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国際医療協力研究委託費 17 (公)6 アフガニスタンの看護学部カリキュ ラム協働開発 Collaborative Development of Baccalaureate Program in Afghanistan 田代 順子 ( Junko Tashiro, RN, PhD ) 協働研究者: Shamsurahim.

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Presentation on theme: "国際医療協力研究委託費 17 (公)6 アフガニスタンの看護学部カリキュ ラム協働開発 Collaborative Development of Baccalaureate Program in Afghanistan 田代 順子 ( Junko Tashiro, RN, PhD ) 協働研究者: Shamsurahim."— Presentation transcript:

1 国際医療協力研究委託費 17 (公)6 アフガニスタンの看護学部カリキュ ラム協働開発 Collaborative Development of Baccalaureate Program in Afghanistan 田代 順子 ( Junko Tashiro, RN, PhD ) 協働研究者: Shamsurahim Rahim, Sherin Aqua Zarif (Kabul Medical University) 松谷美和子、長松康子、山崎好美、梅田麻希、林亜希子 ( WHO 看護開発協力センター聖路加看護大学) 武田優子、大西弘高(東京大学国際医学教育研究センター)水嶋春朔(国立保健医療科学院) 第 6 回医学教育国際協力研究フォーラム 12 月 14 日 2007 年

2 話題( Topics) アフガニスタンの看護学部カリキュラム アフガニスタンの看護学部カリキュラム 協働的開発の背景と経緯 ( Background of this project) ( Background of this project) カブール医科大学看護学部のカリキュラ ム カブール医科大学看護学部のカリキュラ ム 開発過程 (Progress of this project) (Progress of this project) カブール医科大学看護学部プロジェクト の カブール医科大学看護学部プロジェクト の 今後の課題 (Future direction of this project) (Future direction of this project)

3 アフガニスタンの看護学部カリキュラム 協働的開発の背景と経緯 ( Background of Collaborative Nursing Education Project for Afghanistan ) July, 2002: July, 2002: “Comprehensive Needs Assessment in Education (CAN)” “Comprehensive Needs Assessment in Education (CAN)” ODA (Japan International Cooperation Agency) started to plan. ODA (Japan International Cooperation Agency) started to plan. January, 2005: January, 2005: The first trainees from Kabul Medical University (KMU) The first trainees from Kabul Medical University (KMU) hosted by Japanese International Cooperation Agency (JICA), designated by International Research for Medical Education (IRME), Tokyo University. hosted by Japanese International Cooperation Agency (JICA), designated by International Research for Medical Education (IRME), Tokyo University. March, 2005: March, 2005: JICA started “Medical Education Project” JICA started “Medical Education Project” August, 2005: August, 2005: Collaborative Inter-disciplinary Study Team consists of IRME and WHO C.C. at SLCN for Nursing Education started Collaborative Inter-disciplinary Study Team consists of IRME and WHO C.C. at SLCN for Nursing Education started October, 2006 October, 2006 Started to work with faculty members of Faculty of Nursing of Kabul Medial University Started to work with faculty members of Faculty of Nursing of Kabul Medial University

4 実践研究の枠組み Conceptual Framework Structure (構造) Process (過程) Outcome ( 成果 ) Structure (構造) Process (過程) Outcome ( 成果 ) People's Health Status Life Expectancy Major Causes of Death Infant Mortality Maternal Mortality Health Care Providers Human Resources Health Care System Health policy Regulations Financial condition Human resource development People’s Self-care Health Care Providers Quality of health care services Workload Health Care system Accessible health care facilities Financial support and Health professional and workers education Development of Educational Program for Human Resource for Health People’s Health Status People’s accessibility of care People’s satisfaction Financial burden Health Care Providers Satisfaction Health Care System Cost-effectiveness

5 目的と 2005 - 2006 年の目標 ( Main goal and Studies in 2005 & 2006 ) The main goal of educational development in Afghanistan is strengthen nursing and consequently promote the health of the people by focusing on women and children The main goal of educational development in Afghanistan is strengthen nursing and consequently promote the health of the people by focusing on women and children Goals of 2005 To determine Afghanistan’s critical health needs that would guide the development of their baccalaureate nursing program Goals of 2006 To develop educational program of Faculty of Nursing, Kabul Medical University To develop educational program of Faculty of Nursing, Kabul Medical University

6 2005 年度の研究成果 (既存データ分析) Findings of Study in 2005 Health Indicators of the Afghanistan Life Expectancy at Birth: 42 years old (WHO, 2004) Life Expectancy at Birth: 42 years old (WHO, 2004) Under age 5 yrs. mortality rate: 258/1000 Under age 5 yrs. mortality rate: 258/1000 Infant Mortality: 144/1000 lb (Ministry of Health Afghanistan, 2002) Infant Mortality: 144/1000 lb (Ministry of Health Afghanistan, 2002) Maternal Mortality: 160/100,000birth Maternal Mortality: 160/100,000birth Population Growth: 2.67% (2006 est.) Population Growth: 2.67% (2006 est.) Sex ratio at birth: 1.05 male/female Sex ratio at birth: 1.05 male/female Human Resource in Health (WHO, 2001) Number of ( Density per 1000 people) Number of ( Density per 1000 people) Physician: 4,104 ( 0.19/1000 ) Physician: 4,104 ( 0.19/1000 ) Nurses: 4,752 ( 0.22/1000) Nurses: 4,752 ( 0.22/1000) Dentist: 630 ( 0.03/1000) Dentist: 630 ( 0.03/1000) Pharmacist 525 ( 0.02/1000) Pharmacist 525 ( 0.02/1000)

7 政府保健行政官・指導者ニーズ調査結果: A : ヘルスケアニーズ Findings (A) :Health care needs (A-a) Destroyed health care system and (A-a) Destroyed health care system and institutions institutions (A-b) High maternal mortality (A-b) High maternal mortality (A-c) High infant mortality (A-c) High infant mortality (A-d) High blood pressure and other chronic (A-d) High blood pressure and other chronic diseases diseases (A-e) Infectious disease: Measles, HIV/AIDS (A-e) Infectious disease: Measles, HIV/AIDS (A-f) Psychiatric illness such as post traumatic stress disorder (PTSD) and depression. (A-f) Psychiatric illness such as post traumatic stress disorder (PTSD) and depression.

8 Findings (B) : Human resource development needs 政府保健行政官・指導者ニーズ調査結果: B : 保健人材育成ニーズ Findings (B) : Human resource development needs (B-a) unbalanced distribution of health worker or personnel between urban and rural areas; (B-a) unbalanced distribution of health worker or personnel between urban and rural areas; (B-b) reduced numbers of female human resource in health because of the cultural and regional value; (B-b) reduced numbers of female human resource in health because of the cultural and regional value; (B-c) less management of human resource development due to heavily relied on non- governmental agencies. (B-c) less management of human resource development due to heavily relied on non- governmental agencies.

9 2005 年度の研究方針: Future Directions of Collaborative Study Team for Development of Nursing Education in 2005 To form international inter-disciplinal study team between Afghanistan and Japan To form international inter-disciplinal study team between Afghanistan and Japan To develop a nursing program that prepares nurse leaders who can manage and develop nursing and health activities within the health system consisted of tertiary, secondary, and primary To develop a nursing program that prepares nurse leaders who can manage and develop nursing and health activities within the health system consisted of tertiary, secondary, and primary This collaborative work developing a nursing educational program, it should be based on the cultural values such as gender-role in Afghanistan, and community health. This collaborative work developing a nursing educational program, it should be based on the cultural values such as gender-role in Afghanistan, and community health.

10 Shamsurahim Rahim Dean of Nursing faculty October 1 4, 2006

11 I. History of Kabul Medical University I. History of Kabul Medical University II. Organization and Administration II. Organization and Administration III. Health system in Afghanistan III. Health system in Afghanistan IV. Philosophy of education IV. Philosophy of education V. Goals of Nursing education V. Goals of Nursing education VI. Concept of Nursing VI. Concept of Nursing VII. Components of Baccalaureate Curriculum of Year of Study VII. Components of Baccalaureate Curriculum of Year of Study XIII. Subjects and Credit XIII. Subjects and Credit 学部案内内容 ( Contents )

12 カブール医科大学の歴史 I. History of Kabul Medical University In1933,The nucleus of higher education established as a Medical Faculty by the supervision of Turkish professor Refqi big with 8 lecturers. In1933,The nucleus of higher education established as a Medical Faculty by the supervision of Turkish professor Refqi big with 8 lecturers.

13 In 1985, the mentioned Medical faculty progressed to Medical institute and to Medical University in 200 3. In 1985, the mentioned Medical faculty progressed to Medical institute and to Medical University in 200 3.

14 the Ministry of Public Health. In 1940, the Medical Faculty established the Primary Nursing School In 1962, the Secondary Nursing School established, with the cooperation of German government アフガニスタン看護教育の歴史 History of Nursing Education

15 In 1976, the Primary Nursing School of Medical Faculty joined to this Secondary Nursing School, and after that has promoted to Health and Science Institution. In May, 2006, Kabul Medical University established the Faculty of Nursing which is the first faculty of nursing in Afghanistan.

16 Pediatric faculty Dentistry Faculty (Stomatology) Vice CH in Administrative affairs E D C Vice CH.in education affairs Curative faculty Library Executive Board of the University Academic Council 11 Dept. 10 Dept. 11 Dept University Hospitals G.Director Nursing Faculty 4 Dept Chancellor Vice CH. in scientific affairs Research Center Publication Audio- visual Finance Account Human resource Evaluation committee Postgraduate committee PBL committee Curriculum committee Public Health Clinical Nursing Research & Education Fundamental II. 組織と管理体制: Organization and Administration

17 プライマリーヘルスケア Basic package of health services (primary care system ) Components: 1-Maternal and newborn health. 2-Child health and immunization. 3-public nutrition. 4-Disability. 5-Communicable diseases. 6-Mental health(community management).

18 保健サービス ( Basic Package of Health Services ) -Community health workers -limited curative care -out patient. -Same services as a HP -But more complex out patient care -Will be staffed by a nurse, mid wife and vaccinators. - Covers area of to60000people -Offering BHCs, normal delivery, handling Some complications, grave care of child illness, complicated malaria, physiotherapy. - Covered 100, ,000 population beds, for surgery, medicine, pediatrics, obst & gyn, and out patient for mental health & dental services.

19 医療サービス ( Essential Package of Hospital Services ) 1-District hospital (DH): mentioned before. 2- provincial hospital(PH): 100- 200 beds, services offered by DH, infectious diseases, rehabilitation, nutrition, physiotherapy services as well. 3-Regional hospital(RH): beds beside offered PH, ENT, Urology, Neurosurgery, Orthopedics, plastic, Cardiovascular and the other specialties. has training program. 4-University hospital: serve as RH, in addition practical field of medicine, Pediatrics, Nursing and Dentistry students and research. is under the authority of the medical university.

20 VI. 看護教育の理念: ( Philosophy of Nursing Education ) Education is characterized by training the mind to think, gaining knowledge through engagement in intellectual activities, pursuing research and disseminating knowledge that is useful for all citizens and that also encourages their continuous intellectual growth. Education is characterized by training the mind to think, gaining knowledge through engagement in intellectual activities, pursuing research and disseminating knowledge that is useful for all citizens and that also encourages their continuous intellectual growth. The education should help individuals to live usefully and happily, able to solve problems. The education should help individuals to live usefully and happily, able to solve problems. Faculty of Nursing, Kabul Medical University will establish a strong system of education in order to enable our students to seek the goals including the highest quality of life of the people and progress of health care in Afghanistan. Faculty of Nursing, Kabul Medical University will establish a strong system of education in order to enable our students to seek the goals including the highest quality of life of the people and progress of health care in Afghanistan.

21 V. 看護の理念 ( Concept of Nursing ) A graduate nurse serve all individuals equally A graduate nurse serve all individuals equally A graduate nurse has sufficient knowledge on how to practice in health system for both treatments and prevention of diseases A graduate nurse has sufficient knowledge on how to practice in health system for both treatments and prevention of diseases A graduate nurse gains professional attitude and skills to help both patients and clients in the community A graduate nurse gains professional attitude and skills to help both patients and clients in the community A graduate nurse associates with health care professionals, health workers, birth attendants, community volunteers and leaders A graduate nurse associates with health care professionals, health workers, birth attendants, community volunteers and leaders A graduate nurse has sufficient capacity for taking leadership in nursing practice and administration in health care services. A graduate nurse has sufficient capacity for taking leadership in nursing practice and administration in health care services.

22 Basic Package of Health Service Essential Hospital Service Nursing CommunityHospital 看護理念図 ( Concept of Nursing )

23 VI. 看護教育の目標 (Objectives of Nursing Education) use a framework of assessment, planning, implementation, and evaluation in providing nursing care in the (BPHS) and in the (EPHS) use a framework of assessment, planning, implementation, and evaluation in providing nursing care in the (BPHS) and in the (EPHS) analyze situations using multiple sources of data in order to identify problems, possible courses of sector of their consequences. analyze situations using multiple sources of data in order to identify problems, possible courses of sector of their consequences. make and defend decision on basis of evidence and ethical considerations. make and defend decision on basis of evidence and ethical considerations. communicate about health matters with members of the community. communicate about health matters with members of the community.

24 deliver basic preventive and curative care services for communicable diseases. deliver basic preventive and curative care services for communicable diseases. use advanced knowledge to provide services within specialized areas. use advanced knowledge to provide services within specialized areas. teach and work together with families and community health other workers. teach and work together with families and community health other workers. use basic nursing strategies and to promote health comfort. use basic nursing strategies and to promote health comfort. conceptualize, and analyze data for purposes of quality assurance and research. conceptualize, and analyze data for purposes of quality assurance and research. work collaboratively in the health care system. work collaboratively in the health care system.

25 VII. 学部カリキュラムの概要 ( Components of Baccalaureate Curriculum of Year of Study ) Fourth Year Anesthesia Nursing (18 ) ; Operating Theater Nursing (18) ; Critical Care Nursing (1 8) ; Anesthesia Nursing (18 ) ; Operating Theater Nursing (18) ; Critical Care Nursing (1 8) ; Psychiatric Nursing (18) Community Midwifery (18) ; Public Health Nursing ( 18 ) Psychiatric Nursing (18) Community Midwifery (18) ; Public Health Nursing ( 18 ) Nursing Education (3) ; Nursing Administration (3) ; Nursing Research (10) ; Biostatistics (2) Nursing Education (3) ; Nursing Administration (3) ; Nursing Research (10) ; Biostatistics (2) Third Year Adult Nursing III (4) ; Pediatric Nursing Ⅰ(4) ; Maternal Nursing Ⅰ(3) ; Psychiatric Nursing & Mental Health Ⅰ (3); Community Nursing Ⅰ ( 4 ); Adult Nursing Ⅳ (4) ; Pediatric Nursing Ⅱ(4) ; Adult Nursing III (4) ; Pediatric Nursing Ⅰ(4) ; Maternal Nursing Ⅰ(3) ; Psychiatric Nursing & Mental Health Ⅰ (3); Community Nursing Ⅰ ( 4 ); Adult Nursing Ⅳ (4) ; Pediatric Nursing Ⅱ(4) ; Maternal Nursing Ⅱ(4) ; Psychiatric Nursing and Mental Health Ⅱ(3) ; Community Nursing Ⅱ( 3) Maternal Nursing Ⅱ(4) ; Psychiatric Nursing and Mental Health Ⅱ(3) ; Community Nursing Ⅱ( 3) Second Year Adult Nursing I ( 3) ; Adult Nursing II (5) ; Anatomy and Physiology I (3) ; Pathology (2) ; Adult Nursing I ( 3) ; Adult Nursing II (5) ; Anatomy and Physiology I (3) ; Pathology (2) ; Pharmacology I (3) ; Health system (2) ; Nutrition (2) ; Anatomy and Physiology II (4) ; Pharmacology I (3) ; Health system (2) ; Nutrition (2) ; Anatomy and Physiology II (4) ; Physiopathology (3) ; Pharmacology II (3) ; Medical ethics (1) ; Foreign Language III (2) Physiopathology (3) ; Pharmacology II (3) ; Medical ethics (1) ; Foreign Language III (2) Law (optional) (1) ; Foreign Language IV (2) Law (optional) (1) ; Foreign Language IV (2) First Year Fundamental Nursing I (3) ; Fundamental Nursing II (5) ; Chemistry I (3) ; Biology I, (3) Fundamental Nursing I (3) ; Fundamental Nursing II (5) ; Chemistry I (3) ; Biology I, (3) Chemistry II (Biochemistry) (3) ; Biology II, (3) ; Information Technology (Computer) (2) (optional); Chemistry II (Biochemistry) (3) ; Biology II, (3) ; Information Technology (Computer) (2) (optional); Physical Education (1) ; Art (3) ; Islamic Study I (1) ; Foreign Language I (2) ; Information Physical Education (1) ; Art (3) ; Islamic Study I (1) ; Foreign Language I (2) ; Information Technology (Computer skill) (2) ; Psychology (2) ; Sociology (2) ; Islamic Study II ( 1) ; Technology (Computer skill) (2) ; Psychology (2) ; Sociology (2) ; Islamic Study II ( 1) ; Foreign Language II (2) Foreign Language II (2)

26 Reference WHO The World Health Report 2006 WHO The World Health Report 2006 WHO The World Health Report 2005 WHO The World Health Report WHO (2006) The World Health Report. WHO. WHO (2006) The World Health Report. WHO. JICA (2005). Report on Preliminary Evaluation of Medical Education in Afghanistan. JICA. JICA (2005). Report on Preliminary Evaluation of Medical Education in Afghanistan. JICA. International Research Center for Medical Education (2005). Proceedings: The 4 th Forum of International Cooperative Research for Medical Education. IRCME, Tokyo U. International Research Center for Medical Education (2005). Proceedings: The 4 th Forum of International Cooperative Research for Medical Education. IRCME, Tokyo U. Afghan Ministry of Health (2003). Guidelines for Development of a Health Worker Certification System. Ministry of Health, Afghanistan. Afghan Ministry of Health (2003). Guidelines for Development of a Health Worker Certification System. Ministry of Health, Afghanistan. Afghan Ministry of Public Health, CDC & UNICEF (2002) Maternal Mortality in Afghanistan: Magnitude, causes, Risk Factors and Preventability. Ministry of Health, Afghanistan. Afghan Ministry of Public Health, CDC & UNICEF (2002) Maternal Mortality in Afghanistan: Magnitude, causes, Risk Factors and Preventability. Ministry of Health, Afghanistan.

27 今後の課題 カリキュラムの概要試案の評価と洗練 カリキュラムの概要試案の評価と洗練 科目シラバスの作成のためのファカル ティ力量開発 科目シラバスの作成のためのファカル ティ力量開発 更なる教育支援のための協働計画 更なる教育支援のための協働計画


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