EAST AFRICA COMMUNITY

eHEALTH WORKSHOP
November 8-10, 2010

eLearning Nurse Upgrading

Programme: Kenya’s
Experience
Presented by:
Caroline Mbindyo - AMREF HQ
8 November 2010
Current HCW Density: Nursing
• Global distribution of the health workforce (per 10 000 population)
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 did not have the
requisite skills to offer quality services (clinical, managerial,
research)
• Cost of training
A health system under extra-ordinary pressure requires extra-
ordinary effort

Address the shortage of qualified nurses Increase access to affordable,

in Kenya rapidly and cost-effectively
Improve standards of nursing care and
the health of disadvantaged people in
Kenya quickly
higher education for
professional development of
practicing nurses, majority of
who are women and located in
the rural area.

Provide skills to enable nurses perform Work towards health-related

new tasks shifted to them MDGs (4, 5 & 6)
The Programme at a Glance
• Regulations & Examinations
• Standards & Guidelines
definition
• Coordinating school activities

• Content development
• Programme management
• Infrastructure deployment
• Capacity building
• Advocacy • Funding in
Public Private cash & kind
Partnership • Skills transfer

• Student enrollment
• Policy issues
• Programme
• Release of nurses to learn
implementation • Course approval
• Tutoring, assessments &
examinations
The Programme Design
•Setting up eCenters
•12-hour access for students
•Help Desk set-up at AMREF
ACCESS
•eContent DEPLOYMENT
development
•LMS & CD-ROMs
•Tutors trained in schools
•Mentors in the clinical areas
•Face-to-face sessions
LEARNER •End of module examinations
SUPPORT
MODULAR
CURRICULUM
•General Nursing
•Reproductive Health
•Community Health
•Specialized Areas
COURSE
STRUCTURE
•Over 1,100 hours of learning
•52 weeks of clinical experience
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 tutors & mentors trained to
support eLearners
• Improved nursing care - immediate
application into practice.
• Reduced cost of learning
• Increased demand for eLearning from
countries and organisations
• eLiteracy
The Story So Far
• Established of AVS to test innovative
teaching methods
• Rolled out Diploma in Community
Health accredited by Moi University.
Registered 53 students from 10 African
countries since 2009(Moi/AMREF)
• Management training for NACC staff and
sub-grantees. Goal is train 7,000 within 3
years. (UCLA/NACC/AMREF)
• Rolled Infection Prevention & Control
course for all provincial hospitals in
Kenya (CDC/MoHs/AMREF)
• Replicating the programme with the
Ministry of Health in Uganda which
targets to upgrade 11,000 EMs to RMs to mLearning @ AMREF
tackle maternal mortality
Programme Challenges
• Large scale maintenance
of IT Infrastructure
• Limited IT support at
decentralized centres

• Resistance to change
• Techno-phobic
students & teachers

• Inadequate approved
clinical placement • Limited access to
facilities Internet connectivity
in rural locations
Programme Evaluation
Level 4: Results
As Performance
Eg –Improvements in health outcomes,
institutionalisation
improved health service efficiency (mortality,
morbidity, healthcare utilisation)

Level 3: Behaviour
Practice
Eg – Improvements in health worker
performance (peer review, observation,
patient exit surveys)
BEHAVIOUR CHANGE
ENABLING
FACTORS
Level 2: Learning Competence
Feedback
Eg – Improvements COMPETENCE
in competence (pre-test Self-directed learning
vs post-test, self-assessment) Problem based learning
Simulations and case
based learning
Level 1: Reaction Engagement Distributed learning
Eg – Positive response to training
ENGAGEMENT
Interactive
Competency based
Clear learning objectives
Relevant assessments
eLearning Capability Maturity Model
Conclusion & Looking Forward

1950’s -1960’s 1960s -1970s 1980s -1990s 2000 & beyond

AMREF is Introduction of Introduction of Introduction of

founded core Radio print-based technology
activities – Flying programmes on distance supported learning
Doctors Services national Radio education including
delivering health for health telemedicine,
care to remote workers eLearning and
areas mLearning

Africa may have complex challenges but we are finding simple way
to resolve these challenges.
Thank You!
caroline.mbindyo@amref.org
www.amref.org
@shakwei