Pioneering E-learning in Kenya To Boost Nurse Numbers
|Photo: Keishamaza Rukikaire/IRINThe e-learning programme allows nurses wanting to upgrade their qualifications to continue working while they study.|
An ambitious new e-learning programme is aiming to mitigate the severe nursing shortfall in Kenya and boost the country’s ability to manage diseases such as malaria, tuberculosis and HIV/AIDS.
“In Kenya, 85 percent of nurses are of the most basic cadre, and at the Kenya Medical Training College (KMTC) it ordinarily takes two and a half years to finish an upgrade, while with e-learning it only takes one year,” said Marsden Momanyi, media officer of the African Medical and Research Foundation (AMREF), a health development NGO facilitating the programme.
The project, which began in 2005, aims to upgrade the skills of 22,000 Kenyan nurses over a five-year period, a task that would take the KMTC 220 years at its current intake level of 100 students per year. “This training programme will have a fundamental impact on our nursing numbers,” said Momanyi.
AMREF and the health ministry’s Nursing Council of Kenya are running the project jointly, with funding from global consulting firm Accenture.
“So far, more than 100 learning centres have been established across the country, and more than 2,000 students have started the e-learning programme,” Momanyi said. The qualification takes the nurses from basic status to a more advanced ‘registered’ status.
Apart from a shortage of higher-cadre nurses, Kenya faces a general shortfall of nursing staff that is severely straining a health system already struggling to cope with the rise of epidemics like HIV and TB over the past two decades.
The East African country has lost more than 3,000 of its most experienced nurses in the past five years, with most leaving the continent for jobs in Europe and the United States, where they can earn considerably more than the less than US$300 per month they make at home.
It is estimated that at least another 10,000 nurses are needed, in addition to the 25,000 already employed in the public and private health sectors, to provide adequate care to Kenya’s 34 million citizens.
“By international nursing standards, for every eight-hour shift a nurse with a basic diploma should have 10 patients, while a nurse with an advanced certificate should have five patients under their care,” said Paul Kavoo, nursing officer-in-chief at Thika District Hospital, northeast of the capital, Nairobi, in Central Province.
“But in this country, the situation is such that a nurse with the most basic qualification cares for up to 40 patients per shift, while one with an advanced certificate cares for 16 to 18.”
Although Thika hospital has an official bed capacity of 265, there are often close to 400 in-patients, with many sharing beds. Kavoo said the hospital needed 350 nurses but was operating with just 234.
Two tiny rooms at Thika hospital, containing fewer than 10 computers, serve as one of the AMREF project’s e-learning centres; students are grateful even for such limited facilities.
“Both my wife and I are students in this programme, and if we had to go to KMTC then one of us would have had to quit work to go to school full-time,” said Joseph Warutere. “This way, although it is very time consuming, we can both carry on working while we get our qualifications.”
He got his basic training in 1986, and said the e-learning programme was giving him a much-needed update. “Although the basic tenets of nursing remain the same, this programme places a lot of emphasis on management of emerging diseases like HIV and TB, and because we are still working while we do it, we are able to put into direct practice what we are learning.”
Programme participants are guided by in-hospital mentors, with lectures by specialists a few times a month.
Kenya’s internet access is generally limited to urban areas, so the course uses software that can be downloaded onto a computer. A further 2,000 students who have no access to computers are using print versions of the programme, which take slightly longer to complete.
“Access to computers is a big issue and a challenge for us – at the moment we have provided over 400 computers, but this is still one computer to five nursing students; we need to do better,” Momanyi said.
Another hurdle is that many rural nurses are not computer literate and need lessons in how to operate a computer before they can start the course. According to Lucy Muhoro, an e-learning mentor at Thika hospital, “the mouse is like a miracle” to many students.
“It wasn’t easy for me, because I had to learn from scratch how to use the computer,” said George Arumba, also a student at Thika. “I did a short course before I started, and now I’m finding it easier.”
The cost of the course – about US$1,500 – has also prevented many potential students from signing up. “Many students get loans and others get support from their families; a few are on scholarships from various organisations, but for most it’s very tough,” said Adesuwa Akinboro, head of e-learning at AMREF. The organisation is working with its partners to advocate for institutional funding and subsidies for nurses in the programme.
The first batch of e-learning graduates received their certificates in October of this year, in Nairobi. AMREF is reviewing the possibility of replicating the programme in other countries in the region facing severe nursing shortages.