Using e-learning to address health worker shortages in Kenya
Author: AMREF Kenya
The training and recruitment of health workers in Kenya has traditionally relied on classroom training in specific residential institutes. This had led to a situation of many aspiring health workers with too few opportunities to enter classroom-based training colleges, even as there was an acute shortage of health workers. With 22,000 nurses needing to advance from certificate to diploma level, the use of traditional classroom methods would have taken more than 200 years, considering that the system could only absorb 100 students a year. There was a clear need to urgently increase the supply of health workers to meet this need.
The African Medical and Research Foundation (AMREF), in collaboration with the Nursing Council of Kenya (NCK) and Accenture, a global management consulting company, provided an innovative solution to this problem. They devised and implemented e-Learning courses on several aspects of health workers’ training, such as a diploma nursing course. The eLearning Nurse Upgrading course came into being as a result of a desire by the Nursing Council of Kenya to improve the standards of patient care in the country by equipping enrolled nurses with skills to manage new and re-emerging diseases. This would not only address the critical shortage of qualified nurses in Kenya, but it would also result in improved health services, particularly to disadvantaged communities.
AMREF approached Accenture to help convert the course content into eLearning mode, to set up the structures and infrastructure required to implement the course across the country, and to build the capacity of AMREF staff to effectively manage the programme. The programme was introduced in September 2005 as a pilot project, the result of a partnership with the Ministry of Health, Kenya Medical Training Colleges, as well as private and faith-based nursing schools. It was expected that with eLearning, the NCK would be able to upgrade all 22,000 nurses in less than 10 years, and at a fraction of the cost of the residential programme.
E-learning offered students the attractive opportunity to combine training with their regular work, and thus did not require them to take time off from work. This was a very important reason for the massive enrollment.
The programme has had a positive impact on the quality of nursing care in the hospitals where the students and graduates of the eLearning programme work. They are reported to be more motivated, knowledgeable and proactive. As the training programme built nurses’ capacity (for example, by training them in the use of computers), they took on additional activities which were earlier performed by doctors. This in turn helped doctors focus more on their core activities. The work of the administration is also lessened since the nurses do not need as much supervision as they did before. Time is saved because fewer meetings are held to explain procedures to the nurses.
The end result is an improvement in overall patient care. Whereas some patients used to stay for up to a month in the wards, the maximum stay is now 14 days. The wards are less congested and the doctors can concentrate on other patients.
The programme’s success in Kenya has also led to interest in its replication in other African countries including Uganada, Zambia, Sudan, Rwanda, Malawi, Tanzania and South Africa.
E-Learning courses for health workers, when expanded to include all cadres of health workers, and exploiting new technologies to increase reach, can effectively address critical shortages of human resources for health and HRH skills in Africa and beyond.