One of the primary obstacles in meeting the Millennium Development Goals is the scarcity of human resources for health, including the lack of a qualified health care workforce to provide for the needs of maternal and child health and populations with HIV/AIDS, malaria, and tuberculosis. In Nigeria, the main point of free, accessible health care is the primary health care center. Yet the quality of care available in these centers is often inadequate and contributes to the poor health outcomes found in the Nigerian population. Today, Nigeria has one of the highest mortality rates worldwide, particularly among women and children. The majority of these deaths are preventable. (See Table 1. Source: WHO Nigeria Country Profile, 2009 data)
|Table 1. Selected Health Indicators, Nigeria, 2009 Data|
|Maternal mortality ratio (per 100,000 live births)||840||620||260|
|Under-5 mortality (per 1,000 live births)||138||137||60|
|Neonatal mortality (per 1,000 live births)||48||49||30|
|Tuberculosis prevalence (per 100,000 population)||497||475||201|
Like many developing countries in Africa and throughout the world, nurses and community health officers (CHOs) are the backbone of Nigeria’s health care system. Nurses and CHOs are often asked to engage in clinical and public health leadership responsibilities for which they have no education or training. This is particularly common at the primary health care level, where a nurse and/or CHO is often the sole health care worker in the facility. Expanding the capacity of these frontline workers is a critical aspect of building sustainable health care systems and will require innovative educational programs based on the specific realities that exist in Nigeria.
One such innovative educational initiative is the Primary Health Care Specialist (PHC-S) Diploma Program developed by the University of Maryland School of Nursing’s (UMSON) Office of Global Health. Working closely with the University of Maryland School of Medicine’s Institute of Human Virology (IHV) in Baltimore and in Nigeria; Nigerian nurse leaders from Obafemi Awolowo University, Ile Ife; University of Nigeria, Nsukka; and Ahmadu Bello University, Zaria, this 12-month advanced diploma program is designed to rapidly and effectively address the immediate human-resource needs that exist in Nigeria and meet the need for greater competency and skill development in the primary health care sector. The PHC-S program specifically addresses the burden of disease in Nigeria, including essential aspects of prevention and treatment for HIV/AIDS, tuberculosis, malaria, infant and child health, as well as common adult health problems such as diabetes and hypertension. The PHC-S will serve primarily as an expert independent clinician who can conduct assessments and diagnoses and provide treatment and personalized health care for individuals and families. For more information about the PHC-S program, please contact Yolanda Ogbolu, PhD, CRNP-N (email@example.com).
Institutional Strengthening Project, Haiti
The UMSON Office of Global Health has embarked on a new project in Haiti that brings together the University of Maryland Schools of Medicine and Nursing, UMIHV, and the University of Maryland Medical Center (UMMC), to develop an infectious disease training curriculum for Haiti’s principal nursing school. The Institutional Strengthening Project, Haiti (ISPH), will build the capacity of the nation’s nurse workforce, nursing education, and the health care system to cope with the dire need for services resulting from the January 12, 2010 earthquake and to respond to future disasters and epidemics.
The Infectious Diseases Nursing Certificate Program is one component of ISPH. It is an initiative that will expand the capacity of UMSON faculty to engage in advancing nursing education and practice in global health settings. This program will be the first post-baccalaureate certificate program for nurses to be recognized by the Haitian Ministry of Health and will be housed in a renowned health sciences educational institution, University of Notre Dame of Haiti. There are partnerships available on multiple levels of ISPH. The project is funded by the Health Resources and Services Administration, with the Center for Disease Control (CDC), Haiti as in-country donor administrator. For the educational and training component of ISPH, CDC is partnering with multiple University of Maryland collaborators: UMSON the School of Medicine’s Institute of Human Virology and Department of Orthopedics, UMMC, and the R Adams Cowley Shock Trauma Center. Partners on the ground in Haiti that will conduct future activities are the University of Notre Dame of Haiti School of Nursing and School of Medicine and a network of four Catholic hospitals across the country: San Francois de Sales, San Bonifas, San Damien, and Sacred Heart.
At least five University of Maryland entities are engaged in ISPH, working together to implement various aspects of the program. UMMC employees have donated vacation hours toward Haiti relief efforts post the 2010 earthquake, which focused on providing services to patients at San Francois de Sales Hospital and rebuilding the institution. Many UMSON and School of Medicine faculty members and staff have become engaged in the development of the project. For more information on this project, please contact Marik Moen, MPH, MSN, RN (firstname.lastname@example.org).