Strengthening Nursing Leadership and Community Health in Rural Namibia: Partnerships for Continuing Professional Development

Even though health care infrastructures are well developed in Namibia, shortages of health care providers continue to limit delivery of services. Serving rural populations presents particular practice challenges as roughly two-thirds of the 2.3 million Namibian people still live in remote rural regions of the country (National Planning Commission, 2013). In 2010 a law was passed in the Namibian Parliament mandating that all registered nurses, and all health care professionals, in Namibia must earn 30 continuing education units (CEUs) annually to maintain their registration with the Health Professions Councils of Namibia (HPCNA), (HPCNA, 2015). Fulfilling this requirement is particularly difficult for nurses assigned to rural clinics. Educational programmes approved for CEUs (continuing education units) by the HPCNA Continuing Professional Development (CPD) Desk are offered in larger urban areas or in the district hospitals hundreds of kilometers from the remote clinics. While baccalaureate prepared nurses have had educational content related to population-focused health care and leadership, enrolled nurses have completed a programme of training that focuses on the care of individuals in structured settings. Nevertheless, even a broad-based baccalaureate nursing education cannot not prepare graduates for all the complexities of rural practice. Indeed, most student clinical experiences take place in large urban areas where there are resources available and a network of supportive colleagues.  As such, CPD offerings for nurses in rural areas must be focused on knowledge, skills, and attitudes that are relevant when one is working alone in relatively unstructured settings and caring for both individuals and entire communities. Improvisation, critical thinking, developmental evaluation (Patton, 2011), and implementation of population-focused interventions are equally as important as competent health assessment skills and knowledge of basic pharmacotherapies. Indeed, findings and recommendations of the Assessment of the National Quality Management Systems (Baobab Research & Training Institute, 2014) stated that “leadership at the facility level is needed to create an environment where staff respect each other and more importantly where all staff respect patients” (p. 51). One of the recommendations of this assessment was to integrate a culture of quality care into the pre-service training of health professionals and reinforce a culture of quality carethrough “in-service training and on job training of staff” (p. 50). It is a culture of quality care that this CPD programme seeks to uplift by strengthening nursing leadership and community health in rural Namibia. Continuing professional development is also consistent with Guidelines for Implementing Culturally Competent Care (Douglas et al, 2014). The CPD programme represents a partnership among the Health Professions Councils of NA, the Ministry of Health’s Quality Assurance Unit, and rural nurses. Additionally, graduate nursing students from a Lutheran College in Minneapolis, MN, have participated in the programme, learning about health and nursing leadership in rural Africa. The program began humbly in 2011 and preliminary outcomes indicate key aims of the programme are being realized. This poster will highlight emergent processes and outcomes of the programme to date and plans for future development.    

+ Baobab Research & Training Institute. (March 2014). Assessment of the National Quality Management Systems used to Monitor and Improve Quality in Health Service Provision in Hospitals and Health Centres in Namibia. Windhoek: MoHSS.  

+ Douglas, M., Rosenkoetter, M., Pacquiao, D., Callister, L., Hattar-Pollara, M., Lauderdale, J., Milstead, J., Nardi, D., & Purness, L. (2014). Guidelines for implementing culturally competent nursing care. Journal of Transcultural Nursing, 25(2), 109-121. 

+ Health Professions Councils of Namibia (HPCNA). (2015). Continuing Professional Development (CPD). Retrieved from http://www.hpcna.com/index.php/cpd

+ National Planning Commission - Office of the President. (2013). Namibia’s Fourth National Development Plan - NDP4 2013/14 - 2016/17. Windhoek: National Planning Commission.

+ Patton, M.Q. (2011). Developmental evaluation: Applying complexity concepts to enhance innovation and use. New York, NY: The Guilford Press.