Features

Voices From The Capacity Project: Developing The Health Workforce—Training Future Nurses and Midwives in Rwanda

“If we train our own people, we will have the service providers needed for Rwanda,” says Mary Murebwayire, director of the Nursing and Midwifery Task Force in Rwanda’s Ministry of Health. Toward this aim, the Ministry has focused on revamping its nursing education programs and producing skilled graduates who are ready to respond to the country’s most pressing health needs.

In January 2007, five priority nursing schools in Rwanda welcomed the first students in the new three-year, competency-based Registered Nursing and Midwifery A1 Programs. In collaboration with the Belgium Technical Corporation, APEFE and Columbia University, the Capacity Project supported the curriculum design and implementation of these programs, which are vital to the government’s plans to phase out lower-level A2 programs and transition to a workforce of A1 or higher-level professionals. Viviane Mukakarara, the Project’s Nursing and Midwifery Team leader in Rwanda, drew on her expertise in nursing education to take a leadership role in this effort.

Sister Josephine Mukamunana is the director of the Rwamagana Nursing and Midwifery School. “Without Capacity Project funding and technical assistance,” she states, “we would have nothing to run the school.” Thirty-nine students entered the new A1 programs at Rwamagana, about evenly divided between nursing and midwifery. The final class of A2 students will complete their studies in November 2007.

Sister Winifrida Ugirimbabazi, academic-in-charge and a teacher at Rwamagana, describes the new curriculum and its performance-based approach. “HIV, family planning, maternal and child health and gender content is integrated into the courses,” she reports. “Students learn the knowledge and theory in the classroom, go into the community to become aware of client needs and illnesses and then go to clinical practica in the health centers and hospitals to learn how to practice their skills.”

“The new competency-based curriculum will help the community, because the students are learning knowledge and skills in the lectures and clinical practica,” says Immaculae Muhawenimana, a midwifery assistant who serves on the Ministry of Health Nursing and Midwifery Task Force. “They go out to the community to get to know the people.” This effort is important, she adds, because “training midwives will help to lower maternal and newborn mortality.” The A1 midwifery program is the first pre-service program of its kind in the country.

Sister Marleen Creve is a teacher at the Rwamagana School, which was built in 1964. “The most comprehensive renovations—to classrooms, dormitories, the library and computer lab—were supported by the Capacity Project last year,” she explains. Sandrine Dushimimana, an A2 student, experienced the “before” and “after” conditions. Now, she says, “We have improved nutrition, better housing, space for studying, new books, clean and repaired dormitories, new paint…everything is new and clean. These things help us have better health and less disease while we are in school.” Creve agrees: “It is easier for the students to learn in a better environment.”

Providing faculty and students with access to current information is vital. As Ugirimbabazi points out, “Some of the old books in the school library do not contain current information. The Internet helps students and teachers find updated medical information.” In collaboration with the five schools and Kigali Health Institute, the Project organized ongoing library management assistance. At Rwamagana, library staff member Maurice Ndashimye comments on the changes: “Now we use the Dewey Decimal system for cataloging, and we keep our library inventory in an Excel database. We have a system for checking out books, and teachers and students are always using the library. Even the Rwamagana district hospital staff use our library, because of the recent books we received from the Capacity Project.”

Solange Umurerwa, an A2 student, says she has learned about “how to educate clients, counseling and providing all the family planning methods. I will be a good nurse to help the population have good health.” Dushimimana shares her confidence. “We have enough materials for learning and practicing our profession, enough practice in the clinical practicum sites and enough knowledge to become good nurses in the future.”

“The Capacity Project has contributed greatly,” says Murebwayire. “Where we find a gap, they fill the need.”

[August 2007. Print a PDF version. For more information, please contact

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The Capacity Project, funded by the United States Agency for International Development (USAID) and implemented by IntraHealth International and partners, helps developing countries strengthen human resources for health to better respond to the challenges of implementing and sustaining quality health programs.

The Voices from the Capacity Project series is made possible by the support of the American people through USAID. The contents are the responsibility of IntraHealth International and do not necessarily reflect the views of USAID or the United States Government.