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| Dean FHS |
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| Lecturer |
Dr MFONFU Daniel
Independent Researcher
Tel: +237 677601207
Email: dmfonfu@yahoo.com
UNIVERSITY OF
BAMENDA – FACULTY OF HEALTH SCIENCES – SECOND YEAR MEDICAL STUDENTS OF
2015
COMMUNITY HEALTH
PRACTICE IN MULANG HEALTH AREA
Goal of community Health Practice by the Faculty of Health Sciences (FHS):
The practical
training course in community Health Practice has as objective to familiarize
the 2nd year medical students with the exercise of establishing the
diagnosis of the health situation of the community as stated in the ‘Academic programmes of the Faculty
of Health Sciences, University of Bamenda’
Objectives:
a) Collect data from households using questionnaires
– on environmental sanitation and on vaccination status of children 0-23 months
b) Educate the population on some identified
factors that could cause health problems while on the field
c) Analyse data collected
d) Determine health needs and problems
e) Propose solutions and strategies to solve
needs and problems identified
Teams:
20
teams will be constituted by the 59 students of MD2 – 19 of 3 members and 1
team of 2 members. Three Groups of students will be formed according to the three
zones of Mulang Health Area – Mulang, Musang, and Ngomgham. The sites will be
selected by balloting. The groups will be formed after the choice of sites. Each
group will elect a group leader. Equity
will be expressed in, among others, gender and first official language (English
and French). There will be equity in
formation of teams and the election team and group leaders. The leaders will
ensure that discipline reigns during the CHP period and that all logistics are
available.The team leaders are accountable to the group leaders while the group
leaders are accountable to the lecturers.
Criteria for the choice of sites
Accessibility
Estimation of surface area
that could have enough sample size
Mobilisers
A mobiliser is a person
living in the quarter, who has a good knowledge of the site; who has been
working as a mobiliser in other health activities; who will lead and introduce
the students to the families and assist the students in interpreting the
questions to the respondents in case they don’t understand; and who will
provide security to team.
Movement of teams in the sites
Each
of the 20 teams will be accompanied by a community mobiliser.
Divide sites into about tow accessible
sections; Select the section where to start. Ensure that the sample of 10
households is obtained from each of the sections. The only criterion for the selection of a
household in a compound is the presence of children from 0-23 months in the
household. Each team will move from compound to compound collecting data from a
selected household with children 0-23 months in the compound.A compound is a
collection of households in an area with the same landlord. A compound
consisting of a hotel will not be chosen.In a compound consisting of a storey
building only one household with children 0-23months will be chosen. Choose
only one household in a compound.10 households will be selected each day. A household is defined as a social unit comprising people
living in the same house, with the samefamily head, and sharing food from the
same pot. One household is chosen in the compound because the compound may have
the same environmental characteristics for all the households.
Tools
i)
Questionnaire for the environmental sanitation
ii)
Questionnaire for the collection of data on vaccination status
iii)
Manual synthesis form for the synthesis of environmental sanitation
questionnaire
iv)
Manual synthesis for the compilation of data on vaccination status
v)
Software for the zone synthesis of data from the manual synthesis of
sitesof environmental sanitation
vi)
Software for the zone synthesis of data from the manual synthesisof zone
of vaccination status from sites
vii)
Health Area software for the synthesis of zones for environmental
sanitation
viii)
Health Area software for the synthesis of zones for evaluation of
vaccination coverage rate.
Topics covered by questionnaire:
The topics of Environmental
sanitation and Expanded Programme of Immunisation (EPI) taught in the first
year of medical studies as stated in the ‘Academic
programmes of the Faculty of Health Sciences,
University of Bamenda’.
Data collection on '03 - 04 June 2015:
Collection of
data from households was done using questionnaires – on environmental
sanitation and on vaccination status of children 0-23 months for two days.
This
was done by observing the environment, and interviewing a knowledgeable
respondent in the house (father, mother, and caretaker).
The
Lecturer will collect data of the previous month from the principal health
centre of the health area on the main diseases diagnosed and the routine EPI in
order to compare the data and vaccination coverage rate with that found in the community.
Health facilities in the health areas
Identify
and list the private approved health facilities in the sites, approved private
pharmacies; and traditional practitioners, and patent medicine scores.
Compilation of data from the Zones:Compilation of data
collected by the team is done on the same day of the data collectionin class in
the afternoon as from 13:00 using the manual synthesis form. The group
synthesis will be done using the softwareconceived for the purpose. Each group
will choose a secretary versed in computer science and having a good performing
laptop.
The
synthesis of the most frequent diseases/health problems will be done in a
plenary sessionto identify them so that all the teams and groups will have the
same diseases, about 5 of them; the same is done for incapacitating or
disabling diseases; and health insurance.
The group syntheses are
supervised and approved by the Lecturer.
Each group submit the
electronic copy of the approved group synthesis to the Lecturer.
Writing of group reports
Three group or zone reportswill
be written according to Mulang, Musang and Ngomgham. Report writing begins on
the first day of the community health practice. The reports are written
according to the format given by the Lecturer and using the tables in the zone
synthesis software in the ‘sheet of Tables Graphs) in environmental sanitation
and in the sheets of ‘Graphs and tables’ in the zone vaccination synthesis.
Presentation of group reports
Group reports are presented
using power point in class. The Dean, who is the Head of the Department of
Public Health, presided the group presentations.
Each group handed in a hard
copy and an electronic copy of the report to the Lecturer.
Synthesis of Health Area data
Each group submitsa copy of
the software for the zone synthesis to the Lecturer so that he could make the
health area synthesis.
Using the Health Area synthesis
software: copy the TOTAL (YES/NO) in the ‘Grand Total’ Sheet of the
environmental sanitation software of the zone and paste them in the respective zone
of the Health Area software, starting from zone1. Copy the GRAND TOTAL from the
'Table' sheet of vaccination zone synthesis software and paste in the
corresponding Zone sheet of the health area synthesis software starting from
zone1 Thesesyntheseswere discussed and corrected with students in class. The
graphs of this health area synthesis and pictures taken by students in the
field are used to write the health area power point presentation that isdisplayed
during the meeting with the Administration and Community representatives.
Assessment of students:
Attendance of each student at
each activity is registered by a signed roll call; each absence will cost a student
5 points. Only justified medical certificate may be admitted by Faculty
administration. Complete absence will mean 0 marks.
The students will be
evaluated on the quality group reports and group presentations by the Lecturer.
The evaluation will be based
on comments made by Professors and Lecturers during the power point
presentation by the group representatives.
Materials:
Questionnaires – to be
produced by the lecturers/the FHS
Pen – to fill the
questionnaires and make notes on some observations made in the field
Camera – to snap good and
bad findings
Laptop – to fill in data for
synthesis using the corresponding softwares and to type the reports
Exercise book – to note some
observations while in the field
Umbrella in case it rains
White gown
Transport
The university bus will
collect students from the campus at Mile 3 at 07:00 to Mulang Health Area
through Foncha Street. The teams will be dropped at points in their various
zones near their sites and will be picked up by the bus at about 12:30 back to campusfor
synthesis. The teams will meet their mobilisers at points indicated.
Communication will be by phone.
Supervision of teams in the field
The supervision of teams in
the field will be done by the Lecturers and the Dean; the communication channel
will be by mobile telephone.
PREPARATION OF CHP AT THE LEVEL OF THE DEAN
OF FHS
- The Dean requested and obtained authorization from the
Divisional Officer of Bamenda II by the letter no 29/06/3100/5/445
of 27 of May 2015 to carry out the community health practice and diagnosis in
Mulang health area.
- The Dean
requested and obtained a bus from the
vice Chancellor of the University of
Bamenda
- The Dean wrote the invitation for the meeting for the
presentation of the results of the CHP to Administrative & Community
Representative; these invitations were distributed by Dr Mfonfu Daniel
POSITIVE OBSERVATIONS
BY THE MEDICAL STUDENTS
·
Mobilizers
facilitated the work
·
Mobilizers
taught us how to interact with people of the community
·
The
questionnaires made things easier
·
The
excel program for synthesis made the work easy
·
The
lecturer was caring about the students on the field
·
The
presence of the Dean reinforced the seriousness of the exercise
·
The
vaccination coverage rates amongst children 12-23 months were very good for the
antigens evaluated
§ Most
houses have pipe borne water supply which they say hardly stop flowing
§ There is a
beautiful integrated health centre that coordinate health activities in the
health area
§ Some
people separate their waste into organic and inorganic.
§ Very few
people buy drugs from hawkers.
§ Many
people declared that they sleep under a mosquito net.
§ The road
bellow Foncha through Mulang is being constructed
§ The
Students educated the population on some identified factors that could cause
health problems while on the field
§ No
identification of any vaccine preventable disease according to the EPI program
of Cameroon while on the field.
§ In some
restaurants, hand-washing is done with water flowing from a container.
§ The
school bus aided us in transportation
§ The
community collaborated and were welcoming
WEAKNESSES
TO BE IMPROVED BY THE MEDICAL STUDENTS
§ Community
health practice of the area coincided with the day of IWC on the first day
of CHP making it difficult to find the number of children required
§ The road
from La chance bridge through Musang
zone including the Mulang Health Centre, to Ngomgham is very bad thus
reducing accessibility to the Mulang HC
§ The target
0-11month used as denominators for the calculations vaccinations rates include children who are either above
or below the recommended age groups
§ Some water
closet toilets are directed to the stream; this practice can cause water borne
diseases in people downstream - such as cholera, typhoid, hepatitis A, and etc.
§ Very many
people do not believe in protecting their body privacy because most simple pit
latrines are poorly constructed with bad slabs, poor or no walls, without roofs
&lids for squatting holes, providing a fertile ground for fly
multiplication and consequently disease transmission.
§ Poorly
constructed wells & springs with poor hygienic conditions are still being
used in many households
§ Some
people throw waste in streams.
§ Some
septic tanks are poorly constructed while some are directed to the stream.
§ In most
restaurants, hand-washing is done with water put in a single bowl.
§ Most
piggeries and poultries are very dirty and have offensive odour.
§ Some
people do not properly use their mosquito nets; some use it as window blinds.
§ Building
in the Mulang river bed thus narrowing it,
§ One bus
carrying students to the field bring the second batch very late in the field
when most parents would have left the house
RECOMMENDATIONS BY STUDENTS
- The days of data collection on the
field should not correspond with that of Infant Welfare Clinic at the Principal
Health Centre
- In the spirit of multi sectorial
development of health:
§ The Regional Delegation of Public
Health (Ministry of Public Health) should stop the selling of manyanga (palm
kernel oil) in health facilities.
§ The Ministry of Animal Husbandry
should train farmers to keep piggeries and poultries clean and inoffensive.
§ The Ministry of Agriculture and
Agricultural Schools should promote organic farming using the large amount of
organic waste generated from our households and markets.
§ The Ministry of Public Health, WHO
and UNICEF should establish the proportions for target populations to be used
as denominators in EPI.
- Let us promote organic agriculture
§
Let
us separate household waste and waste from the markets into organic and
inorganic;
§
Let
us take the organic waste to our farms and use it as organic fertilizer.
§
Setting
up an industry for producing organic fertilizer out of these organic waste,
will serve as a source of employment.
§
The
Ministry of Agriculture should lead us
-
Clean
the water bed of Mulang River.
-
Prevent
people from building in Mulang River Bed.
-
Provide
more dustbins in the streets.
-
Recruit
sanitary inspectors to inspect the sanitary conditions of bars, restaurants,
the environment and toilets; and provide IEC for behaviour change.
- The FHS should inform the community
by mass media well before hand of the date of community health practice to be
carried out by students.
- The University should provide 2
buses to carry the students to the field; one bus could bring them back
CONCLUSION
BY STUDENTS
1.
We have tried as much as possible to present to you
the results of the Community Health Practice in Mulang Health Area concerning
the assessment of environmental sanitation and evaluation of vaccination
coverage of children aged 0-23months.
2.
We are grateful to the community for their
cooperation and welcoming spirit.
3.
We are also grateful to the mobilizers who
facilitated our work by taking us exactly to houses with children of our
required age range (0-23 months).
4.
We plead the information that we have provided will
help us improve the living conditions of our population in Mulang Health Area
at our various posts of responsibilities.
5.
We are very grateful to the school authorities for
organizing this course.
MEETING OF THE ADMINISTRATION AND
COMMUNITY REPRESENTATIVES REPORT OF PRESENTATION OF RESULTS OF COMMUNITY HEALTH
PRACTICE (CHP) AT MULANG HEALTH AREA TO ADMINISTRATIVE AND COMMUNITY
AUTHORITIES ON01 JULY 2015
Goal
of presentation of results of community health practice (CHP) at Mulang health
area to administrative and community authorities:
Ø Provide a
feedback on CHP to authorities so that they could use it to give Information,
Education and Communication (IEC) to the
population of Mulang Health Area in order to enhance behaviour change for the
improvement of healthy environmental sanitation and lifestyle
ADMINISTRATIVE AND COMMUNITY PARTICIPANTS
1.
Mr
Fonguh Joseph Ngu – 1st Deputy Mayor Bamenda II Council
2.
Dr
Manjo Matilda – Regional Delegate of Public Health for North West Region
3.
Tangang
Fidelis A. – Representative of Government Delegate of Bamenda city Council
4.
Ndah
Johnson – Representative of Chief of Mulang integrated Health Centre
5.
Akenji
Rachel – Member of the Management Committee of Mulang Health Area
6.
Mbugang
Michael - Member of the Management Committee of Mulang Health Area
7.
Ngang
Daniel - Member of the Management Committee of Mulang Health Area
8.
Chi
Simon – Focal Person for Mobilisers
9.
Dr
Mfonfu Daniel – Lecturer
10.
Ms
Kinyuy Solange Kiven – Lecturer
11.
Prof
Kuaban Christopher – Dean of the FHS, and Head of the Department of Public
Health
All the 2nd year students of 2015
participated at meeting
METHOD
A selected group of students made a power point
presentation of the report of the community health practice realised at Mulang
Health Area by the students with the assistance of the lecturers.
OBSERVATIONS
OF PARTICIPANTS:
Ø All participants listened keenly
to the presentation made by the students and contributed positively to the
efforts made by the students and thanked the Dean for choosing Mulang Health Area.
They declared that the presentation had revealed to them what they did not know
and stated that they were thus armed to educate their population.
Ø The participants requestedthe
copies of the presentation so that they can use it to sensitize their
population and carry out the recommendations proposed. They declared that they
have found in the Faculty of Health Sciences a real partner.
Ø The Dean promised to progressively
improve on the questionnaire to include other important recent activities
carried out by the Ministry of Public Health.
Ø Recent vaccines like pneumo and
rotavirus will be included in the
following years of CHP in other health areas
Ø The Dean promised the participants
the electronic copies very soon. The Dean sincerely thanked all invitees for
their participation
Ø The meeting started at 10:00am and
ended at 12:00noon
Reasonsof posting this Community
Health Practice (CHP) report at the internet
-
The
Dean recommended the posting of this report at the internet in order to share
knowledge.
- Community
Health Practice is an activity in the curriculum of training in all medical
schools in Cameroon so the FHS in the University of Bamendais sharing its
technical-know-how in all its components and tools with other universities and it
iswilling to provide technical assistance to other universities.
- The
Dean believes that a FHS must have an impact on the local communityin improving
their environmental sanitation and life style that is why sincetook over the
running of this FHS the 2nd year students have been carrying out the
CHP in the different health areas of Bamenda Health.
- The
Dean believes that a FHS should contribute in improving some components of the
health system
- The
dean provided both electronic and hard copies of the reports to health
authorities and community representatives.
- People
of goodwill after reading this report may decide to help the health area in
solving some of the problems identified.
