Title:	Community Oriented Primary Care
Keywords:	Primary Health Care Measuring health status Health systems Health promotion Disease prevention, control and elimination
Country:	Germany
Institution:	Germany - Institute of International Health, Berlin
Course coordinator:	Dr Hans-Friedemann Kinkel
Date start:	2025-02-24
Date end:	2025-03-07
About duration and dates:	2 weeks
Classification:	advanced optional
Mode of delivery:	Face to face
Course location: Institute of Tropical Medicine and International Health Charité - Universitätsmedizin Berlin Augustenburger Platz 1 D-13353 Berlin,Germany
ECTS credit points:	3 ECTS credits
SIT: 90 hours SIT: ● Contact (in-class: lectures and group work): 60h ● Self-directed learning: 30h Week 1: 45h (9h/day) Contact (lectures): 30h (6h/day) Self-directed learning: 15h (3h/day) Week 2: 45h (9h/day) Contact (in-class: lectures and group work): 30h (6h/day) Self-directed learning: 15h (3h/day)
Language:	English
Description: At the end of the module the student should be able to: 1. Propose an intervention/ programme/ service for a common health problem, disease or condition for a community health team 2. Discuss and debate interventions/ programmes/ services rendered by a community health team for common health problems, diseases or conditions 3. Explain the principles of Community Oriented Primary Care (COPC) 4. Describe the role and function of a community health team (“outreach team”)
Assessment Procedures: Assessment procedures: 1. A 1.5 hour closed book written exam (multiple choice and open-ended questions; accounting 50% to the overall mark) and 2. An assessment of a 20-30 min oral group work presentation (ca. 4-5 people per group) (accounting 50% to the overall mark) Exam: The exam covers the theoretical aspects of the module. The pass mark is 60% or more of the achievable points gained. If the student does not achieve the pass mark he/she can re-sit on a date agreed on with the module coordinator (preferably within 4 weeks after the module). Presentation of group work: The group work is a proposal for an intervention/ programme/ service for a community health team dealing with a specific health problem, disease or condition of choice in a setting of choice in a low- or middle-income country (LMIC). The proposal will be presented orally (ca. 20-30 minutes) in front of the class and marked by the module coordinator. The proposal will be marked for content (80%) and presentation (20%) using an evaluation matrix. The presentation is passed if 60% or more of the achievable points are gained. If a group fails, each group member has to do an individual assignment (ca. 1500-2000 words) that needs to be submitted within 4 weeks after the module. The assignment will be the same task as the presentation, only that each student can decide individually about the specific health problem, disease or condition and the setting he/she wants to work on. The assignment will be marked for content (80%) and layout (20%) by the coordinator using an evaluation matrix. The assignment is passed if 60% or more of the achievable points are gained. A second re-examination for both types of assessment is permitted but may be linked to conditions set by the Committee of Admissions and Degrees, such as attending the course again in the following year (no additional fees). The results of the exam and the presentation will be communicated to the students usually during the week after the course. Students receive two grades based on their overall mark, one according to the German (absolute) 6 point decimal grading system (1.0 [excellent/sehr gut] – 6.0 [not sufficient/ ungenügend], pass mark: ≥ 4.0 [sufficient/ ausreichend]) and one according to the (relative) ECTS grading system (A top 10%, B next 25%, C next 30%, D next 25%, E lowest 10%).
Content: ● History of COPC. The origins of Community Oriented Primary Care (COPC) with an emphasis on South Africa; How COPC evolved in other parts of the world; Influence of COPC on PHC/Alma Ata; The development of Community Health Worker (CHW) programmes and COPC in recent years ● The Health Team (HT). The composition of a HT/“outreach team”, Definitions of “community”, the role of a HT in the health system and the community, the role and mandate of the members of the HT ● Implementation of COPC. Steps of implementing COPC (based on the South African experience) ● Principles of COPC (Marcus, 2013) (I): Information. The role of information about the community (e.g. local demographic differences and implications on health services), the household (i.e. socioeconomic context and risk factors at household level) and the individuals (i.e. individual demographic and health related information and risk factors) for delivery of equitable, comprehensive, information/evidence based and person centered health services; Information management (e.g. data collection, e-/m-health solutions, access to information, confidentiality, data safety, personalised and aggregated data), M&E and reporting ● Principles of COPC (II): Equity. Definitions of Equality and Equity (Whitehead, 1992), health disparity (referring to the concept of social determinants of health) ● Principles of COPC (III): Comprehensive Care. The spectrum of health care from promotion, prevention, treatment and care, rehabilitation and palliation; prevention concepts (primary, secondary, tertiary); screening strategies (opportunistic/ systematic); high risk based (individual) prevention and population based prevention (Rose, 1985); ● Principles of COPC (IV): Practice with Science. Emphasising principles of diagnostic & screening research (Sackett & Haynes, 2002), limits of diagnostics & screening, the role of research in COPC, “big data”-approach (Krumholz, 2014) ● Principles of COPC (V): Person centered care. Opportunities and limitations of personalised care (evidence/algorithm based care), Person centered care (holistic approach) (Ekman et al. 2011) ● The household assessment. Definition of “household”. Opportunities and challenges assessing common variables of a household (e.g. composition, dependency, relation of members, “vulnerability”, headship, dwelling type, access to water/ electricity/ sanitation etc., exposure to air/ water/ land/ pest/ noise pollution, income etc.) ● Health status assessment and community based interventions: The challenges as well as the opportunities of a health team dealing with common health problems, disease or conditions in the community/ the home of a person differ from the ones health professionals face in a clinic or hospital setting. The sessions in this block will introduce to programmes/ interventions/ services a HT could offer. Specific health problems, disease or conditions will be chosen for deeper learning such as: - General Health & Lifestyle (Functionality, sensory, body mass, nutrition, exercising, smoking etc.) - Child health (e.g. child development, infant feeding, Vitamin A, immunization, deworming) - HIV (e.g. education, prevention/ community based testing, treatment support, “95-95-95” strategy) - Tuberculosis (e.g. education, prevention/ community based screening, treatment support, “90-90-90” strategy) - Reproductive Health (e.g. Ante-, post- and neonatal care, sexual health/STI, “men’s health”, contraception use, family planning, adolescent health) - Chronic/ Non-communicable diseases (e.g. education, prevention/screening, adherence support) - Mental health (e.g. education/ prevention/ screening, examples: dementia, depression, psychiatric disorders) - Cancer (e.g. cervix, breast, prostate, colon cancer) - Physical & Sexual assault (e.g. education, prevention/ screening)
Methods: 15. Learning Methods: The course uses participatory learning, based on lecture with short group work and discussions (37 hrs), practical demonstrations (3 hrs), role play (3 hrs), supervised/guided group work (12 hrs), self-directed learning (30 hrs), and includes a written exam (2 hrs) as well as assessed group presentations (3 hrs).
Prerequisites: Successful completion of the core course (basic knowledge about PHC and health systems in LMIC, good understanding of primary care principles, good understanding of common health problems in LMIC, ability to critically review and appraise literature/ guidelines, basic project management and planning skills). No further or specific subject areas have to be completed before the module can be started. If not a native English speaker: Internationally recognised English proficiency certificate equivalent to a TOEFL score of 550 paper/213 Successful completion of the core course. English TOEFL test 550 or 213 computer-based or 79/80 internet-based or IELTS band 6.0.
Attendance: Max. 30 students (unlimited tropEd Max. 30 students (unlimited tropEd students). In order to be permitted to write the exam and receive a grade report or an attendance certificate, students have to attend 85% of the contact time.
Selection: 18. Selection, if applicable: Participants are selected on a first come first served basis Deadline for application: 8 weeks before module start Deadline for payment: 4 weeks before module start (if not otherwise agreed on) We shall confirm the module 6 weeks before the module starts which is subject to a sufficient number of applications (minimum 8). Late applications will be considered as long as places are available. Application forms can be found here: https://internationalhealth.charite.de/en/application_admission/
Fees: 1.050,00 EUR TropEd MScIH students and alumni (For Berlin students who started their studies in 2022 or earlier the old scale of fees applies. Please see here) 1.312,50 EUR for others.
Scholarships: Not available
Major changes since initial accreditation: The content remained unchanged. While in the initial courses the coordinator himself taught most sessions, a number of new lecturers and facilitators could be recruited over the past years to present specific real life examples from around the world (Nepal, Rwanda, Ethiopia etc.) and discuss COPC practice. Also the life demonstration of an mHealth application (AitaHealth®) which is used by community health workers in South Africa is now part of the course. Using the app, students can enrol in a fictive health team (“Rudolf Virchow”) and use the app to register and assess fictive households and their members and get a demonstration how this data can be accessed by a team leader via a PC).
Student evaluation: Student evaluations were very good and the course has become very popular. Students particularly like the link between theory, i.e. the principles of COPC and primary care and the vivid examples of COPC practice. For many students the course is a revelation about the potentials of COPC and large-scale community based outreach programmes worldwide and about how primary care can and should be provided. Nevertheless, the challenges the practice of COPC faces also caused frustration at times. The role-play mimicking a visit of community health workers at a home of a family so far was always a highlight.
Lessons learned: Beware of conceptual differences: COPC refers to large-scale (governmental) community outreach programmes as part of national health systems and not to “community engagement” as part of international aid projects. It is important to have examples from different parts of the world included. It is also an aim to have more people who are actively practicing COPC presenting/ reporting/ teaching in the module to demonstrate the variability and flexibility of COPC to different contexts.
tropEd accreditation: Accredited in December 2017 and re-accredited in Munich in February 2023. This accreditation is valid until February 2028.
Remarks: 1. Marcus T. Community Oriented Primary care. COPC Principles, the Individual, the Family and the Social Structure of Society. 2013, Cape Town, South Africa: Pearson Education South Africa (Pty) Ltd. 2. Whitehead M. The concepts and principles of equity in health. Health promotion international 1992;6(3):217-228 3. Sackett DL and Haynes RB. The architecture of diagnostic research. BMJ 2002;324:539-541. 4. Krumholz HM. Big data and new knowledge in medicine: the thinking, training, and tools needed for a learning health system. Health Aff (Millwood) 2014;33(7):1163-1170 5. Rose G. Sick individuals and sick populations. Int J Epidemiology 1985;14:32-38 6. Ekman I, Swedberg K, et al. Person-centered care--ready for prime time. Eur J Cardiovasc Nurs 2011;10(4)248-251
Email Address:	MscIH-coordinator@charite.de
Date Of Record Creation:	2017-12-17 15:42:23 (W3C-DTF)
Date Of Record Release:	2017-12-17 20:57:35 (W3C-DTF)
Date Record Checked:	2018-06-27 (W3C-DTF)
Date Last Modified:	2024-09-24 09:47:01 (W3C-DTF)