How to Upgrade 22,000 Nurses in Kenya
Nairobi (KEN), May 2007 – In a public-private partnership, Accenture and the African Medical and Research Foundation (AMREF) have developed the Kenya Nurses Training Program. eLearning Program Manager Adesuwa Akinboro from AMREF will present this very successful case study in the conference section "Online Learning Opportunities for Health Professionals".
How did the cooperation with Accenture come to be?
Adesuwa Akinboro: AMREF and the Nursing Council of Kenya have been involved in the training of nurses for over five years now. Initially, this was through the distance education print-based mode. However, due to the chronic nurse shortage, the need to accelerate the training of health workers arose.
AMREF approached Accenture, a global management consultancy, technology services, and outsourcing company with many years of experience in eLearning for a solution. Together, AMREF, Accenture, and the Nursing Council of Kenya designed a solution to address the chronic shortage of registered nurses in the country.
Could you please describe the outline of the program?
Adesuwa Akinboro: Twenty-seven nursing schools are currently implementing the program. Their role is to enrol the students, who are drawn from hospitals, health centers, non-governmental organisations, and from the general population. The students must meet the following requirements:
A community health nurse certificate (ECHN);
Furthermore, government employees should have more than three years of service.
Once enrolled, the students take the course at their places of work on computers that are installed and maintained by AMREF. The program currently has 100 of these centers equipped with a total of 340 computers. These include hospitals and medical training colleges. The eLearning centers have an AMREF trained mentor whose responsibility is to assist the students during their clinical placements and to serve as the first level of computer help-desk support.
The upgrading program is structured into four modules. Every module consists of several units with two self-tests in each module. In addition to the self-tests, the schools administer a written exam at the end of each module and a final exam at the end of the course. The school also monitors student progress on an ongoing basis.
The need for practical experience cannot be over emphasised. The program requires that all students receive practical experience at approved hospitals, and this is one of its strengths since it allows students to put into practice the knowledge they will have acquired almost immediately.
What has been the most important experience? Which obstacles did you have to overcome?
Adesuwa Akinboro: This has been a very exciting program. It has motivated the nurses enrolled in their provision of health services across the country. The nurse managers have also noted and commented on the improved service delivery as a result of the eLearning programme. In addition, it has enabled many nurses who previously did not have the opportunity to take the course to do so.
Such multi-faceted national level programs will encounter obstacles in implementation, particularly when they contain such innovative components. The program has a strong risk management strategy in place and thus mitigates the following risks and challenges:
The need for internet access, connectivity, and IT infrastructure in the hospitals where the nurses work. AMREF has provided computers but is currently looking into the connectivity issue.
The release of students from hospitals to take up the training, since nurse managers initially did not quite grasp the benefits that eLearning can bring.
The fees charged by schools. As you might expect, the cost of taking the course should be less than that of a residential course. This has not always been the case. Through stakeholder sensitisation, this is gradually being achieved.
Policy issues: there is the need to integrate eLearning into the training policy for health workers.
Stakeholder identification and involvement is crucial to ensuring their participation support and continued buy-in.
So far over 2,000 student nurses have been enrolled for the eLearning courses. Can you tell us any success stories?
Adesuwa Akinboro: Through our monitoring and evaluation exercises, we have received feedback from nurse managers regarding improvement in the quality of care provided by the trainee nurses. The managers have attributed this to the eLearning course. In addition, nurses have broadened their managerial and technical knowledge and acquired IT skills.
This has enhanced their confidence and motivation. The program has enabled more nurses to enroll than was previously possible with the residential programme. Some nurses who previously could not get admitted to the course due to the limited number of places available and who have tried for over ten years have finally been able to enroll. The uptake of the program by students, schools, and hospitals has been overwhelming.
Many more nurses need to be trained. What are the next steps that need to be taken?
Adesuwa Akinboro: A core component of this program is skills transfer and as such, the partnership has built up the capabilities of AMREF, the Nursing Council of Kenya, and the schools, including through a bespoke training programme delivered by Accenture Learning. The eLearning model can be used to train other cadres of health workers even to the degree level.
We now cover all of the country’s eight provinces. This infrastructure is capable of training the remaining nurses. We also intend to hook up the centers to the Internet so that we can improve communication and access to information, encourage collaboration among students, improve data management, and get the most out of our Learning Management System.
Will the cooperation between AMREF and Accenture continue?
Adesuwa Akinboro: Yes, the cooperation will continue. As a result of this program, AMREF and Accenture have extended the partnership to include other organizational areas such as strategic support. Furthermore, discussions are also underway that will allow replication of the program in other African nations. This is indeed just the beginning and an excellent example of North-to-South cooperation and of a public-private partnership.