FUNZOKenya is a USAID funded, IntraHealth International Inc. led � - PDF document

FUNZOKenya is a USAID funded, IntraHealth International Inc. led �ve year project that is supporting the Government of Kenya’s efforts to transform its health worker education and training systems. For further information please contact the Chief of Party through: P.O. Box 66726 – 00800, Ring Road/Lower Kabete Rd, Westlands , Nairobi Kenya 9 West building, 4th Floor Tel: +254 ebsite: http: //www.intrahealth.org/page/kenya July -October 2014 T here is an old saying: “A journey of 1000 miles begins with one step.”’ Even though Outspan Medical Training College is yet to cover their 1000 miles, it made the important step in 2009 when it opened its doors to the �rst group of students. On that day, after waiting for 12 hours, only 11 students turned up. This was not the start Ms Lydia Muthoni, who had left her teaching job at the Kenya Medical Training College to become principal of the institution had dreamt of. Five years later with a population of over 800 students and more than eight programs, Outspan is one of the largest medical training institutions in Central Kenya region. The college is one of 15 collaborating institutions working with FUNZOKenya, and has bene�ted greatly from the systems strengthening support from the project. Ms Muthoni is pleased that of the 15 institutions under the collaboration, Outspan is the only private college, the other 14 being either public or owned by faith based organizations. “When the FUNZOKenya team visited my of�ce and explained to me the objectives of the project, I found them very appealing and immediately shared with the college board, which approved the collaboration without hesitation.” She said. “FUNZOKenya was God send. We have bene�ted greatly from this partnership. Because the objectives of the project are in line with our own objectives, the partnership has propelled us to move even faster in pursuit of our objectives.” Ms Muthoni added. The college has been strengthened in faculty, clinical placement and mentorship, curriculum development, resource mobilization and use of technology particularly eLearning among other areas. Outspan is also contracted to provide in-service training for health workers within the central Kenya region. The principal says their involvement in in-service training has greatly improved the relationship with the ministry. “Before the ministry used to see us simply as a private enterprise out to make pro�ts. Our college is playing a critical role in training health workers and is helping the ministry towards realizing the health workforce numbers necessary to deliver universal health coverage. With the FUNZOKenya collaboration we have interacted closely with the ministry and there is now greater understanding . ” She said Besides strengthening the college’s partnership with the Ministry of Health, the partnership has bene�ted their instructors. “Our lecturers are now well updated on the MoH policies and regulations and are constantly aware of what is happening at the Ministry of Health” She added. Ms Muthoni believes that after three years of systems strengthening training colleges should integrate high quality demand driven in-service trainings. “Training colleges have the right environment for in-service training. In the last two years we have trained over 300 health workers. We have learned that when the training is done at the training college they concentrate more unlike in hotel venues. With the support of the project we have developed the necessary curriculum and our faculty has been trained on curriculum development.” She said. Ms Muthoni wants the Ministry to provide the necessary supervisory support for colleges to provide regular in-service Strengthened Capacity: Outspan MTC ready to offer in-service training Tutors from various training institutions for a group photo at OMC campus in Nyeri during one of the capacity building training “Thanks to the FUNZOKenya collaboration, we have interacted closely with the Ministry of Health and there is now greater understanding.” Ms Lydia Muthoni- Principal Outspan MTC 2 C atherine Abongo is a third year student at St. Joseph’s Nyabondo Medical Training College (MTC), where she is pursuing a diploma in Kenya Registered Nursing. During her time, the college did not have an Information Technology (IT) laboratory thus severely limiting the development of her IT skills. Knowing how critical IT skills are in the world she lives in, and especially so for the health workforce she is soon to join, Catherine was among students who were thrilled at the launch of the college’s �rst computer lab in September 2014. The lab was established, courtesy of an equipment support grant from the FUNZOKenya project. In 2012, FUNZOKenya carried out an assessment of the capacities of 14 training institutions using the internationally tested Health Professionals Management Tool (HPMT). The assessment revealed among other things the need for St. Joseph’s Nyabondo MTC to improve its facilities and invest in IT. The project supported the purchase of 20 computers, computer desks, chairs and classroom white boards. The grant also included KES1.5 million for text books. “I am happy that I will have an opportunity to learn computer skills before I �nish my training.” Abongo said. Asked what she would really want to do with the computers she replied “I would really like to learn how to search for information on the Internet because this will help me when I go to the �eld.” St Joseph’s Nyabondo MTC is a faith-based medical training institution located in Nyakach Constituency, Kisumu County. The college offers training in Kenya registered nursing and pharmacy. Despite its aging infrastructures, the college continues to provide hundreds of students an opportunity to become health workers, hence contributing to national health workforce development. Apart from the computer lab, the college used part of the grant funds to stock its library with new books, tables and chairs and stock the classrooms with chairs, projectors and white boards which improved the teaching and learning environment. Mr Alfred Juma, the college principal said, “We are very happy to have received this support. We appreciate the role of IT in modern healthcare and this investment will improve the way we prepare our students for the job market.” Juma adds that the support from FUNZOKenya project, which included competency training in resource mobilization and management, has also spurred them to look for more resources through their resource mobilization committee and were able to raise resources for ten more computers, chairs, white boards for their classrooms among other essential materials. “Our infrastructure is in serious need of upgrade and we are grateful for the generous contribution from FUNZOKenya. Using the skills gained in resource mobilization trainings we are working very hard to raise more resources ”. JOY AS ST JOSEPH’S NYABONDO MTC STUDENTS FINALLY GET THEIR FIRST IT LAB A n assessment of the capacity of 15 training colleges in Kenya carried out by FUNZOKenya project in 2012 using the Health Professional Management Tool (HPMT) revealed a number of glaring shortcomings in the state of medical education in the country. The survey looked at such critical aspects of training as infrastructure, management, curriculum development and review, faculty, clinical placement practices as well as training equipment , which are critical in ensuring high quality of the health worker graduating from the institutions. The assessment recommended among other issues strengthening of curriculum review mechanisms, development of policies that promote faculty development, and diversi�cation of income streams to allow greater investment in infrastructure and equipment. Over the past two years a number institutions have made tremendous efforts towards addressing these challenges. As a project we continue to support institutions to develop strategies of addressing bottlenecks that may compromise the quality of their trainees. We have worked with several colleges to strengthen their curriculum development and review mechanisms, setting up curriculum review committees develop new curriculum and review existing ones to ensure they are responsive to training needs of the country. We have also supported faculty strengthening initiatives including training in pedagogy. These two aspects are critical in ensuring that institutions are giving the right content to the learners and that this content is being delivered effectively. To improve infrastructure and training equipment, FUNZOKenya is working with the institutions to improve their business processes and mobilize additional resources through public private partnerships to invest in improving training facilities. In the last year the project supported two institutions to acquire training equipment through small grants. I am grati�ed to note that these institutions mobilized more resources beyond what was provided by the project. These initiatives are aimed at ensuring that the institutions improve their skills laboratories, IT infrastructure, libraries as well as classrooms Dr James Mwanzia, FUNZOKenya Chief of Party Students of Nyabondo MTC at the IT lab after it was of�cially commissioned Message from the Chief of Party W hether it is to address a medical condition such as diabetes, maintain a desirable body weight or to build the requisite energy for competitive sports or simply eating healthy, Kenyans are looking for the right diet that will help them achieve their objectives. However, due to lack of effective regulation the nutrition and dietetics sector has been dominated by people with questionable credentials commonly referred to as ‘quarks’ that have been prescribing substances in the name of improving nutrition that have often harmed consumers. Although Kenyans are aware that some of the people purporting to offer nutrition and dietetic services and products are not trained, the desire to cure such conditions as diabetes, cancer, arthritis among others drive them to do just about anything. Established in 2007, the Kenya Nutrition and Dietetics Institute (KNDI) regulates standards and practices in the nutrition profession. These efforts were spearheaded by Prof Julia Ojiambo, whose desire to see order in the nutrition sector bore fruit when she successfully engineered the passage of an Act of Parliament; the Nutritionists and Dieticians Act No. 18 of 2007. In order to effectively deliver on its mandate, the institute with support from FUNZOKenya developed training and indexing guidelines to govern the accreditation of training institutions and registration of nutritionists and dieticians in Kenya. “We got our mandate in 2007 but without funding we could not do much. FUNZOKenya came in at the right time.” Prof Ojiambo said. “At the time there were many colleges offering nutrition training that had not been regulated to meet required standards. The training standards are very useful because we can now ensure that all colleges have the right facilities to deliver the minimum prescribed curriculum requirements.” She added. The Training Standards prescribes the minimum entry quali�cations required at every level of training, including prerequisites for lectures, laboratories, clinical instructors among other categories. Dr Gordon Nguka, Head of the Department of Nutrition Sciences Masinde Muliro University of Science and Technology (MMUST) says the injection of discipline in the training was long overdue. “The biggest bene�ciary of these new standards will ultimately be the patients. There have been many people with questionable training backgrounds practicing or marketing products some of which have been harmful to the consumers.” Dr Nguka added. MMUST and Maseno are the �rst training institutions to receive full accreditation to train nutritionists and dieticians after satisfying KNDI’s stringent criteria. “We are pleased to have received the Accreditation certi�cate after a rigorous inspection process. We all worked very hard to get the certi�cate because we believe this will be good for our students. Dr Nguka explained. Dr Agatha Onyango, Head, Health and Nutrition department at Maseno University was pleased that the desire to meet the KNDI standards spurred the university Management to invest in facilities. She says, “thanks to the KNDI accreditation process the management invested in improving the laboratory and hired clinical instructors. These are important facilities that we did not have and which we probably wouldn’t have acquired if not for the need to comply with the new KNDI regulations.” She said. The two training institutions have also initiated indexing of nutrition students using the prescribed indexing guidelines provided to them by the institute. Indexing is important to track the development of professionals in nutrition and dietetics, ensure quality standards in training are met and assist KNDI establish a database of students pursuing nutrition and dietetics programs. The FUNZOKenya project is supporting regulatory bodies in the health sector to increase their capacity to regulate various professions. The project has supported KNDI to develop training standards, indexing guidelines as well as CPD guidelines. W ho trains the trainer? How does the training of the health worker affect service delivery? These are the questions many in the health sector are grappling with. A survey on the state of medical education in Kenya conducted in 2012 revealed that most instructors lacked teaching skills also known as pedagogical skills FUNZOKenya is supporting training institutions to enhance their capacity in pedagogy and clinical assessment/mentorship. A national TOT workshop was conducted in September 2013, to train a group of trainers that would cascade the competencies to other institutions. Speaking during one of the cascade trainings held at Outspan Medical College, Ms Nixi Mbuthia a lecturer in the nursing department of Pwani University says, “lack of pedagogical training among instructors greatly affects the quality of the health worker produced.” She argues that though most trainers know their content well, lack of pedagogical skills in some trainers affect the way they deliver the content. “We have tutors who come straight from practice and have limited understanding of teaching methodology. Teaching requires more than mastery of content. There is need for trainers to undergo pedagogical training so as to increase the quality of training in our medical schools.” She added. Ms Lydia Muthoni the principal of Outspan Medical College says lack of pedagogical skills is a serious gap in the health training system. “You can’t just wake up and go to class to teach. Teaching is itself a profession which is often ignored in the medical sector.” She says. “Such simple things as proper preparation before lessons and communication with the class are part of a well-trained tutor. My experience is that students perform well when they are taught by instructors with well-developed teaching skills. Unfortunately, though this is emphasized in training under the Ministry of Education, it has not been done in health training.” Mbuthia hails the initiative by FUNZOKenya to increase pedagogical skills among tutors. “I am pleased that besides imparting the necessary pedagogical skills, FUNZOKenya is exposing the tutors to new technologies and trends in teaching. We cannot maintain a business as usual attitude when the modern patient is informed and may already have a lot of information before coming to the health practitioner. There is need for more innovative ways of delivering healthcare and this is what as tutors we must prepare the health worker for.” The Outspan Medical College training brought together members of faculty from Nairobi, Coast, Central and Eastern regions to impart these skills. Why pedagogical skills are critical for health trainers 3 Nixi facilitates during the ToT cascade training held at Outspan Medical College in early September “The biggest bene�ciary of these new standards will ultimately be the patients. There have been many people with questionable training backgrounds practicing or marketing products some of which have been harmful to the consumers.” Dr Nguka, MMUST HIGH STANDARDS: INJECTING ORDER IN TRAINING OF NUTRITIONISTS “I told my family that I had been admitted to study Nursing at Outspan Medical College. They were exited and promised to support. My two brothers helped raise some of the fees for the 1 st semester. Unfortunately, they thought that what was on the fees structure was for the full three years and when they learned that it was only for the �rst year they gave up and disappeared. The fees arrears begun to accumulate and though my mother tried to reassure me I knew it was a big burden for the family. Without the intervention of Afya ELimu Fund in my second year I would probably have dropped out.” Evalyn Muturi rd Year Studen t “KMTC as a public institution gives a chance for students from all over the country. We receive students from marginalized areas such as Turkana who are from very poor backgrounds. Some of the students come in with promissory notes from politicians and have to constantly move from of�ce to of�ce looking for support. This disturbs the students psychologically and affects their performance. We would like all our students to feel equal however unequal their backgrounds may be. The Afya Elimu Fund has provided a reliable source of funding for most students. Those who received the funds have had remarkable peace of mind since it covered most of their tuition fees. For most needy students once their tuition is paid they do everything to stay in class” Mr. Alloyce Musuya Principal, KMTC Kisumu “After prolonged domestic problems my parents separated when I was in form one and I found myself struggling to stay in school. I knew I had to struggle so that I can in future help my struggling mother and my siblings . I really wanted to join Tenwek School of Nursing and when I was admitted I organized two fund raising meetings in my village during the �rst year. The logistics of organizing these fund raisers were affecting my studies. Even when I was in school I would Afya Elimu Fund came the principal encouraged me to apply. The money I got from the loan was enough to clear my fees arrears and though a small amount now remains and I am very comfortable. I am also happy because since I was supported by Afya ELimu Fund the college has not asked me to go and fetch the balance.” “ Dominic Langat, 3 rd Year Student “When my mother’s diabetes got worse and she had to be amputated my life changed for worse. I had to look for odd jobs with the hope of raising enough money to pay fees did peoples laundry and other house chores. I even sold �sh along the shores of Lake Victoria. This was not enough to pay my fees and so I decided to tell the principal that I wanted to drop out. I am grateful to the principal because he encouraged me to stay on and did not send me home. When Afya ELimu announced the loans last year the principal called me to his of�ce and asked me to apply. The teachers even helped me �ll the forms. Now I am comfortable and looking forward to graduating.” Catherine Abongo, 3 rd Year Student What they said about the Afya Elimu fund one year Later M aseno University in collaboration with FUNZOKenya on July 24, 2014 hosted a symposium that brought together academicians, policy makers as well as practitioners in health training. The symposium discussed how to improve training of health workers in the region. The symposium was a key FUNZOKenya contributing to developing and sustaining regional ‘Communities of Practice’ around health workforce training and was the second such meeting in the region. County Governments present pledged to work together to tackle the health and health workforce-related challenges. Kericho County Governor Hon. Prof Paul Kiprono Chepkwony was the chief guest. During the symposium the University launched a Postgraduate Program in Family and Emergency Medicine. The program aims at ensuring that a cadre of physicians is trained to effectively manage acute and chronic illnesses and play a role in disease prevention and promotion within the community. The �rst class under this program commences in October 2014. Kericho and Kisumu Counties promised to sponsor a doctor each to take the course during this years’ intake; where 10 trainees will be trained. Maseno University Hosts Training Symposium I&M Bank contributes to AEF T he I&M bank became the latest corporate entity to inject funds in the Afya Elimu Fund with a donation of 625,000. To money will support 5 students during the 2014/2015 academic year. The Bank has pledged to inject 3.125 million in the next three years. The cheque was presented by Mr Arun Mathus- CEO, I&M Bank to FUNZOkenya project team led by Mr David Njoka the Director Human Resource Development department at the Ministry of Health. Speaking at the event held at the Banks headquarters Mathus said the I&M Bank was committed to support the health sector through its corporate social responsibility program. He expressed his pleasure to partner with Afya Elimu Fund for greater sustainability and impact of their support. Mr Njoka said that the human resources shortage being experienced within the health sector could only be addressed effectively through partnerships between the private and public sectors In the photo are Mr. Arun Mathus. Peter Milo- FUNZOKenya Assistant Director- representing the Chief of Party, Dr Hazel Mumbo, FUNZOKenya Public Sector Advisor, Charles Ringera, CEO Higher Education Loans Board and, Mr Njoka and Ms Margret Mwago Senior, Manager Public Sector support, FUNZOKenya. AEF is a revolving fund established jointly by FUNZOKenya, the Ministry of Health, the Higher Education Loans Board and other partners to increase access to training fees for students pursuing health training at preservice level. This publication is made possible by the generous contribution of American people through the United States Agency for International Development (USAID). The contents are the responsibility of IntraHealth International and do not necessarily re�ect the views of USAID or the United States Government. Kericho County Governor Prof Paul Chepkwony speaks at the Symposium