Around 78.55% of Nepalese population lives in the rural part of Nepal and most of them have no access to any secondary or tertiary care hospitals.
Article 35 of Constitution of Nepal, 2072 ensures that every citizen shall have right to free basic health services from the state and no one shall be deprived of emergency health services.
As constitution guaranteed primary health care and emergency care to all its citizens, all the sub-health posts are now upgraded. In each health post there are about 5 to 6 technical health manpower in the hills and terai region respectively.
These mid-level providers are disconnected from regular medical /public health education updates due to lack of organized system at present.
If every health post starts a form of CME classes at least 1 hour every day or once in a week, the medical as well as public health knowledge of the health workers would increase followed by the increase in proper diagnosis of patient.
With this we can make better differential diagnosis of disease, timely identify danger signs and make appropriate decisions regarding referrals.
We can improve quality of patient record and record keeping. It is important to provide good medical history to referring doctor regarding patient especially for emergency service.
Also the lessons and manuals/ protocols we share in our class will help to reduce the economic load of the health ministry and various disease treatment divisions by reducing the number of trainings needed in such issues.
Health workers will be updated time to time with the changing knowledge and practices.
I am happy and proud to say that, I had started CME classes in Kalika health post, Achham for the first time in 2074 B.S. In our health post, we had started classes in weekly basis- every Friday, one hour discussion among the health workers. The classes helped us increase our capabilities and we were learning and sharing with one another in each class. Later I started CME classes in Samaijee health post, Dadeldhura during Covid-19 period which was fruitful.
CME class is a very helpful tool to increase the knowledge, practice, capacity and confidence of primary health care providers, in rural setting and other parts where mid-level health care providers are disconnected from regular medical updates.
Madan Pandey
Public Health Inspector (GON)