FACT FINDING ON TEACHING IMMUNIZATION IN MEDICAL SCHOOLS – UGANDA ******* DR. CHRISTINE ZIRABAMUZAALE Makerere University Institute of Public Health – UGANDA *************** Introduction of New Vaccines in East Africa: Lessons Learnt and Maintaining Services The New Stanley Hotel, Nairobi, Kenya December 9-11,2002

Introduction and History of Medical Education In Uganda Two medical schools in Uganda: –Makerere Medical School - Oldest in East and Central Africa. –Started in within Makerere Univ. College of E.A. –Teaching of preventive medicine in the medical school introduced in 1950s. –1975 department of Preventive Medicine exapanded into an Institute of P.H.

Medical Education In Uganda (2) –Todate Makerere Medical School has 23 departments, an Institute and two centres. –Reorganisation of Units will transform the Medical School into a College of Health Sciences with Four schools - i.e School of; Bio- medical Science, Medicine, Public Health and Health Sciences.

Medical Education In Uganda (3) –Mbarara University has another Medical School in Uganda –Started in 1989 in Mbarara, located 200Km. from Kampala City. –Offers both undergrad. and postgraduate Programmes. –Makerere Univ. faculty take part in teaching at Mbarara Medical School. –Other faculty visit as external examiners

Medical School (objectives) To be major centres of medical information Capacity building for –training –research and –service To provide Continuous Medical Education

Medical Schools - Outputs About 250 undergraduates leave Medical Schools annually. Graduates include doctors, dental surgeons, nurses, and pharmacists A total 50 postgraduates graduate annually in Uganda with diplomas, degrees and doctorates. Graduates include clinical and public health specialists.

Teaching of Immunisation in a typical under-graduate programme Makerere and Mbarara Universities share the undergrad. Community-based MBchB curriculum Immunisation covered in 10 of the 74 courses in the MBChB programme curriculum from year two to five. Teaching/training on immunisation is: – comprehensive –introduced as appropriate in all MBchB programmes –introduced in manageable doses

Teaching of Immunisation in a typical under-graduate prog. (contd.) Year two: –Teaching of basic facts on immunology, immunisation, rationale for. –Science of vaccine production. Year three: –Cold chain; Priority target populations for Immun.; Imm. Schedules; Administering vaccines; monitoring and management of adverse effects.

Teaching of Immunisation in a typical under-graduate prog. (contd.) Practical exposures: –Start during clinical training in year three –Heavy during Field placements and Field electives in YEAR FOUR –Continued during Internship training.

Teaching of Immunisation in a typical under-graduate prog. (contd.) Year five: –Revision of all topics covered in earlier years –Updates on new vaccines –Emphasis on infection control (sterility)

Practical Exposures In year four student stay in the field for four weeks during mandatory practical training –Take part in all health centre activities –Community diagnosis Immunisation areas covered: –Cold chain mangt. (Markers, precautions and temperature ranges for various vaccines). –Vaccine handling, administering vaccines & management of adverse effects –IEC & Counselling of clients.

Practical Exposures (contd.) –Take part in mobilisation for immunisation. –Exposure to management of logistics (vaccines, fridges, stores, equipment, materials) –Exposed to field supervision, program administration, monitoring and evaluation.

Undergraduate Programmes Durations differ but most of their curriculi have a dose on immunisation. Graduates are deployed as leaders, managers and implementers of health programmes at district levels, nationwide. Many graduates struggle for opportunities in postgraduate training and continuing medical education

Post Graduate Programmes Upgrading knowledge and skills Appropriate research and surveys Interpretation & implementation of policies Administration of district and national prog. Involved in evidence-based planning Involved in management of resources. Accumulate facts on new technology & eradication of diseases.

Conclusion Teaching of immunisation in Medical schools in Uganda is: –Comprehensive –Introduced as appropriate in all under- and post graduate programmes –Introduced in manageable doses –Practical exposures are mandatory.

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