CIESPAC (Centre inter-états d'Enseignement en SantéPublique pour l'Afrique centrale), a sub-regional public health training institution, originally located in Brazzaville, was created with the vocation of providing Central African countries with qualified health services managers (the turbulent events that occurred in Brazzaville in June 1997 prompted the transfer of the institution to Yaoundéin Cameroon). It offers several courses, the most recent of which culminates with a professional diploma in public health and targets mainly potential health district managers (DPSP--Diplôme Professionnel en SantéPublique). This paper reviews the first four-year experience of implementing the "community-oriented problem-based learning" (PBL) pedagogic approach in francophone Africa. About 70 health professionals (mainly MD and diploma nurses) were trained, using the PBL approach, within a period of three years. Practical field training activities involving the neighbouring urban communities of the institution as training sites were given a key place in the course and thus allowed trainees to perceptively appraise the priority health problems of a district. The most important thing trainees learnt during this course was how to learn. Some of them were also able to participate in some operational research. From this experience, it is clear that trainees are coached to learn solving problems on their own for the rest of their professional career. The neighbouring community of a training institution, when properly approached, can provide a very fertile teaching ground where trainees can acquire first hand practical experience in learning to collaborate with local communities. However, the PBL pedagogic approach requests a mutual understanding between trainees and trainers. As such there is a need for a careful selection of trainees and, even more importantly, for a critical mass of competent and motivated trainers.