The implementation of the first Paediatric Nursing course in Zambia

Project: The implementation of the first Paediatric Nursing course in Zambia

Partners: School of Nursing and Midwifery, University of Brighton | Brighton- Lusaka Health Link (Registered Charity) | Guys and St Thomas Hospitals NHS Foundation Trust | Lusaka School of Nursing, University Teaching Hospital Zambia | Arthur Davidson Children’s Hospital, Ndola working with the School of Nursing and Midwifery, Ndola

Where: Zambia

When: September 2015 – September 2017

Global Need

Globally 5.6 million Children under the age of 5 years died in 2016. This translates into 15 000 under-five deaths per day.

More than half of these early child deaths are due to conditions that could be prevented or treated with access to simple, affordable interventions.[1]

The world has made substantial progress in child survival since 1990. The global under-5 mortality rate has dropped by 56 per cent from 93 deaths per 1000 live births in 1990 to 41 in 2016. Nonetheless, accelerated progress will be needed in more than a quarter of all countries, to achieve the Sustainable Development Goal (SDG) target (1) on under-five mortality by 2030. Meeting the SDG target would reduce the number of under-5 deaths by 10 million between 2017 and 2030.

Context

Prior to the project initial nurse training at the University Teaching Hospital of Zambia included theoretical input regarding infants and children but the Ndola nurse education programme contained no specific child focussed content. At that time nurses requiring specialist paediatric training had to go to other countries at significant expense to the Zambian Ministry of Health. In the long term these funds could be diverted on a national basis to support the sustainability of the paediatric course.

In 2015, Zambia had no existing programme in paediatric nursing and there was no relevant curriculum as yet ratified by the General Nursing Council (GNC) related to paediatric nursing. There is a separate paediatric nursing register held by the GNC but this was set up for nurses who completed post basic training in paediatric nursing outside the country. Therefore, there was already the provision for nurses undertaking the paediatric course in country to be entered onto a specialist paediatric nursing register.

Project Objective

The focus of this project was to develop and establish a sustainable paediatric nursing diploma course in Zambia. This project was driven by local nurses in-country and built upon the successful establishment of the first critical care nursing (CCN) course by the Lusaka School of Nursing that was facilitated through the Brighton-Lusaka Health Link and the School of Nursing and Midwifery, University of Brighton and funded by a British Council England-Africa Partnerships grant.

The development of this curriculum was endorsed by the Department of Paediatrics and Child Health at UTH, the Ministry of Health and the Zambian General Nursing Council.

This project aimed to;

• Implement the first paediatric nursing course in Zambia. This was developed utilising a culturally sensitive approach and the outcome of the project will be a national and professionally endorsed and delivered curriculum that has been developed through educational partnerships.
• Provide nurses with the evidence-based knowledge, skills and competence to deliver enhanced care for infants and children and their families requiring hospital admission in Zambia.

• Develop competence in paediatric nurses’ assessment skills within the multiprofessional team and enhancing their skills in managing and coordinating the care of acutely ill infants and children and their families.
• Improve professional development of nurses by offering a specialist educational programme to develop highly educated paediatric nurse champions.
• Encourage retention of nurses by offering post basic education in paediatrics and career opportunities following completion of the course.
• Build adequate resources to enable the sustained delivery of the paediatric nursing course from both UTH and from other centres across Zambia
• Contribute to the reduction in the morbidity and mortality rates among paediatric hospital admissions.

Activities and the role of nurses

A more highly educated nursing workforce not only improves patient safety and quality of care but saves lives. Nurses in Zambia successfully completing the paediatric course will have improved knowledge and skills and will be competent to provide quality care that will promote positive health outcomes for infants and children admitted to hospital and their families.

The paediatric course has:

• Built capacity in paediatric nursing care from the newborn right through to adolescence.
• Provided opportunities for career development and lifelong learning and nurses encouraging them to remain working in Zambia promoting retention, expanding the health care workforce and improving the wellbeing of nurses.
• Provided quality assured learning and assessment processes for nursing and medical students on paediatric placements. Paediatric nurses successfully completing the paediatric course will act as mentors to students and be role models in delivering a high standard of evidence based nursing care to children and young people and their families.
• Enabled paediatric nurses to be professional partners with other disciplines, particularly demonstrating leadership and change management skills in working with the medical team.

Who has benefitted and what has been learned

The project has been a success not only in implementing the first paediatric nursing course in Zambia but also in raising the status of paediatric nursing in country. The paediatric nurses consider themselves to be champions for children, young people and their families. The important role that the family plays in a child’s life has been recognised by the paediatric nurses and their narratives illustrate how undertaking the course has changed the way they interact with families in their care. The formation of the first paediatric and child health nurses association, an interest group affiliated with the Zambian Union of Nurses Association (ZUNO) has paved the way for paediatric nurses to have access to continuous professional development. The project supported the process of affiliation and the UK project team have alerted the partners to the THET funded project between ZUNO and its equivalent in the UK, the Royal College of Nursing (RCN).  The project was also able to support the first paediatric nursing conference in Zambia and has enabled the educational development of Eric Chisupa and Rodgers Benkele in undertaking child health masters degrees in country.

Looking to the future

The growth of a global health partnership does not happen overnight and to have developed and sustained this level of commitment and achievement highlights a major positive outcome. The Zambian Ministry of Health (MoH) has made a commitment to support this training on a yearly basis which we feel is a huge achievement. We do all feel passionate about nurse education and the difference it can make to the lives of children and their families as well as the nurses themselves.

However, further development in relation to the course from an advanced diploma into a recognised degree programme is critical for its long term survival. LSON is one of five schools that are in the process of developing stronger links and affiliations with the University of Zambia so that in the future the Paediatric and Child Health course will be offered as a degree programme.

 [1] http://www.who.int/mediacentre/factsheets/fs178/en/