EVALUATION OF COMMUNITY HEALTH CURRICULUM IN COLLEGES OF HEALTH TECHNOLOGY IN SOUTHWESTERN NIGERIA

Abstract

Community Health Curriculum (CHC) is critical to the training of health workers who provide comprehensive healthcare at the grassroot. Studies on curriculum evaluation generally across Colleges of Health Technology (CoHT) in southwestern Nigeria have shown non-conformity in their deployment and implementations. Previous studies focused largely on evaluation of health curricula for primary and secondary schools as well as universities to the neglect of CoHT. This study, therefore was designed to evaluate the CHC (adequacy of teaching/learning environment, relevance and adequacy of objectives and contents, assessment techniques, students’ attitude to learning, teachers’ attitude to teaching, mandatory instructional materials, teaching methods, teachers profile and challenges) in CoHT in southwestern Nigeria.

Social System theory, Precede-proceed Health and Context-Input-Process-Product models anchored the study, while the descriptive survey research design was adopted. Purposive sampling technique was used to select six public CoHT namely: Akure, Ondo State; Ibadan, Oyo State; Ijero-Ekiti, Ekiti State; Ilesa, Osun State; Ilese, Ogun State and Yaba, Lagos State in southwestern Nigeria. The community health department in each CoHT was purposively adopted, while the six Heads of Department (HoDs) and the 27 Community Health Tutors were enumerated. The stratified random sampling technique was used to select 511 community health students (200 level- 256; 300 level- 255) across the six CoHT. The HoDs and Teachers Questionnaire (r=0.93), Students Questionnaire (r=0.93) and Students’ Knowledge and Practical Skills Test (r=0.93) were used for data collection. Six sessions of Focus Group Discussion were held with selected students. Qualitative data were content analysed, while quantitative data were analysed using descriptive statistics.

The students’ mean age was 23.40 ± 2.65 SD. The objectives (67.7%) and contents (85.3%) of the community health curriculum were rated highly relevant and adequate, while the teaching/learning environment was grossly not conducive with insufficient classrooms (36.0%). The attitude of the tutors to teaching was positive, while the students had negative attitude to learning. In addition to the minimum required Diploma in education (Primary Health Care) certificate, 67.0% of the tutors possessed Bachelor’s degree in education; however, only 33.3% of the CoHT had the minimum required number of tutors. The teaching methods were obsolete and teacher-centred mainly: lecturing (73.0%) and questioning (64.8%). The tutors relied on chalkboard (87.9%), demonstration room (84.9%), real objects (90.9%) and simulations (81.8%) to teach without basic and modern facilities like laboratories, computers/internet, library, adequate clinical exposure and health centre well equipped for practicals. The students had high knowledge (x ̅=21.55) and practical skills (x ̅=20.84) of community health. The challenges encountered by the tutors included programme overload (69.7%), lack of motivation (63.6%), inadequate programme funding (63.6%), inadequate staff (57.6%), inadequate teaching materials (51.5%) and insufficient materials for practicals (51.5%). Feedback mechanism was relegated in the assessment technique. The community health curriculum in colleges of health technology in southwestern Nigeria, though relevant, adequate and suitable for meeting comprehensive health care at the grassroot, the teaching environment was not conducive and the facilities grossly inadequate.