The objectives of the study were: (1) To determine the present status of awareness of faculty regarding development of curricula and setting up of educational objectives. (2) To determine the present status of awareness of teaching methodologies and evaluation systems adopted and the extent to which the courses contribute to the development of professional skills and competencies in students. (3) To determine the present status of extent to exposure of students / trainees to community set-up. (4) To determine the present status of awareness of students / trainees regarding basic concepts of primary health care and other related services. (5) To determine the present status of linkages between medical colleges / training centers and health services sectors. (6) To determine the present status of facilities available and constraints experienced by the colleges / training centers that effect the organization and efficacy of education programs. (7) To determine the present status of community interaction with peripheral health functionaries and awareness of health services.
The sample comprised of faculty of six randomly selected medical college of Andhra Pradesh; all the eight Regional Training Centers located at Hyderabad, Guntur, Visakhapatnam, and Kurnool; medical undergraduates; multipurpose health workers (MPHWS); PHC/RHC medical officers and 1600 community members categorized into villages equal to or less then 5 kms, between 6 to 10 kms and greater then 10 kms away from health center; and 30 members from each 54 villages.
For data collection separate questionnaires were developed for each category of respondents viz., (1) Faculty of medical colleges; (2) Faculty of RTCs; (3) RHC/RHC medical officers; (4) Medical undergraduates; (5) MPHWS and MPHS and (6) Community members.
The study was descriptive in nature.
Data analysis were analyzed with the help of ANOVA, Duncan’s multiple range test, stepwise regression test, and correlation.
The findings of study were: (1) The faculty of medical colleges indicated their low awareness regarding the concept of educational objectives. Faculty of RTCs gave a better picture in regard to comprehension of the importance of educational objectives and their revision as per the shifting of emphasis of the course expending on altered tasks of target learners and changing national policies. Same observations were found for curriculum planning. The level of awareness of the faculty of medial colleges cannot be considered satisfactory. (2) In respect of undergraduate medical education (the development of professional skills), the levels of adequacy given by the students were lower than those assessed by the faculty and PHC / RHC medical officers. (3) Most of the respondents mentioned that the level of integrated teaching was inadequate. The respondents admitted that lack of interdepartmental cooperation and lake of guidance from administration were the hurdles in the way of implementation of integrated teaching. Another aspect related to integrated teaching is the blend of theoretical and practical sessions. The general impression given was that the time gap exists between coverage of theory aspects and the conducting of related practical sessions, is not very congenial for proper learning and comprehension. (4) Responses show that the coverage of theory aspects was good, but high level of inadequacy were indicated for aspects on community services and hands-on experience while in case of the basic and in-service courses for multipurpose health workers conducted at RTCs, the coverage status was reported as good not only for theory aspects but also for rural services appraisal and needs. (5) It was found that the medical undergraduates continue to be trained predominantly in the urban hospital environment. (6) For the ROME program, only one fifth could spell out its aims, and only one third declared that ROME was successful. In this aspect, the hurdles appeared to be lack of inter-faculty cooperation, poor perception of the faculty regarding program aims, budgetary constrains and transport bottlenecks. The PHC / RHC MOS however responded that in their experience, ROME could be considered successful. (7) There were no strong linkages between the colleges and health services sector, except during the health camps or the students visit to field and health agencies. (8) Medical undergraduate students do not have opportunities to interact with other health team members as indicated by majority of PHC / RHC medical officers as well as majority of undergraduate medical students. (9) According to the faculty, the evaluation system currently followed in the medical colleges is not sensitive to test the general students competencies and some work not showed about the sensitivity. (10) The community showed a good level of awareness regarding the location of general health facility. (11) Analysis of the responses of community member regarding awareness of health services according to the distance of their household from PHC did not show any significant differences. (12) A strong positive correlation existed between the level of awareness of the community regarding the three functionaries viz., MPHW(F), MPHW(M) and the village Dai on the one hand and the awareness of different health services on the other. (13) It was observed that literacy status and type of respondent featured in all the three primary health care indicators viz., MCH services, family welfare services and educational inputs that too as the first and second in order of merit in the case of the first two indicators mentioned. (14) Community members from villages under PHCs attached to medical colleges, students showed higher awareness scores for all the four primary health care parameters as compared to those from other RHC / PHC areas.
Keyword(s): Health Professionals, Primary Health Care