Outcomes of the Training and Policy Unit: A Capacity-Building Initiative in Afghanistan

Monday, 30 October 2017

Basnama Khan, MScN, BScN
Academic Projects Afghanistan, Aga Khan University, Kabul, Afghanistan

Outcomes of the Training and Policy Unit: A Capacity Building Initiative in Afghanistan


Healthcare system in Afghanistan is adversely affected due to war and conflicts, requires re-building, including the development of human resources. With support from international community, Ministry of Public Health (MoPH) has made concerted efforts for the development of stewardship and effective governance. With new vigor, vitality and reorganization, the Ghazanfar Institute of Health Sciences (GIHS), Kabul along with its eight regional Institutes of Health Sciences (IHSs) are training general nurses, midwives and allied health personnel throughout Afghanistan. As part of technical support, initiated in 2002, Aga Khan University, Academic Projects, Afghanistan had established a Training and Policy Unit (TPU), as a pilot project at GIHS in 2012 for 3 years General Nursing Diploma Programme (GNDP).


The overall goal of TPU is to develop meaningful capacity building Faculty development programmes customized to meet the needs of participants while addressing the immediate and longer-term needs of the nursing and midwifery education in Afghanistan. Therefore, its role is to periodically review and revise nursing and midwifery education policies, standards and curriculum; and develop faculty development programmes for all teachers to effectively implement the curriculum, standards and policies to raise the standard of both the professions in the country.


AKU developed a proposal with MoPH and GIHS to establish TPU as a pilot project for nursing programmes in GIHS and 5 regionals IHSs. With generous support from French agency, Agence Francaise De Developpement (AFD), a purposive building was built including a training room, offices and basic needed facilities. During the last 4 years (2012-16) several initiatives have been taken including the baseline assessment for each IHS for their capacity of training nurses; and the implementation of the existing curriculum and policies. Based on the needs analysis further interventions carried out were development of standards; and revision of curriculum and policies for the GNDP; faculty and staff development through various activities to build their capacity for effective implementation of the revised curriculum, standards and policies.


The curriculum, standards and policies for the GNDP, developed in 2006 were revised through consultative workshops and audited by the international consultants, aligning with the international standards. The curriculum standards and policies were approved by the MoPH as national documents and then were disseminated to all stakeholders in entire IHSs. The curriculum, standards and policies are implemented at national level by both public and private sectors.

In the initial years, as it was piloted with GIHS and five regional IHSs, we trained fourteen (14) trainers (2 from each regional IHS and 4 from GIHS) as master trainers for several trainings including a week exposure visit to a standards nursing education programme. These 14 trainers then trained the entire teachers (98) at their respective IHSs for Effective Teaching Skill (ETS), a mandatory training for all nursing teachers in Afghanistan according to revised standards.

During monitoring and evaluation visits we found substantial progress in the implementation of concepts and related activities; subject specific Learning Resource Packages were also been developed as of the revised curriculum.

Considering the outcomes, the project secured additional five year funding and expanded its role to national level for nursing and midwifery education. To build upon the major accomplishments of the TPU, in the second phase we are training additional 24 teachers as master trainers for nursing and midwifery programmes at national level. Some of the trainers, trained in initial phase are trainers in the second phase and also leading faculty development plans and activities in their respective IHSs.

Although the TPU’s role is significant in building the institutional capacity and it has faced some challenges while conducting the capacity building activities. Initially, it was envisaged for training the same trainer though out programme; and most of the trainers were same for all training but few participant drops in between and someone else has to be trained from the existing teachers; and retention of these nursing trainers remains an issue (Evans, Razia & Cook, 2013). Another issue was the bureaucratic processes of approval for the TPU building design and construction; and also for approval of the curriculum, standards and policies from different committees and different levels at MoPH. Security instability also created some limitations for implementation of the activities at some of regional IHSs.


The TPU is an important addition to the nursing education system in Afghanistan as well as a positive step towards the sustainable capacity building initiative for nursing and midwifery education and faculty development. Continue efforts are in progress to establish TPU as a vital unit of MoPH and expand its infrastructure to connect it with regions through IT applications and can also initiate eLearning courses/programme, once resources are available.