Transforming the Nursing Workforce in Liberia through Graduate Education

Abstract

Session presented on Monday, November 9, 2015: Nursing education in Liberia, West Africa has been slowly recovering from the destruction of health care education institutions that was experienced during the horrific civil wars that took place from 1989-2003. There is a dearth of nurses prepared at the diploma or baccalaureate levels of education to meet practice needs and very few masters or doctoral prepared nurses to lead change to improve population health outcomes, public health and strengthen health systems (Flomo-Jones, 2013, Walsh, 2010). Health care financing is primarily provided by international humanitarian aid as Liberia is one of the poorest countries on the globe and thus there are limitations tied to donor interests (Flomo-Jones, 2013, Varpilah, 2011 ). Health care is delivered to the population as a package of basic health care, heavily weighted on preventive or health promotion services (Flomo-Jones, 2013). The weaknesses in health system infrastructure, public health and health care worker capacity in West Africa were made extremely evident by the Ebola epidemic of 2014 - 2015, particularly in the developing countries of Liberia, Sierra Leone and Guinea. In addition, the vulnerability of global health was also made evident by events such as regional and international travelers being able to transport Ebola rapidly through land and air travel causing much concern in developed countries in North America and Europe. Nurses are the greatest number of health care workers in Liberia, but even so their numbers and professional competencies must be increased in order to meet the health needs of the population and to rebuild or establish public health systems that assure rapid detection and an effective early response to any future outbreaks (Flomo-Jones, 2013, Varpilah, 2011). While the potential global impact of under-capacitated health care workforces in developing countries has risen to international concern in 2014 because of the reporting of the Ebola epidemic by the media, in fact we have been working to improve nursing work force capacity in Liberia since 2010 through an innovative curriculum delivery model. Currently there are only two graduate programs for nurses in Liberia. There is a Master of Nursing Management at Cuttington University (Flomo-Jones, 2013). In addition, a Master of Science in Nursing Education (MSN) program was developed in 2010 by expatriate nursing leaders who volunteered their time and expertise. This program is delivered atMother Patern College of Health Sciences (MPCHS), one of five colleges that make up Stella Maris Polytechnic, all under the Catholic Archdiocese of Monrovia. No doctoral programs for nursing are available in Liberia, and very few doctoral-prepared nurses, so volunteer expatriates fill the faculty gap in the graduate program. Modeled on the National League for Nursing's core competencies for nurse educators, the MSN curriculum at MPCHS is taught by expatriate faculty, some who have past connections to Liberia and others with interests in international nursing. Some instructors who are not nurses teach courses on statistics, writing and technology. All are committed to advancing global health by improving nursing education and by preparing Liberian nursing and midwifery personnel for evidence-based practice. The initial cohort had an enrollment of 17 students from eight Liberian schools of nursing, the Liberian Board of Nursing and Midwifery, and the Ministry of Health and Social Welfare. Six professors from the United States and one language instructor from England volunteered to teach in the first phase of the program over a period of 18 months. For the education practicum, students returned to their home institutions to put into practice the principles of teaching and learning. Sixteen students graduated in August 2012 and August 2013 and a third cohort of 15 students will graduate in August 2015. The program was developed and directed by Dr. Edna Johnson, PhD, RN, faculty emeritus, University of Connecticut to 2014. As of spring 2015, the MSN program is directed by Edwin Beyan, RN, BSc, MSN, graduate of the first cohort of students in the MSN program. The program is accredited by the Ministry of Education, Republic of Liberia and scholarships for students and related funding provided initially by FORECAST then handed over to WORLD LEARNING. These funding sources are both made possible through USAID (From the American People). Dorcas Kunkel, BSN, MS, DNP has been a volunteer nurse faculty in the MSN for nurse educators curriculum at MPCHS in Monrovia, Liberia teaching two courses for each cohort of students in 2011, 2012 and 2014.