Nursing And Midwifery Education Reforms In Nigeria: The Journey So Far

Background
Nursing and Midwifery Education Reforms started after the establishment of formal nursing and midwifery education in Nigeria over 80 years ago. Throughout the past decades various aspects of nursing and midwifery education in Nigeria have been restructured or reorganized in order to improve standard of training, efficiency and quality of nursing and health care delivery. A lot of efforts were targeted towards nursing and midwifery education reforms. Strategies that were explored included the Collegiate system, assimilation and absorption into the Universities. Impetus was given to the reforms in 2005 at the Nursing Leaders Conference in Gombe.

The main thrust of the reform agenda was to ensure that Nursing and Midwifery education in Nigeria, evolve in line with the National Policy on Education and also meet emerging socio-economic and health challenges of Nigeria. The Conventional Nursing and Midwifery Education in the Nigerian Educational System. The Council believes that for Nursing and Midwifery education reforms to be relevant, sustainable and acceptable, it should be in line with the philosophy and basic principles of the National Policy on Education.

According to the former Minister of Education Barr. Nyesom Wike,the National Policy on Education is the National guideline for effective administration and management of the educational system at all tiers of Government in Nigeria(National Policy on Education 2013).
Section 1, subsection 3 of the National Policy on Education (2013) states that the Nigeria’s philosophy of education is based on the following beliefs, education is :
• An instrument for national development and social change
• Vital for the promotion of a progressive and united Nigeria
c.) Maximizes the creative potentials and skills of the individual for self-fulfillment and general development of the society.
d) Is compulsory and a right of every Nigerian irrespective of gender, social status, religion, colour, ethinic background and any peculiar individual challenges.
e) Is to be qualitative, comprehensive, functional and relevant to the needs of the society.

Section 4 of the policy emphasizes the provision of equal opportunities for all citizens of the nation at the basic, secondary and tertiary levels.
The Nigerian Educational System is categorized into:
• Early Child Care and Development- aged 0-4 years
• Basic Education- aged 5-15years
• Post Basic Education of 3 years Senior Secondary education
• Tertiary Education in Colleges of Education, Monotechnics, Polytechnics and Universities (National Policy on Education, 2013).

The administration of education in Nigeria according to the Policy is the responsibilities of the:
• Federal Ministry of Education
• 36 State Ministries of Education
• FCT Education Secretariat
• 774 Local Government Education Authorities

The regulation and quality assurance agencies of the educational system in Nigeria are:
• The National Universities Commission(NUC)
• National Board for Technical Education(NBTE)
• National Commission for Colleges of Education(NCCE).

Section 5, paragraph 80 of the National Policy on Education states as follows regarding tertiary education:
Tertiary Education is the education given after Post Basic education in institutions such as Universities and Inter-Universities Centres such as the Nigeria French Language Village, Nigeria Arabic Language Village, National Institute of Nigerian Languages, institutions such as Innovation Enterprise Institutions(IEIs), and Colleges of Education, Monotechnics, Polytechnics, and other specialized institutions such as Colleges of Agriculture, Schools of Health Technology and the National Teachers’ Institutes(NTI) (National Policy on Education 2013, p. 26 ). No mention is made of the Hospital Based Nursing and Midwifery Education in this definition.

In paragraph 112 of the same section of the National Policy on Education, 13 institutions are enumerated as Innovation Enterprise Institutions as follows:
a) Information Technology(IT)Institute
b) School of Oil and Gas Technology
c) Fashion Institute of Technology
d) School of Hospitality and Tourism
e) Film Academy
f) Academy of Creative Arts
g) Construction and Engineering Institute
h)Paralegal School
i) Institute of Telecommunications
j) Institute of Manufacturing
k) Professional Development Teaching Institutes
l) Institute of Banking
m) Agriculture, Cooperative and Allied Industries.

• It should be of concern to all nurses that despite the comprehensive listing above, the Revised National Policy on Education did not mention or make any reference to Schools of Nursing and Midwifery or even the Post Basic Nursing Programmes.
• The Hospital based Schools of Nursing and Midwifery are managed by the Ministry of Health , instead of the Ministry of Education as stipulated by the National Policy on Education.
• The same is applicable to the Post Basic Programmes which are managed by the Teaching Hospitals and not the Parent Universities where the programmes are domiciled.

According to Anyandiran et al (2013) in the National education framework, the hospital based system of nursing and midwifery education has suffered set backs such as:
• Poor structural progression as other post secondary education programmes.
• Lack of recognition of prior learning in the placement of Registered nurses with Post Basic qualifications into the Universities.
• The schools of Nursing and Midwifery are not empowered by Law to award academic certificates.

The above are some indications that the reforms of the contemporary system of Nursing and Midwifery education is a neccesity.
• Nursing and Midwifery Education Reforms: The Journey So far
• Review of entry requirements for Nursing and Midwifery Education. The harmonization of the entry requirements into Nursing and Midwifery education at all levels in Nigeria since 2006 has been 5 O’ Level credits in English, mathematics, Biology, Physics and Chemistry.

Establishment of more Departments of Nursing in Universities in Nigeria.
• As at 2005 there were about ten(10) accredited departments of nursing in Universities in Nigeria. This has increased to 24 currently.
• The departments of Nursing currently running post graduate programmes have also increased. These are two significant areas of Nursing and Midwifery education reforms, though far from adequate.
• The Council is still encouraging Nursing Leaders, the Professional Association and other nurses nursing world nigeria to continue to advocate and work with academic institutions so that more departments could be established.
• The already existing departments that have capacity are encouraged to start Post graduate programmes in Nursing.
• Manpower Development: All aspects of the Nursing and Midwifery Education reforms require directly or indirectly nurses with higher degrees in Nursing.
• The Council is pleased to note that nursing manpower development though still an area of need, has improved tremendously.
• The many more educators with training in education, more nurses with M.Sc. and Ph.D. in Nursing and new Professors in Nursing.

Implementation of Internship for Graduates of the Bachelor of Nursing Science Programme.
• The Council initiated the Internship programme in 2007.
• The NUC gave approval for the programme in 2008.
• The Council had to work with the Federal Ministry of Health and the Office of the Head of Civil Service of the Federation to ensure the programme is incorporated into the Scheme of Service.
• Approval by the National Council on Establishment was given in September 2016
• A Circular notifying of the incorporation into the Scheme of Service was released on September 2016.
• The Scheme commenced in January 2017

Review of Basic and Post Basic Nursing and Midwifery Curricula
• All Basic and Post Basic Nursing and Midwifery curricula have been reviewed in line with current local and global trends in the health care delivery system.
• New Curricula have been developed in Critical Care, Plastic and Burns Nursing, Occupational Care, Nephrology and Oncology Nursing.

Reforms of the Hospital Based Schools of Nursing and Midwifery for Award of Academic Certificate
• The Council signed a Memorandum of Understanding with NBTE in January 2017 for the commencement of the ND/HND Nursing programme.
• This new system would lead to the award of academic certificate in addition to the Professional certificates: RN and RM or RPHN
• The institutions shall be structured as Colleges or Monotechnics with an Enabling Law.
• Admission shall be through JAMB
• The programme shall be for four years after which the graduates will do a one year Industrial( Clinical)Attachment.
• The Council will soon release the Guidelines for the running of the ND/HND Nursing
• The Schools running the current Nursing and Midwifery programmes who are unable to meet with NBTE requirements shall continue pending when they are able meet with the conditions for running the new programme.
• Reforms of the Post Basic Nursing Specialty Programmes.
• Not much has been done in the reforms of the Post Basic Nursing Programmes.
• This area is one of the key subject for deliberation during this Conference.
• The Council will welcome innovative ideas on how to strengthen and reform Clinical Nursing specialty programmes in Nigeria.

Conclusion
Nursing and Midwifery Education Reform is a necessity for growth and development of the profession. It is a task that must be done, with unity of purpose and the cooperation of all the stakeholders success will be attained.