1. COBES
DEFINITION OF:
A LEARNING STRATEGY.
SERVICE-LEARNING

2. RATIONALE OF COBES PROGRAMMES IN GENERAL
Community-Based Education may contribute to the solution of the problem of inequity in service delivery
makes health services available to the community as soon as students begin to learn in that community
The school may play an influential role in regional health policy development (through its staff, students and graduates)
Prevention and health promotion as well as curative care
WHY?

3. RATIONALE OF COBES PROGRAMMES IN GENERAL
CBE may improve health professions education
Enables students to relate theoretical knowledge and practical training
Contextual learning (close resemblance between the learning situation and “real life” leads to better performance)
CBE may equip students with competencies which they will never learn otherwise
WHY?

4. RATIONALE OF COBES PROGRAMMES IN GENERAL
CBE renders opportunities for partnership between the community, university and government
CBE may help to develop and update the curriculum using health priority data
CBE offers students an opportunity to learn and work with other health professionals
WHY?

5. Its aim is to produce community-oriented health workers who are able and willing to serve their communities and deal effectively with health problems at primary, secondary and tertiary level
HOPE  DOPE
It serves the purpose of a health-oriented physician education (HOPE) rather than a disease-oriented physician education (DOPE)
Handbook of Community-Based Education, Schmidt et al, 2000

6. RATIONALE OF COBES PROGRAMME
MAKARERE UNIVERSITY KAMPALA
(Dr. Andrew Mwanika, COBES workshop, MUK, 2nd – 5th of August 2005)
To facilitate the placement of the university’s graduates in the districts.
As most of them are born and grow up in urban areas, they - understandably - have little to bind them to rural districts.

7. RATIONALE OF COBES PROGRAMME
MAKARERE UNIVERSITY KAMPALA
(Dr. Andrew Mwanika, COBES workshop, MUK, 2nd – 5th of August 2005)
To facilitate the placement of the university’s graduates in the districts. As most of them are born and grow up in urban areas, they - understandably - have little to bind them to rural districts.
To achieve contextual learning, by confronting students with the day-to-day realities of the health care delivery system in Uganda from the early stages of their training

8. RATIONALE OF COBES PROGRAMME
MAKARERE UNIVERSITY KAMPALA
(Dr. Andrew Mwanika, COBES workshop, MUK, 2nd – 5th of August 2005)
To facilitate the placement of the university’s graduates in the districts. As most of them are born and grow up in urban areas, they - understandably - have little to bind them to rural districts.
To achieve contextual learning, by confronting students with the day-to-day realities of the health care delivery system in Uganda from the early stages of their training
To integrate the priority health programmes of the Ministry of Health in to the undergraduate medical education

9. RATIONALE OF COBES PROGRAMME
MAKARERE UNIVERSITY KAMPALA
(Dr. Andrew Mwanika, COBES workshop, MUK, 2nd – 5th of August 2005)
To facilitate the placement of the university’s graduates in the districts. As most of them are born and grow up in urban areas, they - understandably - have little to bind them to rural districts.
To achieve contextual learning, by confronting students with the day-to-day realities of the health care delivery system in Uganda from the early stages of their training
To integrate the priority health programmes of the Ministry of Health in to the undergraduate medical education
COBES MUK

10. SO WHAT? OR
WHAT CAN WE DO?

11. HOW CAN THE COBES PROGRAM BE STRENGHTENED BY OUR DEPARTMENT?
HOW CAN OUR DEPARTMENT BENEFIT FROM THE COBES PROGRAM?
HOW CAN THE COBES PROGRAM BE STRENGHTENED BY OUR DEPARTMENT?
End

12. WHAT IS COBES? A compulsory component of the curriculum
 students can not graduate if they do not take part in COBES
A response to certain needs in the country:
maldistribution of health professionals: rural  urban
graduates lack knowledge about community health needs
graduates will work in decentralized district health services
graduates lack leadership and management skills
need for more community research
graduates lack cultural competence

13. COBES GOALS
To integrate priority national health programs into the undergraduate training program
To produce graduates who are well equipped to function effectively in the districts
Serve as a tool for integrating strategic and synergic interests

14. Community participation Facility based activities
COBES OBJECTIVES
Acclimatization
Home based care
School health
Community participation
Facility based activities
Management and administration
Partnerships with CBO’s
Curricular objectives (tutorials)

15. STRUCTURE OF COBES
Pre-placement
- district entry
- criteria of site selection
- training of site tutors
- briefing of students
- grouping of students
- student and tutor guides
- money

17. No specific COBES activities
STRUCTURE OF COBES
COBES activities
First semester
Second semester
Recess
1st
year
8 weeks (2+6)
2nd year
5 weeks (4+1)
3rd year
4th
5th
No specific COBES activities
5 weeks
(4 + 1)

18. - progressive (logbooks / reports) - panel assessment - summative
STRUCTURE OF COBES
Supervision
- site tutor
- faculty of MUK-FoM
Assessment
- progressive (logbooks / reports)
- panel assessment
- summative
Group work

19. BENEFITS OF COBES
Now three years of experience and students remain positive (even less complaints than previously)
Communities and staff at the health care facilities are very happy about the programme
District authorities also very pleased, several districts wanting to be included as well

20. BENEFITS OF COBES
Students have learned a lot of practical skills but also knowledge about the health care system and traditional health care
Faculty staff is exposed to community health problems as well as the students
Partnership with AIM  track patients in the community (e.g. all medicines mixed up together, lack of treatment education)

21. CHALLENGES Sustainability - fees - partnerships - donor support
Supervision
- high turnover of site tutors
- “touristic visits” by faculty staff
Learning materials
Administration
Assessment