Building capacity of training institutions and Ministries of Health in sub-Saharan Africa: The PEPFAR approach

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Background: Sub-Saharan Africa faces a health workforce crisis with only 3% of the world's health care workers for 24% of the global burden of disease and only 1% of the world health expenditure.Recent data indicate that nurses in select African countries were not able to perform critical health care delivery tasks, highlighting the need for relevant nursing and midwifery curricula.The PEPFARfunded Nurse Education Partnership Initiative (NEPI) aims to scale up nursing and midwifery preservice education programs to address essential health challenges through the introduction of competencybased curricula where students are taught, learn, and are evaluated based on how well they can put clinical skills into practice, and through clinical simulation where students gain patient care experience using lifelike models.Structure/Method/Design: NEPI is partnering with governments in five African countries and collecting best practices in nursing curriculum development and clinical teaching and learning methodologies.Baseline assessment of teaching programs and outputs, as well as a desk and data survey of best practices in curriculum development, clinical simulation and training evaluation, were conducted to inform innovation in nursing education across the continent.New topics that require training were also identified, particularly Option B+ for PMTCT. Results (Scientific Abstract)/Collaborative Partners (Programmatic Abstract):Intersectoral collaboration has produced four competency-based preservice curricula, expanding the availability of comprehensively trained nurses to address general health and maternal and child health challenges in Zambia, Lesotho, and Malawi.Simulation laboratories were installed at six nursing education institutions in Lesotho and one refurbished in Malawi; over 1500 nursing students have utilized these laboratories to enhance their skills.A curriculum for Option B+ is being developed to respond to the urgent need for its scale up.Summary/Conclusion: Nurse and midwives with the right knowledge, skills, and abilities are key to a country's mandate to deliver effective primary health care services and tackle priority health challenges.Competency-based curricula, including the Option B+ curriculum under development, and the expanded use of clinical simulation will facilitate increased learning and skill transfer when students care for patients in today's complex, health care environment.Various evaluation methods will assess the effectiveness of these interventions and inform scale up.

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