??????????? 17(?)6 ?????????????????????? Collaborative Development of Baccalaureate Program in Afghanistan

1
??????????? 17(?)6??????????????????????Collabo
rative Development of Baccalaureate Program in
Afghanistan

• ?? ??
• (Junko Tashiro, RN, PhD)
• ?????
• Shamsurahim Rahim, Sherin Aqua Zarif
• (Kabul Medical University)
• ?????????????????????????
• (WHO ?????????????????)
• ?????????
• (????????????????)
• ????
• (?????????)
• ?6????????????????
• 12?14?2007?

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??(Topics)

• ??????????????????
• ???????????
• (Background of this project)
• ???????????????????
• ????
• (Progress of this project)
• ???????????????????
• ?????
• (Future direction of this project)

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?????????????????? ???????????(Background of
Collaborative Nursing Education Project for
Afghanistan)

• July, 2002
• Comprehensive Needs Assessment in Education
  (CAN)
• ODA (Japan International Cooperation Agency)
  started to plan.
• January, 2005
• The first trainees from Kabul Medical
  University (KMU)
• hosted by Japanese International Cooperation
  Agency (JICA), designated by International
  Research for Medical Education (IRME), Tokyo
  University.
• March, 2005
• JICA started Medical Education Project
• August, 2005
• Collaborative Inter-disciplinary Study Team
  consists of IRME and WHO C.C. at SLCN for Nursing
  Education started
• October, 2006
• Started to work with faculty members of Faculty
  of Nursing of Kabul Medial University

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????????Conceptual Framework

• Structure (??) Process(??)
  Outcome(??)

Peoples Self-care Health Care
Providers Quality of health care services
Workload Health Care system Accessible health
care facilities Financial support and Health
professional and workers education
Peoples Health Status Peoples accessibility of
care Peoples satisfaction Financial
burden Health Care Providers Satisfaction
Health Care System Cost-effectiveness
People's Health Status Life Expectancy Major
Causes of Death Infant Mortality Maternal
Mortality Health Care Providers Human
Resources Health Care System Health policy
Regulations Financial condition Human
resource development
Development of Educational Program for Human
Resource for Health
5
???2005-2006????(Main goal and Studies in
20052006)

• The main goal of educational development in
  Afghanistan is strengthen nursing and
  consequently promote the health of the people by
  focusing on women and children
• Goals of 2005
• To determine Afghanistans critical health needs
  that would guide the development of their
  baccalaureate nursing program
• Goals of 2006
• To develop educational program of Faculty of
  Nursing, Kabul Medical University

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2005???????(???????)Findings of Study in 2005
Health Indicators of the Afghanistan

• Life Expectancy at Birth 42 years old (WHO,
  2004)
• Under age 5 yrs. mortality rate 258/1000
• Infant Mortality 144/1000 lb (Ministry of Health
  Afghanistan, 2002)
• Maternal Mortality 160/100,000birth
• Population Growth 2.67 (2006 est.)
• Sex ratio at birth 1.05 male/female
• Human Resource in Health (WHO, 2001)
• Number of (
  Density per 1000 people)
• Physician 4,104
  ( 0.19/1000 )
• Nurses 4,752
  ( 0.22/1000)
• Dentist 630
  ( 0.03/1000)
• Pharmacist 525
  ( 0.02/1000)

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?????????????????A ????????Findings (A)
Health care needs

• (A-a) Destroyed health care system and
• institutions
• (A-b) High maternal mortality
• (A-c) High infant mortality
• (A-d) High blood pressure and other chronic
• diseases
• (A-e) Infectious disease Measles, HIV/AIDS
• (A-f) Psychiatric illness such as post traumatic
  stress disorder (PTSD) and depression.

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?????????????????B ?????????Findings (B)
Human resource development needs

• (B-a) unbalanced distribution of health worker or
  personnel between urban and rural areas
• (B-b) reduced numbers of female human resource in
  health because of the cultural and regional
  value
• (B-c) less management of human resource
  development due to heavily relied on
  non-governmental agencies.

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2005???????Future Directions of Collaborative
Study Team for Development of Nursing Education
in 2005

• To form international inter-disciplinal study
  team between Afghanistan and Japan
• To develop a nursing program that prepares nurse
  leaders who can manage and develop nursing and
  health activities within the health system
  consisted of tertiary, secondary, and primary
• This collaborative work developing a nursing
  educational program, it should be based on the
  cultural values such as gender-role in
  Afghanistan, and community health.

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Faculty of Nursing Kabul Medical University

• Shamsurahim Rahim
• Dean of Nursing faculty
• October 14, 2006

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?????? (Contents)

• I. History of Kabul Medical University
• II. Organization and Administration
• III. Health system in Afghanistan
• IV. Philosophy of education
• V. Goals of Nursing education
• VI. Concept of Nursing
• VII. Components of Baccalaureate Curriculum of
  Year of Study
• XIII. Subjects and Credit

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???????????I. History of Kabul Medical University

• In1933,The nucleus of higher education
  established as a Medical Faculty by the
  supervision of Turkish professor Refqi big with 8
  lecturers.

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In 1985, the mentioned Medical faculty
progressed to Medical institute and to Medical
University in 2003 .
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?????????????? History of Nursing Education

• the Ministry of Public Health.
• In 1940, the Medical Faculty established
• the Primary Nursing School
• In 1962, the Secondary Nursing School
• established, with the cooperation of
• German government

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• In 1976, the Primary Nursing School of Medical
  Faculty joined to this Secondary Nursing School,
  and after that has promoted to Health and Science
  Institution.
• In May, 2006, Kabul Medical University
  established the Faculty of Nursing which is the
  first faculty of nursing in Afghanistan.

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• II. ???????Organization and Administration

Chancellor
Executive Board of the University
Academic Council
Vice CH.in education affairs
Vice CH. in scientific affairs
Vice CH in Administrative affairs
University Hospitals G.Director
E D C
Research Center
Publication
Finance
Library
Account
Audio-visual
Curriculum committee
Human resource
Evaluation committee
Postgraduate committee
PBL committee
Fundamental
Dentistry Faculty (Stomatology)
Nursing Faculty
Curative faculty
Pediatric faculty
Public Health
11 Dept.
11 Dept
4 Dept
Clinical Nursing
10 Dept.
Research Education
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???????????Basic package of health
services(primary care system)

• Components
• 1-Maternal and newborn health .
• 2-Child health and immunization .
• 3-public nutrition .
• 4-Disability.
• 5-Communicable diseases.
• 6-Mental health(community management).

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??????(Basic Package of Health Services)
-Community health workers -limited curative care
-out patient.
-Same services as a HP-But more complex out
patient care -Will be staffed by a nurse , mid
wife and vaccinators.
- Covers area of 30000 to60000people -Offering
BHCs, normal delivery, handling Some
complications, grave care of child illness,
complicated malaria, physiotherapy.
- Covered 100,000-300,000 population -30-75
beds, for surgery, medicine, pediatrics, obst
gyn, and out patient for mental health dental
services.
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?????? (Essential Package of Hospital Services)

• 1-District hospital (DH) mentioned before.
• 2- provincial hospital(PH) 100-200 beds,
  services offered by DH , infectious diseases,
  rehabilitation, nutrition, physiotherapy services
  as well .
• 3-Regional hospital(RH)200-400beds beside
  offered PH, ENT, Urology, Neurosurgery,
  Orthopedics, plastic, Cardiovascular and the
  other specialties. has training program.
• 4-University hospital serve as RH, in addition
  practical field of medicine, Pediatrics, Nursing
  and Dentistry students and research. is under the
  authority of the medical university .

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VI.??????? (Philosophy of Nursing Education)

• Education is characterized by training the mind
  to think, gaining knowledge through engagement in
  intellectual activities, pursuing research and
  disseminating knowledge that is useful for all
  citizens and that also encourages their
  continuous intellectual growth.
• The education should help individuals to live
  usefully and happily, able to solve problems.
• Faculty of Nursing, Kabul Medical University will
  establish a strong system of education in order
  to enable our students to seek the goals
  including the highest quality of life of the
  people and progress of health care in
  Afghanistan.

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V. ?????(Concept of Nursing)

• A graduate nurse serve all individuals equally
• A graduate nurse has sufficient knowledge on how
  to practice in health system for both treatments
  and prevention of diseases
• A graduate nurse gains professional attitude and
  skills to help both patients and clients in the
  community
• A graduate nurse associates with health care
  professionals, health workers, birth
  attendants, community volunteers and leaders
• A graduate nurse has sufficient capacity for
  taking leadership in nursing practice and
  administration in health care services.

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????? (Concept of Nursing)
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VI.??????? (Objectives of Nursing Education)

• use a framework of assessment, planning,
  implementation, and evaluation in providing
  nursing care in the (BPHS) and in the (EPHS)
• analyze situations using multiple sources of data
  in order to identify problems, possible courses
  of sector of their consequences.
• make and defend decision on basis of evidence and
  ethical considerations.
• communicate about health matters with members of
  the community.

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• deliver basic preventive and curative care
  services for communicable diseases.
• use advanced knowledge to provide services within
  specialized areas .
• teach and work together with families and
  community health other workers.
• use basic nursing strategies and to promote
  health comfort.
• conceptualize, and analyze data for purposes of
  quality assurance and research.
• work collaboratively in the health care system.

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VII.??????????? (Components of Baccalaureate
Curriculum of Year of Study)

• Fourth Year
• Anesthesia Nursing (18 ) Operating Theater
  Nursing (18) Critical Care Nursing (18)
• Psychiatric Nursing (18)Community Midwifery
  (18) Public Health Nursing (18)
• Nursing Education(3) Nursing
  Administration(3) Nursing Research(10)
  Biostatistics (2)
• Third Year
• Adult Nursing III (4) Pediatric
  Nursing?(4) Maternal Nursing?(3) Psychiatric
  Nursing Mental Health?(3) Community Nursing ?(
  4) Adult Nursing ? (4) Pediatric Nursing?(4)
• Maternal Nursing ?(4) Psychiatric
  Nursing and Mental Health ?(3) Community Nursing
  ?(3)
• Second Year
• Adult Nursing I (3) Adult Nursing II (5)
  Anatomy and Physiology I (3) Pathology (2)
• Pharmacology I (3) Health system (2)
  Nutrition (2) Anatomy and Physiology II (4)
• Physiopathology (3) Pharmacology II (3)
  Medical ethics (1) Foreign Language III (2)
• Law (optional) (1) Foreign Language IV (2)
• First Year
• Fundamental Nursing I (3) Fundamental
  Nursing II (5) Chemistry I (3) Biology I, (3)
• Chemistry II (Biochemistry) (3) Biology
  II, (3) Information Technology (Computer)
  (2)(optional)
• Physical Education (1) Art (3) Islamic
  Study I (1) Foreign Language I (2) Information

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Reference

• WHO The World Health Report 2006
• WHO The World Health Report 2005
• http//www.cia.gov/cia/pubications/factbook/af.htm
  l
• WHO (2006) The World Health Report. WHO.
• JICA (2005). Report on Preliminary Evaluation of
  Medical Education in Afghanistan. JICA.
• International Research Center for Medical
  Education (2005). Proceedings The 4th Forum of
  International Cooperative Research for Medical
  Education. IRCME, Tokyo U.
• Afghan Ministry of Health (2003). Guidelines for
  Development of a Health Worker Certification
  System. Ministry of Health, Afghanistan.
• Afghan Ministry of Public Health, CDC UNICEF
  (2002) Maternal Mortality in Afghanistan
  Magnitude, causes, Risk Factors and
  Preventability. Ministry of Health, Afghanistan.

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