather difficult in adjusting to new places and with new people. – Worse attitude towards the challenges (Discouraging effects) NOT ALWAYS !!
  • 21. Community Based Learning • Opportunities – Every community acts differently – Activities can be different – More systematic and scientific approach necessary – Involvement of foreign students
  • 22. Community Based Learning • Challenges – Trend of technology driven health sciences education – More financial drive/ glamour – Brain-drain