An assessment of implementation of Community-Oriented Primary Care in Kenyan family medicine postgraduate medical education programmes

Abstract

Background and objectives: Family medicine postgraduate programmes in Kenya areexamining the benefits of Community-Oriented Primary Care (COPC) curriculum, as a methodto train residents in population-based approaches to health care delivery. Whilst COPC is anestablished part of family medicine training in the United States, little is known about itsapplication in Kenya. We sought to conduct a qualitative study to explore the development andimplementation of COPC curriculum in the first two family medicine postgraduate programmesin Kenya.Method: Semi-structured interviews of COPC educators, practitioners, and academicstakeholders and focus groups of postgraduate students were conducted with COPC educators,practitioners and academic stakeholders in two family medicine postgraduate programmes inKenya. Discussions were transcribed, inductively coded and thematically analysed.Results: Two focus groups with eight family medicine postgraduate students and interviewswith five faculty members at two universities were conducted. Two broad themes emergedfrom the analysis: expected learning outcomes and important community-based enablers.Three learning outcomes were (1) making a community diagnosis, (2) understanding socialdeterminants of health and (3) training in participatory research. Three community-basedenablers for sustainability of COPC were (1) partnerships with community health workers,(2) community empowerment and engagement and (3) institutional financial support.Conclusions: Our findings illustrate the expected learning outcomes and important communitybasedenablers associated with the successful implementation of COPC projects in Kenya and will help to inform future curriculum development in Kenya