Ms Clare Davis (South Africa)

Strengthening the African children’s nursing workforce: postgraduate diplomas in child nursing

BUILDING CHILDREN’S NURSING5th Commonwealth Nurses and Midwives Conference

Strengthening the African children’s nursing workforce:

Postgraduate Diplomas in child and critical care child nursing

Clare Davis, Natasha North & Minette Coetzee

London, 6 – 7 March 2020

Sub-Saharan Africa UK

POPULATION LESS THAN 18 YEARS OLD (%) 45 21

UNDER-FIVE MORTALITY RATE (per 1,000 live births) 78 4South Africa 34

66% die in their first year of life and 33% die within the neonatal period.

A THIRD OF ALL CHILD HOSPITAL DEATHS have been identified as AVOIDABLE.

POVERTYHIV/AIDS MALNUTRITIONACCESS

35%of hospital

deaths occur within first 24 hours

66% of children

die at home

67% of deaths

due to five leading

diagnosis

PNEUMONIASEPSISMENINGITIS ACUTE SHOCKED GASTROENTERITIS TUBERCULOSIS

CHILD HEALTH IN SUB-SAHARAN AFRICAThe scale of the challenge

Care provided to the sickest of children…needs to improve to ensure that the mortality rates

continue to decline (McKerrow & Coetzee 2014)

Scarcity of skilled nurses - one of the greatest obstacles to

achieving an effective health-care system

(Kinfu, 2009)

1% of the workforce

Children’s nurses

STRENGTHENING THE SPECIALIST WORKFORCEA core objective

3.2: By 2030, end preventable deaths of newborns and children under 5 years of age…

reduce neonatal mortality to at least as low as 12 per 1000 live births and

under-5 mortality to at least as low as 25 per 1000 live births.

3.C Substantially increase… the recruitment, development, training

and retention of the health workforce in developing countries’.

Objective 1: A Strengthened workforce through education at UCT

Two postgraduate Diplomas: • Child Nursing • Critical Care Child

Nursing

Three educational institutions (Kenya, Malawi and Zambia) assisted to launch child nursing programmes

REQUIRED ATTRIBUTES OF A GRADUATEMore than knowledge and skills…

BE ABLE TO WORK TO BEST

EFFECT POSSIBLE WITHIN

AFRICA’S HEALTH CARE SYSTEMS. .

• Be equipped with contextually

relevant knowledge and skills

• Have a clear understanding of and

responsibility for self

• Be able to lead the delivery of safe,

quality, evidenced based care within

the context of the current health care

system, in particular working with

vulnerable groups

LEARNING IN CONTEXTA key influencer

‘Learning occurs best when what people are taught can be placed in context, and when there are opportunities to apply what they have learned in practice…Without this, lessons learned are easily forgotten.”

Institute for Healthcare Improvement

A key concept influencing our

course content and design

CLINICAL CONTENTA contextual focus

‘Foundations in child nursing’ introduction

Learning focused on conditions most commonly causing death

Maximal time is given to mastering simple, but proven effective and possible, mortality-reducing measures and skills

BIG OUTCOME EXPECTATIONSA necessary goal

Ireen Muleya. Nurse Leader, Zambia

“To lead, and maybe implement for the first time,

the delivery of safe, quality care within the context of the

current health care system”

LEADERSHIP, RESEARCH AND CHANGE MANAGEMENT SKILLSA need for non-clinical skills

• Leadership skills

• Clinical Governance

• Health systems flow

• Evidence-based practice

• Change Management strategies

• A strong clinical voice

• Personal Resilience

TEACHING:

• Flip classroom style teaching

• Clinical class day

• Low-tech simulation

• Practical demonstrations

• Critical thinking exercises

• ASSESSMENT:

• Group-made poster

• Portfolio

• Patient presentation

• Family study

DIVERSE CLINICAL PLACEMENTSUnderstanding the continuum of health

CLINICAL PLACEMENTS

Cardiac / ENT ward

Paediatric Emergency Unit

Closed PICU

Neonatal ICUCommunity Clinic

Medical high care

Short interdisciplinary

placements (Theatre,

Dietician, Radiology)

• Facilitates a better understanding of the health care continuum – health to illness –and its associated challenges

• Meet the clinical settings of the students

FUTURE GOALS Blended part-time learning

• All registered nurses, from various geographical locations

• Commonly the breadwinners and caregivers of a family

• Varying levels of prior academic experience

1 year, face-to-face

2 year, part-time, blended learning

• Enable students to be at home for some of their learning, releasing some of the familial and financial burden of completing the course

• Will allow more time for learning, learning at their own pace

• Less time away from the clinical service

• ALLOWS FOR LEARNING TO OCCUR IN THEIR OWN CONTEXT

TO CONCLUDE..

Objective 1: A Strengthened workforce through education at UCTc

Outcome: Two contextually aligned courses designed to prepare graduates to work to best effective possible within the African

Health Care System

BUILDING CHILDREN’S NURSING5th Commonwealth Nurses and Midwives Conference

Thank youclare.davis@uct.ac.za