More about Community Practice
Department of Community Practice
Makerere University, Uganda
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More about Community Practice |
Department of Community Practice Makerere University, Uganda |
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More Information About Community Practice: The UNICEF/WHO conference in Alma-Ata
1978 identified primary health care as the most cost effective way to
deliver health services. Numerous studies over the last 30 years have
shown large variations in health outcomes even amongst countries with
similar spending/income, education and socio-economic factors. The way in
which a country organises its primary health care makes a critical
difference. The essence of primary health care is addressing the most important
health needs of individuals and populations at the community level, where
people live and work. The Health Sector Strategic
Plan (HSSP) and Ugandan national Minimum Health Care Package (UNMHCP)
define clear priority areas. Health care delivery systems will need
strengthening to realise the realistic and achievable goals of this
policy. This involves strengthening the coordination and cooperation
amongst health care workers outside the hospital setting. There is a need
for comprehensive services instead of the many separate “selective”
programs concentrating on specific initiatives. A
family physician is a doctor who has undergone post-graduate training in
clinical and management skills for primary health care.
They become specialists in the common diseases of every branch of medical
practice from assuring the likelihood of a healthy gestation to helping
people die with dignity. The practice of family doctors and
primary health care teams has been established for very many years around
the world and is undergoing rapid development in many other regions e.g.
South East Asia, Russia, China, Eastern Europe and South America. The
Ministry of Health have demonstrated their value of this course by
awarding graduates “medical officer special grade”
allowing them to proceed through the pay and seniority scales to
consultant status This
3 years Masters programme for doctors is designed to equip them with the
knowledge, skills and attitudes needed to strengthen health care services
and deliver the targets of the Ugandan National Minimum Health Care
Package (UNMHCP). Family doctors provide a
variety of services for individuals, families and communities including
preventative and curative health care. As coordinators they connect the
different tiers of health care provider linking village health workers
with academic teaching hospitals. They have an important role as a focus
to integrate commonly fragmented elements of the health care system. The title “M.Med Community
Practice” has caused some confusion. In the UK graduates from similar
postgraduate courses are called general practitioners, whilst in other
countries the status is family physician. To keep with international
recognition the department has adopted the name of ‘family doctors’
for its graduates. Doctors on the course will be known as Senior House
officers (SHO’s) in Community Practice. A community is any group of people
with a common feature e.g. live in the same village, attend the same
church. The smallest of all communities is a family. When integrated into a primary health
care team, family doctors can function more effectively and enhance the
capacity of the team to deliver more comprehensive services to patients (BMA
1974). Family doctors have been shown to raise the quality and complexity
of services delivered by a primary health care team. They work as team leaders to educate,
motivate and supervise the midwives, clinical officers, comprehensively
trained nurses and village health care workers who form the first point of
contact of patients with health care services. A family physician is a specialist in
the many common diseases seen in all fields of medical practice. They deal
with complex early presentations of unsorted problems outside the hospital
setting. The
advantages of effective primary health care teamwork: 1,
Care given by a group is greater than the sum of individual care VALUE OF FAMILY PHYSICIANS IN
HEALTH SERVICE DELIVERY -
Planning and setting objectives Health
Sector Strategic Plan (HSSP2000/1-2004/5) The
HSSP has been developed as a collaborative undertaking of the Ministry of
Health, related Ministries, the development partners and other stake
holders. The overall purpose of the plan is to reduce morbidity and
mortality from the major causes of ill health in Uganda and the
disparities there in. The 1998 Uganda Participatory Poverty Assessment
project identified ill health as the most frequent cause and reason for
poverty. The
HSSP contains policies on; ·
The Uganda National Minimum Health
Care Package (UNMHCP) ·
Health infrastructure ·
Quality assurance ·
Research and development ·
Information technology and management ·
Procurement of drugs and supplies The Uganda National
Minimum Health Care Package (UNMHCP) The
components of the UNMHCP are ·
Control of communicable diseases.
(Malaria, sexually transmitted diseases, HIV, TB)
The commonest cause of death in Uganda and illness across the age
profile. Also a need for intensified surveillance to help prevent and
better manage epidemics, and monitoring of existing anti-malarial drugs ·
Integrated management of childhood
illnesses Education Strategies, Teaching Methods and Assessment We learn in
a variety of ways from numerous sources. As a postgraduate program, the
emphasis is on self learning, reflective practice and problem based
approaches There will
be regular tutorials each week for the first and second year SHOs,
complemented with protected teaching time whilst in the hospital specialty
departments Doctors on
the course will carry out assignments and write reports, have examinations
at the end of each semester and keep a log book of activities e.g.
presentations given, courses attended, audit projects etc. For a SHO
to be full time, he/she will carry 9 – 15 credit units in a semester and
6 – 9 for a recess term. For each course registered for and attended as
required, there will be a university exam at the end of the semester where
the pass mark will be 50% |
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Copyright 2004 - Last updated on: 15
Jan 2004 |