In 2014, ICAP launched an online training course for nurses and midwives in the Option B+ approach for preventing mother-to-child transmission of HIV. The introductory course was developed to provide up-to-date information on current HIV care and treatment guidelines for HIV positive pregnant women beginning lifelong antiretroviral (ART) at the time of diagnosis. Focused on task shifting, the course was seen as an efficient and effective way for nurses to gain essential knowledge and skills for ART initiation, a task historically reserved for doctors. It was the first online course of its kind.
In Zambia, there are 78 health care workers per 100,000 people, well below the 230 recommended by the World Health Organization. A primary obstacle to achieving health care staffing targets in the country is the low production of sufficiently-skilled students graduating from Zambia’s nursing and midwifery schools. Nurses form the backbone of Zambia’s health workforce, and yet they, have historically had to spend six years completing two separate, expensive programs to become fully accredited nurse-midwives.
Before nurses and midwives begin practicing, they are required to have a range of clinical competencies to achieve licensure. In Ethiopia, opportunities for clinical learning for nurses, however, have been limited, due to a shortage of facilities, and the challenge of providing access to rural teaching sites where there is a high prevalence of malaria, tuberculosis, and HIV.
In the early 1960’s, Malawi’s National School of Nursing operated a model teaching ward at Queen Elizabeth Central Hospital where nursing students developed critical clinical skills by working directly with patients supported by trained clinical supervisors. But with decreased investment in nursing education and a diminishing healthcare workforce, the model ward faded from use in the 1970s. In 2011, ICAP began working with the Ministry of Health (MOH) and Mzuzu University to reintroduce the model ward as a cornerstone of nursing education in Malawi.
In Malawi, there are limited opportunities for nurses and midwives, and many leave the country in pursuit of different positions or quit the field altogether. It’s a trend which contributes, in part, to the high vacancy rate in the profession. Yet in Malawi, where nurses provide nearly 90 percent of patient care, retaining nurses is not only important to meet the population’s health needs, but essential to the scale up and maintenance of ambitious HIV prevention, care and treatment programs.
With more than 1.5 million people living with HIV, Kenya has one of the largest HIV populations in the world and with more than 13,000 new infant HIV infections each year, Kenya accounts for more than four percent of new pediatric infections worldwide. Despite the scale up of HIV care and treatment in Kenya, a shortage of physicians has proven a major obstacle to improving access to care and timely initiation of antiretroviral treatment (ART).