Lifelong learning in African healthcare

Experts at eLearning Africa 2011 suggested that eLearning could bridge the alarming skills gap that exists between nurses trained in different disciplines. Some pointed to successful partnerships with NGOs in East Africa. Others discussed scale and replicability in African medical training.

The question of content and related issues including information access and development was a key theme of the session ‘What contribution can eLearning make towards confronting the skills challenge of Africa’s health sector?’.

Mohamed Labib discussed, a well-resourced website with expert free health sciences information. The vision is to make this relevant and available to all health workers. The importance of partnerships was noted here, both south-south and north-south. The example provided was the University Teaching Hospital in Zambia, partnering with the Royal College of Surgeons in Ireland.

The session included two presentations from the Tanzanian Training Centre for International Health (TTCIH). Angelo Nyamtema pointed out the severe shortage of healthcare workers in Tanzania and discussed the progress being made in developing an eLearning training programme, including their approach to pedagogical design and course structuring.

Aza Lyimo followed up on this by demonstrating TTCIH’s implementation of an eLearning tool (termed ICATT: IMCI Computerised Adaption Training Tool) for training that meets the Integrated Management of Childhood Illness (IMCI) guidelines. One of the key issues noted was the need for localisation, which is currently in progress through the country-specific adaption interface of ICATT, and the ability of the tool to cater for individual and group learning.

Upgrading the skills of Kenyan nurses

Diana Mukami discussed the African Medical and Research Foundation’s successful nurse upgrading programme via eLearning. Since its inception nearly six years ago, the programme – a classic public-private partnership – has enrolled 7000 nurses across 108 eCentres in Kenya and graduated over 2000 nurses. It comprises General Nursing, Reproductive Health, Community Health and Specialised Areas.

AMREF is training nurses in Kenya via eLearning at large scale. (© AMREF)

While highlighting the increased competencies of participants on completion of the programme (for example, 83% of nurses engaged in new skills and work practices after graduation), Mukami suggested that some faced barriers to utilising these competencies in their everyday work.

“But developing the skills to practice eLearning means that the nurses become lifelong learners who can constantly seek new information on emerging and re-emerging issues,” Mukami said.

Lack of eLearning for mental health topics

A severe gap in skills training was emphasised by Roos Korste from the organisation “in2mentalhealth”, based in The Netherlands. In her presentation, she pointed out that there were no eLearning solutions in the area of mental health. This mirrors the lowly status of health training generally in Africa, as highlighted by the fact that there are only 18 psychiatrists in Tanzania, when 659 are needed. She called for urgent action on this important educational issue and was keen to build on what has already been achieved from the use of eLearning in other sectors.

In summary, eLearning can contribute to the skills gap by focusing on local content development, ensuring the course offerings across countries are equitable, building public-private partnerships, and emphasising continuous professional development via freely available resources.

Success stories – replicable and scalable?

The session ‘Mobile learning success stories in the health sector: how replicable and scalable?’ addressed other key challenges in African healthcare learning.

Arndt Bubenzer and Dennis Joseph Mazali presented the lessons learnt from iCall, which uses interactive storytelling delivered via mobile phone for behavioural change issues.

Mobile phones are used for exchanging x-rays within the Botswana U-Penn Partnership. (Photograph by Ryan Littman-Quinn)

Focusing on users, Ryan Littman-Quinn presented his work on a mobile learning programme for providing medical content, including key reference material, to physicians and physician trainees in Botswana. Given that he was focused on specialists, his scope of implementation choices was wider. In a pilot project, medical information applications were installed on data-connected smartphones and given to 28 residents at the University of Botswana Medical Schools. This pilot revealed high levels of use, with drug reference applications and tools to support 5-minute clinical consultations being the most widely used. The project was seen to be replicable, with appropriate funding, in other hospitals, but scale was not such an issue, given the specialist nature of the user base.

Addressing the user’s needs

Sticking with the healthcare theme, Niall Winters presented on-going work on the design of a mobile nurse training tool, developed in collaboration with AMREF HQ in Nairobi. He explained that this collaboration was a result of the organisers of eLearning Africa bringing them together to run a workshop at eLA’10, from which the ideas for this project emerged.

The importance of designing applications with users, so that user needs could be addressed directly, was highlighted, as was the need to focus as much on pedagogical innovation as technical innovation. However, the complexities of such a rich design and development process were noted for replicability. While a train-the-trainer model might work for technical implementation, it was felt that this was unsuitable for pedagogical “roll-out”. As with the Littman-Quinn presentation, scale was not as important due again to the specialist nature of the users.

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