Govt erred in phasing out nursing course, stakeholders say

Health workers say the government has erred by stopping institutions from offering Certificate and Diploma courses in Comprehensive Nursing training, a decision which has since been backed by Parliament’s Committee on Education and Sports.

Napore West legislator Phillips Lokwang recently presented the committee’s report on the matter, saying “the study period was insufficient to impart the requisite skills to the students compared to the other certificate courses in nursing or midwifery.”

A direct entrant from Senior Six needs two-and-a-half years to be awarded a certificate, and three years for diploma in comprehensive nursing, while those upgrading from certificate courses to diploma in comprehensive nursing only need one-and-a-half years.

Lokwang thinks other options should have been explored by the Ministry of Education and Sports, including, reviewing the curriculum for the comprehensive nursing course to enrich it to impart the required knowledge and skills to the students.

The Uganda Nurses and Midwives Council reported having a total population of about 3,557 registered comprehensive nurses and 20,253 enrolled comprehensive nurses.

Practicing medical personnel have, however, cast doubt on the rationale behind phasing out the comprehensive nursing course instead of enhancing it to boost healthcare provision and quality.

Katulina Nkonoka, a trained nurse who owns a drug shop at Bukungu Landing Site in Buyende District, said her sales and clients doubled when she hired a colleague who was a comprehensive nurse because she could handle both mothers and ordinary patients well.

“The comprehensive nurse understood patients better than me who did well in midwifery; so, to me, the government has erred,” she said on Tuesday.

George Kedi, who owns a clinic in Kanyum, Kumi District, in a brief telephone interview, said: “These people (the government and parliament) have shot themselves in the foot.”

He added: “Instead of employing a midwife, a nurse and psychiatric nurse, making them three, we opted for one comprehensive nurse, who we pay a salary for two.”

Freda Lucy Ariimi, a community psychologist, observes that specialisation limits the scope of service and comprehensive nursing offers diversity in health services which is much more suitable for rural communities which are comfortable talking to one person than moving from one to another.

Henry Munaaba Dhikusoka, the director St Michael International Institute of Health, Technical and Management Sciences in Kamuli District, says comprehensive nursing course was a “duplication”.

“It was just like Bachelor of Business Administration and Bachelor of Commerce courses, and needed more teaching and tutorial time as Nursing, Anesthesia and Psychiatric Units,” he observed.

“We have no problem with the phasing out since it was almost the same courses duplicated; but now given more specialisation for Nursing, Anesthesia and Psychiatry,” Munaaba added.

According to him, communities need quality, affordable and accessible health services, which is one of the basic reasons he opted to open a health, technical and management institute in the rural community-based location.

Rev Sr Regina Atimo, the principal Kamuli School of Nursing and Midwifery, said they were prepared for this phasing out since last year when it was mooted, and they now have the first and second year students, and this year they are not enrolling for it.

She said though “a very good health course,” the comprehensive nursing course requires “a lot of tutorial time” which she says would have called for an extra year to adequately prepare students.

“Our students were better and marketable in the field, but we used to offer extra time even at night which required commitment, passion and sacrifice to thoroughly cover it,” she revealed.

One of the students in the last batch of comprehensive nursing course at Kamuli Mission Training School, who declined to be named for fear of reprisal from the administration, described the course as being “hectic, demanding, but well enriched.”

“Comprehensive nursing is good for those who work in health centres upcountry and low-staff areas, and trains one to be all-round,” she said.

She is, however, optimistic that the decision may be reversed in future. People in Uganda are biased; anybody comes up with some idea, it gets implemented and within a short time, it is reversed. Don’t get surprised when it is reinstated in future,” she said.

*Additional reporting by Sam Caleb Opio