Social accountability: a survey of perceptions and evidence of its expression at a Sub Saharan African university

BACKGROUND: Many medical schools express a commitment to social accountability. However there are significant short comings in the ways doctors are educated with respect to the social contract between medicine and society. Being socially accountable in the context of a medical school is to conduct health, research and training activities in such a way that best prioritises the health needs of the people served. However, there is little clarity among medical educators on what is meant to be socially accountable. METHODS: This study sought the perceptions of senior medical educators and students on the concept and evidence of expression of social accountability in at Makerere College of Health Sciences through a cross sectional descriptive qualitative study. Twelve key informative interviews were conducted. The recorded interviews were transcribed and findings analyzed through a collaborative thematic approach. RESULTS: Social accountability was not a familiar concept and had not been encountered by many of the key informants. However, the respondents contented that it is the individual’s responsibility to be ‘sensitive’ to the needs of the communities the individual serves. The respondents made it apparent that the schools’ emphasis on community based training and service among other efforts demonstrate social accountability. There were challenges though that impeded strengthening this position, like the lack of resources in the community to support continued students and faculty stay and a lack of resources to conduct translational research activities from a pre determined research agenda. CONCLUSIONS: Despite a general unfamiliarity of the concept, there was compelling evidence in way of substantial effort and measurable outcomes, that this school has been socially accountable for a long time. However, there is need for increased awareness and a deliberate strategy to improve social accountability in a resource limited context by articulating a model to guide further implementation of the College’s intentions.