Do community-based Medical Schools Produce More Community-based Research? A Review of Four Medical Schools in Sudan and Saudi Arabia

Abstract

Purpose: Despite several publications comparing the educational outcomes of Community-Based Education (CBE) to non-CBE Medical schools, evidence on utilization of community-based research (CBR) is largely lacking. Therefore, the objective of this research was to compare the utilization and quality of community-based research approaches between four community-based education and non-CBE medical school in Sudan and Saudi Arabia. Methods: A review of the literature from four schools in Sudan and Saudi Arabia was performed by searching PubMed electronic database using predefined inclusion and exclusion criteria. Classification of studies and appraisal of quality of community engagement was performed. Results: The review identified a total of 573 articles, 79.4% (455) of which were produced by non-CBE medical schools (Khartoum and Taibah) and 20.6% (118) produced by CBE medical schools (Gezira and Jazan). However, only 9.08% (52) of the articles were CBR while more than a fifth (21.19%) of the school CBE articles were CBR with only almost 6% CBR from the production of non-CBE medical schools. This demonstrates that despite on-CBE schools’ significant production of articles relative to CBE schools, nevertheless researchers were more inclined to utilize hospital, laboratory and internal facilities rather than community-based facilities to conduct research activities. The mean scores obtained for quality of community participation among the 52 CBR reviewed studies conducted by CBE and non-CBE medical schools were 1.33 and 0.07, respectively which effectively translates to significantly higher quality of community engagement in research at CBE schools. Conclusion: Conducting a research in the community instead of the laboratory, hospital or clinical setting does not make it a community-based research. The main challenges facing Community-Based Participatory Research are therefore building and maintaining genuine partnership and trust; sustainability of relationships and commitments; developing the knowledge, capacity and values; sustaining funding, staff, programs, and policy changes. Capacity development for both researchers and communities is required a long with developing policies and funding opportunities within higher education institutions to enhance CBPR as a tool for promotion of equity and social justice.