About the Department
(Historical Background, Philosophy, Context and Prospects)
The department came into existence at the inception of the College of Health Sciences and is evolving as one of the core frameworks of the philosophy and actualization of the aspirations of the College.
Now in its eleventh year as an academic department, its formative years had been marked by a relatively rapid pace of infrastructural development and the dynamics of norming effectual teaching tradition, culture and standards.
To date the department has put in place infrastructure and governance frames geared towards fulfilling the deliverables in under-graduate medical education, the scope of which demands it offering teaching and learning processes in both the basic medical and clinical sciences faculties. Its operational base is the affiliated UUTH.
The discipline of community health is concerned with protecting, reserving and enhancing the health of communities and populations. Its purview which is very dynamic, recognizes the fact that health is determined by factors within the formal health sector and those outside it, and that demographic transition will necessitate transformation in health services system. These changes must be factored into undergraduate medical education.
The Department of Community Health faces the especial challenge of giving credence to a College Curriculum that aspires to be community-oriented. The content of teaching is guided by the minimum requirement of the regulatory body (NUC), but that does not preclude justified modifications.
The modalities and context of delivering knowledge and building skills are made to respond to local needs, while fulfilling the traditions and the highest standards of medical education, at the appropriate levels. Learning is provided through the classroom establishment – community continuum. Lectures start in the second undergraduate year, and the final examination incorporates completing a community based research project. The department recognizes that community health has a very dynamic purview. Thus, while students are taught traditional topics like the bases of biostatistics and primary health care, they will also be oriented to contemporary frameworks such as universal health coverage, social determinants of health and the implications of health transition. While students are enabled to gain knowledge on control of endemic communicable diseases, they are also primed on the vision of the health millennium development goals and the post-2015 global development agenda.
In the Nigerian context, the most likely independent work setting that faces a fresh medical graduate is that of a medical officer during national youth service. A few may later choose community health as a field of specialization. The undergraduate curriculum of the department is designed to realize (NUC) minimum expectation, but overall, study provided encompasses all the major areas of community health and the ten competences of public health.
FUNCTIONS OF THE COMMUNITY HEALTH DEPARTMENT
Activities in the department are clustered under three broad and interrelated functions:
1. Human Resource Development/Training
2. Service Delivery
1. Human Resource Development/Training
The aim of this function is to equip health professionals with a better understanding of health and its dynamics and also to develop competences in the various domains of public health.
This function is structure under the following templates:
(a) Training of medical students based on the MBBS Curriculum
(b) Training of medical doctors under the residency programmes of the National and West African Postgraduate Medical Colleges for obtaining fellowship of the respective colleges as specialists in community/public health.
(c) Training of PHC professionals for award of the diploma of the national Board for Community Health Officers.
(d) Practice attachment for various categories of public health trainees.
(e) Structured continuing professional education for in-house and outside health professionals.
The actualization of these training programmes is subject to the department receiving the appropriate accreditation from the authorized bodies and the availability of an effective configuration of staff. Training is undertaken at the UUTH itself and at the satellite facilities (Comprehensive Health Centre, Ukpom, Ikot Ayan PHC Centre and West Itam PHC Centre). Learning in practice opportunities are further undertaken at the new UUTH Health Centre at Ikot Akpamba in Nsit Ubium Local Government Area.
(f) In addition to the modalities above, the department is in a position to organize or host thematic ad-hoc training workshops or educational fora, when such opportunities arise.
2. SERVICE DELIVERY
CENTRE-BASED ACTIVITIES (in both UUTH and designated primary health care centres) (a) Family health Module
TWO-WAY REFERRAL (to and from other departments)
Follow-up on referred cases (principally communicable diseases, vaccine-preventable infections, nutrition/Diabetics); and other PHC Activities
(b) Epidemiology/Disease control-orientated clinic module for endemic diseases based on presenting index or referred cases. Community surveillance entails periodic reviewing of pattern of presenting complaints and systems and medicines prescription profiles in the health facility in the catchments communities.
(c) Desk Activity module consultation on health systems planning and management, intervention planning and implementation and specific activities/events.
Frequency of Activities (a, b, c, above)
(a) Family Health/ PHC services are provided on daily basis, but specific services (e.g. anti-retroviral treatment and directly observed treatment short-course clinics) may be day stratified on the bases of logistics and demand.
(b) This module is implemented on a weekly basis; medical students are involved during their rural posting.
(c) This module is operationalized as need arises but the demands of training and research may prompt pro-active exploration.
EXTENSION AND FIELD ACTIVITIES
Extension and field activities fall into 5 forms:
(a) Operationalization of the rural and rural-urban primary health care practice facilities, including referral/follow-up of cases between the centre and household and community.
(b) Participation in counterpart initiatives, that is, those activities initiated from outside (e.g. by Local, State or Federal Government Agencies or by donors or communities) in which the Centre/Community Health Department is invited to participate or provide technical back-up. At present, such activities include National Immunization Campaigns, Roll Back Malaria (RBM), Surveillance (HIV/AIDS, Acute Flaccid Paralysis for Polio) Mass Deworming of Children, Nutritional Supplementation and Primary Health Care Survey/Evaluation and various workshops.
(c) Development of practice models, for example, if the department has the mandate and resources to establish a satellite PHC facility in a designated community (as was the case for establishing state anti-retroviral treatment centres), and the UUTH fledgling comprehensive health centre at Ikot Akpamba.
(d) Back-up of Local Government PHC Clinics or State Ministry of Health outlets, at their invitation (for instance IMCI, PMTCT, SMAP, CBHP).
(e) Community Mobilization outreaches, whereby community visits are undertaken to initiate or foster interaction on health and development, or where there is a perceived health need.
Activities at such visits will include community diagnosis, information – sharing, technical assistance and problem-solving (where that is possible) and policy advocacy. Rationale
Participation in or exposure to these activities provides the student (or resident) an opportunity to be able to appreciate and develop some competences relevant to the wide diversity of public health functions. 3. Research Research shall be undertake not only as an academic imperative, but in sustaining the desirable cycle of service improvement and innovation whereby service provision generates insight and challenges for research, and the findings therefrom are put into practice. Research is a continuous process, and so the department will provide a viable setting for individual, group, institutional and networking and collaborative research efforts. MBBS CURRICULUM
EDUCATIONAL OBJECTIVES OF THE COMMUNITY HEALTH UNDERGRADUATE CURRICULUM Over-arched by the vision and mission of the University of Uyo and underpinned by the aims and objectives of the College of Health Sciences, the educational objectives of the department of community health MBBS curriculum are; to
1. Introduce to the student, the concept and purview of community health and its relevance in the health care system of Nigeria.
2. Familiarize the students with the major communicable and non-communicable diseases in Nigeria and the measures adopted to control them.
3. Equip the students with the knowledge and skills needed to work as a medical graduate with minimal supervision in the primary health care setting in Nigeria, in collaboration with other members of the health team in order to reduce morbidity and mortality in the community and also to improve the quality of life generally.
4. Orientate the students to a holistic perspective of health and illness.
5. Impart to the students the basic skills and knowledge for assessing health situations and services and for evaluating health action and outcome.
6. Fulfill the NUC approved academic standards requirements as it pertains to community health.
The curriculum has been developed to meet the present needs of the students, institution and society, and it has the potential to evolve in response to future needs. The content is formulated at the appropriate level for undergraduate medical education as guided by the minimum standard precepts made available by the NUC, but local relevance commands prime consideration. Administrative arrangements, physical environment, teaching methods and institutional stability are factors that will affect delivery of the curriculum to achieve expected outcome. Each of these aspects can be evaluated as an integral part of the rubric of minimum standards. Community health education expressed in this curriculum is designed to be actualized in two complementary settings: the institution and the community.
Subspecialties in Public Health
1. Epidemiology and Control of Diseases
2. Medical Statistics
3. Family Health
4. Environmental Health
5. Health Management
6. Occupational Health
7. International/Port Health
8. Social and Rehabilitative Medicine
9. Health Education 10. Public Health Nutrition 11. Other Evolving areas include: (i) Demography (ii) Sociology and Behavioural Sciences Postings in Community Health The posting in Community Health lasts for 12 weeks and is as follows; 1. Rural Posting – 3 weeks During the Rural posting, students are expected to: (i) Visit a rural community in Ukpom, to understand community structure and development skill in community diagnosis and situation analysis as well as provide possible interventions. (ii) Be exposed to the primary and secondary level of healthcare delivery in a rural setting and acquired a wholistic approach to management of patients. (iii) Visit places of public health interests and alternative healthcare providers in the rural communities. (iv) Know the epidemiology of common diseases through tutorials and seminar presentations. (v) Understand the concept and practice of Primary Health Care (PHC). 2. Urban Posting – 3 weeks During the Urban posting the students are expected to; (i) Familiarize themselves with various components of environmental health in the community through visits to Abattoir, Water Corporation, etc. (ii) Understand the principle of Hazard control in a typical occupational setting. (iii) Gain experience in rehabilitative services by visiting rehabilitation centres. (iv) Understand current concepts in International Health like MDGs/SDGs, Emerging and Re-emerging diseases, climate change, etc. (v) Understand the concept of Health education and communication as well as Health Management through tutorials. 3. Block Posting – 6 weeks During the Block posting, students are expected to; (i) Have lectures in various subspecialties n Public Health (ii) Carry out their project writing and produce a bound copy at the end of the posting. (iii) Have practical exposures at the Public Health Laboratory and Public Health Museum
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