EM/R~Lg/~Ech.~Isc./2 Easmn MEDITE3RRANEAN 15 August 1969

WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR THE BUREAU REGIONAL DE LA Li~t&>I rn s x'l +)A2s) db\ EASTERN MEDITERRANEAN MEDITERRAN~EORIENTALE REGIONAL COMMIm FOR THE EM/R~lg/~ech.~isc./2 EASmN MEDITE3RRANEAN 15 August 1969 Nineteenth Session ORIGINAL: ENGLISH Agenda item 12 TECHNICAL DISCUSSIONS RENIEW OF T'rE EDUCATION AND TRAINING OF NURSES TO MEXT THE 1- OF THE REGION ~~/R~lg/~ech.~isc./2 page i TABLJ3 OF CONTENTS I1 DEFINITIONS 3 1. Tht. Nurse 2. The Auxiliary Nurse 3. Basic Education for the Nurse 4. Post-Basic Education for the Nurss III REKEN OF NURSING Aim MIDWIFERY EDUCATION IN THE REGION 1. Administration b 2. The Students 3, !he Frogramrnes 4. The Practice Area 5. The Present Situation 6. !he Education of Aufiliaq~Nursing Personnel 7. "On-the-jab Training" 8. Midwifery Education 9. Post-Basic Nursing Ed-ucation IV THE NEEDS OF THE REGION I. The Needs of thc Covcrnment 2. ?he Needs of the Population 3 The Needs of the Nursing Profession V IYEl3TING THE NEEDS OF THE REGION 1. Contributions which might be made by the Government, the Population, and the Nursing Profession 1.1 The Government 1.2 'Ihe Population 1.3 The Nursing Profession 2. Specific Pleasures Sor Meeting Needs 2.1 Definition of the Purposes and Objectives of a Sahnol of Nursing 2.2 The Organization and Management of a School of Nursing EM/R~lg/~cch.~isc./2 page ii Page 2.3 The Organization of the Curriculun 23 2.3.1 The Corr~lctionof Theory md Practice 2.3.2 Clinical Teachbg and Supervision 2 Curricular Contont 2.4.1 The Comprehcnsive Curriculw 2.4.2 Subjscts inciuded in the Curricu1u.n 2.4.3 The Curriculum for Auxiliaries 2.4.4 Teaching Staff 2.4.5 Teaching Materials 2.4.6 Methods of Teaching 2.4.7 ?he Establishment of Degree Programmes 3. Continuing Education VI SUMMARY AND CONCLUSION AIJNM VITAL WEALTH STATISTICS AND PERSOKtdEL I INTRODUCTIOPJ The education and the role of nurses are matters of universal interest and concern in the development of health programmes throughout the world, They are particularly important in countries where profound economic, social and political changes have resulted in a revolution in expectations, needs and demands for health services, including nursing care. In each of the six Regions where health programmes are assisted by the World Health Organization there is a diversity of standards in nursing education, nursing roles and functions, and subsequently in nursing services. These are influenced by a country's history, its financial and human resources, and social and cultural patterns. Nursing does not exist in isolation - ito development is closely linked with that of other professions, particularly the health professions. It would be unusual for example to find a setting where there is a rr~edical school but none for professional nurses . In this Region the diversity of standards mentioned above is particularly pronounced, To give an example, it was as long ago as 1955 that the High Institute of Nursing enrolled its first students in a basic degree programme at the University of ~lexandrial. Fifteen years later In 1969, there are still countries where the existing programmes for nurses are at auxiliary level only, 'Ihis is not as disquieting as it may sound, for change takes time. What would be disquieting is if we did not encourage planned and orderly change. In other words, rue must begin programmes of rlursing education in line with the human and other resources availablei but as soon as these resources increase and improve, we should use them in the process of upgrading nursing education, and consequently nursing services, Our topic is the Review of Education and Training of Nurses to Meet the Needs of the Begion. The boundaries of this topic are somewhat elastic -- -- '~ur-,- '~ur-,- lhe Flrst Ten Years of WHO, Geneva 1358 (pge 397). * for not only do the countries vary in their socio-economic development, their human resources and potential, but in the types of health facilities provided, It is normal that a country with a larg~population like Pakistan should place emphasis on some aspects of health services which are not yet considered to be of vital importance in another, like Saudi Arabia....the provision of family planning facilities as an iategral part of maternal and child health scrviccs for example. In turn, if family planning is to bc integrated, nurses and midwives must be qualified to provide the appropriate counselling, the available measures, and follow-up care, Over 65 per cent of the population of the Region is rural, and therefore there is need for c-st and urgent plans for the development of rural health services. These in turn must be staffed by polyvalent nursing personnel who are fitted to provide efficient curative and preventive care in a situation where communications are difficult and distailces are considerable, This paper will consider nursing education as it is known to have pro- gressed over the recent years, as it is today, and the manner in which it might be developed to meet the needs of the countries of the Region in the future. It should be mentioned here.that although the paper often implies a reference to female nurses only, it can on the whole be applied to the in- clusion of men as well. The education and the contribution of the male nurse is not to be dLscounted in either curative or preventive nursing care in the countries of the Regi-on, especially where cultural patterns so indi- cater In the administration and the provision of service in rural health centres, in psychiatric nursing and in teaching this contribution of the male nurse is particularly important. Furthermore, the preparation of the midwife cannot be isolated from a discussion on nursing education. The capable midwife either doubly or singly qualified is an essential member of the health team, particularly in those countries where the infant and maternal mortality rates are still matters for concern. Therefore, many of the factors mentioned in relation to nursing education and its development in the Region 'can also be considered to be applicable to .the education of midwives. I1 DEFINITIONS Before proceeding to a review of nursing education in the Region it may be useful to define certain terms which will be frequently referred to: 1. &e Nurse 11 The nurse is a person who has completed a programme of basic nursing education and is qualified and a;lthorized in her country to supply the most responsible service of a nursing nature for the promotion of health, the prevention of illness and the care of the sick111 . This definition was formulated by the Ii~terna'tionalCouncil of'. Nurses and was accepted by the Fifth WI-IO Expert Committee on Nursing. 2. The Auxiliary Nurse The auxiliary nurse is one with less than full professional quali- fications, who carries responsibiliti'es of a less comprehensive and technical nature, and viho works under the guidance and supervision of nurses. 3. Basic Education for the Nurse "'A planned eciucational programme tnat provides a broad and sound foundation for the effective practice of nursing anti a basis -for advanced r) nursing .education"". 4. Post-Basic Education for the Nurse "A programme for nurses previously prepared in basic nursing that (a) takes place 111 a university 01- vther institute of higher education, '~nternational council' of Nurses (1965) --special and Committee reports pre- sented to 'the ICN Board of Directors and Grand Council meetings in Frankfurt, Juhe 1965, page 6. 2 IBID, page 6. (b) is continued from year to year (i.e, is not a refresher course or a seminar), (c) is recognized by an appropriate authority, (d) has specified admission requirements, and (e) has a full-time teaching staff or faculty"'. I11 FU3VIEW OF NURSING AND MIDWIFERY EDUCATION IN TH?l FCEGION In 1965 the Regional Office sent out questiorxmires designed to obtain information as a background for discussion at a Nursing Seminar to be held the following year. Sixteen member countries completed 144 questionnaires on schools providing basic educational programmes for nurses2. This total excluded the Health Training Institute, Benghazi, Libya and the High Insti- tute of Nursing at the Universities of Alexandria and Cairo, United Arab ~epublic. Eleven of the 144 schools were assisted by IdHO in 1965, and three others had previously had WHO support. The resultant data emphasi.zec1 the considerable diversity which existed in the background of general education, and in the nursing preparation of the personnel designed to provide "the most responsible service of a rlursing nature for the promotion of health, the prevention of illness and the care of the sick". ?he following points were noted: 1. Administration - Only fifty-five of these schools had their own budget. - ?he administrative control of approximately 34 per cent of the schuols was sepa~~atefrom that of a hospital or other health service institution. - The entry requirements in general education varied from four to twelve years - 19 per cent required eleven to twelve yearsj WHO Expert Committee on Nursing, WHO Technical Series, No. 347, 1966 (page 32). 2~orldHeelth Organization, "The Nursing Situation in the ~eglon", Alexandria, EMRO, WHO, Unpublished Paper EM/NURS,SEM/~, 2 November 1966, Annex I, pp.xiv. 46 per cent ten years; 7 per cent six years; 28 per cent four years (forty-four schools in one country). - Six languages were used in 144 schools, including Arabic in sixty-four and English in forty-four; ten s~hoolsinsix cowtries used two languages. 2. The-Students - Approximately 11 per cent of the schools had over 100 students, 57 per cent from sixty-one to 1uO students; 20 per cent from twenty-one to sixty students and 18 per cent had less than twenty- one.

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