Nursing and Midwifery Education in Togo: needs assessment

Thanks to a partnership development grant from the Tropical Health Education Trust (THET) and in collaboration with Vision Togo, a UK-based charity, I recently spent 9 days in Togo, West Africa, with my colleagues Judith Sunderland and Professor Ros Bryar from the School of Health Sciences. The aim of the visit was to explore options for collaboration in teaching and learning and staff and student exchange and draft a formal partnership agreement.

We visited the Ecole Nationale d’Auxilleres  Medicaux (ENAM), the nursing school, as well as the Ecole Sage Femmes (midwifery school) in Lome, the capital. We were also lucky to be able to visit the other nursing and midwifery schools in the north of the country, Kara, and got to see hospitals and rural clinics  across Togo. What we found was fantastic people providing good education in basic premises, and a chronically underfunded health service with skilled clinical staff working in very difficult conditions.

At present, lecturers in Togo need to leave the country and go to neighbouring Francophone countries such as Mali, Cote d’Ivoire or Burkina Fasso to complete an educational programme like our Academic Practice course. This results in few qualified lecturers, as leaving your family for up to a year is an unpopular choice for most. This proved to be one of the most pressing concerns for our Togolese educational partners and supporting the development of a Togolese PGCE equivalent has formed the basis of our partnership agreement. We are working with LEaD towards adapting City’s MA Academic Practice and setting up and teaching this new programme in Togo from 2017, with a view to our Togolese partners taking on the teaching and running of the course after that.

We also found that clinical training equipment was very out of date, the college libraries very sparse and internet access almost non-existent. The latter issue is not helped by the fact that the electricity supply is patchy, with regular power cuts; all these factors (along with the relentless heat!) conspire to make teaching and learning nursing and midwifery in Togo a challenging enterprise.

Hospitals and clinics work out of extremely basic and severely out of date premises, but screening/recall and other systems, despite being entirely manual, are very good. The infant and maternal mortality rates remain high in Togo, with high incidences of infection, malaria, diarrhoeal diseases and TB. Nurses and midwives are struggling with providing a service with limited resources to a very poor population and the effects of this can be seen everywhere.

Community staff struggle to visit rural villages and currently have to walk all day to do their rounds, or take a taxi. Raising some funds to support the purchase of a couple of motorcycles has been added to our list of priorities in the partnership agreement with the Togolese Ministry of Health, a draft of which was collaboratively developed during our visit.

Since our return in late April we have met with the Togolese ambassador and other embassy staff.  They are very supportive of the proposed partnership and draft agreement which we plan to have signed off as soon as possible. This will be followed by a the submission of a full bid to THET to enable all partnership and exchange activity.

Rosa Benato

Senior Lecturer, Education Development,

School of Health Sciences