Knowledge of the national health act among physicians in two tertiary hospitals in Southern Nigeria

Objective: Knowledge of provisions of the National Health Act among physicians and stakeholders is pivotal to its successful implementation. This study aimed to assess the knowledge of the National Health Act (NHA) among Physicians in two tertiary hospitals in Nigeria. Methods: This was a cross-sectional study conducted in two tertiary hospitals in Southern Nigeria. The consecutively recruited eligible respondents were assessed for knowledge of NHA using a 24-item self administered close-ended structured questionnaire. The total obtainable score was 26. Those with <13 points had poor knowledge, 13-21 points had good knowledge and >21 points had excellent knowledge. Data were analyzed using SPSS version 21 software. P-value of < 0.05 was taken as significant. Results: One hundred and ninety-five doctors with a male: female ratio of 1.9:1 participated in the study. The majority (91.8%) were ≤40 years and 129(66.2%) of the participants were ≤ 10 years post qualification. The frequency of correctly answered questions ranged between 7.7% - 89.2%. According to overall knowledge scores; 64.6% had poor knowledge; 35.4% had good knowledge and none had excellent scores. There was no statistically significant association between knowledge of NHA and gender, age, and number of years post qualification (p > 0.05). Conclusion: This study showed that only about a third of the participants had good knowledge of key provisions of the NHA. We strongly recommend that relevant sections of the Act should be incorporated into the medical curriculum both at the undergraduate and postgraduate levels.

The perspectives of nursing students regarding the incorporation of African traditional indigenous knowledge in the curriculum

Background: South Africa was caught off guard by the student unrest in 2015 and 2016. This unrest was named the #fees must fall campaign. During this campaign, students raised the issue of decolonisation of the curriculum, challenging the higher education fraternity and the academic community. This was based on the fact that the existing curriculum has inadequate content on African traditional indigenous knowledge (ATIK), and continues to use the Western approach to address the needs of a multicultural, multiracial and multi-ethnic societies. Institutions responded by initiating dialogues regarding decolonisation of the curriculum in senates, scholars and between different health professional bodies. Aim: This article aimed to explore and describe the perspectives of nursing students regarding incorporating ATIK into the curriculum. Methods: Using a participatory transformative approach, researchers and participants worked collaboratively to inform social change. Participants comprised nursing students. The academics, traditional health practitioners, indigenous knowledge holders and primary health care nurses formed the panellists. Data were collected through one communal dialogue workshop, which lasted for 8 hours, tea and lunch included. Data were analysed thematically. Results: Students' perspectives emerged strongly as four themes, namely, politics of identity, displacement and distortion, curriculum content and institutional resistance. Students expressed that the current education system results in an identity crisis. The existing curriculum does not adequately convey an understanding of ATIK; it is displaced and distorted. Conclusion: Nursing science has great potential to incorporate the wealth of ATIK into its curriculum. In spite of a vibrant and rich cultural heritage, the ATIK specific to nursing sciences still needs to be incorporated into the existing curriculum in a responsive and relevant manner

Challenges of including sex education in the life orientation programme offered by schools: the case of mahikeng, north west province, south Africa

Teenage pregnancy and the prevalence of HIV among school girls are very high in South Africa, despite the introduction of sexuality education in schools since 2002. A qualitative approach of inquiry was used to investigate challenges faced by schools offering sexuality education in Mahikeng, South Africa. Four school principals, seven teachers and 39 learners were interviewed. The curriculum on sexuality education indicates that sexual matters are introduced to learners only when they reach Grade 8, whereas pregnancy is already common among girls as early as Grade 3. Participants from all groups represented in the study revealed that Life Orientation was not taken seriously in schools compared to other subjects. Although learners are very much interested in the subject matter, there were no qualified teachers and the content of the curriculum is very shallow. In addition, schools paid very little attention to this subject since it is not considered for admission into tertiary institutions. There is need, therefore, for the South African government to revise the curriculum content and presentation of Life Orientation to ensure the improvement of sexuality education in schools. The appropriate age-specific topics on sexual matters for learners should also be revised and the qualification of teachers considered

A peer evaluation of the community-based education programme for medical students at the University of Zimbabwe College of Health Sciences: A southern African Medical Education Partnership Initiative (MEPI) collaboration

Background. The University of Zimbabwe College of Health Sciences (UZCHS), Harare, which has a long tradition of community-based education (CBE), has not been evaluated since 1991. An innovative approach was used to evaluate the programme during 2015.Objectives. To evaluate the CBE programme, using a peer-review model of evaluation and simultaneously introducing and orientating participating colleagues from other medical schools in southern Africa to this review process.Methods. An international team of medical educators, convened through the Medical Education Partnership Initiative, worked collaboratively to modify an existing peer-review assessment method. Data collection took the form of pre-visit surveys, on-site and field-visit interviews with key informants, a review of supporting documentation and a post-review visit.Results. All 5 years of the medical education curriculum at UZCHS included some form of CBE that ranged from community exposure in the 1st year to district hospital-based clinical rotations during the clinical years. Several strengths, including the diversity of community-based activities and the availability of a large teaching platform, were identified. However, despite the expression of satisfaction with the programme, the majority of students indicated that they do not plan to work in rural areas in Zimbabwe. Several key recommendations were offered, central to which was strengthening the academic co-ordination of the programme and curriculum renewal in the context of the overall MB ChB curriculum.Conclusion. This evaluation demonstrated the value of peer review to bring a multidimensional, objective assessment to a CBE programme

Training requirements for the administration of intravenous contrast media by radiographers: Radiologists' perspective

Background. The administration of intravenous contrast media (IVCM) is one of the key areas currently under investigation for inclusion in the South African (SA) radiographers' scope of practice. However, for the radiographers to legally administer IVCM, training guidelines must first be identified, developed and accredited by the Health Professions Council of SA.Objective. To investigate the radiologists' perspective of the knowledge, skills and medicolegal training required of radiographers for the administration of IVCM to provide input for the development of national training guidelines. Methods. A quantitative, cross-sectional research study using an online survey, administered by SurveyMonkey, was conducted. The target population included all radiologists residing and practising in the province of KwaZulu-Natal, SA.Results. Fifty-nine participants (60.8%) completed the online survey. Twelve were excluded owing to incomplete surveys, resulting in a final response rate of 48.5% (n=47). The study revealed that various theoretical, clinical/practical and medicolegal study units should be included in the training, i.e. the study of the pharmacology of contrast media, practical training on cardiopulmonary resuscitation and basic life support, as well as the rights and responsibilities of a healthcare professional. In addition, both theory and practical/clinical assessments need to be included.Conclusion. Key data have been provided for the development of national training guidelines for radiographers to administer IVCM, based on scientific evidence that is relevant to the SA context. The study may be of value to other related health professions where scopes of practice are expanded through transforming the education and training curricula

The NOMA track module on nutrition, human rights and governance: Part 2. A transnational curriculum using a human rights-based approach to foster key competencies in nutrition professionals

Background. In response to the challenge of the global health needs of the 21st century; four academic institutions in Norway; South Africa and Uganda; each offering a Master's degree in nutrition; collaboratively developed the NOrwegian MAsters (NOMA) track module on nutrition; human rights and governance; integrating a human rights-based approach into graduate education in nutrition. Objective. To capture students' perceptions about the NOMA track module; focusing on the development of key competencies. Methods. Employing a qualitative approach; 20 (91% response rate) in-depth telephonic interviews were conducted with participating students; voice recorded and transcribed. Through an inductive process; emerging themes were used to compile a code list for content analysis of the transcribed text. Relevant themes were reported according to the professionals' roles described by the CanMEDS competency framework. Results. Participation in the module enhanced key competencies in the students; e.g. communication skills and the adoption of a holistic approach to interaction with people or communities. Their role as collaborator was enhanced by their learning to embrace diversity and cultural differences and similarities. Students had to adapt to different cultures and educational systems. They were inspired to contribute in diverse contexts and act as agents for change in the organisations in which they may work or act as leaders or co-ordinators during interaction with community groups and policy makers. Higher education institutions offering transnational modules should support lecturers to manage the inherent diversity in the classroom as a way of enhancing student performance.Conclusion. The development of future transprofessional modules will benefit from the inclusion of desirable key competencies as part of the module outcomes by following a competency by design process

Surgical Resident Doctor's Perspective of their Training in the Southeast Region of Nigeria

There are several problems militating against satisfactory residency training in Nigeria. These problems may not be effectively identified and resolved if the opinion of the trainee doctors is ignored. Objectives: To review surgical residents' perspectives of their training program in South-eastern Nigeria; with the aim of suggesting evidence-based innovative changes to enable the programs meet global trends and standards. Materials and Methods: A total of 90 semi-structured and pre-tested questionnaires were evenly distributed (30 per hospital) to the surgical residents at three tertiary healthcare facilities in South-eastern Nigeria. Information sought included sociodemographic variables; level in the residency training; rating of program and different aspects; learning environments/opportunities; and suggestions on ways to improve either part or overall program. Results: Analysis of 56 properly completed questionnaires (response rate=62.2) shows that the respondents were aged 29 to 53 years [mean(SD) = 35.3(1.7)]; mostly males (91.1) and junior residents (75). A significant majority of residents (47 or 83.8) rated the surgical residency training in their respective centers as inadequate. Grand rounds were roundly criticized as having misplaced objectives and tending toward fault-finding by Consultants. Suggested interventions for improvement included enhanced supervision/mentoring/teaching by senior colleagues; inclusion of didactic lecture sessions; research trainings; and foreign postings. Conclusion: There exist gaps between expectations of surgical residents and the training offered. These create needed support for an evidenced-based review of surgical residency training program to enable it meet the aspirations of trainees and the ever-changing trend in Medicine. More studies on surgical residents covering other regions of Nigeria; and including the trainers (Consultants); will be of immense value

MB ChB Curriculum Modernisation in South Africa - Growing Doctors for Africa

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Evaluation of the Parallel Rural Community Curriculum at Flinders University of South Australia: Lessons Learnt for Africa

Objectives. To review data collected during an evaluation of the Flinders University Parallel Rural Community Curriculum (PRCC) in order to reflect on its relevance for medical education in Africa.Setting. The PRCC offers a community-based longitudinal curriculum as an alternative for students in their pre-final year of medical training. Design. Individual and focus group interviews were conducted with students; staff; health service managers; preceptors and community members. Results. Students are exposed to comprehensive; holistic; relationship-based care of patients; with a graded increase in responsibility. Students have varying experience at different sites; yet achieve the same outcomes. There is a strong partnership with the health service.Conclusions. The principle of balancing sound education and exposure to a variety of contexts; including longitudinal community-based attachments; deserves consideration by medical educators in Africa

Introducing HIV and AIDS Education into the First Year of a Problem-Based Learning Curriculum : A template for Health Science Education

The HIV and AIDS epidemic will continue to impact medically; socially and financially on sub-Saharan Africa. It is therefore imperative that health science students in Africa experience the reality of the impact of this virus on communities. This article describes an HIV and AIDS education programme instituted at a South African medical school in parallel with the first year of a problem-based learning (PBL) curriculum. In line with the PBL philosophy; the HIV and AIDS programme was largely experiential. Students interacted directly with HIV positive individuals; and through their educational workshops; with local communities. By means of small group sessions facilitated by trained community educators; students explored myths surrounding HIV and AIDS and engaged frankly with colleagues about sensitive issues such as having an HIV-infected family member. Although expensive in terms of human resources; the outcomes of this intervention exceeded the organisers' expectations; particularly in terms of students openly engaging with the reality of being HIV positive and the community organisation networks established. This type of experiential intervention with considerable community exposure has application to other health science curricula

Community Physiotherapy: Curriculum of Instruction and Clinical Practice in Primary Health Care System in Nigeria

Considering the population of this country and the spread of her communities; the only means by which physiotherapy for ALL the citizens can be achieved is through Community Physiotherapy practice. In introducing this paper; some past activities of some pioneer physiotherapists and those of the Nigerian Society of Physiotherapy were reviewed. The major part of this paper has been devoted to the curriculum of instruction in Community Physiotherapy and its clinical practice. The pioneering activities of the College of Medicine; University of Lagos in the training of Community Physiotherapists was cited. That other Universities offering courses of study in Physiotherapy should follow the Lagos example has been recommended. Other recommendations given include the direction and utilization of Community Physiotherapy services by the State Governments through State Health Councils or Health Management Boards. Creation of a Directorate of Physiotherapy in the Federal Ministry of Health for supervising; co-ordinating and aiding of the state activities in Community Physiotherapy has also been recommended