Public Health Education Needs Assessment, Togo, West Africa Ros Bryar, Rosa Benato and Judith Sunderland

Content Background – Togo and Vision Togo The PHC Nursing Roadmap Methods – meetings, questionnaire, observation Findings – education Next steps – MOU, lecturer preparation, clinical support, fund raising

Where is Togo?

Togo Statistics Small, French speaking nation in sub-Saharan Africa 12th poorest nation in the world (World Bank, 2014). Population: 7million, Life expectancy: 56 Maternal mortality: 450 per 100,000 live births – Denmark and UK 12 Under 5 mortality: 78 per 1,000 live births – Denmark 4, UK 5

Nursing and Midwifery Workforce 2.7 nurses and midwives per 10,000 population. Regional African average of 12/10,000, UK average of 88/10,000, Denmark 167/10,000 One of 49 priority countries identified by WHO in 2010 where the health workforce numbers are below the critical figure of 23/10,000 population needed to achieve improvements in maternal and child health (WHO, 2010)

VISION TOGO Charity supporting health care projects in Togo Mobile health unit Advice line Education of nurses and midwives Facebook: Vision Togo

Vision Togo and School of Health Sciences The School of Health Sciences, City, University of London, was approached in 2014 by Vision Togo To identify and support educational needs of nurses and midwives in Togo Partnership development grant from Tropical Health and Education Trust (THET) Needs assessment visit undertaken in April 2016.

Needs Assessment Visit Rosa Benato – Education lead; Judith Sunderland – Midwifery lead; Ros Bryar – Public health Assessment Tool – based on the PHC Nursing Roadmap Site visits - Ecole Nationale Auxilieres Medicaux (ENAM) Lomé and Kara Ecole Nationale Sages Femmes, Lomé and Kara Rural clinics Ministry of Health

Testing the PHC Workforce Development Roadmap – 3rd Global Health Nursing Conference, Galway Does the Roadmap help in promoting effective PHC nursing? Does the Roadmap support integration of Public Health nursing into PHC? What elements and components more critical, in what contexts? Do you want to work with us to test the Roadmap? Contact: R.M.Bryar@city.ac.uk

Reforming Primary Health Care: A Nursing Perspective Published January 2012 Report disseminated to all nursing associations in membership of ICN and available in English, French and Spanish at: http://www.icn.ch/images/stories/documents/pillars/sew/ICHRN/Policy_and_Research_Papers/PHC.pdf

PHC Policy Context Alma Ata Declaration 1978 Re-launch of PHC by WHO 2008 – Primary Health Care Now More Than Ever ICN Definition of Nursing 2003 Sally Kendall 2008 Review for ICN of nursing contribution to PHC 30yrs after Alma Ata Millennium Development Goals to 2015 Sustainable Development Goals 2015-2030

Effective PHC Workforce Components Literature review and case study examples identified three parts of the Roadmap: 1. Positive Practice Environments – provides the context for effective practice 2. Crosscutting workforce components – seven underpinning requirements 3. Key Features of Effective PHC Nursing – five aspects of effective practice

PHC Nursing Roadmap

Visit Assessment Framework Education Competencies Regulation Leadership Managerial Support Skill-Mix Health and Safety Incentives

School of Nursing, Lome

Student Nurses

Teaching

Nurse teachers

Questions: related to the workforce components Education: What courses are in place for: nurses, midwives, nurse teachers, nurse managers, advanced nurse practitioners? What level are these courses at: diploma, BSc, M, PhD? Curricula – practice/theory; hospital/community Recruitment of nursing and midwifery students How many students are currently on pre-registration programmes? Is there a workforce development plan? What CPD is available? Who provides this? How is it provided e.g. classroom; one-to-one; online; in country; external to Togo Access to journals, newsletters, SMS

Needs Identified Need for an M level programme of teacher training for nurse/ midwifery lecturers in Togo who currently have to leave Togo to undertake such training; 2. Exchange of ideas around teaching methods and in particular the use of simulation in teaching; 3. Provision of teaching aids and journals; 4. Support for clinical practitioners including working alongside sharing knowledge, provision of equipment; 5. Opportunities for nurses and midwives to gain employment on qualification.

Next Steps Partnership agreement between City, University of London and the Ministry of Health, Togo Apply for funding to support partnership Recruit partners and mentors from local trusts Adapt City’s MA Academic Practice for Togo Application submitted to BMA fund for books Invited by the Togo Embassy in London to become a Friend of Togo

More Information Film ‘Exchange of Ideas’ from Togo visit on YouTube: https://www.youtube.com/watch?v=5D-fNTP323M Blog on the City, University of London web site: https://blogs.city.ac.uk/learningatcity/2016/05/18/nursing-and-midwifery-education-in-togo-needs-assessment/#.V3QxM7grKhd

City, University of London Northampton Square London EC1V 0HB United Kingdom T: +44 (0)20 7040 5060 E: R.M.Bryar@city.ac.uk www.city.ac.uk/http://www.city.ac.uk/news/2016/may/city-set-to-sign-partnership-with-togo