EFFECT OF A RURAL COMMUNITY HEALTH POSTING ON MEDICAL STUDENTS' KNOWLEDGE OF THE HEALTH EDUCATION ASPECTS OF PRIMARY HEALTH CARE

Abstract

This evaluation case study looks at the effect of the rural Ibarapa Community Health posting on medical student attitudes and knowledge of the health education aspects of primary health care.The Igboora rural campus of the College of medicine, university of lbadan served as site for the research which covered six months. Pre and post tests, participant observation, and documentary sources were the data gathering instruments used to study 11 fourth year medical students who undertook the rural Ibarapa Community Health posting. Ibarapa posting is unique in medical education not only in Africa but other parts of the world because health education is given prominence both in the posting syllabus, and also in programme implementation. Specific health education skills which medical students learn include patient counseling, group health presentations, social and behavioural diagnosis of individual patients and communities, school health education, assessment of behavioural Implications of health service design. and training and supervision of volunteer primary health workers. While post test results indicate a statistically significant increase in knowledge concerning health education concept In the context of primary health care, the overall level of knowledge still required improvement. Generally, student attitudes on primary health care shifted from slightly favourable to more favourable by the end of the posting but there remained areas where students were reluctant to embrace PHC fully. For example a sizeable minority expressed caution about the desirability for non-physician members of the health team to diagnose and treat minor ailments in communities ,and were of the opinion that the leadership of PHC teams should be vested in medical doctors only. The main reason adduced for performances below expectation appeared to be inadequate time for the posting to enable in-depth coverage of all aspects of the posting syllabus. In view of this shortcoming, coupled with the historic and continued importance attached to the posting programme by University authorities, it is recommended that a three to four months posting period be arranged. It is hoped that the findings of this study will be useful to those responsible for the development and improvement of the health education curricula in the context of PHC for medical Students not only Ibadan but throughout Africa.