Abstract
Background: The Maternal and Child Survival Program of United States Agency for International Development conducted a study in 2017 to assess the outcome of an initiative to strengthen Expanded Programme on Immunization (EPI) pre-service training. The pre-service training initiative was undertaken by the Ministry of Health (MOH) with support from partners in 2012-2016. The overall objective of the study was to assess the adoption and effectiveness of the initiative in the competency (knowledge, skills and attitude) of graduate nurses. Methods: The study included a conveniently selected sample of 14 pre-service training institutions, 23 field practicum sites, and 29 health facilities in western Kenya, and used quantitative and qualitative methods of data collection. Results: All pre-service training institutions were found to have adapted the WHO EPI prototype curriculum. Overall, tutors followed training method in the classroom as suggested in the curriculum, except evaluation of students’ learning lacked tests or quizzes. Students had opportunities for hands-on practical experience in the field practicum sites. Graduate nurses were found to have acquired the skills for vaccinating children. However, some pre-service training institutions lacked functional skills labs for practical learning of students. In addition, students did not receive up-to-date information on EPI program, and lacked knowledge and skills on monitoring and documentation of EPI coverage during preservice training. Conclusions: It appears that the EPI pre-service training strengthening initiatives facilitated competency-based EPI training of nurses in Kenya. However, preservice training institutions still have scope for improvement in the skills lab, hand-washing practice, providing up-to-date information, and training students on coverage monitoring and documentation.
Highlights
As of 2015, Kenya had 148 health training institutions, of which 102 are for nursing training, distributed in 36 of 47 counties [1]
The degree to which the participating training institutions improved the pre-service training was evaluated by reviewing adaptation of Expanded Programme on Immunization (EPI) Prototype curriculum, skills lab, availability of reference manual, competency of tutors, and skills practice of students’ in the field practicum sites
EPI prototype curriculum either all or some priority topics recommended in the World Health Organization (WHO) EPI prototype curriculum
Summary
As of 2015, Kenya had 148 health training institutions, of which 102 are for nursing training, distributed in 36 of 47 counties [1]. In 2011, the WHO Africa Regional Office developed the Expanded Program on Immunization (EPI) prototype pre-service training curriculum (updated in 2015) for competency-based training in nursing and midwifery schools [4]. From 2012-2016, the Kenya Ministry of Health (MOH), in collaboration with the Nursing Council and with the support of EPI partners, launched an initiative to strengthen EPI pre-service training for nurses. The initiative included adaptation of the WHO prototype curriculum and mid-level manager training for nurse tutors from all pre-service training institutions (public, private, and faithbased) across the country. Methods: The study included a conveniently selected sample of 14 pre-service training institutions, 23 field practicum sites, and 29 health facilities in western Kenya, and used quantitative and qualitative methods of data collection. Some pre-service training institutions lacked functional skills labs for practical learning of students. Conclusions: It appears that the EPI pre-service training strengthening initiatives facilitated competency-based EPI training of nurses in
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