Implementation of Social Accountability in Undergraduate Medical Training at a Sub- Saharan African Medical School: Stakeholders’ Perspectives

Abstract

Background: Social accountability for medical schools is the obligation of the medical school to direct its core activities toward meeting the priority needs of the community. The core activities of medical schools are education, research, and service. Social accountability is a global concept that requires local contextualisation. Stakeholder partnerships are central to the implementation of social accountability, and stakeholders need to work together in planning, implementing, and evaluating social accountability in undergraduate medical education. We aimed to explore stakeholders' perspectives on the implementation of social accountability in undergraduate medical training at Makerere University School of Medicine. Methods: This was an exploratory qualitative study. Data was collected between September 2022 and December 2022. Ethical clearance was obtained from the Makerere University School of Medicine Research Ethics Committee. Fourteen stakeholders in undergraduate medical training at Makerere University School of Medicine were interviewed, including three policymakers, one health administrator, three health professionals, three community representatives, two medical students, and two representatives from the medical school. Transcripts were analysed to generate themes using the six-phase approach to thematic analysis described by Braun and Clarke. Results: Diverse expressions of the implementation of social accountability were present in all three core activities of the medical school. The curriculum and community-based education research and service were key expressions of social accountability in education activities. Research to understand community needs was described within community-based education research and service. The opportunities to improve the implementation of social accountability include involving civil society partners and improving equity in undergraduate medical training. Conclusion: Our study found evidence of the implementation of social accountability in undergraduate medical education. The opportunities to improve the implementation of social accountability in undergraduate medical education include: involving civil society partners in training medical students about the community; working with the community living in the nearby slum; and providing financial support for students.