Community based medical education: a tool for developing countries

Medical education should be socially responsive,1 by producing health personnel who respond to the health needs of the population they serve. Almost all developing countries are signatories to the international declaration on the promotion of healthcare delivery (see, for example, www.who.int/hpr/NPH/docs/jakarta_declaration_en.pdf or www.who.int/hpr/NPH/docs/declaration_almaata.pdf) and are striving to continually increase their health coverage. Community based medical education may serve as a tool for achieving this.

The main determinants of appropriate strategies to achieve good health coverage for as much of the population as possible within the shortest possible time include demographic information, health status indicators, and available resources. The demographics of nearly all developing countries shows that 60-80% of the population live and work in rural areas,2 where health problems are common and health personnel inadequate — some places have next to no contact with even a community health worker.

Coupled with this is the fact that a country may achieve the millennium development goals without substantially improving the health of its poorer population, since the goals are expressed as national averages, and the aggregate data that they generate may mask growing inequalities between …