Creating Community Responsive Physicians PDF Download

Hermeneutic-phenomenological interviews were conducted to explore community-based extension workers? (CBEWs?) previous work and training experiences and how such experiences contributed to their present working relationships as partners in community development. CBEWs? responses foreshadowed challenges and problems of coordination that could have otherwise been addressed had they been considered integral elements of previous training curricula. The findings throw light on how government policies, though explicitly formulated to enhance conditions of service coordination, can be in variance with realities of coordination at the village level. Awareness of the fissure of policies and actual coordination does not refute the importance of government intervention in community development, given CBEWs? status as government employees. Rather, it is only with understanding of and familiarity with CBEWs? circumstances that such policies would truly address the challenges, problems, and possibilities of effective coordination.CBEWs? comments reflected both awareness and learned understanding of social and political complexities surrounding their work as partners in community development. Authority and interventions such as political interference, illiterate communities, enlightened communities, and passive and negative attitudes complicate their working together, resulting in problems of resistance, rejection, and other tensions that defeat the spirit of working together. Meaningful acceptance of community development as a collective undertaking needs to be backed by a deliberate unification of CBEWs through centrally organized training. Such training programs must not only illuminate the lived experiences of CBEWs as they work among themselves and with other community-based groups in the villages, but also provide opportunities for CBEWs to take active roles by engaging in activities such as placements in authentic work settings, mini-interdisciplinary groupings of CBEWs with local communities, and other team activities. There will be no end to the reservoir of learning if intentional efforts are made to incorporate local knowledge and needs, that is, immediate challenges, problems, and needs of CBEWs as they work with the local communities. Further, effective coordination requires basic skills of communication, leadership and management, personal and human relations, technical skills and relevant attitudinal orientations.The features described here are not exhaustive, but have in common the intent of making training programs truly sensitive to CBEWs? needs as partners in community development