角井39

信弘

特集：合同臨地訓練
Community based research by team in KMTC, Kenya
Yoneatsu OSAKI1), KMTC/JICA project2)

1.

What is KMTC?

Kenya Medical Training, College (KMTC) wasestablished in 1927, namely KMTC has a history ofseventy-five years. In its headquarters in Nairobi, there
are five faculties composed of a total of sixteen
departments and one unit. In addition, twenty-threeconstituent colleges are located throughout Kenya. 600
teaching staff are training a total of 6,000 students whowill acquire, when graduated, qualification in one of thehealth and medical disciplines except that of a physician.
Thus, more than 90% of co-medical and health workers
in Kenya are the graduates of KMTC. They will be seenat the health facilities in any rural area. KMTC also
brings up clinical officers. Although they are notphysicians, they can be engaged in the almost same
medical work as the physicians under the Clinical
Officers Act. They will be found in the small hospitals orheaelth centers in a remote area where the physicians
are not available.
KMTC has a Board of Management appointed by the
Minister of Health. The Board guides all policy matters.
The Director is the Chief Executive of the College.
The functions of KMTC are based on the three pillarsof training institutions, i.e. education, research andservice to the cmmunity. Among other roles KMTC is
mandated:
To train and develop students in various disciplines atdifferent levels in accordance with health needs of thecommunity and the sector; To develop trainers of heatlh
workers in various disciplines with the capacity toeffectively teach, design and produce teaching materials
and conduct research; To play a pivotal role in
1）Department of Hygiene, Faculty of Medicine, Tottori
University2）Kenya Medical Training College, P.O. Box 30195, Nairobi,
Kenya

strengthening of promotive and preventive health careservices through educational outreach.
Nairobi college, the headquarter of KMTC, has 16
departments and 1 center. These 16 departments wereclassified into 5 faculties. Faculty of Clinical Sciences
include 3 departments, namely Department of Nursing,
Department of Clinical Medicine, and Department ofPharmacy. Faculty of Public Health Sciences include 4
departments, such as Department of Environmental
Health Sciences, Department of Health Education,
Department of Medical Engineering, and Department ofCommunity Oral Health. Faculty of Research andInformation include Department of Medical Education,
Department of Health Records and Information, andDepartment of Information Technology. Faculty ofDiagnostic Sciences include Department of Medical
Imaging Sciences, and Department of Medical
Laboratory Sciences. Faculty of Rehabilitative Scineces
include Department of Dental Technology, Departmentof Physiotherapy, Department of Occupational Therapy,
Department of Orthopedic Technology, and Counseling
Unit.

2.

Outline of KMTC/JICA Project

The Project aims to upgrade educational capability of
KMTC teaching staff, which will eventually result inproviding Kenya with competent co-medical andhealth workers.
Since KMTC as a whole is a mammoth college as
explained above, the current Project focuses its activities
on the teaching staff of six primary health care related
departments (Departments of Nursing, Health Records
and Information, Cinical Medicine, Medical Education,
Environmental Health Sciences) at Nairobi Headquarters
and of Department of Community Nutrition at Karen
College. However the teaching staff of other departments
in Nairobi as well as constituent colleges are invited to

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Community Based Research by Team in KMTC, Kenya

participate in the annual middle level manpower training
seminar and the information technology (IT) training.
The duration of the Project is five years from the 1 st
March 1998 to 28th February 2003. Major activities of thisprojects are follows;(1) Dispatch of Japanese experts on Project
In total, the twelve long-term and nineteen short-term
experts have been dispatched to the Project up to theend of the fiscal year 2001.

(2) Overseas Training
The categorized numbers of KMTC trainees who havereceived overseas training up to 2001 are as follows (seeTables 1).
Table 1 achievements Overseas trainings
Counterpart training in Japan

15

Group training in Japan

4

Long-term (2 years) training in Japan

2

Third country training in Thailand

3(3) Provision of Equipment
JICA has provided teaching materials (e.g. audiovisualequipment, textbooks, personal computers, etc.)
necessary for upgrading the educational capacity ofteaching staff, which amounts to the total of 95,105,000
yen in the last three years.
(4) Middle Level Manpower Training Seminar
With the middle level manpower training budget of
JICA, a training seminar has been organized annually forthe middle level teaching staff on the specific topic for
two to four months.
Year

Number of

TOPIC

1998

Project

cycle

management

Participantsandpresentation skill

32

1999

Research methodology

30

2000

Curriculum review and development

31

2001

Primary health care through community mobilization & participation

basic office applications and 370 participants weretrained as follows:(Staff from KMTC and constitution colleges)
Instructor training: 34, User training: 122 (Healthworkers from other institutions), User training: 100.
The training courses are now conducted by the KMTC
instructors who received the computer training earlier.
70% of the ex-participants in Nairobi campus are utilizing
the acquired skills in their work. (Survey results in
February 2001)(6) Improvement of Education Curriculum
By September 2001, 19 existing curricula have beenrevised and updated and one curriculum has been newly
developed. A bibliography for curriculum review anddevelopment was produced by the Department of
Nursing.
(7) Production of Teaching Materials
Activities are started in Department of Clinical
Medicine(CM) from April 2001.
Workshops for teaching materials production wereconducted as follows:
1. 5-30 June 2001 for lecturers in CM, KMTC Nairobi.
2. 3-7 September 2001 for lecturers in CM fromconstitution colleges.
3. 7-9 November 2001 for lecturers in CM, KMTC
Nairobi.
Up to November 2001, the lecturers have produced 3teaching manuals, 2 posters, 100 transparency sheets, 1
brochure and several handouts in Department of Clinical
Medicine.
(8) Consolidation of Organizations and Facilities
In order to strengthen IT system and training, theDepartment of Information Technology was created. To
facilitate practical exercise in the environmental health,the Practical Demonstration Building was constructed
and opened on 31 August 2001.
(9) Other activities
As one of the activities in connection with the 1999
course of the Middle Level Manpower Training(MLMT),a public toilet was constructed in Riruta, Nairobi, withthe cooperation of the local community. Its opening
ceremony took place on 22 May 2001.4.

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Community-Based Research by Team as a Program of
MLMT(5) Information Technology (IT) Training
Up to September 2001, 18 courses were conducted in

MLMT (Mid-Level Manpower Training) is one of the

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Yoneatsu OSAKI

most important activities in the JICA/KMTC (Japan
International Cooperation Agency/Kenya Medical
Training College) project. This program has been
prepared for teachers from faculties in the Nairobi
headquarters without long-term experts from Japan andfrom branch schools of KMTC all over Kenya. This is an
educational program of several months' duration. In
order to encourage the independence of the Kenyan side,
the Japanese side has requested Kenyan side bearing themoney for management of this program, so that theburden proportion by KMTC has increased during these.
The MLMT has been planned, managed, and conducted
by JICA long-term experts, the faculties of the KMTC,Japanese short-term experts and Kenyan experts outsideof KMTC (university teachers or NGO). For example, in
fiscal year 1999, this program invited Dr Takagaki(Kitasato University medical school) and Dr Osaki(National Institute of Public Health) to teach researchmethodology.
The MLMT is carried out through the exchange of
official documents (Exchange of note) between the
Kenyan and Japanese governments, according to official
records (Record of discussion) about this project. This
document describes the purpose and contents of MLMT
during this project, as follows:

To improve the teaching skills of faculties in
1998

KMTC through foundamental training in a logicalframework and by sharpening presentation.
To improve teaching and research skills of

1999

faculties in KMTC by presenting a series oflectures about research methodology and by
conducting field research.
To emphasize teaching techniques of faculties

2000

through the production of teaching materials andmanagement of information.
To improve teaching skills of faculties through2001

primary health care education and curriculum
development.
To improve teaching and research skills of

2002

faculties again by presenting a series of lectures
about research methodology and by conducting
field research.

In 1999, MLMT was carried out from August 9 toNovember 30. Thirty teachers participated in thisprogram from the branch schools and the Nairobi school.
During the first month of the program, short-term

41experts gave lectures on research methodology,
epidemiology, and statistics, and computer handlingpractices. The participants lived together in dormitories
on the Nairobi campus and they learned about thesignificance, methods, and procedures of the CommunityBased Research by team (Gourin) that was carried out at
the National Institute of Public Health, Japan. Dr.
Takagaki introduced even the most advanced researchmethodology of molecular biology.
The participants were divided into 6 teams. Each teamfocused on malaria, HIV/AIDS, diarrhea, acuterespiratory infections (ARI), malnutrition, or poor
sanitation. First, they used the Internet to search for
related articles. Then they discussed researchmethodology, including the purpose of the research,
subjects, sampling methods, and the contents of thequestionnaire, and they wrote a research proposal.
Researchers from the Kenya Medical Research Institute(KMRI, another JICA project in Kenya) sometimes
helped the participants. The team members used theInternet to collect related articles and information, andvisited research areas and contacted local professionals
to create research questions. They discussed anddeveloped research methodology, target population,
sampling procedure, sampling size, checkpoints duringhome visit interview, and the contents of thequestionnaire. After that, they conducted a field survey
on each topic. They visited the research area to performthe interview survey and to observe sanitation status,and so on. They brought information back to KMTC,
input data on a worksheet using the computer, andcalculated and analyzed the data. They summarized theresults of the survey and wrote a research report.
Furthermore, they brought the sammuarized results ofthe survey to the people in surveyed slums andpresented it to the residences and local public healthpersonnel in easy-to-understand explanation. For
example, the Malaria team visited a public open space inthe surveyed slum, asked walking people to get together
to hear their presentation and conducted an open-air
meeting to report their research results. They also
conducted an on-campus meeting to report research
results to the faculties at the Nairobi school. Some of thebetter teams had a chance to present their results in theclosing ceremony inviting leading officials from the
Ministry of Health in Kenya and from the Japanese
embassy and Kenya JICA office.
This was the first time that most of the participants
had conducted a field research, summarized the results,
written reports, and presented the results. Moreover, formany of them, they had not previously visited a slum.

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Community Based Research by Team in KMTC, Kenya

They revealed the real health status of the slum in
Nairobi, and it was important for the participants to be
confident as a researcher. Moreover, they had a lot of
valuable experiences with their colleagues; both in theirteam activities and during the time they spent in thecampus dormitory. Recently, we observed some
improvements on the Kenyan side. The graduates of
MLMT in the Nairobi school supported the operation of
MLMT, and KMTC established an organization tooperate MLMT. This is nothing but a feasible humanresources development. This is a very important successand evaluation point for the project.
The summary of presented information explaining
Japanese Community-Based Research by Team is shownin appendix
Appendix.

Community-Based Research by Teamin Japan
Educational program for community-based
research by team and its steps

1.

PurposeThe goal of community-based research by team is thatstudents who specialize in different disciplines form ateam and experience team activities to help them
manage public health problems at the field level. This
program is regarded to be an increasingly importantpart of the curricula of both the Master and Diploma
courses in the National Institute of Public Health.
Characteristics of Community-Based Research byTeam (Gourin)
Team approach by students with different backgrounds,
specialities, and experiences.
On-site training: students visit field and discuss withresponsible personnel from the field or people or patientsliving in the field.
This program respects team discussions and decisions.
Since students learn all processes of the research, they
are not evaluated by the final research report alone.

also how to approach the local community in order to
identify solutions.
To realize interdisciplinary collaboration.
To learn how to write reports and present research
results.
To learn the research process, including planing,
implementation, collaboration with personnel in the field,
data analysis, evaluation, report writing, presentation,
public health intervention, production of educational
materials for the public, etc.
For personnel in the field and teachers to learn from theprocess and to find the key to improvement of services,
ets.

2.

Community-based research

Can cover any field of public health.
Is conducted with quantitative and/or qualitative
research methods and is undertaten by a team.
The team is formed by students from different
departments.

3.

Research field

Prior to the survey, there needs to be a thoroughdiscussion with those in the field regarding the generalthematic topic. The views of problems at the local levelshould be the primary consideration. The topics of theresearch are therefore embedded in the local context inthe field. The goals and the nature of the researchshould be discussed in detail with the personnel in thefield to ensure that they clearly understand the process.

4.

Setting the topics for each team

Visiting the field, discussing health problems withpersonnel in the field
Reading major important documents about the fields,
and some scientific books or papers.
Discussing with team members
Ironing out differences of opinion according to publichealth importance and feasibility.
Reference
1. KMTC/JICA project Homepage, http://www.
jicakenya.org/kmtc/index.htm

Objectives
To learn not only wide-ranging research methods, but

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Example of outline of community-based researchCollecting data

Presentation of results to the field
Presentation to the faculries in NIPH

Presentation on the national
scientific meeting
Submitting a manuscript toa scientific journal

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