Investing in community-based education to improve the quality, quantity, and retention of physicians in three African countries.

Abstract

Context: Th e Medical Education Partnership Initiative (MEPI) is a $US 130 million program funded by the United States government supporting 13 African medical schools to increase the quantity, quality, and retention of physicians in underserved areas. Th is paper examines how community-based education (CBE) is evolving at MEPI schools to achieve these goals. Methods: We utilized data from the fi rst two years of site visits and surveys to characterize CBE eff orts across the MEPI network and provide detailed descriptions of three models of CBE among the MEPI programs. Results: Th ere is widespread investment in CBE, with considerable diversity in the goals and characteristics of training activities among MEPI schools. Th ree examples described here show how schools are strengthening and evaluating diff erent models of CBE to achieve MEPI goals. In Nigeria, students are being sent for clinical rotations to community hospitals to offl oad the tertiary hospital. In Uganda, the consistency and quality of teaching in CBE is being strengthened by adopting a competency-based curriculum and developing criteria for community sites. At Stellenbosch University in South Africa, students are now off ered an elective year-long comprehensive rural immersion experience. Despite the diversity in CBE models, all schools are investing in e-learning and faculty development. Extensive evaluations are planned to examine the impact of CBE strategies on the health workforce and health services. Discussion: Th e MEPI program is stimulating an evolution in CBE among African medical schools to improve the quality, quantity, and retention of physicians. Identifying the strategies within CBE that are reproducible, scalable and optimize outcomes will be instructive for health professions training programs across the continent.