Scaling Up Nursing Education in Two African Countries

Purpose: Describe nurse and nurse faculty shortage in two African countries and activities by the World Health Organization (WHO), President's Emergency Plan for AIDS Relief (PEPFAR), Clinton Health Care Initiative etc. to address nurse and nurse faculty shortages in Kenya and Rwanda, and discuss early progress.

Methods:  Review of literature and government documents, participation in WHO scale-up, focus group with African nurse educators, and direct observation of efforts to scale-up education of nurses and nurse faculty.

Results: Africa, which bears 24% of the global burden of disease yet has 3% of the workforce (WHO, 2007), is thought to need an additional 2.4 million doctors and nurses. Kenya has 10 nurses/10,000, Rwanda 4 nurses/10,000 compared to the US which has about 100 nurses/10,000 people. There are 68 accredited institutions training nurses in Kenya: 6 teaching enrolled nurses, 53 teaching registered nurses and 9 offering the BScN. In Rwanda, the A2 level nurses have been eliminated. There are now 5 diploma schools (A1 Nurses) and the Kigali Health Institute offers the only bachelors program in nursing sciences (A0 nurses). African nurse educators state they need both fiscal and human resources to expand and enhance their nurse education programs. The Medical Education Partnership Initiative (MEPI) supports institutions in 12 African countries that receive support from PEPFAR to expand/enhance medical education. A program similar to MEPI, the Nurse Capacity Building Program (NCBP/NEPI), is planned for nursing but on a much smaller scale. The Clinton Health Initiative, Rwandan MOH and a coalition of US Schools of Nursing were recently funded by the US government to support nursing and midwifery faculty and strengthen clinical teaching programs in Rwanda.

Conclusions: Although the NCBP/NEPI and Rwanda programs are promising, more innovative global and local solutions are desperately needed to address nurse and nurse faculty shortage in Africa.