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Nursing Education and Training in the Eastern Caribbean

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  • 23
    The Nurse Workforce in the Eastern Caribbean http://dx.doi.org/10.1596/978-1-4648-0830-2
    CHAPTER 5
    Nursing Education and Training in
    the Eastern Caribbean
    Introduction
    Based on recent baseline data collection, Eastern Caribbean countries have an
    adequate supply of human resources for health (HRH), which meet or exceed
    the World Health Organization’s recommended minimum of 25 HRH personnel
    per 10,000 population. The big question, however, is whether the adequate sup-
    ply of HRH is sufficiently trained in competencies for managing noncommuni-
    cable diseases (NCDs). If NCDs are to be prevented or effectively managed,
    strategies for combatting these diseases should incorporate an HRH component
    to facilitate the planning and management of the health workforce responsible
    for NCD treatment and prevention.
    Most Eastern Caribbean countries have a public technical or community col-
    lege offering associate degrees and, in some cases, bachelor of science degrees. But
    students seeking further education or specialization must look to universities
    abroad, but this is expensive and only a few scholarships are offered to foreign
    students.
    The University of the West Indies is the main source of postgraduate training
    for NCDs. Across its four campuses in Barbados, Jamaica, and Trinidad and
    Tobago, 63 courses were offered in 23 subjects that deal with primary or tertiary
    health care and NCDs in the 2013/14 academic year. The University of the West
    Indies in Jamaica offers training for family nurses, and Barbados Community
    College offers training in community health nursing, administration, and nurse
    education. Laboratory training is available in Jamaica, Trinidad and Tobago, and
    the United States. But very few of the region’s universities offer a comprehensive
    postgraduate program for HRH.
    Planned learning, training, and development activities are the tools that orga-
    nizations use to improve employee skills and knowledge. In the health sector,
    training is the key to improving the performance of both individual health work-
    ers and the sector as a whole. Training can involve various approaches, such as
    structured courses, mentoring, coaching, job shadowing, peer exchange, and
  • 24 Nursing Education and Training in the Eastern Caribbean
    The Nurse Workforce in the Eastern Caribbean http://dx.doi.org/10.1596/978-1-4648-0830-2
    self-learning. Competency-based training is a useful alternative to time-based
    models for in-service and continuing professional development training of HRH.
    Competency-based training allows the health sector to identify training needs
    based on service delivery requirements.
    The Pan American Health Organization (PAHO) offers several short-term
    training opportunities for health personnel in the Eastern Caribbean, and works
    closely with ministries of health to design training modalities based on needs
    identified by the ministries. This training covers, among other things, manage-
    ment and technical clinical skills. Nongovernmental organizations also provide
    targeted training in some Eastern Caribbean countries. The following sections
    look the education and training of nurses in the four case study countries
    (Dominica, Grenada, St. Lucia, and St. Vincent and the Grenadines).
    Dominica
    Dominica has one public nursing school, the Faculty of Nursing at Dominica
    State College. Its nursing programs include the following:
    • Certificate in Practical Nursing. A one-and-a-half-year program in which nurs-
    ing graduates are trained as nursing assistants. They are not permitted to
    administer medication.
    • Primary Care Nursing Program. This includes practical nursing and midwifery
    training. Graduates provide supplementary care to doctors.
    • General Nursing Program. A two-and-a half-year program to train registered
    nurses.
    • Post-Registered Nurse Midwifery Program. For general nurses who have han-
    dled 25 successful deliveries under supervision. This requirement limits the
    number of nurses eligible to apply; 15 students a year are accepted into the
    program.
    • Bachelor of science in nursing. The program, begun in September 2014, includes
    additional courses and clinical rotations. The program was introduced after the
    Regional Nursing Body lobbied for a bachelor of science nursing program, and
    in response to a government decision to have all entry-level nurses hold at least
    a bachelor’s degree by 2011. Entry into the program is competitive: as of
    March 2014, 60 applications were submitted for 20–40 positions. The col-
    lege’s ability to accept more students is limited by lack of clinical space,
    supervision, and faculty numbers. Access to the heavily government-subsidized
    program is by no means restrictive: costs are quite low—EC$50 per credit, and
    students who cannot afford this are offered loans—and entry requirements
    easy. Some government scholarships are available. To be accepted into the
    program, applicants must pass five key subjects in grades 1 and 2, including
    English, math, and science. Students are then required to take a one-year, pre-
    health program and pass it with a grade point average of at least 2.5. Those
    interviewed over the program had positive responses. The Regional Nursing
    Body sets the curriculum and the qualifying exams, thus ensuring consistency
  • Nursing Education and Training in the Eastern Caribbean 25
    The Nurse Workforce in the Eastern Caribbean http://dx.doi.org/10.1596/978-1-4648-0830-2
    in training throughout the region. The college works closely with the Ministry
    of Health to design courses that meet the needs of the population. Its pass rate
    was 90 percent at the time of writing.
    1
    As well as the public nursing program, two private universities offer training:
    Ross University School of Medicine, which graduates physicians, and All Saints
    University, which offers a premedical program.
    Apart from midwifery, Dominica offers no specialty certification opportunities.
    Higher-level nursing training and specialization outside the country are available
    in Barbados (Community Health College, offering training in community health
    nursing, administration, and nursing education) and Jamaica (University of the
    West Indies, offering training for family nurses).
    PAHO and several nongovernmental organizations provide short-term train-
    ing for health workers. PAHO and Ministry of Health training includes work-
    shops on management, communication, and technology. This helps fill gaps in
    competencies, but is no substitute for the extensive specialty training that is
    needed. In the past, PAHO provided significant support for training, but this was
    hit by budgetary constraints. PAHO also provides fellowships for students seek-
    ing advanced training outside their home countries, but this ended in 2014
    because of budgetary constraints and management issues. Because participation
    in this training was not tracked, the same people often attended the workshops.
    And with no dissemination plan, knowledge was not passed on to other health
    care workers—a concern since many experienced nurses are near retirement.
    Grenada
    Grenada formerly had two nursing schools: one at T. A. Marryshow Community
    College (TAMCC) and one at St. George’s University. The TAMCC program was
    moved to St. George's University in 2015. George’s University offers a master’s
    in public health and a master’s in health management. The university is in discus-
    sions to merge its bachelor of sciences in nursing program with that of TAMCC.
    Midwifery is St. George’s University’s only specialization training for nursing.
    As in all countries in the region, Grenada’s curriculum and exams are stan-
    dardized and set by the Regional Nursing Body.
    Specialized training other than midwifery is not offered locally. Some medical
    professionals travel to China for specialized training, which is free to Grenadians,
    or to neighboring countries for training, including the four campuses of the
    University of the West Indies.
    As well as the formal nursing program, the Caribbean Public Health
    Agency, the Joint United Nations Programme on HIV/AIDS, PAHO, and the
    U.S. President's Emergency Plan for AIDS Relief offer short-term nursing
    training courses and workshops focusing key needs identified by the Ministry
    of Health, including customer relations, foot care, eye screening, primary
    health care development, dialysis, infection control, and mental health.
    The ministry has relied heavily on PAHO for short-term training, but

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Nursing Education and Training in the Eastern Caribbean

Nursing Education and Training in the Eastern Caribbean. Questions whether the adequate supply of human resources for health (HRH) in Eastern Caribbean countries is sufficiently trained in the competencies needed to manage noncommunicable diseases (NCDs). If NCDs are to be prevented or effectively managed, public health strategies must include a component for planning and managing the health workforce. Planned learning, training, and development activities are the tools that organizations can use to improve employee skills and knowledge, but the education and training of nurses varies across the four case study countries. In Dominica, for example, no specialty certification opportunities exist in nursing schools apart from midwifery. Higher-level nursing training and specialization outside the country are available in Barbados and Jamaica. Similarly, in Grenada, specialized training other than midwifery is not offered locally. Some medical professionals travel to China for specialized training, which is free to Grenadians, or to neighboring countries, including the four campuses of the University of the West Indies.

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