South Sudan

Q2/2011: Nursing & Midwifery College Update

August 16, 2011

Bilha Achieng

Project Goals:
To improve the quality of and access to professional health care services by imparting the necessary skills through a three-year diploma program in either nursing or midwifery at the first College of Nursing and Midwifery in South Sudan accredited by the Ministry of Higher Education and Juba.

Project Objectives:

1. Provide model courses in Registered Nursing and Registered Midwifery in the first National Health Training Diploma Institute in Southern Sudan
2. Provide a curriculum recognized by all ministries associated with education in the GOSS
3. Provide leading edge skills laboratory and library for students
4. Provide improved clinical setting for student training
5. Provide highly qualified instructors and tutors for the duration of the three year program
6. Provide an unprecedented model of health care sector capacity building for Southern Sudan
7. Provide a sustainable solution to Southern Sudan’s Maternal and Infant Mortality Rate, the former, which is the highest in the world at 2,054/100,000 as per the 2006 South Sudan Household Survey. Approximately 200,000 women die each year giving birth.
University that offers a diploma of Registered Nursing and Midwifery Status.

Summary of RMF/WCF-sponsored activities carried out during the reporting period under each project objective:
Implemented activities in-line with RMF/WCF sponsored activities and project objectives include;

1. Support to the Ministry of Health, Republic of South Sudan and project partners in the coordination and implementation of project activities over the reporting period. Also in line with the approved college annual work plan.
2. Continued facilitation of inter-linkages with UNFPA, MOH and other stakeholders in ensuring quality assurance in the implementation of both nursing and midwifery curricula in the diploma program.
3. Contribution of essential content by college tutors in the review of the draft diploma midwifery curriculum which will be later finalized and endorsed by the Ministry of Health for use by all Diploma National Health Institutes.
4. Facilitation of a ‘Clinical Mentors Workshop’ by tutors, held for nurses and midwives supervising JCONAM students during clinical practice.
5. Procurement of college stationery, cleaning and skills laboratory equipment for use at the Juba College of Nursing and Midwifery.
6. Provision of support to college students through the payment of monthly student allowances to cater for minor expenses.
7. Contraction of 2 specialist lecturers in the areas of Pharmacology and Epidemiology to tutor both programs.

Results and/or accomplishments achieved during this reporting period:

1. Through the collaborative financial support of RMF/WCF and UNFPA, the Diploma program was able to kick off its second year with the students focused on successfully completing both theoretical and practical sessions as required by the curriculum.
2. Both UNDP and JICA continued their support towards the project; UNDP supporting the construction of male and female hostels, kitchen, mess hall. JICA on the other hand took over renovation of the 2 existing classrooms, construction of 2 additional classes to cater for a second intake in January 2012, construction of window bars at the administration block, construction of a perimeter fence, installation of a generator. This is scheduled to take place between July 2011 and February 2012.
3. After the construction of the metallic burglar proof window bars at the new facility, the college was able to move into the teaching hospital.
4. WHO donated additional 8 books to the college.
5. UNFPA donated books and skills laboratory equipment to the 3 UNFPA funded institutes in South Sudan. They are; Juba College of Nursing and Midwifery, Kajojeji National Health Training Institute and Maridi National Health Training Institute. This will further add to the donations provided to the college by JICA.
6. The college Principal and 2 UNFPA Midwifery Specialists had the privilege of attending the Durban Triennial Conference in June whereby stakeholders came together to discuss issues affecting midwifery, how they impacted the different regions and avenues of tackling them as a common body. The theme for this conference was ‘Midwives tackling the Big 5 Globally’. The big 5 are likened to the big 5 animals (challenges encountered by midwives in service delivery to mothers and children); globalization, listening to women and their parents, the continuum of care, strengthening midwives and midwifery practice and culture, societies and traditions.
7. The project successfully completed a 3 day workshop on development of ‘Clinical Mentorship Skills’. This was a capacity building initiative that was done in collaboration with the Ministry of Health in order to highlight what is required of a clinical mentor in the wards. The tutors were also able to attend a workshop organized by JICA on The Skills and Art of Midwifery-Towards Quality and Sustainable Midwifery Education.
8. The college Principal and Tutors played a critical role in the review process of the midwifery curriculum which culminated in a 5 day workshop whose objectives were to; develop standards and guidelines of midwifery education in South Sudan, review of both diploma and enrolled midwifery curricula.
9. The Juba College of Nursing and Midwifery held its first Management and Advisory Board Meeting in June 2011. The forum drew together representatives from; the line Directorates in the Ministry of Health, The Principal of the College, the different project partners, Juba University, The Ministry of General Education and the legal arm of the Ministry of Health. Chaired by Dr. Margaret Itto, the Director General of Training and Professional Development in the Ministry of Health, issued highlighted included; confirmation of board members, the development of the board constitution, frequency of meetings and other documents relevant to the board.
10. The reporting period saw the review of the draft Reproductive Health Policy and Strategy in South Sudan which outlines different components of the health systems that have both direct and indirect impacts on the project. This document is yet to be finalized. In addition, The 2011 State of the World Midwifery Report was circulated in June. This document aims at highlighting strategies of strengthening the practice of midwifery around the world.
11. The college was able to secure 2 first aid kits that were to cater for minor injuries. The Ministry of Health further confirmed its support to cater to the medical costs incurred by the student when treated at Juba Teaching Hospital.
12. JCONAM students were on the forefront of both International Day of the Midwife and Nurse on May 8th and May 12th respectively. The confirmed their commitment to South Sudan towards improving the standards of health through increasing access to and quality of skilled health care personnel.

Impact this project has on the community (who is benefiting and how):

1. The college will equip the students with the critical skills that are necessary in providing a much needed service within Southern Sudan. According to the last Southern Sudan Household Survey that was carried out in 2008, only 30% of the population has access to skilled health services throughout the 10 states. 10% of women have access to delivery services from traditional birth attendants and village midwives and community midwives. A large portion of these village midwives and traditional birth attendants are old and/or illiterate, cannot communicate effectively and do not have the capacity to detect complications or offer referral advice. The graduated students thus fill this gap by providing professional, accredited services to be used within hospitals, primary healthcare facilities and primary healthcare units. For use in access to skilled birth attendants, access to family planning services, access to basic and comprehensive emergency obstetrics and neonatal care. Equipped with these skills they will participate in taking part in reduction of the highest maternal mortality placed at 2,054/100,000 live births in Southern Sudan.
2. Under the stewardship of the Ministry of Health, a series of consultative meeting have been called. These meetings bring together different stakeholders in the area of education and health to discuss issues relating to education delivery, standards, guidelines, advocacy etc. in health education. These will have a direct impact on JCONAM and other institutes within the Republic of South Sudan.
3. The current human resources for health distribution present a largely urban-rural bias. The health personnel are mainly found within 3 states of the 10 states. It is the hope that the students will return to their state of admittance and work with the surrounding health facilities.
4. With the engagement of the Ministry of Health, this project aims at not only building the capacity of the graduating nurses and midwives but also the tutors. The project through UNFPA has contracted the services of international tutors to provide continuous training of the national tutors during the project period. They are currently using the Nursing and Midwifery curricula endorsed for use by the Ministry of Health together with other policy and strategy documents.
5. As of December 2013, the Juba College will have graduated an initial 40 students in both Nursing and Midwifery. They will be the pioneering class with Diploma certificates.
6. The students will be equipped with skills to provide services to the immediate and surrounding communities with Juba having a population of 140,396 as per the 2008 Sudan Population and Housing Census; Juba Teaching Hospital is Central Equatoria State’s major referral and teaching hospital. These skills involve general nursing care, birthing services, family planning, and skills in basic and comprehensive emergency obstetric and neonatal care. Equipped with these and other skills the students will increase access to and quality of health care services not only in Central Equatoria State but all also in the 9 other states.
7. The college is also providing direct and indirect employment to national and international tutors, cleaners, gardeners and watchmen and those providing food stuffs to the college. Established as the first nursing and midwifery Diploma College in Southern Sudan, the Juba College of Nursing and Midwifery has been epitomized as a symbol of hope in providing skilled and qualified health professionals in Southern Sudan. Through the students’ enthusiasm and inspiration to make a difference, the nursing and midwifery professions are now viewed as critical and necessary in the health care workforce. The two professions have become quite attractive to both male and female O-level school leaver in Southern Sudan and this is reflected by the number of applications to join the program received by the Ministry of Health.

Plans for next reporting period:

1. Continued implementation of both curricula and project annual work plan to facilitate the effective delivery of the diploma program.
2. Procurement of additional books, skills laboratory equipment, information technology, office equipment and uniforms for the college
3. Provision of technical support to the Ministry of Health in the review and endorsement of both nursing and midwifery curricula
4. Review and endorsement of relevant college documents such as; rules and regulations, clinical objectives, terms of reference for a management and advisory board and college committees and the project partners’ memorandum of understanding.
5. Coordination of partners engaged in construction work by UNDP and JICA at the Juba Teaching Hospital
6. Identification of meetings, workshops and conferences that have a direct impact of the improvement of the project
7. Support resource mobilization initiatives to fund additional project activities.

Success story(s) highlighting project impact:

1. The college skills laboratory and library were once filled with empty cupboards and tables. Now both spaces boast the donations from the different project partners. As the college has just moved to the Juba Teaching Hospital, equipments and books are yet to be placed for use by the tutors and students.
2. JCONAM students started their second year in the diploma program from May 2011 and were further split into their respective courses. Course master plans were developed and timetables finalized for the year. They were further merged to be taught Pharmacology and Epidemiology but will later be split when the Nursing program goes into clinical practice in mid-August.
3. The St. Mary’s-Juba Link will join the project in November of this year. Their contribution is in the form of volunteer tutors; additional skills laboratory equipment not procured and technical input in the review both curricula among other initiatives.
4. Under the leadership of the Ministry of Health, the different project partners continue to meet monthly to coordinate all matters relating to the project. This helps in identification of priorities for the next month, identification of key partners in key issues and avoiding duplication of efforts.

Country Page: South Sudan Initiative Page: Juba College of Nursing and Midwifery