1. Low uptake of upgrading course among nurse- midwives through eLearning model in Tanzania: is it entry qualifications or computer-phobia? Lujenje S 1,Ngilangwa David P 1, Chaya Pius 1, Noronha Rita 1 1 Amref Health Africa, Dar es Salaam, Tanzania 1 st Amref Health Africa International Conference Safari Park Hotel, Nairobi, Kenya 24-26 th November, 2014

2. Outline Issue Description Lessons learnt Next steps and recommendations Acknowledgments

3. Issue Human resource for health shortage is daunting –Nurse-midwives in particular remain low The situation contributes significantly to high number of maternal mortality in the country –51% of deliveries are assisted by skilled personnel Range of initiatives have been done to increase number of training institutions and enrolled students Yet, the country experience dearth number of HRH –Tanzania has 65% unmet needs for its required HRH Thus, equipping available HRH to conduct multi- task including deliveries remain critical

4. Issue… Amref Health Africa through its global campaign “Stand Up for African Mothers” is contributing towards addressing HRH shortage in Tanzania Supporting training of nurse-midwives in nine regions with severe shortage of HRH in Tanzania Through e-Learning eLearning programme uses the existing national curriculum for conventional nursing training schools for upgrading nurses Curriculum are installed in students’ computers in all participating nursing schools

5. Description In April 2011, Amref Health Africa in collaboration with MoHSW launched two-year project Upgrade 2,800 nurses-midwives from certificate to diploma level through eLearning in 9 nursing schools This is a two year in-service training Allows nurse-midwives to remain at their workstation Study at their own pace, with minimal disruption to their work schedules To do practical of what they have learnt Contrary to full-time studies

6. Description… The programme implementation was preceded by a rapid assessment to determine; -Tanzania’s e-Learning preparedness -Revising the existing national curriculum to suit a eLearning model -Obtaining approval of curriculum from regulatory bodies -Sensitizing nurses to join the programme The programme has been widely publicized nationwide and most of targeted i.e. in-service nurses are aware of it However since its inception uptake of the programme has been remained low

7. Description … Uptake of eLearning among students in Tanzania IntakeNumber of applicants Number of selected/qualified April 201316089 Sept 201322288 April 20145222

8. Lessons learnt eLearning acceptance was high from nurses and employees Majority of targeted nurses wanted to join the course Entry qualifications of one pass in either Biology or Chemistry plus two years work experience obstructed them Other reasons given for low uptake of the course were –lack of prior training or exposure to computers –challenges in balancing work, family and education life –Distance from workplaces to nursing schools especial during face to face meetings with their tutors

9. Next steps and recommendations To scale up the programme to other schools and intensify its sensitization Regulatory body should review entry qualifications to improve access to Continuous Professional Development (CPD) for nurse-midwives

10. Acknowledgement o All donors (GSK 20% Re-investment) o The Government of Tanzania o Nursing Schools o All eLearning programme stakeholders