Harmonizing
capacity
building and
work
responsibilities of
Rwandan nurses
through
E-learning
Presented by :
Gilbert MUNYEMANA
National University of Rwanda
E-merge 2012
CONTENT
 BACKGROUND
AND RATIONALE
 IMPLEMENTATION
 ACHIEVEMENT
 CHALLENGES
PROCESS
TO DATE
AND REMEDIALS ACTIONS
 CONCLUSION
I. BACKGROUND AND RATIONALE
A. RWANDA

Landlocked country situated
in central Africa

Land Area: 26,338 square
Kilometers.

Population: Approx. 12 million

Borders: Uganda to the north,
Tanzania to the east, Burundi
to the south and Democratic
Republic of Congo to the
west.
Source : http://www.gov.rw/,
http://en.wikipedia.org/wiki/Rw
anda
I. BACKGROUND AND RATIONALE
B. INDICATORS : POPULATION & MEDICAL PERSONNEL

Total population: 10,412,820 millions

Doctors: 1/18,000 inhabitants

Nurses: 1/1,476 inhabitants

62.8% of Nurses in rural areas(2008)and 78% (2010)

38.2% of Nurses in Urban areas(2008)and 22% 2010
Source : Ministry of Health : http://moh.gov.rw
I. BACKGROUND AND RATIONALE
C. EDUCATION OF NURSES

Before 2005, education of nurses in Rwanda was
organized within general secondary education
awarding an A2 certificate.

Graduates were
associate nurses.

In order to improve the quality of the education and
services in the health sector, the Government of
Rwanda ruled in 2007 to stop A2 nursing students
(associate nurse level) and instead start training A1
nurses (diploma level) and midwives in 2007.
subsequently
employed
as
I. BACKGROUND AND RATIONALE
EDUCATION OF NURSES / CAPACITY BUILDING NEEDS

There are 5 government schools of nursing and
midwifery: Nyagatare, Kibungo, Byumba,
Rwamagana and Kabgayi .

These existing fulltime programmes in the 5 Schools of
Nursing and Midwifery only admit about 100 A2 nurses
per year

According to the National Council for Nurses and
Midwives of Rwanda (2009), about 5000 nurses and
midwives were working in Rwandan health sector.
I. BACKGROUND AND RATIONALE
C. EDUCATION OF NURSES / CAPACITY BUILDING NEEDS

Those were challenged to go back to school for upgrading
their level but they did not want to quit their jobs, and

The Ministry of Health could not afford to replace them
without paralyzing the functioning of hospitals and health
centers.
These raised two fundamental Questions

How can we mitigate two conflicting obligations, namely
capacity building and work responsibilities ?

How to train the existing nurses and new ones to meet the
MDGs with limited capacity of existing nursing schools ?
I. BACKGROUND AND RATIONALE
In collaboration with the National University of
Rwanda,
through
its
Centre
for
Instructional
Technology, The Ministry of Health embarked on Elearning for education of nurses which started with
320 students on board in 2012 academic year
II. IMPLEMENTATION PROCESS
A. DEFINING OBJECTIVES
Broad objective : To promote the quality of nursing and
midwifery health services in Rwanda
Specific objectives
 To improve nurses’ and midwives’ knowledge and skills
using the modern methods of teaching and learning

To equip different health settings with well trained &
qualified nurses and midwives

To contribute to the reduction of infant and maternal
mortality rate (refer to MDG # 4 & 5)

To have upgraded & qualified about 1500 nurses and
midwives by the year 2020.
II. IMPLEMENTATION PROCESS
B. Verification of requirement
Focus on :
 Infrastructure and facilities

Curricula ( Content organization , Approach to
teaching and learning with Moodle and Assessment

ICT skills ( Computer skills, E-resources, Online
databases)

Report , recommendations were made and have
been considered to facilitate the start of the program
II. IMPLEMENTATION PROCESS
C. E-learning platform in place
 After
a pedagogical and technical evaluation ,
Moodle Learning management system was
selected ( The Lauriallard’s Conversational
Framework was the main evolutional tool )
 Moodle
is Web application developed as a set of
tools which can serve the world community to
achieve educational objectives in completely
online or blended learning environment. Also
known as Learning Management system or Virtual
Learning Environment
II. IMPLEMENTATION PROCESS
 The
E-learning for Nursing education is now
accessible on : http://www.elearning.moh.gov.rw/
With the platfom ,
Teacher can ...
create
online courses
upload files
In different
format
Initiate online
collaboration
Create learning
activities
Students
assessment
Class
administratio
n
With the platform,
Students can ...
Access learning
Material at
anytime and from
any where
Online discussion
with other
students and
teachers
upload the
accomplished works
for assessment
Share interesting
material with
others
II. IMPLEMENTATION PROCESS
D. Training

The teaching staff : The existing teachers of the 5
Schools of Nursing and Midwifery have been trained in
e-Learning .

IT officers of the 5 Schools have been trained to
empower them with skills to help students and
teachers on the use of moodle e-learning platform

IT officers in collaboration with the NUR team trained
Students enrolled in e-learning program on how to
effectively use the system.
II. IMPLEMENTATION PROCESS
E. STUDENTS ADMISSION

In the first in-take 140 head of health centers country
wide were enrolled in the e-Learning program.

In addition , 175 nurses were selected basing on the
criteria of passing the entry examination organized by
the Ministry of Health in 2010

Being registered in the national council of nurses and
midwives is another requirement for the to be enrolled
in the e-learning program

It was a requirement for each of the e-learning
student to have his/her personal computer and if
possible a modem to facilitate in accessing internet in
their place of work.
II. IMPLEMENTATION PROCESS
F. PROGRAM STRUCTURE AND ORGANISATION OF THE CONTENT

The programme shall run for a period of 3 years
divided into 6 semesters. The programme is
conducted in a modular system, using a blended type
of learning. The full time program lasts 2 years

The programme is structured in such a way that 80%
part of it is delivered online via e-learning platform
while students are at their respective workplaces,
whereas the rest of the programme include face-to
face contact sessions at the Schools of Nursing and
midwifery

The Ministry of Health arranged that Nurses be
facilitated to attend their face to face session
II. IMPLEMENTATION PROCESS
F. PROGRAM STRUCTURE AND ORGANISATION OF THE
CONTENT

During face-to-face contact sessions with lecturers at
the teaching institutions, students benefit from the
available resources at the Schools of Nursing and
Midwifery, including lecturers, libraries, and internet
facilities. Students are provided with learning aids
developed at the Schools, including course hand-outs

During the phase of face-to face learning sessions,
students will also have practical sessions in skills
laboratory at school and undergo a session of
integration of clinical competences. This is a form of
continuous assessment of clinical learning, and
knowledge construction through the integration of the
acquired clinical skills and competences with theory.
III. ACHIEVEMENT TO DATE

The e-learning program for Rwandan nurses’
education commenced on 2nd –January – 2012

The first intake of 320 in the 5 schools of nursing and
midwifery ,currently the total number is 315 , 5
dropped out due different reasons.

Improved teaching skills for the teachers of schools of
nursing and midwifery where at 10 teachers in each
school of nursing and midwifery have been trained

All e-learning students have been trained and at They
have so far completed 5 courses.

An evaluation of their learning process is planned
before the end of 2012
IV. CHALLENGES AND REMEDIALS ACTIONS

Language barrier , since English is now the medium of
instruction while some nurses had their previous
education in French. Some of the E-learning students
encounter barriers in communication.


Teachers of the nursing schools are putting more
emphasis on English language during face to face
sessions. NUR is developing computer based self
teaching materials to ease English learning
The Nursing and midwifery school teaching staff are
now overloaded . Their work load has now doubled.

The Ministry of Health is finding a way to mitigate this
problem .
IV. CHALLENGES AND REMEDIALS ACTIONS

Internet connectivity is still slow in some parts of the
country as well as nursing and midwifery schools.


The Ministry of Health in collaboration with the
National service providers is working on this issue
Students travel long distances from their place of work
to the training sites for face- to- face sessions, this is
due to the fact that the training centers are few
compared to the number of students from all over the
country.

There is a plan to increased e-learning training
centres, In the next intake two more centres will be
added to the 5 existing ones
Conclusion

Upgrading A2 nurses to A1 level through e-learning is of utmost
importance in strengthening the Health sector in Rwanda.

Through the e-learning system, students learn at their own pace
,with more flexibility . This will benefit individual students because
they will continue to work and earn salaries, at the same time
studying and stay closer to their families. It will also benefit
healthcare facilities in terms of continuity of care .

All stakeholders currently involved in the project deserve a
considerable recognition for their tireless efforts being invested.
The journey is still long and any contribution to support this initiative
is welcomed

With the commitment of all stakeholders, the project will achieve
its objectives and help Rwanda to develop through a healthier
population
THANKS YOU FOR YOUR ATTENTION