Social Accountability not Universally Understood

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‘Social accountability is poorly understood and quite often interpreted by individuals as a personal responsibility or a set of values,’ said Dr Amy Clithero-Eridon who graduated with a PhD in Family Medicine.

‘Local context matters when defining a term that is not universally understood, yet gaining in importance as an educational concept. It is essential to know how it is understood, interpreted, put into practice, and, most importantly, the impact on graduates and the communities in which they practice,’ she added.

Clithero-Eridon’s study titled, Understanding of Social Accountability in the Nelson R. Mandela Medical School (NRMSM) Curriculum, was supervised by Drs Andrew Ross and Stephen Knight of UKZN, and Drs Cameron Crandall and Danielle Albright of the University of New Mexico. It aimed to understand how health professional education in the area of social accountability is developing at the School and, ultimately, how this is translated within communities through graduate practice.

The research relied on qualitative techniques supplemented by quantitative data where appropriate. A survey was conducted among Medical students, community mentors and physician preceptors on their understanding of the term “social accountability” Clithero-Eridon analysed Medical students’ background characteristics, motivation for pursuing a medical career and future practice intentions. She then compared the characteristics and practice intentions of NRMSM graduates working in district hospitals to non-NRMSM graduates. The survey included hospital and community health facility staff associated with the training or supervision of first-year Medical graduates.

The study’s findings point to a noticeable lack of interest in primary care, and in particular, family medicine amongst graduating students. ‘Although a third of all medical doctors reported their intention to remain at district hospitals, graduates from non-South African schools remained longer than graduates of the NRMSM or other South African medical schools,’ she said.

Clithero-Eridon said that consideration of a student’s characteristics on admission, and sustaining initial motivation through community immersion with mentors who reinforce the values of primary care and community involvement throughout the curriculum, can assist students in “becoming” socially accountable as part of their professional identity formation.

‘Raising awareness in health professional schools of how their students experience social accountability would enable the development of more targeted and effective strategies and programmes to create a fit-for-purpose workforce,’ she added.

‘Social accountability is both an institutional and personal responsibility. It is not solely academic learning nor does it replace technical skills. It is an ongoing process of planning, doing, and acting and not a final endpoint.’ 

Clithero-Eridon is a faculty member at the University of New Mexico in the Department of Family and Community Medicine. ‘In addition to teaching Medical students about the social determinants of health, health policy, and health services research, I participate in numerous educational research initiatives focusing on educational best practices, health services research, and social accountability within medical education.’

She is the North American Regional Representative for the Network Towards Unity for Health, a global organisation that fosters equitable community-oriented health services, education, and research to improve health locally and globally. She is an active member of the Training for Health Equity Network (THEnet), a global consortium of 13 universities that studies aspects of social accountability in different contexts and assists health professional organisations that strive to become socially accountable.

‘I would love to teach at UKZN as a guest lecturer. I don’t just teach - I learn from students and exchanging knowledge, ideas and resources is fun! I would also like to assist medical schools globally in their pursuit of social accountability and grow family medicine as a specialty in partnership with THEnet.’

Words: Nombuso Dlamini

Photograph: Supplied