2. Involvement of the health sciences students in the
Community Health Development through Community
Based Learning
Dr. Biraj Karmacharya
Dhulikhel Hospital Kathmandu University Teaching Hospital,
Nepal

3. Nepal

4. Nepal
General statistics..
 Average life expectancy: 63.7
 Crude birth rate: 29.2/1000
 Crude death rate: 8.5/1000
 Total fertility rate: 3.1/woman
 Infant mortality rate: 48/1000
 Under 5 mortality rate: 61/1000
 Births attended by skilled health staff: 18.7%
 Population: per doctor: 18439; per hospital bed: 2349

5. Health Sciences education in Nepal
After the restoration of democracy in 1990 and liberal policies
in the field of education and health sector, tremendous boom
in the health sciences education in Nepal.
– In 1990: 1 medical college
(Capacity of producing 40
doctors/year) for almost
previous 15 years.
– In 2008: About 14 medical
colleges (Capacity of
producing about 1400 doctors/
year)
– Still more in pipeline..
– Similar growth in other allied
health sciences field..

6. Health Sciences education in Nepal
• Less addressed issues:
– Dichotomy between
government health system
and the private sector
initiatives
– Poor integration of the
health sciences institutions
with the national health
system

7. Community Based Learning
• Principles
– The setting in which the
students of health sciences
get education does not
always reflect the situation
of the country in a broader
sense.
– The need is to develop not
just medicos but also
leaders in their concerned
fields.
– Real life exposure is
essential
Institutional Objective of the medical program of KUSMS
– Holistic approach competent and socially responsible
Technically to health
physicians to meet the existing emerging health needs

8. Community Based Learning
• Activities
– Stay with the community
– First understand the problems
– Discuss on the problems
– Plan interventions
– Arrange for continuity of the
activities by the community
– Different activities as per
different disciplines

18. Community Based Learning
Experience so far….
– The extent of CBL is different in
different institutions
– Dhulikhel Hospital Kathmandu
University Teaching Hospital is
a community based
organization.
– Network of its own different
community based outreaches
in rural areas

19. Community Based Learning
• Benefits
– Change in perspective
– Unexpected situation/ challenges
– Real-life exposure to the different
health related issues
– Sense of satisfaction because of
reaching to the people who would
have otherwise remained away
from the services
– Less cost incurred for a greater
volume of activities
– Encouragement for newer things
– Newer insights

20. Community Based Learning
• Limitations
– Rather difficult in
adjusting to new
places and with new
people.
– Worse attitude
towards the
challenges
(Discouraging effects)
NOT ALWAYS !!

21. Community Based Learning
• Opportunities
– Every community acts
differently
– Activities can be
different
– More systematic and
scientific approach
necessary
– Involvement of foreign
students

22. Community Based Learning
• Challenges
– Trend of technology
driven health sciences
education
– More financial drive/
glamour
– Brain-drain

23. Photo features