DL4H INTERNAITONAL WORKSHOP

eLearning Nurse Upgrading Programme: Kenya’s

Experience

Presented by:Caroline Mbindyo - AMREF HQ

26-27 October 2010

Global HRH Crisis

eLearning Programme Background

• Moratorium on hiring new nurses• Inadequate facilities to up-skill nurses in Kenya

– Shortage of qualified nurses – As at 2004, over 80% of nurses in Kenya were ENs

– Only 4 government nursing colleges offering upgrading from enrolled to registered nurse as at 2004 (100 nurses / annum)

– Health facilities in rural areas run by EN who do not have the requisite skills to offer quality services (clinical, managerial, research)

• Cost of training– Relatively high cost of education - Nurses earn

£160/month on average

A health system under extra-ordinary pressure requires extra-ordinary effort

The Programme at a Glance• Regulations & Examinations• Standards & Guidelines

definition • Coordinating school activities

• Policy issues • Release of nurses to learn• Course approval

• Student enrollment• Programme

implementation• Tutoring, assessments &

examinations

• Content development • Programme management • Infrastructure deployment• Capacity building• Advocacy

Public Private

Partnership

• Funding in cash & kind

• Skills transfer

The Programme Design

LEARNER SUPPORTLEARNER SUPPORT

•Tutors trained in schools•Mentors in the clinical areas•Face-to-face sessions•End of module examinations

DEPLOYMENTDEPLOYMENT

COURSE STRUCTURE

COURSE STRUCTURE

•Over 1,100 hours of learning•48 weeks of clinical experience

•eContent development•LMS & CD-ROMs

ACCESSACCESS

•Setting up eCenters•12-hour access for students•Help Desk set-up at AMREF

MODULARCURRICULUM

MODULARCURRICULUM

•General Nursing•Reproductive Health•Community Health• Edu, Management & Mental Health

The Story So Far

• Increased access to health education – 34 schools with an enrollment of

over 7000 nurses– 108 eCenters across the country

• Over 400 faculty members & mentors trained to support eLearners

• Improved nursing care - immediate application into practice.

• Reduced cost of learning• Replicating eLearning across other

cadre and other countries• Programme mainstreamed and to be

handed over in December 2010

Programme Challenges

• Resistance to change• Techno-phobic

students & teachers

• Large scale maintenance of IT Infrastructure

• Limited IT support at decentralized centres

• Limited access to Internet connectivity in rural locations

• Inadequate approved clinical placement facilities

Lessons Learnt / Good Practice

• Partnership, partnership, partnership– Shared infrastructure, shared governance, shared

responsibility– Programme sustainability

• Continuous assessment & improvement of the programme in line with changing environment

• eLearning should be customized to meet the infrastructure - hardware, software, bandwidth availability, electricity supply etc of the country in which it is being implemented.

• Accessibility– IT infrastructure in rural & urban locations– Tutor and student eLiteracy

• Policy support at national and institutional level

Programme Replication Framework

Conclusion & Future Direction

• eLearning is not only feasible but also effective in scaling up Human Resources for Health (HRH) in resource constrained situations.

• There is no one-size-fit all solution to eLearning. It must be customized to meet the needs.

• AMREF has developed Replication Assessment Toolkit© and Implementation Guide© to assist resource poor countries implement eLearning.

• Exploit opportunities offered by mobile phones to increase access to health information for health workers.

AMREFs Mobile Learning (mLearning) platform

Thank You!

www.amref.orgcaroline.mbindyo@amref.org@shakwei