Human Resource for Health Development in Rwanda: Challenges and Opportunities in Nursing Education and Training

Sunday, 30 July 2017

Sheila Shaibu, PhD, MSN, BEd
School of Nursing, University of Rwanda, School of Nursing / University of New York, Rory Meyer School of Nursing, New York. USA, Kigali, Rwanda
Oluyinka Adejumo, DlittetPhil
School of Nursing and Midwifery, NYU Rory Meyers College of Nursing/University of Rwanda College of Medicine and Health Sciences/ HRH Rwanda program, Kigali City, Rwanda
Olivia Bahemuka, DNP, MSN
School of Nursing and Midwifery, Human Resource for Health, University of Rwanda, College of Medicine and Health Sciences, Rwanda, Rwanda
Gilbert Banamwana, MSc
School of Nursing, University of Rwanda, School of Nursing, Kigali, Rwanda

Background: - Rwanda has several Schools of Nursing that offer a baccalaureate in Nursing Science and an equivalent of a diploma in Nursing Science. The Enrolled Nursing equivalent of nursing has since been phased out. The University of Rwanda (UR) now has 4 campuses of nursing who all offer a Baccalaureate in Nursing and Midwifery program (Mukamana, Uwiyeze & Sliney, 2015). In 2015, the UR Human Resources for Health program admitted 117 students into the Master’s degree in Nursing which offers 8 tracks, among them an Education and Leadership and Management track with an enrollment of 14 students. The purpose of this presentation is to discuss the trends, challenges and opportunities that are observed in Nursing Education in Rwanda.

Trends

Nursing Education in Rwanda is evolving, with more nurses being enrolled into the baccalaureate Nursing program. More male nurses are being admitted into the Nursing program, including the faith based Schools of Nurses which previously did not admit male students. Although most schools of Nursing are short staffed, the schools also have a few faculty who are prepared at Master’s degree level in various specialties, including Nursing Education. Most Schools of Nursing have a Simulation Laboratory that are used for clinical teaching for both Midwifery and Nursing. All the campuses of the University of Rwanda are equipped with teleconferencing equipment and are therefore, also offering distance E-learning Nursing program to upgrade diploma nurses to baccalaureate nursing.

Challenges 

Due to shortage of faculty, nurses are still teaching non-nursing subjects such as microbiology and anatomy and physiology among others. Nursing education is moving towards learner centered environments (Valiga, 2012), yet classes are large and teaching strategies used are not always student centered. Teaching generation Y students using traditional teaching strategies may pose a challenge to this cohort of learners (Eckleberry-Hunt & Tucciarone, 2011). Clinical supervision of undergraduate students is limited given the student numbers and the distances from the Schools of Nursing where students are attached, as there are not always resources available for faculty travel for follow up of students. The curriculum is congested and not harmonized across the different Schools of nursing. Many nursing programs still struggle with letting go of content and decongesting the curriculum (Benner, 2012; Dalley, Candela & Benzel-Lindley, 2008). Issues of overloading courses with content and using student centered teaching strategies are addressed in the curriculum review workshops and curriculum assignments. Resources such as teaching equipment for simulation laboratories, books, video conferencing, and journals also pose limitations.

Opportunities

Evolving regulation requirements have been used to both adopt new requirements of the Higher Education Council and address curriculum changes as well as harmonizing the curriculum. Nursing education workshops have also been offered to faculty to address gaps in teaching. The Smart Rwanda Master Plan (Ministry of Youth and ICT, 2015) can transform nursing education in Rwanda through e-learning courses. There is a global shortage of nursing faculty (Nardi & Guryko, 2013) however, Rwanda’s nursing faculty is young and vibrant, and can transform nursing education and practice given the opportunity. The consortium of the United States Institutes (USI) have donated teaching resources and the twinning of local faculty with USI faculty have transformed nursing education and practice in Rwanda.

Significance to Nursing

Nursing is the backbone of the health workforce in many countries including Rwanda and any health goals and targets set by the international community and the government require a well-educated nursing workforce to transform the targets through practice. Nurses are pivotal to achieving the Sustainable Development Goals and addressing the social determinants of health. Therefore, an increase in the nursing workforce will go a long way towards improving practice and the health of the Rwandans.