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

2. 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

3. Where is Togo?

4. 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

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)

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

7. 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.

8. 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

9. 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:

15. 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:

16. 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

17. 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

18. PHC Nursing Roadmap

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

20. School of Nursing, Lome

21. Student Nurses

22. Teaching

23. Nurse teachers

25. 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

26. 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.

27. 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

28. More Information
Film ‘Exchange of Ideas’ from Togo visit on YouTube:
Blog on the City, University of London web site:

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