CURRICULUM FOR NURSING AND MIDWIFERY TECHNICIAN
1/1/2016
Ministry of Health and Sanitation
Sierra Leone
CURRICULUM FOR NURSING AND MIDWIFERY TECHNICIAN
2016
FOREWORD
In response to the call of his Excellency the President on the need to reduce drastically the rate of the death of our mothers and newborn in Sierra Leone, there is the urgent need to produce more midwives and other critical health cadres in the country.
Likewise, the shortage of higher cadres especially RNs and RMs and the existence of adequate number of SECHNs with no midwifery skills necessitated the reviewing and upgrading of their training curriculum and nomenclature to reflect the required competences. The realization of the above will help address the current and future health demands of the population of Sierra Leone. Hence, the need to train nurses that will serve as nurses and midwives in the health care delivery system.
In order to complement the efforts of the Government, the Directorate of Nursing and Midwifery Services of the MoHS in collaboration with Nurses and Midwives Board, professional associations and other key stakeholders across the health sector decided to review the SECHN Curriculum and develop a new curriculum which will focus on preparing future nurse-midwife technician.
This strategy will contribute to improved quality, utilization and career progression of the cadre of SECHNs by upgrading their skills and education requirements. This will address the inadequate number and quality of midwives in the country and will equally contribute to the reduction of maternal and newborn mortality. This is the right direction toward achieving the Sustainable Development Goals 3.
It is hoped that nursing and midwifery training institutions will use this document in the implementation of the programme to produce safe and competent nurse-midwife technicians.
I will now extend my thanks and appreciation on behalf of the Ministry of Health and Sanitation (MOHS) to all those who have participated in this great work.
Dr. Brima Kargbo
Chief Medical Officer (CMO)
Ministry of health and Sanitation
ACKNOWLEDGEMENTS
The development of the Nursing - Midwifery Technician (NMT) curriculum represents the collaborative efforts of the Directorate of Nursing and Midwifery Services, the Nursing and Midwifery Council, Nursing and midwifery training institutions, WHO, UNFPA, CHAI, and other health development partners (see appendix)
On behalf of the Ministry of Health and Sanitation, let me acknowledge the invaluable support of all those who have contributed to the development of this curriculum.
Sincere appreciation is extended to WHO for funding as well as providing technical assistant throughout the development process. Special recognition is extended to the Country Representative, Dr. Anders Nordstrom and Mrs. Margaret Phiri for their support and expertise in leading this process from the inception onto the finalization of the document.
This development workshop was facilitated by Dr. Chika Ugochukwu from Nigeria Ms. Tiwonge Mbeya from Malawi and Margaret L Phiri from WHO Country Office of Sierra Leone . Sincere acknowledgement is due to them for the insight provided during the process.
The directorate and that of the Nursing and Midwifery Council look forward to the implementation of this document in the training of midwives.
Mrs. Hossinatu Mary Koroma
Chief Nursing and Midwifery Officer (CNMO)
Ministry of Health and Sanitation
CONTRIBUTORS
The MOHS and the Sierra Leone Nurses and Midwives Board Secretariat would like to give special thanks to the following persons and organizations for contributing to the development and review of this curriculum:
NO / NAME / DESIGNATION / INSTITUTION1. / Ms. Hossinatu Kanu / Chief Nursing Officer / Directorate of Nursing and midwifery Services- MOHS
2. / Mrs. Hannah Coker / Registrar / Nursing and Midwifery Board
3. / Dr. Joan Shepherd / Principal, / National School of midwifery, Freetown
4 / Colonel Agatha Sandy / Principal / Defence School of Nursing, Freetown
5. / Mrs. Safiatu Foday / SLMA President / UNFPA
6. / Mrs. Margaret T. Macarthy / Country Midwife Adviser / UNFPA
7. / Mrs. Christiana Massalay / Deputy Registrar / Nurses and midwives board
8. / Matron Mary Fullah / Deputy CNMO / Directorate of Nursing and midwifery Services- MOHS
9. / Mr. Donald Conteh / MoHS / CHAI
10. / Bro. Michael Koroma / CEO/ Principal / St. John of God Catholic Hospital and School of Nursing
11. / Mrs. Patricia Bah / Chairman / WACN
12. / Mr. Sahr James / Coordinator / Department of Nursing Njala University, Bo campus
13. / Mr. Senessi Margao / President / Sierra Leone nurses Association
14. / Mrs. Evelyn A. Bangura / Coordinator / Department of Nursing, EBK University, Makeni
15. / Fatmata Macarthy / Midwife Tutor / Department of Nursing, Njala University, Bo campus
16. / Fofanah-Jones / Nurse Tutor / Department of nursing, Eastern Polytechnic, Kenema
17. / Cornelia Macauley / Nurse tutor / Faculty of Nursing, COMAHS
18. / Dr. Joseph Eden Hotah / Dean- Faculty of Nursing / COMAHS
19 / Mrs. Patricia Kamara / Midwife Tutor / National School of midwifery, Freetown
20. / Mrs. Margaret Loma Phiri / WHO/MCH Expert / WHO
21. / Mrs. Francess Fornah / Head of School / School of Midwifery, Makeni (SOMM)
22. / Mrs. Velma Cole / Tutor / SOMM
TABLE OF CONTENT
FORWARD
ACKNOWLEDGEMENT------3
ACRONYMS------6
1.0. INTRODUCTION------8
1.1.Background and Context------8
1.2. Rationale for NMT Curriculum Development------9
1.3. Development process of the NMT Curriculum------9
1.4. What is new in the Curriculum------10
1.5. Re-organisation of the modules------11
2.0. Mission------11
3.0. philosophy------11
4.0. competences of the graduates------12
5.0. programe aim------12
6.0. programme outcomes ------13
7.0. programme structure and courses------13
8.0. admission policies------17
9.0. TEACHING AND LEARNING METHODS------17
10. ASSESMENT AND EVALUATION METHODS------18
11. COURSE DESCRIPTION AND CURRICULUM------19
Content Outline: Year 1
· Anatomy and Physiology------20
· Patient and Staff Safety------23
· Patient and Staff Safety Practice------26
· Behavioural sciences ------28
· Pharmacology in Nursing------31
· Nutrition and Dietetics------33
· Principles And Practice of Nursing------36
· Fundamentals of Nursing I------40
· Fundamentals of Nursing Practice II------45
· Medical Nursing I------51
· Medical Nursing Practice I------54
· Surgical Nursing I------57
· Surgical Nursing Practice I------61
·
Content Outline: Year 2
· Medical Nursing II ------66
· Medical Nursing Practice II------69
· Surgical Nursing II------71
· Surgical Nursing Practice II------77
· Community health Nursing------82
· Community Health Nursing Practice------86
· Mental Health and Psychiatric Nursing ------88
· Mental health and Psychiatric Nursing Practice------91
· Paediatric Nursing------94
· Paediatric Nursing Practice------98
· Patient Care Study
Course Outline : Year 3
· Overview of Anatomy and Physiology essential to Midwifery Practice------102
· Therapeutic Communication Counselling and Health Education------104
· Fundamentals of Midwifery------107
· Fundamentals of Midwifery Practice------109
· Midwifery Science I------111
· Midwifery Science Practice I------115
· Midwifery Science II------117
· Midwifery Science Practice II------121
· Emergency Obstetrics and Newborn Care------124
· Emergency Obstetric and Newborn care Practice------126
· Community Midwifery------129
· Community Midwifery Practice------131
· Neonatology------133
· Neonatology Practice------135
ACRONYMS
AIDS Acquired immunodeficiency syndrome
AMTSL Active Management of the Third Stage of Labour
ARVs Antiretroviral Virus
ARDS Acute Respiratory Distress Syndrome
BAS Basic Sciences
BEmONC Basic Emergency Obstetric and Newborn Care
EmONC Emergency Obstetric Newborn Care
BFHI Baby Friendly Health Initiative
BTL Bilateral Tubal Ligation
BPH Benign prostrate Hypertrophy
CBDA Community Based Distributing Agent
CPR Cardio-Pulmonary Resuscitation
CV Cardio Vascular
EENT Ear, Eye, Nose and Throat
FAO Food and Agriculture Organisation
GCE General Certificate of Education
GIT Gastro Intestinal Tract
HLD High Level Disinfectant
HIV Human immunodeficiency virus
HRH Human Resource for Health
IBS Irritable Bowel Syndrome
IPC Infection, Prevention and Control
ICU Intensive care Unit
ICM International Conference of Midwives
ICN International Council of Nurses
ICT Information and Communication Technology
IMCI Integrated Management of Childhood Illness
IV Intravenous
ICT International Confederation of Midwives
ICT Information, Communication and Technology
IUD Intra Uterine Device
M&E Measurement and Evaluation
MCHA Maternal and Child Health Aides
MCH Maternal and Child Health
MDR Maternal Death Review
MDSR Maternal Death Surveillance Response
MICS Multiple Indicator Cluster Survey
MMR Maternal Mortality Rate
MoHS Ministry of Health and Sanitation
MCQs Multiple Choice Questions
MVA Manual Vacuum Aspiration
NTD Neglected Tropical Disease
NANDA North American Nursing Diagnosis Association
NHSSP National Health Sector Strategic Plan
NMB Nurses and Midwives Board
NMC Nursing and Midwifery Council
NMT Nurse Midwife Technician
NGO Non-governmental organization
NURCS Nursing Clinical Sciences
NURSS Nursing Specialty Sciences
OSCE Objective structural clinical examination
OSPE Objective Structured Practical Examination
PHU Peripheral Health Unit
PMCT Prevention of Mother to Child Transmission
PNC Postnatal Care
PBL Problem-based learning
PEP Post exposure prophylaxis
PHC Primary Health Care
PMTCT Prevention of Mother to Child Transmission
PPE Personal Protective Equipment
PEM Protein Energy Malnutrition
POP Plaster of Paris
RVF Retro Vaginal Fistula
SCM State Certified Midwife
SECHN State Enrolled Community Health Nurses
SLDHS Sierra Leone Demographic Health Survey
SRH Sexual and Reproductive Health
SOCS Social Sciences
STI’S Sexually Transmitted Infection
SLNA Sierra Leone Nurses Association
SLMA Sierra Leone Midwives Association
TB Tuberculosis
TPR Temperature Pulse and Respiration
TBA Traditional Birth Attendant
UNAIDS The Joint United Nations Programme on HIV/AIDS
UNFPA United Nations Population Fund
VCT Voluntary Counselling and Testing
WACN West African College of Nursing
WASCE West African Secondary Certificate of Education
WHO World Health Organization
1.0. INTRODUCTION
1.1 Background and Context
The training of Enrolled Nurses started before the advent of Primary Health Care(PHC) in the 1970’s. The need for the training of State Enrolled Community Health Nurses (SECHNs) came about in response to the country’s adoption of the Primary Health Care approach which required the presence of nurses at community level with community health knowledge and skills. In effect, SECHNs were prepared using a curriculum which was community-health oriented for them to function as Enrolled Nurses at community level. These Nurses (SECHNs) are expected to work in Peripheral Health Units (PHUs). However, due to the changes in the health needs of the population and shortage of professional Registered Nurses (RNs) and professional Registered Midwives (RMs), SECHNs are now found working at all levels of health service delivery in the country. .The country has the highest maternal and infant Mortality rates of 875 per 100,000 in 2008 and 1,165 per 100,000 live births (Demographic Health Survey, 2013). One of the contributing factors is the critical shortage of health workforce especially qualified health professionals. This needs an urgent attention with respect to improving the quality and quantity of the different cadres of the health workforce. Specifically, there is an urgent need to improve the quality and quantity of Nursing and Midwifery workforce who works at the different levels of the Health Care Delivery System.
Currently, there are a total of 6,848 employed nursing and midwifery workforce of which 2,447(24%) SECHNs, 357(4%) RNs, 315(3%) RMs and 69% are the other auxiliaries by the Ministry of Health and Sanitation (MoHS(HRH Cadre mapping, 2016). And there are about 3,000 SECHNs unemployed.
In order to improve the quality and the future utilization and career progression of SECHNs, the Nursing and Midwifery stakeholders met to review their roles and deployment to respond to the changing health demands of the country especially that of the Skilled Birth Attendants and building a resilient health workforce; thus the review of the existing SECHN curriculum and the development of a revised competency-based Curriculum for training of future Nursing and Midwifery Technician (NMT). The developed competency-based Curriculum for Nursing and Midwifery Technician is an answer to the 10- 24 months recovery plan call in a long term, which requires a scale up in the training of midwives in Sierra Leone. This will address the inadequate number and quality of midwives in the country and will equally contribute to the reduction of maternal and newborn mortality. This is the right direction toward achieving the Sustainable Development Goals 3.
1.2 Rationale for NMT Curriculum DEVELOPMENT
In response to the call of his Excellency the President on the need to reduce drastically the rate of the death of our mothers and newborn in Sierra Leone, there is the urgent need to produce more midwives and other critical health cadres in the country.
Likewise, the shortage of higher cadres especially RNs and RMs and the existence of adequate number of SECHNs with no midwifery skills necessitate the reviewing and upgrading of their training curriculum and nomenclature to reflect the required competences. The realization of the above will help address the current and future health demands of the population of Sierra Leone. Hence, the need to train nurses that will serve as nurses and midwives in the health care delivery system.
In order to complement the efforts of the Government, the Directorate of Nursing and Midwifery Services at the MoHS in collaboration with Nurses and Midwives Board, professional associations and other key stakeholders across the health sector decided to review the SECHN Curriculum and develop a new curriculum which will focus on preparing the future nurse-midwife technician.
1.3. DEVELOPMENT PROCESS OF THE NMTCURRICULUNM
The State Enrolled Community Health Nursing (SECHN) curriculum has been reviewed on October 2016. The process was consultative and involved a series of activities such as:
1. Study tour in the sub region(Malawi) to learn best practices on Nursing and Midwifery education
2. Review of the existing curriculum in line with the International Council of Nurses
(ICN) and International Confederation of Midwives (ICM) and WHO competences,
3. Reviewing of the content for its relevance to national health needs and the expected roles of NMT. During the review process, the following key gaps were identified after a general consensus and agreed that there is the need to address them. These are as follows:
· Poor organization of the content in line with international standards
· Insufficient theory and clinical hours for midwifery practice
· Unclear content outline leading to inconsistency in the content delivery.
· Leveling of the content was not clear
· Clinical content was not indicated in the theory content
· Content for communication skills was not evident
· Infection , Prevention and Control content was not outstanding
· The nursing process was absent