Advanced Practice Nursing in Kenya

Contact:
Aga Khan University – School of Nursing and Midwifery, East Africa
Kenyan Nurses Association

Role

The role of the Advanced Practice Nurse in Kenya is in development(Rasul, 2020; Sahib et al., 2020).  They role has yet to be developed and has met significant pushback in the past to attempt to advance nursing practice (East et al, 2014).  

Some of the greatest barriers identified include: lack of advanced nursing role regulation, lack of regional benchmark, medical profession (Dela Christmals, Crous, & Armstrong, 2019; East et al, 2014).  Meanwhile, significant healthcare gaps, particularly throughout rural parts of Kenya along with nurses making up the majority of Sub-Saharan Africa (SSA) drives the advancement of nursing practice to promote Kenya’s health disparities (Dela Christmals, Crous, & Armstrong, 2019).  

While the role has not been yet developed, Kenya has made significant strides to facilitate the process to advance nursing practice.   In November 2020, the Aga Khan University in Pakistan, hosted a conference to promote the role of the Advanced Practice Nurse in Pakistan and West Africa, and during that conference Rasul (2020, November) reported expanded masters level education programs for Advanced Practice Nurses in Kenya and reported a midwifery program would be developed by 2021.  

Most recently, the Aga Khan University posted on May 6, 2022 that the Kenyan government approved the nursing and midwifery policy facilitated by the AKU demonstrating the imminent implementation of a formal APN role in Kenya and SSA.

Specialization

Meanwhile, Kirigia (2020) presented that the Child Health Nurse Practitioner curriculum has been nearly implemented.  This would establish the first formal initiative to provide quality graduate-level education advanced nursing practice role in the country and SSA.  The focus of the CHNP focus was determined by the majority population of SSA and being regarded as the most vulnerable to disease burden (Dela Christmals, Crous, & Armstrong, 2019).

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References:
Aga Khan University. (May 6, 2022). Government approves nursing and midwifery policy conveniened by AKU.  Retrieved July 9, 2022 from: https://www.aku.edu/news/Pages/News_Details.aspx?nid=NEWS-002763

Dela Christmals, C. & Armstrong, S.J. (2019). The essence, opportunities and threats to advanced practice nursing in Sub-Saharan Africa: A scoping review. Heliyon. 5(2019). doi:10.1016/j.heliyon.2019.e02531

Dela Christmals, C., Crous, L., & Armstrong, S.J. (2019). The development of concepts for a concept-based advanced practice nursing (Child health nurse practitioner) curriculum for Sub-Saharan Africa. International Journal of Caring Sciences. 12(3)1410. doi:10.1136/bmjopen-2019-035580

East, L.A., Arudo, J., Loefler, M., & Evans, C. (2014). Exploring the potential for advanced nursing practice role development in Kenya: A qualitative study. BMC Nursing. 13(33). doi:10.1186/s12912-014-0033-y

Kirigia, C. (2020). Impact of advanced practice nurses and midwives on patients’ outcomes: A systematic review. International Journal of Health Sciences and Research. 10(6). doi:10.6084/m9.figshare.1246230.v1

Rasul, F. (2020, November). President’s Address. Shaping the future: Introducing advanced practice nursing in Pakistan and East Africa.  Aga Khan University, Pakistan.  Retrieved May 22, 2022 from: https://www.aku.edu/events/apn/Pages/home.aspx

Sahib, S., Ndirangu, E., Pallangyo, E., Mbuthia, G., & Kimani, R. (2020). Introduction of an advanced practice nurse program in Kenya: A new era in nursing education.  In Sigma’s VIRTUAL 31st International Nursing Research Congress. Retrieved July 9, 2022 from: https://sigma.nursingrepository.org/bitstream/handle/10755/21045/Shaibu_Poster.pdf?sequence=1&isAllowed=y

Advanced Practice Nursing in Namibia

Snapshot

APN Role Exists in Country Today:
Yes

Title:
Midwifery and Neonatology Specialist Midwife (Midwifery and Neonatology)
Critical Care Nursing Specialist Nurse (Critical Care)
Psychiatric Nursing Specialist Nurse (Mental Health)

Nationally Certified/Registered:
Yes

Recognize Foreign Licensure:
Yes

Treatment Authority:
Yes

Prescribing Authority:
Yes

Practice Autonomously:
Uncertain (Yes in rural areas)

Contact:
Nursing Council of Naimibia

Role

The nursing role in Namibia today is expected to train all nurses to also be midwives because of the high need to assist in pregnancies.  As a result, all nurses practice to this level.  Because of the lack of physicians in more rural areas, the nurses in these regions may offer thorough assessment, diagnosis, and treatment based on their being the isolated health provider in a rural area.  Training at the bachelors level has been developed as of 2008 and encouragement from the Namibian government has been to continue to expand the education of nursing (Klopper & Uys, 2010).

As of 2008, the Nursing Council of Namibia also identifies there are several specialties in nursing by which an individual can be trained as a (Health Professions Councils of Namibia, n.d.):

  • Midwifery and Neonatology Specialist Midwife (Midwifery and Neonatology)
  • Critical Care Nursing Specialist Midwife (Critical Care)
  • Psychiatric Nursing Specialist Nurse (Mental Health)

Education & Certficiation

Individuals in the nursing roles can be trained at the bachelor level (Klopper & Uys, 2010).  While all the nurses trained in Namibia have been expected to perform midwifery care, individuals from surrounding countries who come to Namibia to work may not be trained in this task.  As a result, the Namibian schooling offers training to teach those individuals to additionally have the skills to work as a midwife (Klopper & Uys, 2010).

The individuals who pursue the specialties obtain a Masters degree in their specific subject (Health Professions Councils of Namibia, n.d.).

Specialties

The Nursing Council of Namibia does identify several specialties as nurse specialists as mentioned previously as: Midwifery and Neonatology, Critical Care, and Mental Health nurse specialists.  Nurses are also able to obtain a nursing diploma in general nursing as a: midwife, nurse with midwife capabilities, or dermatology (Health Professions Councils of Namibia, n.d.).  According to the Nursing Council of Namibia, there is government sanctioning that identifies additional advanced diplomas that allow a nurse to gain further education in various specialist subjects (Health Professions Councils of Namibia, n.d.):

  • Advanced University Diploma in Operating Room Nursing Science
  • Diploma in Opthalmological Nursing Science
  • Advanced University Diploma in Health Promotion, Clinical Diagnosis and Treatment
  • Advanced Diploma in Nursing Education
  • Advanced Diploma in Critical Care Nursing
  • Advanced Diploma in Dermatology
  • Advanced Diploma in Anesthetics
  • Advanced Diploma in Health Service Management
  • Advanced Diploma in Unit Management for Registered Nurses
  • Advanced Diploma in Clinical Nursing Science, Health Assessment, Treatment and Care
  • Advanced Diploma in Community Health Nursing Science
  • Advanced Diploma in Midwifery and Neonatal Nursing Science
  • Advanced Diploma in Occupational Health Nursing Science
  • Advanced Diploma in Gerontological Nursing Science
  • Advanced Diploma in Child Nursing Science
  • Advanced Diploma in Orthopedic Nursing Science
  • Advanced Diploma in Oncology
  • Advanced Diploma in Neonatology
  • Advanced Diploma in Trauma Nursing Science

While this list of advanced diplomas is extensive, it is uncertain the accessibility of these advanced diploma programs, as only the first five were identified to be offered by the University of Namibia (Health Professions Councils of Namibia, n.d.).

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References:
Health Professions Councils of Namibia (n.d.).  Nursing council of Namibia.  Retrieved from: http://www.hpcna.com/nursing_min.php

Klopper, H. & Uys, L.R. (2012). The state of nursing and education in Africa: A country-by-country review [Google eReader version]. Sigma Theta Tau.  Retrieved from: http://books.google.com/books?id=SzgiwENnd4UC&source=gbs_navlinks_s

Advanced Practice Nursing in Sierra Leone

Snapshot

APN Role Exists in Country Today:
Yes

Title:
Nurse Anesthetist
Nurse Midwife

Nationally Certified:
Uncertain

Recognize Foreign Licensure:
Uncertain

Treatment Authority:
Yes

Prescribing Authority:
Yes

Practice Autonomously:
Yes

Contact:
Sierra Leone Nurses and Midwives Board (for registration) – Registrar: Mrs. Hannah Coker; Phone: 076673741 / 033885138 / 030
Sierra Leone Nurses Association

Role

To understand the advanced nursing practice role in Sierra leone, one must understand the basic structure of nursing in the country.  Essentially, there are several levels of nurse training and several specialties offered in their training:

  • Nurse tutor
  • Opthalmic Nurse
  • Public Health Nurse
  • Maternal and Child Health Aides

Additionally, there are two specific roles of APNs in the country:

  • Nurse-Midwife
  • Nurse Anesthetist

Not much information is available on the nurse anesthetist role, however, they have been in practice for at least 5 years (Klopper & Uys, 2012).  The Nurse-Midwife role encompasses an autonomous role with assessment, diagnosis, and treatment authorities including perinatal care and sexually transmitted infection management around that period as well.

Education and Certification

The National School of Midwifery offers a 2 year program to be taken after basic nursing (Klopper & Uys, 2012).  Ongoing education and recertification is required every 2 years, implying a fairly rigorous process to maintain registration.  The Nurse Tutor, opthalmic nursing training, bachelors of science in nursing, and state registered nurse training is offered through the Faculty of Nursing, a college formerly known as the National School of Nursing.  In the meantime, Sierra Leone has been having nursing educational institutions pop-up that are not accepted and credited by the Sierra Leone Nursing and Midwifery Board because of the increased interest of individuals to become professionals in healthcare.  The endeavor to start up such schools in the country has been deemed as an illegal activity; because of this, the Nursing and Midwifery Board have been cracking down and attempting to stop this from occurring by discouraging facilities from hiring individuals with non-accredited nursing education (Sierra Express Media, 2013).

Specialties

Various disciplines of nursing training are offered through the Faculty of Nursing college, namely medical, surgical, basic sciences, and public health.  Additionally this school offers the specialty of opthalmic nursing education (Klopper & Uys, 2012).

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References:
Klopper, H. & Uys, L.R. (2012). The state of nursing and education in Africa: A country-by-country review.  Sigma Theta Tau.  Retrieved from: http://books.google.com/books?id=SzgiwENnd4UC&source=gbs_navlinks_s

Sierra Express Media (2013).  Moves to shut down illegal nursing activities.  Retrieved from: http://www.sierraexpressmedia.com/archives/53712

Advanced Practice Nursing in Swaziland

Snapshot

APN Role Exists in Country Today:
Yes

Title:
Nurse-Midwife
Nurse Practitioner

Nationally Certified:
Uncertain

Recognize Foreign Licensure:
Uncertain

Treatment Authority:
Yes

Prescribing Authority:
Yes

Practice Autonomously:
Yes

Contact:
Swaziland Nursing Council

Role

There are chiefly two roles of Advanced Practice in Swaziland.  Of note, the role of the registered nurse includes the ability to assess, diagnose, and treat patients for a number of conditions (Klopper & Uys, 2012).  Outside of the registered nurse role, there are two areas of Advanced Practice Nursing:

  • Nurse-Midwife – Provide delivery, maternal health, and sexually transmitted disease care.
  • Nurse Practitioner – Provide advanced assessment, diagnosis, and treatment, including prescribing.  Primary in the hospital setting.

Education

There are two programs in Swaziland that educate Nurse-Midwifes.  A nurse must first have their diploma or bachelors of science in nursing prior to entering the program.  In general, the Midwifery course takes one year to complete (Klopper & Uys, 2012).

There are currently no Nurse Practitioner programs in Swaziland.  Apparently, they previously but are no longer present (Klopper & Uys, 2012).

Specialties

Uncertain

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References:
Klopper, H. & Uys, L.R. (2012). The state of nursing and education in Africa: A country-by-country review.  Sigma Theta Tau.  Retrieved from: http://books.google.com/books?id=SzgiwENnd4UC&source=gbs_navlinks_s