Nita Muir, Jill Durrant Brighton and Lusaka: Partnership working to support capacity building of critical care nursing in Zambia This document is an output from the EPA Project funded by the UK Department for Business, Innovation and Skills (BIS) for the benefit of the UK and African Further and Higher Education Sectors. The views expressed are not necessarily those of BIS, nor British Council

Link established in 2005 between Lusaka University Teaching hospital and Brighton Sussex University Hospital and with the School of Nursing, University of Brighton All current work mapped to MDG`s and health needs in country. Two programs have been successful in supporting education, training and curriculum development with funding from British government using a wide team approach. 1: Critical care Nursing 2. HIV education for nurses

Ministry of Health identify health training as key to building capacity in country There has been no support for any post qualifying training despite this being an aim of the Zambian nursing council since Critical care nursing identified by Zambian nurses as urgent - University Teaching Hospital is one of a few hospitals in Zambia with an Intensive care unit but currently only 1 nurse in ZAMBIA who has received further education in this arena.

Achievements 1.Continuing Professional Education for critical care nursing through Curriculum development 2.Professional development of nurse educators 3.Curriculum written by Zambian educators and approved by Zambian General Nursing Council and MoH, start date to be July 2011

Achievements: Zambian partners secured funding from Clinton foundation to fund infrastructure (building and new library)

Upskilling of nurse educators in education and teaching skills and OSCE Upskilling of literacy skills Upskilling of nursing in ICU

I feel very privileged to be one of the first nurses to be given a priority to do the training and feel we are advancing education and not stick to the few specialities we have (RN) Deaths that occur in ICU due to inadequate knowledge of the care will be avoided. Direct quote from Zambian clinical nurse tutor)

Huge wider successes –Shared Learning between countries, hospitals and education arena`s for staff and students –Developing professional status in Zambia for Nurses –Continuing professional development for participants –Enhanced working using Evidence based practice and modern librarian resources

Building capacity in paediatric life support in UTH, Zambia A survey of undergraduate and postgraduate training needs was conducted jointly by Zambian and UK Physicians in 2008 which showed a lack of practical skills in the resuscitation and stabilisation of the severely ill child care workers who deliver acute care to children. There is currently no training in paediatric resuscitation in Zambia A mortality audit conducted over the same period demonstrated that 62% of paediatric deaths at UTH occurred within the first 48 hours after admission

Dr Seddon (Consultant Paediatrician) from the Royal Alexandra Childrens hospital, Brighton is coordinating a British Council /THET grant of £89,000 over three years to deliver an APLS course, that is very effective, low-tech systematic approach to the care of the very sick child. It provides health care workers with the essential knowledge and skills needed to prevent unnecessary deaths. During the project which will be adapted to suit local needs will deliver the APLS course to 120 healthcare workers ( including doctors and nurses) and train 8 UTH staff as independent instructors to ensure sustainability beyond the life of the project

At the same time myself and my colleague Susanne Simmons who is also a child branch/Neonatal lecturer are planning to visit UTH to carry out a Needs Assessment Exercise in relation to the feasibility of developing in partnership with our stake holders, a Child Nursing Curriculum. We are in the process of submitting a Start- Up Grant application with THET to fund this and we are also investigating other funding streams for the main project The project will assess the most crucial areas of action – actions that will have the most significant impact in reducing infant mortality rate in Zambia which according to WHO 66.6 per 1,000 live births in 2011 and work towards the MDG Four- reducing IMR by two thirds by 2015

A mortality audit conducted over the same period demonstrated that 62% of paediatric deaths at UTH occurred within the first 48 hours after admission The APLS course, developed by the Advanced Life Support Group offers a very effective, low-tech systematic approach to the care of the very sick child. It provides health care workers with the essential knowledge and skills needed to prevent unnecessary deaths. During the project which will be adapted to suit local needs will deliver the APLS course to 120 healthcare workers ( including doctors and nurses) and train 8 UTH staff as independent instructors to ensure sustainability beyond the life of the project

According to the Integrated Management of Childhood Illness (IMCI) the high mortality rates are due to; convulsions, inability to drink, vomiting everything, unconsciousness or lethargy and specific combinations of signs and symptoms that identify severe illness. Many of these deaths could be prevented if very sick children are identified soon after their arrival in the health facility and treatment is started immediately.