In Low and Middle-Income Countries (LMICs) like Kenya, the role of primary care, is the foundation for a sustainable health care system, necessary in confronting Africa’s burden of preventable disease and contributing towards its social and economic progress.

The Department of Family Medicine at Aga Khan University in collaboration with the community and primary health teams, conducts a rotation programme known as the Community Oriented Primary Care (COPC) that runs for a period of 6 weeks for its residents in the rural coastal community of Mariakani and Kaloleni in Kilifi County.

The main objective of the rotation programme is to strengthen the devolved public health care systems and improving access to equitable quality care particularly for the socio-economically marginalized populations in the country.

Dr Florence Mbatia and Dr Nelson Fundi, both 3rd year residents, took part in the COPC rotation program in Gotani and Tangatisini Health Centres, Kaloleni District in Kilifi County.

As part of the program, they interacted with the community, through door-to-door visits and community outreach programs to enable them to understand the underlying primary health care concerns and needs that the community is constantly facing and to prioritize and implement health interventions by collaborating with the community health care teams.

“During my rotation program, I focused on the burden of Upper Respiratory Tract Infections (URTI) and its management in the primary health care facilities based on the analysis of the disease burden in Kilifi County. We noticed that community health care team would normally prescribe antibiotics in many cases where there was no need. We had to conduct capacity building trainings to help them understand occasions to prescribe antibiotics and the side effects of antibiotics overuse,” said Dr Mbatia.

In addition, the program helps the residents to support the health systems of the local community by actively participating in capacity building and conducting training sessions to the community health workers in Kilifi County who are a very important link between the family physician and the community.

“Personally, the rotation program has really helped me to grow professionally and has enabled me to make a strong, positive impact to the overall well-being of the community in Kilifi County. I have been able to develop competencies and skills, which are critical towards addressing the primary health care needs not only of the individual, but also of the family and the community,” added Dr Mbatia.

The current rotation program was facilitated by the Access to Quality Care through Extending and Strengthening Health Systems (AQCESS), a four-year project undertaken by the Aga Khan University funded through a Canadian grant. 

“The COPC has enabled me to actually understand what primary health care entails in a rural setting. The skills I have acquired provides me with a great opportunity to engage the community health workers and volunteers and to instil behaviour change. During my interaction with the community in Kilifi County, communication skills is very critical. There is need to understand the culture, the religion, interpersonal communication, even literacy level of a community,” says Dr Nelson Fundi.

Under this rotation program, the residents are required to share their knowledge and experience to build local capacities in health facility management at primary health care and community levels and to create access to research field sites for faculty and the residents.