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Evaluation of Pre-service curriculum

Evaluation of the curriculum on immunisation at nursing and midwifery schools in West Java Province, Indonesia, 2015-Present

The University of Antwerp has a long-standing collaboration with the University of Padjadjaran (UNPAD) in Bandung, Indonesia, with activities initiated in the early 1980s. Priority domain of the collaboration between the Faculty of Medicine of UNPAD and the Department of Epidemiology and Social Medicine of the University of Antwerp was institutional strengthening and capacity building in teaching and research, formalised through regularly-updated Memoranda of Understanding.

Within the scope of this MoU, the Faculty of Medicine and Faculty of Nursing of UNPAD and NESI/University of Antwerp strengthened their collaboration in the area of vaccine-preventable diseases starting in 2014. The South-East Asian Region (WHO/SEARO) is the one most lagging behind regarding new vaccine introduction and immunisation programme strengthening. This has considerable impact on childhood morbidity and mortality, as by far the greatest birth cohorts are in this region. Strengthening national immunisation programmes and supporting the introduction of new vaccines will further reduce the morbidity and mortality of vaccine-preventable diseases.

A joint operational research study entitled “Evaluation of the curriculum on immunisation at nursing and midwifery schools in West Java Province, Indonesia” was initiated in 2015. The objectives of this study include: (1) to map which EPI-related topics are taught; (2) to list materials and demonstration equipment used in EPI teaching; (3) to evaluate knowledge on EPI of students and lecturers; and (4) to determine strengths, gaps and training needs. Ethical approval for the study was obtained from the Health Research Ethics Committee of the Faculty of Medicine of UNPAD.


A preparatory visit took place in November 2015, and data collection was conducted from 8-22 January 2016. The data collection was supported by two medical students of the University of Antwerp, participating in the study in the framework of their master thesis, together with two tutors of the Faculty of Nursing of UNPAD. A total of 7 training institutions, including 15 nursing and midwifery programmes were evaluated. The target population included coordinators and lecturers of EPI classes, clinical instructors conducting internships, and nursing and midwifery students. Data were collected through semi-structured interviews and focus group discussions.

Preliminary results indicate that all nursing and midwifery schools have EPI included in their training package, but a wide degree of variation was observed between the schools regarding immunisation-related content in the curriculum, time allocation, teaching methods, and evaluation. The study also suggests that EPI-related education is more extensive in midwifery programmes than in nursing programmes.

The results and recommendations from the study will be shared with all participating institutions and the immunisation programme in West Java, and will be used to strengthen EPI training at nursing and midwifery schools. The two medical students from the University of Antwerp completed their MSc theses successfully in June 2017. Results will be further disseminated through presentations at symposia and through publications.


Technical competencies of nurse lecturers on Expanded Programme of Immunization training, Kenya Medical Training College (KMTC), 2014 – Present

Kenya Medical Training College (KMTC), in collaboration with NESI/University of Antwerp, initiated a field based study in 2014 to assess the “technical competencies of nurse lecturers on the Expanded Programme on Immunization in Kenya Medical Training College.” With its network of colleges across the country, KMTC is one of Kenya’s leading health training institutions, training up to 90% of the health workforce. This study is a follow-up of the evaluations carried out in nine African countries – including Kenya – in 2011, assessing the status of EPI training at pre-service health training institutions. In Kenya, KMTC is taking the lead in driving the EPI pre-service curriculum implementation at the nursing schools.

The aim of the study was to determine the technical competences (knowledge, skills and attitudes) of nurse lecturers in EPI at KMTC. The study also aimed to determine factors that could influence EPI competencies among nurse lecturers and to propose recommendations to address their needs.

Ethical approval was obtained by the KMTC ethical research committee and by the National Commission of Science and Technology and Innovation. In addition, all participants signed a consent letter.

Before the start of the study, enumerators were trained on data collection and a pilot study was conducted in one of the colleges. The survey was conducted in 23 nursing colleges. A total of 117 lecturers and 23 nursing colleges heads participated in the study. A descriptive cross-sectional study design was used to collect quantitative key informant interviews, focus group discussions and observations. Purposive sampling was used to select the lecturers from the 23 nurse training colleges.


Related materials:

EPI Prototype Curricula for the Nursing/Midwifery Schools in the WHO/AFRO Region

WHO Regional Office for Africa, 2015

Data were collected during 2014-2015. The study found that socio-demographic, individual characteristics and institutional factors directly or indirectly influenced technical competencies of the nurse tutors in the implementation of the EPI pre-service training programme. The main findings of the study indicate that: (1) a significant number of respondents did not recently participate in refresher courses aiming at boosting tutors’ competencies in teaching EPI; and (2) institutional factors like staffing, number of students, and quality of teaching materials and equipment directly affect the nurse tutors’ performance in teaching EPI.

Thus, the following recommendations were identified to improve the quality of EPI training given by nurse tutors at KMTC:

  1. Development of a staff capacity improvement programme to ensure continued education of the EPI tutors, while nurse tutors are encouraged to assume personal responsibility for their own academic advancement;
  2. Development of clear staff profiles with corresponding required academic competencies;
  3. Ensuring adequate facilities, teaching materials and equipment;
  4. Standardising the number of hours of EPI theory and clinical training; and
  5. Standardising the maximum number of students per class.

The results of this study  were presented during the 4th Kenya Medical Training College Scientific Conference, organised from 8-10 June 2016 in Nairobi, Kenya.

Following the recommendations, a workshop to introduce the revised WHO/AFRO EPI prototype curriculum will be organized for the KMTC colleges during 2017. The process of the EPI curriculum revision will be led by a representative from KMTC, who also participated in the revision of the WHO/AFRO EPI prototype curriculum for nursing/midwifery schools.

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    Last updated: Jun 4, 2021
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