Health Professions Education Programs Reorientation Towards Social Accountability: The ENACIER Model

The Network: TUFH and Social Innovations Partners are thrilled to announce the latest edition, “The Network: Towards Unity for Health (TUFH) Social Accountability and Interprofessional Education.” We had the pleasure of again partnering to bring you this special edition featuring global health pioneers working across sectors to improve the quality of life for citizens in ecosystems throughout regions around the world.

In 2019, we see global trends emerging such as an increased focus on social and environmental determinants of health, dramatically rising health care costs, and increasing inequity in health outcomes. Layered with advances in data and information technology, these conditions have become more apparent to the public. We also are seeing a new era of social accountability. Social Accountability and Interprofessional Education have been identified as critical best practices to drive better health outcomes. However, there still exists a gap between systemic implementation and adoption and this blueprint for more equitable, sustainable, and holistic health care. We believe this edition is an important step in moving towards closing this gap to improved health care for all people.

We are excited to feature the talented practitioners of this “Network of Networks” who are building the bridge to the future through the health field and their articles that shed light on a promising path forward to improved health care and outcomes for people across the globe. We hope you too learn from these individuals operating at the cutting edge of global health and incorporate their best practices into your work, ideas, and policies that will help to shape our collective future and make improved care a reality for all people.

The seventh article is

Health Professions Education Programs Reorientation Towards Social Accountability: The ENACIER Model

Cameroon is a nation that on average still has almost half of its population living in rural areas. Some schools that train health professionals use rural communities for community health internship placements. The most prevalent form of community internship uses a model where students go into the community, collect data on health indicators, and write a report which they submit in school for their grades. These communities expressed the desire to see some form of intervention as opposed to the data collection orientation that all the schools were using. To address this problem, the nursing curriculum was modified to increase the school’s social accountability to rural communities and expand leadership competencies in nursing students. The ENACIER model (empower, negotiate, assess, collaborate, intervention, evaluate and report) was developed and at its core was an intensive training using a 12-hour curriculum. It prepared undergraduate nursing students to leverage technology like point-of-care testing and local resources through community participation, to address one identified health-related problem during a 12-week internship. They will then work with community individuals and groups to solve this problem with the resources available within the community. Thus, with the students’ help, communities were able to prioritize their own problems and implement indigenous solutions within their own resources.

Read the full article here.


Dr. Maboh M. Nkwati is the pioneer Head of Nursing and Deputy Vice-Chancellor for Academic Affairs at the Biaka University Institute of Buea Cameroon. He has been working for 14 years in health professions education and academic governance. He is passionate about improving individual and community health through education and has been active in the development of health professions education in Cameroon. In this context he has led curriculum development in a wide range of health and nursing subject areas. His primary research interest is in the area of health professions education (and improving health care through education), active learning, and elderly care. This has led to publications in academic journals that include articles on innovative approaches to curriculum development, elderly care, student-led community health improvement projects, and the evolution of professional education. He is also introducing the concept of interdisciplinary clinical simulation in health professions education in Cameroon at Biaka University Institute of Buea.

Maboh is also serving as member of the academic board of Equals Institute Australia. He is co-investigator of a World Diabetes Federation funded project to improve rural diabetes management using a synergy of student nurses and primary care nurses in the South West Region of Cameroon. He is a member of multiple professional associations in Cameroon and internationally. He is actively involved in professional advocacy and the fight against fraud in health professions education and practice. He is also the founder of the Health Research Foundation that provides health research consultancy and training services in Cameroon 

Maboh’s educational background includes a Bachelor of Nursing Science and Master’s in Nursing Education from the University of Buea Cameroon, and a PhD from the University of Essex in the United Kingdom. He is also a 2012 Fellow of the Foundation for the Advancement of International Medical Education and Research (Philadelphia USA).

Dr. Aminkeng Z. Leke is fellow (2011) of the Foundation for International Medical Education and Research (FAIMER)-USA. He holds a BSc. in medical laboratory science and MSc in chemical pathology from the University of Buea-Cameroon; and a PhD in Pharmacoepidemiology from Ulster University-UK.  

Since 2007, he has served in various administrative and academic roles at Biaka University Institute of Buea; his latest (in 2016) being Deputy Vice Chancellor for Research, Cooperation, and Quality Management.  

Dr. Leke has been a lead member of many curriculum development committees on health professions education in Cameroon. His manual “Medical Laboratory Science for Nurses” written in 2008 has been a great educational resource for many nursing students across Cameroon. He has a keen interest in community health and maternal/infant health. He led an innovative project on diabetes management in rural Cameroon that won the TUFH Projects that Work International Award in 2015. This project is currently being funded by the World Diabetes Foundation with potential nation-wide adoption. One of Dr. Leke’s recent projects has produced the first data on maternal medication use and safety in pregnancy in Cameroon. In his past work in Europe, he investigated maternal use of antibiotics and risk of congenital anomalies by analyzing the European Surveillance of Congenital Anomaly (EUROCAT) database. Currently, he is working with the ZikaPlan Global Birth Defects Team to develop an app for the identification and accurate description and coding of congenital anomalies in low-resource settings. He is also involved in the WHO Pregnancy Registry project in Africa. 


Pauline B Nyenti is a nurse educator working with the Training Schools for Health Personnel, Limbe Cameroon. She is adjunct faculty in the departments of Nursing at the Biaka University Institute of Buea and the University of Buea, both in Cameroon. Nyenti holds a Master’s in Nursing Education and a Bachelor of Nursing Science from the University of Buea Cameroon. She is also a 2014 fellow of the Foundation for Advancement of International Medical Education and Research (FAIMER) Institute in Philadelphia, Pennsylvania. She enjoys teamwork and is very passionate about enabling students to discover and develop their capacity to contribute to the health of communities. This has led her to remain active in various community projects involving students both at the Health Research Foundations (HRF) Buea and in schools where she teaches. 

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