Low uptake of upgrading course among nurse-midwives through eLearning model in Tanzania: is it

entry qualifications or computer-phobia?

Lujenje S1,Ngilangwa David P1, Chaya Pius1, Noronha Rita1

1 Amref Health Africa, Dar es Salaam, Tanzania

1st Amref Health Africa International Conference

Safari Park Hotel, Nairobi, Kenya

24-26th November, 2014

Outline

• Issue

• Description

• Lessons learnt

• Next steps and recommendations

• Acknowledgments

Issue• Human resource for health shortage is daunting

– Nurse-midwives in particular remain low

• The situation contributes significantly to high number of maternal mortality in the country – 51% of deliveries are assisted by skilled personnel

• Range of initiatives have been done to increase number of training institutions and enrolled students

• Yet, the country experience dearth number of HRH – Tanzania has 65% unmet needs for its required HRH

• Thus, equipping available HRH to conduct multi-task including deliveries remain critical

Issue…• Amref Health Africa through its global campaign “Stand Up for African Mothers” is contributing towards addressing HRH shortage in Tanzania

• Supporting training of nurse-midwives in nine regions with severe shortage of HRH in Tanzania

• Through e-Learning

• eLearning programme uses the existing national curriculum for conventional nursing training schools for upgrading nurses

• Curriculum are installed in students’ computers in all participating nursing schools

Description• In April 2011, Amref Health Africa in collaboration

with MoHSW launched two-year project

• Upgrade 2,800 nurses-midwives from certificate to diploma level through eLearning in 9 nursing schools

• This is a two year in-service training • Allows nurse-midwives to remain at their workstation• Study at their own pace, with minimal disruption to their work

schedules• To do practical of what they have learnt

• Contrary to full-time studies

Description…• The programme implementation was preceded

by a rapid assessment to determine;- Tanzania’s e-Learning preparedness- Revising the existing national curriculum to suit a eLearning

model- Obtaining approval of curriculum from regulatory bodies- Sensitizing nurses to join the programme

• The programme has been widely publicized nationwide and most of targeted i.e. in-service nurses are aware of it

• However since its inception uptake of the programme has been remained low

Description…Uptake of eLearning among students in Tanzania

Intake Number of applicants

Number of selected/qualified

April 2013 160 89

Sept 2013 222 88

April 2014 52 22

Lessons learnt • eLearning acceptance was high from nurses and

employees

• Majority of targeted nurses wanted to join the course

• Entry qualifications of one pass in either Biology or Chemistry plus two years work experience obstructed them

• Other reasons given for low uptake of the course were– lack of prior training or exposure to computers

– challenges in balancing work, family and education life

– Distance from workplaces to nursing schools especial during face to face meetings with their tutors

Next steps and recommendations • To scale up the programme to other schools and

intensify its sensitization

• Regulatory body should review entry qualifications to improve access to Continuous Professional Development (CPD) for nurse-midwives

Acknowledgement

o All donors (GSK 20% Re-investment)

o The Government of Tanzania

oNursing Schools

o All eLearning programme stakeholders