ORIGINAL RESEARCH

 

Integrating Prevention of Mother to Child HIV Transmission competencies into the nursing curriculum: Methodological lessons from a university-based undergraduate programme

 

 

Nomafrench Mbombo; Million Bimerew

School of Nursing, University of the Western Cape, South Africa

Correspondence

 

 

---

ABSTRACT

South Africa (SA) has the highest number of women infected with HIV and AIDS during pregnancy, which results in more than 70 000 infected babies being born each year AIDS is the major contributor to maternal and child morbidities and mortalities in the country. To combat this, the SA government has developed a national policy to prevent mother-to-child HIV transmission (PMTCT). However, for effective implementation of this policy, there is a dire need for a competent, skilled health worker to render the service. In response to this, the School of Nursing at the University of the Western Cape has integrated PMTCT competencies into the undergraduate Bachelor of Nursing Science curriculum. In this paper, we described teaching and learning approaches used to integrate PMTCT competencies, including the skills laboratory methodology and case-based learning, as well as a portfolio of evidence assessment tool. A quantitative descriptive design was used to analyse data collected from students in regard to assessment of PMTCT competencies achieved. The study used the conceptual framework of Lenburg's competency outcomes and performance assessment model, which focuses on competency development and assessment in a clinical environment. HIV competencies, including PMTCT, should be integrated both theoretically and at service delivery into other nursing and midwifery competencies, including assessment strategies. Provincial policies in provision of antiretrovirals by nurses and midwives become barriers to successful implementation of PMTCT, resulting in limited learning opportunities for students to practice PMTCT competencies. Further research is required to assess an attribute, affect, which is another prong for competencies.

---

 

 

“Full text available only in PDF format”

 

 

References

Blumenthal, S., 2012, Making AIDS history: Achieving an HIV-free generation, viewed 30 July 2012, from http://www.huffingtonpost.com/susan-blumenthal/international-aids-conference_b_1694865.htm        [ Links ]

Burns, N. & Grove, S., 2009, The practice of nursing research. Appraisal, synthesis and generation of evidence, Elsevier, St Louis.         [ Links ]

Chikering, A. & Gamson, Z., 1987, 'Seven principles for good practice in undergraduate education', American Association of higher education Bulletin 39(7), 5-10.         [ Links ]

Doherty, T., Chopra, M., Nsibande, D. & Mngoma, D., 2009, 'Improving the coverage of the PMTCT programme through a participatory quality improvement intervention in South Africa', BMC Public Health 9, 406. http://dx.doi.org/10.1186/1471-24589-406        [ Links ]

Fullerton, J. & Thompson, J., 2005, 'Examining the evidence of the International Confederation of Midwives' essential competencies for midwifery practice', Midwifery 21(1), 2-13. http://dx.doi.org/10.1016/j~.midw.2004.10.004        [ Links ]

Ginsbury, A.S., Hoblitzelle, C.W., Sripipatana, T.L. & Wilfert, C.M., 2007, 'Provision of care following prevention of mother-to-child HIV transmission service in a resource limited setting', AIDS 21(18), 2529-2532. http://dx.doi.org/10.1097/QAD.0b013e3282f155f4, PMid:18025890        [ Links ]

Gordon, R., 1994, 'Keeping student at the centre: Portfolio assessment at the college level', Journal of experimental education 17(1), 23-27.         [ Links ]

International Confederation of Midwives, 2011, The state of the world's midwifery report, viewed 30 June 2011, from http://www.unfpa.org/sowmy/resources/docs/main_report/en_SOWMR_Full.pdf        [ Links ]

International Labour Organization, 2009, 'HIV/AIDS and the world of work', in ILO (ed.), Proceedings of the 98th International Labour Conference, report IV(1), Geneva, Switzerland, 03-19 June.         [ Links ]

Israel, E. & Kroeger, M.C., 2003, Integrating prevention of mother-to-child transmission of HIV into existing maternal, child and reproductive health programs, viewed 14 July 2010, from http://www2.pathfinder.org/site/DocServer/Technical_Guidance_Series_3_PMTCTweb_01.pdf?docID=242        [ Links ]

Lenburg, C.B., 1999, 'The framework, concepts and methods of the competency outcomes and performance (COPA) model', Online Journal of Issues in Nursing (4)3, viewed 10 July 2010, from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/ Volume41999/No2Sep1999/COPAModel.aspx        [ Links ]

Lenburg, C. & Mitchell, C.A., 1991, 'Assessment of outcomes: The design and use of real and stimulation nursing performance examinations', Nursing & Health Care 12, 68-74. PMid:1996172        [ Links ]

MacIsaac, D. & Jackson, L., 1994, 'Assessment processes and outcomes: Portfolio construction', in L. Jackson & R.S. Caffarella (eds.), Experiential learning: A new approach. New directions for adult and continuing education, pp. 63-72, Jossey-Bass, San Francisco. http://dx.doi.org/10.1002/ace.36719946205        [ Links ]

McIntyre, J. & Gray, G., 2000, 'Preventing mother-to-child transmission of HIV', Medicine (1)1, 30-31.         [ Links ]

Melrose, S., 2004, 'What works? A personal account of clinical teaching strategies in nursing', Education for Health 17(2), 236-239. http://dx.doi.org/10.1080/13576280410001711067        [ Links ]

Mitchell, G.C., 2009, 'Adult learning and high stakes testing strategies for success', Adult Learning 15(3/4), 16-18.         [ Links ]

National Department of Health, 2007, Saving mothers report, National Department of Health, Pretoria.         [ Links ]

National Department of Health, 2010a, Country progress report on the declaration of commitment on HIV/AIDS, viewed 11 July 2012, from http://data.unaids.org/pub/report/2010/southafrica_2010_country_progress_report_en.pdf        [ Links ]

National Department of Health, 2010b, Negotiated service delivery agreement document, National Department of Health, Pretoria.         [ Links ]

National Department of Health, 2011, Prevention of mother to child HIV transmission (PMTCT) policy guidelines, National Department of Health, Pretoria.         [ Links ]

Pathak, L., Kwast, B. & Mallah, D., 2000, 'Process indicators for safe motherhood programmes: the application and implications as derived from hospital data in Nepal', Tropical Medicine & International Health 5(12), 882-890. http://dx.doi.org/10.1046/j.1365-3156.2000.00662.x        [ Links ]

Perez, F., Mukotekwa, T., Miller, A., Orne-Gliemann, J., Glenshaw, M. & Chitsik, I. et al., 2004, 'Implementing a rural programme of prevention of mother-to-child transmission of HIV in Zimbabwe: First 18 months of experience', Tropical Medicine and International Health 9, 774-783. http://dx.doi.org/10.1111/j.13653156.2004.01264.x        [ Links ]

Quinn, F.M., 2001, Principles and practice of nurse education, Neson Thornes Ltd., London.         [ Links ]

Schmidt, B.S., 1999,'Constructing curriculum: Creating ateaching-learningspace', Nursing Sciences Quarterly 12(4), 297-298. http://dx.doi.org/10.1177/08943189922107214        [ Links ]

Temmerman, M., Quaghebeur, A., Mwanyumba, F. & Mandaliya, K., 2003, 'Mother-to-child HIV transmission in resource poor settings: How to improve coverage?', AIDS 17(8), 1239-1242. http://dx.doi.org/10.1097/00002030-200305230-00016        [ Links ]

Treatment Action Campaign, 2009, Address by the President of the Republic of South Africa, Mr. Jacob Zuma, to the National Council of Provinces (NCOP), viewed n.d., from http://www.tac.org.za./community/node/2767        [ Links ]

United Nations Programme on HIV/AIDS and World Health Organization, 2009, Integrating prevention of mother-to-child transmission of HIV into existing African health care system, viewed 16 July 2010, from http://data.unaids.org /pub/Report/2009 /JC1700_ Epi_Update _2009 _en.pdf        [ Links ]

Wagner, S. & Ash, K., 1998, 'Creating the teachable moment', Journal of Nursing Education 37, 278-280. PMid:9749819        [ Links ]

Welty, T.K., Bulterys, M., Welty, E.R., Tih, P.M., Ndikintum, G; Nkuoh, J. et al., 2005, 'Integrating prevention of mother-to-child transmission of HIV into routine antenatal care: the key to program expansion in Cameroon', Journal of Acquired Immune Deficiency Syndromes 40(4), 486-493. http://dx.doi.org/10.1097/01.qai.0000163196.36199.89        [ Links ]

White, R. & Ewan, C., 1991, Clinical teaching in nursing, Nelson Thomas Ltd.,London, PMid:2002672        [ Links ]

World Health Organization, 2010, PMTCT strategic vision 2010-2015: Preventing mother to child transmission of HIV to research the UNGASS and Millennium Development Goals, WHO Press, Geneva, viewed 22 July 2010, from http://www.who.int/hiv/pub/mtct/strategic_vision.pdf        [ Links ]

World Health Organization, United Nations Children Fund, United Nations Programme on HIV/AIDS & United Nations Population Fund, 2007, HIV and infant feeding: Framework for priority action, WHO Press, Geneva, viewed 10 May 2010, from http://www.who.int/hiv/pub/mtct/infant_feeding/en/index.html        [ Links ]

Wright, W.A. & Barton, B., 2001, 'Students mentoring portfolio development', in J.E. Miller, J.E. Groccia & M.S. Miller, (eds.), Student assisted teaching: A guide to faculty student teamwork, p. 60-76, Anker, Bolton.         [ Links ]

Yip, H.K., Smales, R.J., Newsome, P.R.H., Chu, F.C.S. & Chow, T.W., 2001, 'Competency-based education in a clinical course in conservative dentistry', British Dental Journal 191(9), 517-522. http://dx.doi.org/10.1038/sj.bdj.4801221a        [ Links ]

 

 

Correspondence:
Nomafrench Mbombo
Private Bag X17
Bellville, 7535, South Africa
Email: nmbombo@uwc.ac.za

Received: 04 July 2011
Accepted: 28 Sept. 2012
Published: 14 Oct. 2012