In 2008, the Kenya Ministry of Health (MOH) embarked on a process to strengthen pre-service training for the Expanded Programme on Immunization (EPI) using the WHO prototype curriculum, partnering with the WHO, UNICEF and the United States Agency for International Development’s (USAID) Maternal and Child Health Integrated Program. In 2017, USAID’s Maternal and Child Survival Program (MCSP) conducted an assessment of the outcomes of the pre-service training initiative. MCSP undertook a desk review of the nursing curricula; observed the tutors in their classrooms, students in their clinical practicum sites, and nursing school graduates during their immunization sessions; and conducted in-depth interviews with nursing graduates, health facility managers, and subcounty EPI supervisors.
Thirteen of 14 pre-service training institutions had adapted at least the priority EPI topics recommended in the EPI prototype curriculum to their nursing training curricula. Most tutors had sufficient knowledge and skills for teaching EPI content in the classroom. However, most pre-service training institutions lacked EPI equipment, commodities, and tools in the skills labs for demonstrations and lacked updated reference manuals.
Most public clinical practicum sites sampled had environments that were conducive to learning and students had the opportunity to get hands-on EPI experience. Across all types of practicum sites in the study, two-thirds gave students the opportunity to practice dropout tracking and only one-third gave students hands-on experience in coverage monitoring.
The managers of the health facilities and subcounty EPI supervisors stated that the nurses came to health facilities prepared to immunize children, but not prepared for proper recordkeeping. They lacked knowledge and skills required to prepare summary reports and calculate coverage and dropout rates. The managers and supervisors added that the nurses from public institutions appeared to be more competent than those from the private and faith-based universities.
The full findings of this study will be useful for further improving the EPI pre-service training in Kenya. They will also be useful for other countries in the region looking to strengthen their EPI pre-service training. JSI/Maternal and Child Survival Programme. 2017.