IMPROVING THE PERFORMANCE OF HOSPITAL NURSES IN UPPER EGYPT
While the Egyptian health system is characterized by an extensive infrastructure, an adequate number of physicians and nurses, medical technology and medicines, and good access to care, there still exists poor quality of care. The Improving the Performance of Hospital Nurses (IPHN) project works with the Ministry of Health (MOH) to address this challenge.
Empowering Health Professionals to Improve Services
Nurses play a central role in health service delivery, especially in remote areas where they may be the only frontline providers of care.Their care is critical in preventing and controlling infections, ensuring client satisfaction, and promoting quality of care in the health centers, hospitals, and clinics.
However, despite their importance and large presence in the health sector, nurses and the nursing profession are not highly valued. Training programs for nurses are lacking in leadership and management training. As a result, there is a gap between nurses' existing skills and the skills they need to provide quality patient care. Adding to the deficiency in skills is a lack of authority, which contributes to low morale among nurses and transpires into poor standards of care and low client satisfaction. The IPHN project aims to fill this gap in training by using the Leadership DevelopmentProgram (LDP).
Identifying Challenges to Achieve Results
Through the program, nurses at all levels will successfully identify and address key health care challenges and achieve measurable results. More specifically, the project's expected results are:
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Nurses are aware of and committed to adhering to the Ministry of Health (MOH) standards and guidelines for infection control, basic nursing care, and communication.
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Nurses are empowered to take initiative to face the challenges and produce better results in the three focus areas of the project.
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Increased local capacity through a group of trained facilitators.
This group will promote the methodology across districts and governorates, leading ownership and sustainability of the program.
Using the LDP to Build Capacity
Through the IPHN project, MSH builds on established successes to adapt and implement the Leadership Development Program for nurses in select government hospitals in the Upper Egypt governorates of Aswan, Luxor and Qena by working closely with our partner, the Om Habibeh Foundation (OHF), the MOH, and USAID.
The LDP is a proven approach to equip working teams to address real challenges by building leadership and management capacity. In 2002, the LDP was successfully delivered with the support of USAID and the MOH to teams in primary health care units in Aswan. The program continues to achieve impressive results in health service delivery outcomes and has been sustained in Aswan by local facilitators and local resources.
To complement the leadership and management training from theLDP, OHF has added to the program to include technical content that will improve nurses' adherence to MOH standards and guidelines in infection control.
This program will target approximately 492 nurses, who work in selected hospitals in Aswan, Luxor and Qena. With the support of local facilitators and OHF, the initial phase will begin with four concurrent LDPs targeting approximately 102 nurses in several districts of Aswan. In the second phase, the LDP will be scaled up to Luxor (3 LDPs) and Qena (10 LDPs) using local facilitators to foster ownership and sustainability of the program. Anticipated program goals include:
- Increasing the capacity of local facilitators;
- Reinforcing the knowledge and skills learned in thetrainings;
- Disseminating training materials in Arabic;
- Strengthening existing mechanisms for in-servicetraining for nurses.
As a result of the LDPs, we anticipate improvements ininfection control, basic nursing care, and communication.
REDUCING MATERNAL MORTALITY IN ASWAN, EGYPT
MSH first implemented the LDP in Egypt from 2002 to 2003 in three districts of Aswan Governorate, one of the poorest areas of Upper Egypt. Ten teams totaling 41 health workers participated in the pilot phase of the program. After USAID funding ended, local doctors and nurses scaled up the program to 184 health care facilities using only health ministry resources. They trained more than 1,000 health workers. In 2003, the three districts increased the number of new family planning visits by 36%, 68%, and 20%, respectively, compared to the same period the year before. In 2005, the Aswan LDP facilitators chose the governorate-wide challenge of reducing the maternal mortality rate (MMR) from the 2005 rate of 86.9 per 100,000 live births to 50. To accomplish this, LDP facilitators brought Safe Motherhood Committees to every district in the governorate. Between 2006 and 2007, the Aswan Governorate reduced the MMR from 50 per 100,000 live births to 35.5 per 100,000.
