Stakeholder Perspectives on the Family Adoption Program in a Newly Established Rural Medical College, Odisha: A Qualitative Study
Abstract
Background: The Family Adoption Program (FAP), introduced under India’s Competency-Based Medical Education (CBME) framework, aims to promote early community engagement, empathy, and contextual understanding among medical students. This study explored multi-stakeholder perspectives on FAP implementation in a newly established rural medical college in Odisha. Materials and Methods: A qualitative exploratory study was conducted using focus group discussions (FGDs), key informant interviews (KIIs), and in-depth interviews (IDIs) among first-year MBBS students (n = 20), faculty (n = 8), community health workers (n = 2), and community households (n = 10). Data were collected using semi-structured guides, audio-recorded, transcribed, and analyzed using Braun and Clarke’s thematic analysis approach with inductive coding and triangulation across stakeholder groups. Analytical approach: Manual coding and thematic analysis. Results: Five core themes emerged: emotional connection and trust, role expectations and identity confusion, communication and cultural barriers, learning and transformation through exposure, and program facilitation and orientation. Strong concordance across stakeholders highlighted rapid rapport-building and experiential learning, facilitated by frontline health workers. However, discordance was evident in role expectations, with communities often anticipating curative services, and in program facilitation, where gaps in orientation and preparedness were noted. Communication challenges extended beyond language to sociocultural and structural factors influencing engagement. Conclusions: FAP is an effective platform for early experiential learning and social accountability in rural settings. However, its implementation is shaped by context-specific challenges, including role misinterpretation and facilitation gaps. Strengthening community sensitization, continuous mentorship, and systematic integration of frontline health workers as community partners may enhance the social accountability and effectiveness of FAP.