Developing Competencies of Nurses and Midwives During Pre-Service Education in Uganda: Using Evidence-Based FP and RH Resources and Tools
In Uganda, there is a shortage of health workers, and the available health workers (HWs) often perform below expectation because they lack the specific skill mix to effectively respond to the health needs. The total estimated health workforce is about 45,598, serving a total projected population in Uganda of about 31.8 million. This means that there is one health worker for every 697 people, taking the entire health work force together. According to the WHO, a country with less than 2.28 health workers (doctors, nurses and midwives only) per 1000 population is regarded to be in severe shortage of health workers to meet its health needs; for Uganda it is about 1.55. This challenge is augmented by low proficiency levels of the health work force in the country. (Midterm review report of the health sector strategic and investment plan (HSSIP) 2010/11-2014/15.)
Knowledge-Based Education and Training (KBET) is the most widely spread approach for health workers in Uganda. This approach has very little emphasis on competency of the student to actually deal with health needs. However, this is changing with the advancement of the Competency Based Education and Training (CBET) approach which promotes a student centred learning where teaching and learning address the distinct learning needs, interests, and aspirations of individual students. Incorporating this approach in the curricula for all certified courses in nursing and midwifery is being considered in Uganda.
Adopting What Works
The Training Resource Package (TRP) is one mechanism being adopted to help propel the CBET for Nurses and Midwives in Uganda. The TRP offers essential resources for family planning (FP) and reproductive health trainers, supervisors, and program managers. The entire package is designed to support up-to-date training on family planning and reproductive health.
A pre-service training workshop to disseminate and apply the TRP and other evidence based FP/RH tools to strengthen FP training for nurses and midwives education in Uganda was organised by Evidence to Action (E2A) and IBP Initiative in collaboration with the East Central and Southern Africa Health Community College of Nursing (ECSACON), the Uganda Nurses and Midwives Council (UNMC) and MOH.
The five-day training workshop was attended by 40 participants including; Nursing and midwifery tutors from different institutions, representatives from the umbrella body for practicing nurses and midwives in Uganda (UNMC), and representatives from the Uganda Family Planning Consortium (UFPC).
In addition, a representative from the Tanzania Ministry of Health Reproductive Health In-service Training Division shared their experience with the TRP and provided a regional context for adaptation in Uganda.
Un-packing the TRP: Participants were provided with the FPTRP electronic version and taken through how to access the resources and tools and how they can adapt them for their work.
Introduction to the FP High Impact Practices (HIPs): A presentation on HIPs was made and resources shared with the group. This engaged participants to learn what has been proven to work in FP/RH and how to avoid ‘reinventing the wheel.’
Accessing the Knowledge Gateway: The group was introduced to the Knowledge Gateway which provides organisations and individuals working in FP/RH with a global platform to exchange knowledge, best practices, resource materials and tools.
Training certificates: All the training participants received certificates of participation in the dissemination and application of FP TRP to strengthen Nursing and Midwifery Education in Uganda.
Follow-up and learning: To support follow-up of participants on the training outcomes, UFPC secretariat and IBP set up and is managing a site on the Knowledge Gateway called Training Resource Package Uganda Members. Training participants were added and oriented on how to navigate the site. All the training materials, the training report, and other resources will be uploaded to the site for participants to access. This will also provide a platform for the trainers and the trainees to interact and share knowledge and experiences in line with the TRP.
Post-training plans: The major activities planned include the following:
- Revising the Diploma in comprehensive Nursing course curriculum including development of a detailed job description which is currently missing
- Reviewing the certificate in Nursing and midwifery course curriculum in line with the CBET
- Providing guidance in curricula content development and
- Coordinating training participants and learning through the Knowledge Gateway
The Participants’ Voices
"I am very enthusiastic about the TRP that has been provided because it brings all the materials in one package. Previously different schools have had diverse approaches to teaching family planning and personally I was depending on the available text books on family planning. It is also very good because we now have standardized information that will be disseminated to the students regardless of the school that they come from. This package will definitely ease my work." — Grace Nakku, Midwifery tutor, Nsambya School of Nursing and Midwifery, Kampala
"This training was what we needed all along; I hope proper follow up is made to ensure that the outcomes of the training are achieved." — Juliet Zawedde, Nursing tutor, Kibuli