Investing in the next generation of nurses and midwives in Tanzania SHOPS Plus and partners designed a pilot program that gives nursing and midwifery students practical clinical skills.

One of the greatest challenges to improving the delivery of essential health services in Tanzania is the shortage of trained health workers. This affects all health areas, including family planning, HIV, and malaria. Historically, students studying at private medical training institutes have had to rely on securing practicum opportunities within public health facilities, but these are limited. The result is that these students have trouble getting the practical training they need.

This is why SHOPS Plus, in partnership with the Association of Private Health Colleges, designed a pilot focused on increasing the practical clinical skills of nursing and midwifery students.

Massana Hospital is one of the health facilities serving as a rotation site.

Site rotations at health facilities, technical skills developed

A group of 50 nursing and midwifery students from private medical training institutes in Dar es Salaam received practical clinical experience at private medical facilities from June to September 2018. In the pilot, students rotated to learning sites at health facilities affiliated with the Private Nurses and Midwives Association, the Christian Social Services Commission, Massana Hospital, Hindu Mandal Hospital, and Hubert Kairuki Hospital, where they learned about family planning, integrated HIV care, antenatal care, and primary health care.

Students learning new skills and gaining practical clinical experience from instructors during their site rotations.

“We train nurses who will help us tomorrow”

Martin Paul Sankey is a clinical instructor at Hindu Mandal Hospital in Tanzania. Sankey does not believe that you can learn everything at school. He believes that as students, we learn many things in theory while we are at school but we get our practical learning in the workplace. However, with this program, Sankey knows he can make a difference and give his students the clinical and practical skills they need, which is an opportunity he wishes he had when he was in school.

Sankey observes a student as she practices a skill on a patient.
“Nursing is not just a theory, it needs practices,” Sankey explains. “When students were completing their studies they had no practical skills. The practice helps them in many ways. They will be able to have practical skills. We train nurses who will help us tomorrow, who can give us good care.”

Sankey is just one of many instructors equipping the next generation of nurses and midwives in Tanzania with the skills they need to provide quality services to the many clients that will depend on them once they complete the program.

“From the experience I have received, I now believe I can work in any hospital”

Brighton Simon Mahenge is a student at Masana College. He decided to go to nursing school because of the struggles his family faced accessing health care at their local hospital.

“One day my parents went to the hospital and they didn’t receive treatment because of lack of workers, including nurses,” Mahenge reflected. “That pushed me to study nursing. Nursing work is good because it saves peoples’ lives.”
Mahenge is one of many students that become nurses and midwives to make a difference in their communities.

Mahenge loves his job because he gets to help people and save lives while earning an income. As a student, he understands the value of education and learning practical clinical skills, including patient rights. These invaluable skills taught by experienced instructors have given him an advantage over other students entering the workforce.

Mahenge and his classmates learn a new skill from one of their instructors.
“I believe that the rotations have helped me a lot and have made me a better nurse and a better employee from the experience I have gained by working in various hospitals,” Mahenge said. “I think other students will benefit if they have the opportunity to pass through the program. From the experience I have received, I now believe I can work in any hospital.”

For nursing students like Mahenge, being prepared to work in both public and private health facilities is critical to addressing the shortage of health workers in Tanzania.

“My hope was that this collaboration will continue”

Elizabeth Onesvoro Kijugu is an assistant lecturer at the Kairuki School of Nursing. Like Sankey, she believes that this program will make a difference at the national level through a standardized curriculum.

Kijugu believes that standardized training nationwide is important.
“The advantage of having standardized material for practicum, which means that we will have uniform [training] within the country [so] that all stakeholders, all schools of nursing will be using those practicums and it will enhance the training and the knowledge and the competence of students,” Kujugu said.

In her experience, the feedback from students, instructors, directors, health facilities, and administration from the institutes has been positive, which she believes is key to the program being successful in the future.

Kijugu uses a manikin patient to teach her students a new skill.
“The future I see, I think we are going to have students and nurses who are competent in Tanzania, through this practicum placement and the support from SHOPS Plus,” Kujugu explains. “I can see that we are going to get nurses that are able to address several issues, for example, HIV and AIDS, family planning, and the other diseases.”
These students are the next generation of nurses and midwives in the country.

New skills, new outcome

The pilot will help inform future training programs developed by the Directorate of Nursing Services in Tanzania, specifically involving private-to-private practicum rotation as a means to improve the quality of HIV service delivery by private providers through improved and critical hands-on experience.

In addition to the pilot, SHOPS Plus contributed to new national guidelines and training curricula developed by the Ministry of Health’s Director of Nursing. These new guidelines are part of a national initiative to improve hands on practical experience for nursing and midwifery students.

The instructor talks to patients in the waiting room while her students watch and learn.

About SHOPS Plus

Sustaining Health Outcomes through the Private Sector (SHOPS) Plus is USAID’s flagship initiative in private sector health. The project seeks to harness the full potential of the private sector and catalyze public-private engagement to improve health outcomes in family planning, HIV, child health, and other health areas. SHOPS Plus Tanzania supports the efforts of the Tanzanian Ministry of Health’s Director of Nursing Services and a broad coalition of public and private stakeholders to develop improved national guidelines and training curricula for Tanzania’s nursing and midwifery educators and clinical instructors.


Photo credit: Sama Jahapour

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