Dr. Andrew Mwanika, head of COBES, describes how the decentralization by the government has put new responsibilities on the districts. After an assessment of manpower in the districts and a feasibility study, the Faculty of Medicine responded with a curriculum change, comprising Problem-Based Learning and COBES. The curriculum aligned students’ training to health needs of the country and was designed to prepare students for rural practice, integrating priority health programs into their training and acclimatizing students to the rural districts. COBES now has a presence in 43 districts. Not surprisingly, attendance at health facilities goes up 30% when the students go out, and the program has a high level of acceptability with the communities and the district health offices.