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The African Medical and Research Foundation (AMREF) is an independent, nonprofit organization whose mission is to improve health and health care.
AMREF aims to ensure that every African can enjoy the right to good health by helping to create vibrant networks of informed communities that work with empowered health care providers in strong health systems. AMREF’s work strengthens Africa’s health systems and health human resources and uses six entry points that include HIV/AIDS; malaria; safe water and basic sanitation; family health; disaster management and emergency response; and health care-related training.
AMREF is headquartered in Nairobi, Kenya, and is the continent’s leading health development organization. In 2005, AMREF won the prestigious Gates Award for Global Health for making a major and lasting contribution to the field of health in Africa.
Every day in Africa, more than 3,000 children under the age of five die from malaria—a devastating statistic that illustrates why the continent urgently needs to increase the number of frontline health care workers who are qualified to treat such diseases as malaria, the leading cause of child morbidity and mortality in Africa. More than 85 percent of Kenya’s nurses are “enrolled nurses,” unable to obtain the advanced training needed for a “registered nurse” diploma. With that diploma, registered nurses have the skills to combat the spread of diseases such as malaria, AIDS/HIV and tuberculosis that have such a devastating impact on the country.
Although there are nearly 20,000 “enrolled” nurses waiting to upgrade to “registered” status, Kenya has the resources and classrooms to train only 100 registered nurses a year using traditional classroom methods. At that rate, it would take literally hundreds of years to certify these 20,000 enrolled nurses. To address Kenya’s shortage of qualified health care workers, AMREF was asked by the Kenyan Ministry of Health to find a rapid and sustainable health care training process to upgrade Kenya’s 20,000 enrolled nurses to registered status.
AMREF is internationally known for its pioneering initiatives, including a leading-edge telemedicine program that enables remotely located health workers in sub-Saharan Africa to consult live on difficult cases with doctors at AMREF’s central laboratory in Nairobi. To address the nursing crisis, AMREF initially designed a paper-based distance learning course, but soon realized that this approach would not quickly and efficiently address the problem. AMREF then approached Accenture (references to Accenture include Accenture Ltd and its subsidiaries as well as independent charitable organizations that bear the Accenture name) and together the two organizations agreed that a new and ground-breaking approach to health care training in Kenya was needed—e-learning.
However, transforming the vision of e-learning into reality meant overcoming hurdles that have hampered past efforts to implement technological solutions in Africa. Drawing on past experiences, AMREF recognized that the success of an e-learning initiative hinged on forming partnerships and obtaining advanced technical skills. In 2005, AMREF teamed with Accenture and the Kenya Nursing Council to develop a revolutionary e-learning program that would enable Kenya to train and certify these 20,000 nurses in just five years.
Under the five-year program, Accenture is donating $2.9 million to AMREF to develop and implement an innovative e-learning program to address Kenya’s critical nursing shortage. The donation consists of a $1.7 million contribution by the Accenture Foundations along with $1.2 million of in-kind services including program management expertise and 14,500 hours of donated time from professionals in Accenture Learning BPO Services, an Accenture business that provides learning outsourcing services.
The e-learning program has three primary objectives:
The funding from the Accenture Foundations is providing for the program management, staffing and administrative needs of the program; PC infrastructure for the training centers; as well as orientation and training for the mentors who would support the nurses during training. The contribution from Accenture Learning BPO Services is being used to develop the e-learning content and infrastructure, specifically:
The e-learning program is designed to run over five years and has three distinct phases: design and program planning, to last three months; followed by a three-month pilot serving 143 nurses in four regional training centers with assistance of Accenture Development Partnerships; and then a six-month rollout of the full solution to all regional training centers. Following rollout will be four years of ongoing support of the e-learning program by Accenture. Today, the program is entering into its full “run mode” having successfully completed all pilot programs.
The program is designed to leverage the Accenture Web-based Learning Management System that tracks student registration, enrollment and completion of each e-learning module. The scalable technology will grow with AMREF’s changing needs, and allow Kenyan health officials to compile up-to-date information about graduates’ specialized skills. The program also employs Accenture's proprietary learning content development approach that enables the efficient conversion of paper-based material to the e-learning format, including instructional topics, imbedded photographs and graphics, and online assessments to evaluate a student’s proficiency.
As the program progressed, AMREF determined that in order to effectively address the nursing shortage, it needed to reach nurses in the more remote areas of Kenya that have limited public transportation. Therefore, the number of e-learning centers to be established across Kenya to deliver the e-learning solution was substantially increased, with the objective of making the training more accessible to Kenya’s remote nursing population.
One of the primary goals of the e-learning initiative is self-sufficiency. The project was designed to gradually transfer skills and knowledge from Accenture, giving AMREF an increasing ability to manage the technological elements of the program, as well as to lead efforts to provide local Kenyan support and coordination. By educating AMREF to administer and expand the project on its own, the organization will not be as dependent on outside help after the initial five-year ramp-up period and will better enable it to develop similar programs in Kenya and other African nations.
AMREF is on schedule to achieve its goal of certifying nearly 20,000 registered nurses by 2011. Four modules consisting of 143 hours of training have been developed and deployed. The help desk and learning management system have been rolled out. More than 100 e-learning centers—many in the remotest areas of Kenya—have been established to deliver the e-learning training, and 27 nursing schools have also implemented the program. To date, more than 2,000 nurses have enrolled in the e-learning program with enrollment expected to peak in 2008. The first graduation of nurses is scheduled for September 2007.
Additionally, knowledge transfer to AMREF personnel—including content development, technology and program management skills—is complete. In the words of Jo Ensor, chief executive of AMREF UK, “The skill transfer that has taken place between Accenture and AMREF has added huge value to this innovative project. From the start, Accenture placed great emphasis on transferring knowledge and capacity to AMREF’s team in Kenya. They have helped develop one of AMREF’s strongest project teams. I’ve seen many AMREF employees transformed by the experience of working with Accenture, both in terms of their project management skills and their confidence. This has had a positive and sustainable impact on AMREF, our people and the project.”
The 20,000 newly trained registered nurses the initiative will create over the next five years will be dispersed throughout Kenya—a complete departure from what could be done employing traditional classroom methods. These nurses represent a staggering increase in the number and skills of frontline health care workers. They will be skilled at treating Kenya’s most debilitating diseases, such as HIV/AIDS and malaria, as well as at administering preventative treatment—vaccinations, pre- and post-natal care—in the nation’s remote and most impoverished areas. The e-learning courseware also trains nurses in disaster management and how to respond to man-made and natural catastrophes familiar to Kenya, such as famine.
This visionary e-learning program is groundbreaking on many fronts. It represents one of the first uses of e-learning to train health professionals in Africa, improving the quality of training while drastically reducing the time it takes to certify registered nurses. Additionally, the learning management system provides an invaluable tool as it enables Kenyan health officials to match skilled resources with specific needs.
AMREF and Accenture have reinvented the education process by harnessing the potential of computer-based learning to dramatically advance Kenya’s medical training capabilities. Already, AMREF is preparing to replicate Kenya’s e-learning model in other African nations. According to Peter Ngatia, director of learning systems for AMREF, “This program is not only going to drastically improve the health system in Kenya, it is also going to be replicated by other countries—and the positive impact on Africa’s health system will be enormous.”
“Accenture has helped AMREF introduce a training model that is truly sustainable. This is just the beginning of what we hope will be an e-learning revolution that will enable Kenya as well as the world’s poorest nations to use technology to curb disease and improve the quality of lives,” says Matthew Edwards, the Accenture senior executive sponsor overseeing the relationship with AMREF.
According to Ellen Balaguer, managing director-BPO Services, Accenture, “This program has provided a special opportunity to leverage our technology, resources and the expertise of our people to help solve a serious health care crisis in Africa. It has been a very rewarding experience for our people to work with the AMREF staff, and we look forward to seeing how this program is replicated throughout Africa.”
AMREF and Accenture have been recognized for their contributions and global efforts on this program, including 2006 Gold Medal Laureate for the ComputerWorld Honors Program and a profile in the 2006 Global Corporate Citizenship Report (US Chamber of Commerce). The AMREF e-learning program has also been featured in the Financial Times and the CNN documentary Inside Africa.
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