National Training Operational Plan 2013 to 2016 · National Training Operational Plan 2013 to 2016. 1 ... This National Training Operational Plan ... capacity of existing training

Ministry of HealthGovernment of the Republic of Zambia

National Training Operational Plan2013 to 2016

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Foreword

This Operational Plan aims to summarize the current situation in health training institutions acrossthe country and evaluate the progress made against the 2008 National Training Operational Plan(NTOP), including improvements in infrastructure and changes in enrolment at individual schools.Furthermore, the document provides information for increasing the overall training capacity ofvarious critical health care providers in line with the national scale-up plan for health care workers inZambia.

The Operational Plan is an effort made by Ministry of Health in collaboration with cooperatingpartners to address the human resources in health crisis that Zambia is experiencing. It is specificallytargeted towards increasing the number of graduates from health training institutions, both grant-funded and non-grant-funded.

The training institutions covered in this operational plan include government, mission, and privatelyowned Nursing and Midwifery Schools, Biomedical and Paramedical Colleges, Medical Schools andprivate Universities. It is envisaged that implementation of the activities in this document willfacilitate the achievement of our vision of providing cost-effective, quality health services as close tothe family as possible. NTOP implementation will contribute towards attainment of health relatedMillennium Development Goals (MDGs) and other national health priorities in a clean, caring andcompetent environment. This will ensure equity of access in health service delivery and contributeto the human and socioeconomic development of the nation.

The Ministry of Health wishes to encourage all stakeholders to continue their strong commitment tothe implementation of this operational plan over the next four years, as a part of the greater effortto address Zambia’s HRH crisis.

Hon. Dr. Joseph KasondeMinister of HealthLusakaMay, 2013

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AcknowledgementsThe 2012 assessment and development of the updated National Training Operational Plan (2013 -2016) was successful due to the active support and dedication of many different stakeholdersinvolved in Zambia’s health sector. I wish to recognize the dedication of all those involved, bothdirectly and indirectly, whose contributions and insights helped to ensure that this Plan is of thehighest quality.

The Plan was developed through a participatory and consultative approach, with contributions andinsight from management and staff across many different levels of the Ministry of Health; GeneralNursing Council (GNC); Health Professions Council of Zambia (HPCZ); the University of Zambia (UNZASchool of Medicine); Ministry of Science Technology and Vocational Training, the CooperatingPartners and the principal tutors in every health training institution across Zambia both public andprivate. Special thanks go to staff in the Ministry of Health.

On behalf of the Ministry of Health, I also wish to acknowledge the financial and technical support ofthe Swedish International Development Agency, as well as the Clinton Health Access Initiative(CHAI), who provided the financial and technical assistance for the development of the operationalplan. I thank them for their zeal and commitment to the collection and analysis of data.

I am aware that the implementation of this Plan will pose many challenges, but with thecommitment and cooperation of all stakeholders, both those mentioned here, and other unnamedcontributors, I strongly believe that the goals outlined in this Plan may be attained.

Dr. Peter MwabaPermanent SecretaryMinistry of Health

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Table of ContentsForeword.................................................................................................................................................1

Acknowledgements.................................................................................................................................2

Table of Contents....................................................................................................................................3

List of Tables and Figures ………………………………………………………………………………………..………………………. 4

List of Acronyms ……………………………………………………………………………………………………………………………... 5

Executive Summary………………………………………………………………………………………………………………………….. 6

Introduction ............................................................................................................................................8

Objectives of the National Training Operational Plan ……………………………………………………………......…. 10

PART ONE: 2008 NTOP Evaluation ………………………………………………………………………………………….……… 10

Background ...........................................................................................................................................10

Methodology.........................................................................................................................................12

NTOP assessment tool development............................................................................................12

Data Collection..............................................................................................................................13

Analysis and Reporting..................................................................................................................13

Findings and Results of Data Analysis ...................................................................................................13

Focus area 1 – Health Care Worker production ...............................................................................13

Student Enrollment Numbers .......................................................................................................13

Graduate Numbers .......................................................................................................................16

Focus area 2 – Quality of Education .................................................................................................19

Focus area 3 - Infrastructure.............................................................................................................21

Focus Area 4 – Finance .....................................................................................................................22

2012 NTOP RECOMMENDATIONS ........................................................................................................25

PART TWO: NTOP 2013 to 2016 …………………………………………………………………………………………………..… 50

Operational Plan 2013 to 2016 ……………………………………………………………………………………………………… 51

ANNEXES ...............................................................................................................................................72

1. Map of Training Institutions .....................................................................................................73

2. Training Institution Profiles ......................................................................................................74

3. NTOP Survey Tool....................................................................................................................152

4. Cost of Training, by Cadre .......................................................................................................163

5. List of Assessed Infrastructure Projects from Contracted Quantity Surveyor……………..……...165

6. Tracking of 2008 NTOP Recommendations: Progress from 2008 to 2012…………………….….. 167

7. Estimated Student Enrollment Numbers for Health Training institutions……………………..….. 172

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List of Tables and FiguresFigure 1: Healthcare worker gap to funded establishment, 2012 data .................................................8

Figure 2: Health workforce projection, 2014 to 2020 ............................................................................9

Figure 3: Increases in HCW enrollments and graduates, 2008-2012, and HCW projections based oncurrent growth rates, 2013-2020……………………………………………………………………………..……….…………. 14

Figure 4: Enrollment, by Cadre, 2008-2012, compared to 2007 Baseline and Target set in 2008 NTOPReport ………………………………..………………………………………………………………………………………………………... 15

Figure 5: Pre-Service vs. In-Service Enrollment, vs. 2012 targets, by Cadre ….……………………………….. 16

Table 1: Numbers of annual graduates per cadre, 2008 – 2012 ……………………………………………………...17

Table 2: Health Worker Graduate Projections 2013 to 2020 …………………………………………………………. 18

Figure 6: Number of TIs operating within GNC tutor: student minimum ratio of 1:20 …………………. 20

Figure 7: Achievement of 2012 enrolment targets by 2008 NTOP Funded TIs ……………………………….. 22

Table 3: NTOP infrastructure project budget and expenditure …………………………………………………….. 23

Table 4: Category of TI by NTOP Project Funding Status, comparing Activities and Expenditures ……23

Table 5: TIs operating parallel programs ……………………………………………………………………………………….25

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List of AcronymsBScCHAICICMCMECPDCPsDEMDNSEMENFTEGNCGRZHCWsHMISHPCZHRHMCDMCHMDGsMoEMoESTMoHMScNEPINTOPNHRHSPPSMDRNRMSIDASOMTEVETA

TIUNZAWHO

Bachelor of ScienceClinton Health Access InitiativeClinical InstructorsCertified MidwivesContinuing Medical EducationContinuing Professional DevelopmentCooperating PartnersDirect Entry MidwifeDepartment of Nursing SciencesEnrolled MidwifeEnrolled NurseFull-time EquivalentGeneral Nursing CouncilGovernment of the Republic of ZambiaHealth Care WorkersHealth Management Information SystemHealth Professions Council of ZambiaHuman Resources for HealthMinistry of Community Development Mother and Child HealthMillennium Development GoalsMinistry of EducationMinistry of Education, Science and TechnologyMinistry of HealthMaster of ScienceNurse Education Partnership InitiativeNational Training Operational PlanNational Human Resource for Health Strategic PlanPublic Service Management DivisionRegistered NurseRegistered MidwifeSwedish International Development Cooperation AgencySchool of MedicineTechnical Education, Vocational and Entrepreneurship TrainingAuthorityTraining InstitutionUniversity of ZambiaWorld Health Organisation

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Executive SummaryZambia continues to suffer from a significant shortfall of all health workers, operating at only 43% ofits funded establishment (FE) target for clinical Health Care Workers (HCWs). Furthermore, it is likelythat the current FE target significantly underestimates what Zambia’s need for HCWs will be by2020. Because the best means of increasing the number of HCWs working within Zambia is toincrease the nation’s HCW training outputs, it is critical that this is prioritized by all stakeholdersworking within this arena.

This National Training Operational Plan (NTOP) 2013 to 2016 report was developed to address thegap between Zambia’s current rate of HCW production and the demand for additional HCWs toserve the total health needs of the fast-growing Zambian population. The report consists of anintroduction to the NTOP, its main objective and the means to achieving this objective. Theremainder of the document is subdivided in to two parts. Part one consists of the findings from anevaluation of the 2008 NTOP, and results of data analysis with recommendations for how to moveforward in scaling up HCW production. Part two consists of a high level costed operational plan forimplementing the key NTOP 2013 to 2016 recommendations. This plan is time bound and includesoutput indicators and targets. The overall objective of the NTOP 2013 to 2016 is to have a clearstep-wise implementation plan for solving the Zambian HRH crisis by 2020.

The 2008 NTOP evaluation showed that the overall enrollment target for 2012, set back in 2008, hasbeen reached. However, some critical cadres, including midwives, clinical officers and environmentalhealth staff have fallen short of their specific targets. Enrollment increases are in part due to ‘self-sponsor’ students, allowing TIs to scale up without additional funding from government, orenrollments at private TIs. Self sponsored students are frequently required to procure their ownaccommodation, a strategy that has not been taken up by nursing/midwifery schools, restrictingtheir capacity to scale up.

Data on student to tutor ratios was gathered; fewer than 30% of TIs assessed were working withinthe present tutor: student minimum ratio. Many TIs cited a lack of qualified tutors available andproblems with staff appointments. This is a major constraint for TIs who wish to scale-up studentenrollments but still ensure that they are maintaining minimum educational quality standards.

The current status of all planned 2008 NTOP infrastructure projects was assessed. The project typesthat had the highest completion rates included the construction of classrooms (66% of projectscomplete), student accommodations (62%), and teacher accommodations (58%), as well as thefurnishing of various facilities (74%). Of the projects that were not completed, the poorest rates ofcompletion were found in the construction of lecture theatres (17% of projects complete) and skillslabs (25%).

The key recommendations coming out of the 2008 NTOP evaluation are as follows: Curriculum reviews: to ensure all nurses and clinical officers have core competencies in

emergency obstetric and newborn care. E-learning: to be scaled up for pre-service training, in-service training and continuing

medical education (CME) / continuing professional development (CPD). Two student intakes per year – combined with staff development to ensure adequate

numbers of skilled teachers for theoretical knowledge and practical skills acquisition.

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Day scholars – so accommodation available at the training institution is not the limitingfactor for enrolment scale up.

It is believed that if the above key recommendations from the NTOP 2013 to 2016 are fullyimplemented at all the training institutions (TIs) for all different cadres, the Zambian HRH crisiscan be resolved by 2020. With an overall estimated investment of USD $43,827,572 over the nextfour years, there can be a 147% increase in the number of students enrolled annually in presenthealth training institutions, from 3818 enrolled in 2012, to an expected 9450 enrolled in 2016. Withan additional investment of USD $15,094,340 over the next three years, there could be an additional1000 students enrolled annually at a new large scale National Training Institute in Lusaka.Furthermore if bonding / provisional licensing for all HCWs for a designated period of time can beadopted as policy, then increased numbers of new graduates will be available for deployment tovacant positions in public health facilities.

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38% 36% 48%

46%

100% 41%28%

43%

06,000

12,00018,00024,00030,00036,00042,000

Doctors ClinicalOfficers

Midwives Nurses Pharmacy Lab OtherHCWs

TotalClinical

CurrentMoH Target

IntroductionIn the last five years, the Ministry of Health (MoH) of the Government of the Republic of Zambia(GRZ) and cooperating partners (CPs) have initiated and implemented a number of interventionsresulting in an increased capacity to produce more health care workers (HCWs)nationally and deploythem more equitably within the public health sector, including:

Reopening closed nursing schools;

Expanding the physical capacity of existing training institutions to increase student intake;

Introducing new training programmes, including a pre-service Certified Midwives and a pre-service Post-Basic nursing degree and distance learning for nurses and midwives;

Opening new private training institutions; and

Placing HCWs into vacant positions to ensure a more equitable distribution across thecountry

Many of the above interventions were as a result of a National Training Operational Plan (NTOP)initiated in 2008. These efforts have increased the number of HCWs working in Zambia’s publicsector, and have been accompanied by increases in budgetary funds directed at both improvingHCW salaries and increasing the number of available positions within the government’s fundedestablishment (FE) for health workers. However the nation continues to suffer from a significantshortfall of all health workers, operating at only 43% of its clinical HCW target of 39,3601, as shownin Figure 1 below.

Figure 1: Healthcare worker gap to funded establishment, 2012 data

Given the estimated enrollment numbers per training programmes collected from all HCW traininginstitutions across the country (see annex 7) , adjusted for various attrition factors, the currentfunded establishment positions target is expected to be exceeded by 2020 as shown in Figure 2below. However, the estimated enrollment numbers are dependent on the TIs completing presentinfrastructure projects which have been budgeted for in the coming few years. It also assumes thatnursing schools take on additional day scholars who find their own accommodation outside of the TI.The enrollment numbers also include 6000 students predicted to be enrolled in to e-learning pre-service programmes.

1 Ministry of Health, Human Resources for Health Strategic Plan 2011-2015, WHO need-based target staffing methodology

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Figure 2: Health Workforce Projection, 2014-20202

2 MoH Human Resources for Health Strategic Plan, 2011-2015; excludes data from 2011-2012

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Objectives of the National Training Operational PlanThe overall objective of the NTOP 2013 to 2016 is to have a clear step-wise implementation plan forsolving the Zambian HRH crisis by 2020.

The specific objective of this NTOP is to increase the enrollment of HCW trainees so that the gapbetween HCW production and demand for HCWs is eliminated by 2020.

The means to achieving the above objective, which the NTOP 2013 to 2016 report will facilitate,include:

Having a shared understanding by all HRH stakeholders, as to the strategic directionrequired for resolution of the Zambian HRH crisis.

Identifying necessary resources for implementation of activities, including financialcontributions and technical expertise.

Seeking participation and commitment to the NTOP 2013 to 2016 implementation from GRZand health CPs.

Creating effective coordination and communication structures, to assign roles andresponsibilities for NTOP 2013 to 2016 implementation.

PART ONE: 2008 NTOP EVALUATION

BackgroundIn early 2008, the MoH produced an “Annual Training and Development Plan’ for HCWs which settargets for increasing each of the specific health cadres. To develop a costed, step-wiseimplementation strategy, a National Training Operational Plan (NTOP) assessment was carried out.This involved field visits to health Training Institutions (TIs) across Zambia. That assessment helpedall stakeholders to understand the training capacities of TIs; the challenges they faced to scaling upstudent numbers; what optimization strategies could be utilised to maximize HCW production withexisting resources available, and what further investments could be made to address specific TIbarriers to training scale-up.

Based on NTOP 2008 findings, the MoH agreed on cadre specific training scale-up targets, and withsupport from CPs they embarked on a rigorous rehabilitation and construction programme at 27selected health TIs (NTOP implementation Phase 1). Partially donor supported, MoH’s 2008 CapitalInvestment Plan (CIP) ZMK 32 billion (approximately USD 9 million) was invested in 26 nursingschools and 1 biomedical school during 2008/2009. The investments ranged from refurbishments tobuilding new infrastructure (classrooms, lecture theatres, student hostels, staff housing) or investingin teaching aids, vehicles etc. Unfortunately a number of other investments prioritized in the 2008NTOP were never completed due to shortfalls in funding from 2009 onwards.

It was against this backdrop that a National Human Resources for Health (HRH) consultative meetingwas convened in January 2012. The focus for the meeting was to discuss how to increase Zambia’s

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health workforce in the public sector. Among the key points raised was the need to refocus onimproving training outputs from health TIs, as highlighted in Objective B of the National HumanResources for Health Strategic Plan 2011 - 2015 (NHRHSP). Included in the meeting’s discussionswere concerns about the inadequate, up-to-date information on TI activities, and to what extent the2008 NTOP had actually been implemented. Following development of the NHRHSP 2011-2015 agroup was tasked to assess the 2008 NTOP to better understand the current situations of Zambia’shealth TIs and assist them in generating pragmatic, sustainable solutions to challenges in increasingtraining outputs, whilst maintaining minimum quality standards.

The 2012 NTOP assessment was carried out in 42 health TIs across Zambia; 19 GRZ, 8 Mission and 15Private Schools. While there are 47 TIs registered with both the General Nursing Council (GNC;training schools for nurses and midwives) and Health Professions Council of Zambia (HPCZ; trainingschools for all other health cadres), only 42 were training students at the time of the fieldassessments in May-July 2012. The remaining five institutions were not yet completed / functional,or still awaiting full accreditation to train students, and thus were not surveyed as a part of thisstudy.

The NTOP assessment tool collected data across the following areas: Program Overview (Enrollmentand Graduate numbers), Staffing Information, Quality of Education, Infrastructure, Equipment, andFinances. The overall objectives of the 2008 NTOP evaluation were:

1. To obtain a comprehensive assessment of ALL health training schools (GRZ, Mission, andPrivate) to provide school-specific requirements for each TI to meet training scale up targetsset by MoH in 2008.

2. To compare budgets for specific projects allocated for financial support at the 27 targetedtraining schools in the initial NTOP, against what financial support was actually received andwhat activities were actually carried out.

3. To determine options for strategic potential investments at various training institution thatwould assist MoH in meeting HRH funded establishment staffing targets.

4. To identify innovative strategies for optimizing the use of existing resources in TIs, that canallow scale-up in the number of students trained and share lessons learned from TIs that havedone so successfully.

5. To identify the 2008 NTOP’s impact to date, and which further investments could win the“greatest gain” in increasing HCW numbers, for the level of investment made.

This 2008 NTOP evaluation aims to provide an overview of individual training institutions activities todate, present key issues facing TIs, both at the individual and collective levels, and offerrecommendations for maximizing health institutions’ enrollment capacities.

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Methodology

NTOP assessment tool developmentThe assessment tool was developed through collaboration between representatives of the MoHDirectorates of Human Resources, Planning and Policy, Clinical Care Services and Diagnostics, PublicHealth and Research, and the Clinton Health Access Initiative (CHAI).

The 2012 NTOP evaluation was originally intended to measure the extent to which 2008 NTOP fundedactivities occurred at the original 27 health training schools targeted in phase one of the trainingoperational plan. However, as the process moved forward, stakeholders agreed that information wasneeded from all functional health TIs, either public or private to fully understand the capacity thatcould be utilized in a national scale up of HCWs.

A desk review of all TI assessments carried out prior to the 2008 NTOP was conducted, and the 2008NTOP report was reviewed to establish a qualitative baseline detailing the greatest challenges faced byTIs at that time. The 2008 NTOP data collection tool was then updated to ensure that the datacollected was comprehensive. Quantitative date was collected through the data collection tool, whilstqualitative data was also collected through stakeholder interviews.

Stakeholders’ feedback was requested and incorporated, and a pilot to test the assessment tool wasconducted in selected training schools around Lusaka. The questionnaire was adapted based onlearning from the pilot assessment, and a physical checklist was developed to assess the status ofthe projects planned for within the 2008 NTOP (see questionnaire and physical checklist in Annex 3).The final assessment tool collected data on the following thematic areas:

Theme Details

Contact Information Overview of the training school’s information, and key contact persons.

Program Overview Current details on the programs available at the school, estimated numberof applicants versus the enrollment numbers.

Student Details Overview of enrollment and graduate numbers over the past 5 years (2008– 2012).

Staffing Information Number of full time staff; number of staff transferred, retired and/orconfirmed over the last 3 years; ratios of tutors/lecturers to the number ofstudents.

Quality of Education Information on the use of current classroom space, any innovative (nonclassroom) based teaching methods being used, ratios of equipment (skillslaboratory, computers, textbooks etc.) to the number of students;

Infrastructure Checklist of infrastructure at the schools (those funded by NTOP - what hasbeen completed/incomplete or delayed or modified activities), numbers –student or staff- having benefited from the NTOP activities, information onaccommodation and transport.

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Data CollectionFive assessment teams of at least 4 people, including representatives of the Directorates of HumanResources and Administration, Planning and Policy, Clinical Care Services and Diagnostics or PublicHealth and Research, and the Clinton Health Access Initiative conducted the assessment, together withthe Provincial Clinical Care Specialist and the Provincial Nursing Officer from each Provincial HealthOffice. Each team was assigned assessment areas based on geographical distribution of the healthtraining schools, and each visited from 4 to 14 schools. The teams visited all 42 active health traininginstitutions across the 10 provinces of Zambia, including all GRZ, Mission and Private TIs. Moredetailed physical checks of infrastructure were done at the 27 TIs who benefited financially from theinitial NTOP 2008/09 phase 1.

Four TIs were excluded, as they had not yet started training HCWs at the time the survey wasconducted. These included Senanga School of Nursing, Cavendish University, and 2 other new TIs inCentral and Lusaka Provinces. Survey questions were posted to the TI’s Principal Tutor or TrainingSchool Administrator, as well as Tutors and Department Heads.

Analysis and ReportingData collected was analyzed and cleaned, and additional qualitative information collected duringdiscussions with TI staff, was used to fill data gaps, clarify ambiguities or enhance the informationprovided by the survey. Profiles for each individual TI were then prepared, summarizing each trainingschool’s progress and achievements, especially in reference to the NTOP Phase I, and highlighting keyareas of need.

Findings and Results of Data Analysis

Focus area 1 – Health Care Worker production

Student Enrollment NumbersZambia’s health training institutions have made significant progress since 2008 in increasing thenumber of students enrolled in and graduating from health care training institutions nationwide.This is illustrated by the graph below; as the average training program is between 2-3 years, one cansee this lag in the number of graduates from the time of enrollment.

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Figure 3: Increases in HCW enrollments and graduates, 2008-2012, and HCW projections based oncurrent growth rates, 2013-2020

2008 2009 2010 2011 2012Total %Increase

Compound AnnualGrowth Rate

(CAGR)Enrolled 2413 2666 3120 3736 3759 55% 9.2%Graduated 1720 1941 2389 2463 2497 45% 7.7%

Both enrollments and graduates increased significantly over this period. It is important to note,however, that these rates of increase are unsustainable, and enrolment figures will eventuallyplateau. The percentage increase in each number varies by cadre, as demonstrated in figure 4below.

1720

45362413

3818

2497

0

1000

2000

3000

4000

5000

6000

7000

8000

Enrolments

Graduates

9.2% Annual Increase

7.7% Annual Increase

7575

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Figure 4: Enrollment, by Cadre, 2008-2012, compared to 2007 Baseline and Target set in 2008NTOP Report

Overall, the enrollment target set in the 2008 NTOP has been reached. However, a few cadres,including midwives, environmental health staff and nutritionists have fallen short of their targets.While the number of nurses enrolled increased substantially, significant increases in enrollmentshave also been seen in non-nursing programmes. These increases are partly due to theimplementation of programs where students are able to ‘self-sponsor’, or pay for their owneducation, thus allowing the training institution to increase enrollment without additional fundingfrom government. Self sponsored students are frequently required to procure their ownaccommodation, or to pay more for housing within the institution than sponsored students. Thisstrategy has not been taken up by nursing schools, as they still attempt to provide housing for allstudents, creating issues in implementing such parallel nursing programmes.

When looking at the increased number of enrolments over the past years, it is also important toconsider the contribution of the 11 private schools (26% of the total TIs) that have opened since2008. They have collectively contributed 23 % of the increase in the number of students enrolledand 16% of the increase in the number of graduates from 2008 to 2012. These schools often have

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smaller capacities than the public institutions, with intakes averaging between 20 and 55 studentsper year, and therefore do not contribute proportionally to overall enrollments and outputs.

It is also worth noting that the number of students includes both pre-service and in-service students.This is especially noticeable for certain fields, including midwifery, which includes both direct-entryCertified Midwifery (2 years) and direct-entry Registered Nursing/Midwifery (3.5 years), as well as in-service Enrolled & Registered Midwifery programmes (1 year upgrades). A majority of Nurse Tutorsare also in-service trainees, as are all Specialist Nurses and Medical Licentiates. As a result, theactual number of health workers that enrolled in 2012 and will be entering the system as NEWhealth workers is 3299, over 400 below the 2012 target.

Figure 5: Pre-Service vs. In-Service Enrollment, vs. 2012 targets, by Cadre

Graduate NumbersThere has been a 33% increase overall in annual number of healthcare worker graduates between2008 and 2012. However, this increase largely depends on the cadre. Some cadres, such as nurses,had significant increases in enrollment following investments resulting from the 2008 NTOP, the

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results of which have been felt in recent years. Doctors, on the other hand, have a training period of7 years, so graduate numbers for 2012 are dependent on enrollment in 2005, and the impact of anyincrease in enrollment, such as the increase from 56 to 118 between 2009 and 2010, will not be feltuntil 2016. The number of clinical officers and medical licentiates also decreased, however, thischange was due to a program scale-up with the expectation of funding, and then when that fundingdid not come through from GRZ, programs were forced to reduce their numbers.

Table 1: Numbers of annual graduates per cadre, 2008 – 2012

Cadre 2008 2009 2010 2011 2012

% increasechange from2008 to 2012

CompoundAnnual Growth

Rate (CAGR)

Doctors 67 50 48 73 65 -3% -0.6%

Nurses 844 1023 1205 1413 1425 69% 11.0%Midwives 220 270 298 346 345 57% 9.4%

Clinical Officers 130 181 246 71 82 -37% -8.8%

Other 459 417 592 560 580 26% 4.8%

TOTAL 1720 1941 2389 2463 2497 45% 7.7%

While this significant increase in nurses and midwives is critical given the focus on MDG 4 and 5targets, by providing HCWs with the skills to save unnecessary loss of life in mothers and youngchildren, as mentioned above, a large portion of the increase in nurses is in specialty nurses, all ofwhom are in-service trainees. Specialty nurses have a reduced chance of serving in rural areas, asthere are few positions for them on the funded establishment in these areas. As a result, the rate ofnew HCWs graduated is likely less than the 7.7% annual increase presented in Figure 3.

For some cadres the length of the training programme means that there is a significant lag timebetween enrolment and graduation, which is why both enrolment and graduation numbers need tobe taken in to consideration when doing workforce planning. HCW graduate projections based onthe number of students that are currently enrolled, by cadre, is shown below in table 2 and paints aclear picture of the health workers in the pipeline. Currently, if graduation rates remain consistentat 90%, projections indicate that 500 doctors will graduate between 2015 and 2019, over 500biomedical science professionals will graduate between 2013 and 2016, and over 3,400 nurses and600 clinical officers will graduate between 2013 and 2015.

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Table 2: Health Worker Graduate Projections 2013 – 20203

CadreProgramLength 2013 2014 2015 2016 2017 2018 2019 2020 TOTAL

Post Basic Nurse - Masters 8 5 17 4 4 4 34

Medical Doctor 7 32 50 106 131 212531

Post Basic Nurse - Bachelors 6 15 29 45 69 117275

Pharmacist 5 32 40 53 45 45215

Biomedical Scientist 4 110 154 151 162577

Environmental Health Scientist 4 21 27 24 45117

Physiotherapist 4 18 21 23 45107

Clinical Officer General 3 102 311 222635

Dental Technologist 3 0 7 07

Environmental Health Technologist 3 108 158 173369

Laboratory Technologist 3 103 114 134351

Pharmacy Technologist 3 93 99 104296

Physiotherapy Technologist 3 71 85 89245

Radiography Technologist 3 86 95 96277

Registered Nurse 3 643 746 9622351

Nutritionist 3 94 184 41319

Certified Midwife 2 94 92186

Enrolled Nurse 2 528 5541082

Medical Licentiate 2 27 2754

Registered Midwife 2 163 167330

Clinical Officer Specialists 1 1414

Enrolled Midwife 1 101101

Registered Nurse Specialists 1 114114

Dental Therapist 1 7272

General Counsellor 1 4646

3 With addition of enrolments at new TIs accredited in 2012, but enrolled first students after the NTOP assessment wascompleted. These include Cavendish University, City University College of Science and Technology and Kabwe College ofHealth Sciences

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Focus area 2 – Quality of EducationWith a scale-up in healthcare worker training numbers, it is crucial to ensure that the quality oftraining remains high. There are now more students in the classroom than ever before, and TIs havebeen pushed to continue scaling up without a proportional increase in government funding orresources, both infrastructure and otherwise. Some infrastructure expansion has occurred (ex.additional classrooms, lecture theatres, hostels) but the enrollment expansion has been that muchgreater than the infrastructure expansion. There are concerns as to whether the quality ofeducation being provided may have changed, and TIs must work to ensure that they meet standardsset.

One major factor that dictates the quality of the education provided is the presence of a sufficientnumber of tutors and lecturers to teach the large student population in both theory and clinicalpractice.

Initial data collected in 2008 NTOP compared to the 2012 NTOP survey revealed that the number oftutors increased from 253 to 413, an increase of 160 tutors (63%), but still short of the 2008 NTOPgoal of 171 additional tutors. The schools that were not surveyed in 2008 reported 30 tutors in2012, bringing the total number of health TI tutors to 443, a shortfall of 114 tutors needed nationallyfor TIs to meet the minimum tutor: student ratios, as required by the health regulatory bodies(discussed below).

The number of clinical instructors also increased significantly between 2008 and 2012, with a 100%increase seen at all 2008 NTOP TIs (from 66 to 132), reaching a combined total of 199 in 2012 at allTIs throughout Zambia. However, this value is still far from the over 820 Clinical Instructors requiredaccording to GNC and TEVETA required ratios for this cadre.

It is worth noting, however, that this increase is not necessarily representative of the true increase inthe number of tutors, as many TIs hire part time tutors, lecturers, and clinical instructors.Unfortunately the magnitude of this shortfall cannot be assessed with the data gathered in thisreport, as although TIs reported on both full-time and part-time staff, they did not report thenumber of hours that the part-time staff worked within each individual TI.

All TIs are required to meet minimum standards intended to ensure that a certain quality ofeducation is maintained. These standards include a specific number of students per tutor orlecturer, minimum academic requirements for student admission, and minimum levels of physicalequipment and infrastructure per students admitted. Those TIs that do not meet these minimumstandards may be placed on probation by their respective regulatory body (GNC or HPCZ) and thenre-assessed at the end of this probation period. If the TI still does not meet these minimumstandards, the school may be closed.

For example, the GNC has the following minimum tutor to student ratios:

Overall, for each TI 1 : 20 Theoretical sessions 1 : 50 Small group/practical sessions 1 : 10 Clinical 1 : 10

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Data on student to tutor ratios was gathered through the NTOP survey; only 29% of TIs assessedwere working within the present tutor: student minimum ratio.

Figure 6: Number of TIs operating within GNC tutor: student minimum ratio of 1:20

TI TypeCurrent Average

Tutor: Student RatioTutors

NeededTutors

Present GapGRZ/Mission 1 : 25.5 507 403 104Private 1 : 18.6 50 40 10Nursing 1 : 24.8 263 191 72Non-Nursing 1 : 19.2 294 252 42Urban 1 : 20.2 415 353 62Rural 1 : 28.5 142 90 52ALL TIs 1 : 23.1 557 443 114

Private TIs reported the lowest tutor: student ratios, however, they also reported a higherpercentage of part-time staff than GRZ/Mission institutions, so this value may be artificially high. TheNon-nursing TIs, on average, also met the required tutor: student ratio; the average among urban TIsfell just above the required ratio.

When asked for reasons why they were unable to meet these minimum ratios, many TIs cited a lackof qualified tutors available, problems with staff appointments, with either a lack of funded positionson the establishment to employ the necessary number of tutors, or a promotion/transfer processthat leads to delays in the disbursement of staff remuneration. This is a major constraint for TIs whowish to scale-up student enrollment numbers but still ensure that they are maintaining minimumeducational quality standards.

Although an insufficient number of qualified instructors persists, graduation pass rate trends atnursing TIs have remained largely stable over recent years, averaging 87% between 2008 and 2011.Given that the national licensing exams for nurses and midwives are set and regulated by the GNCwith few fundamental changes from year to year, this rate can be used as a measure of consistencyin the quality of education provided. Comprehensive historical pass data was not available from

8

4

9

24

9

0

5

10

15

20

25

30

GRZ/Mission Private Nursing

20





NeededTutors





9

4

9

4

24

7

19

13

Nursing Non-Nursing Urban Rural

Met

Unmet

71% of all TIs donot meet the

required ratio of1:20

20





NeededTutors





Met

Unmet

71% of all TIs donot meet the

required ratio of1:20

21

non-nursing cadres, however, so no conclusions can be drawn regarding the pass rates of othercadres.

Focus area 3 - Infrastructure

Following the 2008 NTOP report and planning cycle, there were 132 projects planned for the yearsof 2008-2012. Investments planned ranged from construction, expansion, and outfitting of traininginfrastructure such as classrooms, student accommodations, faculty housing, and staff offices andskills laboratories.

During the NTOP 2012 field assessment a checklist was developed to assess the current status of allplanned 2008 NTOP infrastructure projects. Survey findings showed that:

120 projects received funding from MoH

78 projects were completed and are currently in use

42 projects were incomplete or delayed (27 of these are awaiting the completion ofinfrastructure work, 15 have been stalled indefinitely)

12 projects did not receive funding from MoH and thus were not begun

The projects types that had the highest completion rates included the construction of classrooms(66% of planned projects complete), student accommodations (62%), and teacher accommodations(58%), as well as the furnishing of various facilities (74%).

Of the projects that were not completed, the poorest rates of completion were found in theconstruction of lecture theatres (17% of planned projects complete) and skills labs (25%), as well asthe purchase or repair of vehicles (20%).

Only 5 TIs completed all of their infrastructure projects, for a total of 18 projects. These TIs include: Chipata School of Nursing & DEM Eastern Kabwe School of Nursing & Midwifery Central Kalene School of Nursing Northwestern Mufulira School of Nursing & Midwifery Copperbelt Ndola School of Nursing & Midwifery, & Theatre Copperbelt

In addition to these TIs, there were 19 that completed a portion of their infrastructure projects, for atotal of 60 out of 114 projects (52%).

There were four additional schools, School of Medicine, Chainama Hills College, Evelyn Hone College,and Solwezi Nursing School, that were evaluated in the 2008 NTOP report, but not included in thePhase I funding cycle for projects. Because there were no subsequent phases of funding after 2008,none of the projects that were identified as necessary to these training institutions were everfunded. These 37 additional projects were not included in the 132 listed above.

22

Findings demonstrated that there was little correlation between the completion of projects and aproportional increase in enrollment by 2012. Among schools that received NTOP funding, those thatshowed the highest enrolment increases were the TIs that strategically completed all components ofa project, including construction, appropriate outfitting, and furnishing. Of the 23 TIs that received2008 NTOP funding, 10 reached enrolment targets laid out for 2012, and 13 did not.

Figure 7: Achievement of 2012 enrolment targets by 2008 NTOP Funded TIs

TIs that did not reach the 2012 enrolment targets set in the 2008 NTOP may not yet have achievedtheir full enrolment potential, as there were a number of delays in project execution, includinglengthy procurement processes and other delays in construction.

Three schools (Chainama, Evelyn Hone, and School of Medicine) made the greatest contribution toincreasing enrolment without receiving any funding through the NTOP. These schools did receivefunds from other sources, both from the government and from outside contributors, to completespecific projects. All three of these TIs are large, urban schools, located in Lusaka, and had greaterpotential for expansion due to their locations and their ability to address accommodation andfinancial constraints by taking on self-funded day scholars. Public transport is also more easilyaccessible allowing day scholars to reach the TI for classes each day.

Focus Area 4 – FinanceThe total budget for the planned infrastructure projects outlined in the 2008 NTOP was estimated atZMK 28.1billion, equivalent to USD $5.51 million4. Recipients surveyed during 2012 NTOPassessment field visits reported that they had received a total of ZMK 27.8 billion ($5.45 million) forthe projects. Of the 132 planned infrastructure projects that were a part of the 2008 NTOP, 120received at least a portion of designated funds (91%) and 12 (9%) of projects were not given any ofthe funding planned through NTOP allocated grants (i.e., ZMK 27.8 billion funded, at least in part,

4 2008 NTOP Report

23

120 of the 132 planned projects). Overall reported expenditure by TIs on NTOP 2008 infrastructureprojects was ZMK 31.6 billion ($6.19 million), with an additional ZMK 3.8 billion ($746,916) fundedby financial support outside of NTOP, needed to complete these 120 projects.

Table 3: NTOP infrastructure project budget and expenditureZMK USD

Total budget for planned 2008NTOP infrastructure projects

28.1 billion $5.51 million

TIs received (2012 survey) 27.8 billion $5.45 millionOverall reported expenditureby TIs on NTOP 2008infrastructure projects

31.6 billion $6.19 million

Balance from financial supportoutside of NTOP

3.8 billion $746,916

The below table illustrates the monies spent by TIs that completed all of their proposed projects,completed a portion of their projects, or those that were included in the 2008 NTOP but received nofunding.

Table 4: Category of TI by NTOP Project Funding Status, comparing Activities and Expenditures(ZMK ,000s)

# ofTIs

PlannedActivities

NTOPBudget(ZMK)

CompletedActivities

ActualInvestment

Investmentvs. NTOPBudget

TIs that were fully funded andcompleted all projects 5 18 5,347 18 4,879 - 468TIs that were partially fundedand completed some projects 18 114 22,760 60 26,739 +3,978TIs that were included in the2008 NTOP but received nofunding** 4 37** 93,878** 0 0 N/A**Note: Chainama College of Health Sciences, Evelyn Hone College, and School of Medicine (includedunder ‘TIs that were included in 2008 NTOP but received no funding’) NTOP projects and budget costsare estimates detailed in the 2008 NTOP report, and were not formally costed or budgeted for inPhase I of NTOP projects

Although the TIs that completed all of their projects did so within their original budgets, those thatcompleted only a portion of their projects exceeded the funds budgeted for 114 projects on thecompletion of just 60 projects. These higher-than-expected costs were in part due to rising costs inconstruction materials, as well as fluctuations in the strength of the Zambian currency ininternational markets.

Student Funding

Historically, most students have been sponsored by GRZ to study in their chosen area (the % of costscovered range from 25% to 75% of the total cost of training, depending on the course of study), with

24

the expectation that the health graduates will work in public health facilities after their training.Unfortunately to date, there is no compulsory service / bonding system to compel pre-servicegraduates to service government health facilities on graduation.

Students that are awarded a government grant/scholarship are funded through a larger GRZ grantgiven to the TI that partially covers the training costs of each sponsored student. It should be noted,that a student who is GRZ sponsored still is required to pay a designated amount in student fees.The amount that each student is required to pay is dependent on both the program of study and theTI, as different TIs choose to allocate their grants to cover training costs in different ways. A fewschools have also been able to successfully implement means testing, and are thus able to awardgovernment grants to students based on financial need.

However, the increased demand for enrolment in health TIs has led to the development ofadditional programs, including those at private TIs and those ‘self sponsored’ programs at GRZ TIs,where GRZ sponsored students and self-sponsored students are taught together. Much like thoseattending private institutions, self-sponsored students cover their own training costs to the TI,including teaching, food, and accommodation costs if living in school hostels While the amountcharged to a self-sponsored student is enough to cover the per student cost to the TI, it is alsoimportant to note that, because the teacher salaries are paid directly by GRZ, rather than paid for bythe TI with GRZ grant money, TIs that have self-sponsored students do not pass the salary costsalong to them. Thus, even the self-sponsored students can be considered to have at least a portionof GRZ sponsorship if they train in a public TI.

Additionally, some schools may use the self-sponsored student’s fees to cover both the cost of theirtraining and subsidize other plans that the TI is interested in pursuing. For example, the fees paid peryear of a GRZ-sponsored student pursuing a course in Medicine (MBChB), offered at the School ofMedicine, are approximately ZMK 13.2 million, whereas the costs paid by a self-sponsored student inthe same course are ZMK 28.6 million. Because the total cost per year to train a doctor is ZMK 14.9M(including tutor salaries, school overheads, and all school fees), the remaining 13.7 million per self-sponsored student, per year, may be allocated to other programs. This has allowed the School ofMedicine to increase their IT infrastructure, fund their community based activities, and so on.

The cost to train a Clinical Officer, on the other hand, is approximately ZMK 15.8 million per year for3 years. The fees for a GRZ sponsored student are ZMK 4.3 million per year, in comparison to ZMK 10million for a self-sponsored student. Neither of these fees covers the entire annual cost of training,thus, the self-sponsored student is also, in part, being sponsored by government. Further costs oftraining can be found in Annex 5.

Self-sponsoring should also not be confused with ‘parallel programming’, which means that anadditional intake of students is taken on by a TI and run in parallel. This could mean one intake istaught in the morning and the other intake in the afternoon. Alternatively it could mean that adouble intake is taken on at the beginning of a programme, taught the theoretical foundationcourses in tandem, but then subsequent practical and theoretical courses are taught in analternating but parallel fashion, so twice as many students can graduate from any one TI at the sametime. Both the normal and parallel programme should have a mix of GRZ sponsored, self-sponsoredor scholarship/donor sponsored students to ensure that the quality of the training offered for eitherprogramme remains comparable.

25

The assessment found that the following 5 TIs are now accepting self-sponsored students. 16% ofthe students enrolled in 2012 (587 of the 3599 total) are self-sponsored students. The details are asfollows:

Table 5: TIs operating parallel programs

Training Institution NTOP Fundsrecipient

Parallel Programme # of students enrolledin 2012

Chainama College ofHealth Sciences

No Clinical Officers General 100 (50 in Jan, 50 inJune)

Evelyn Hone No Physiotherapists and P.Technologists

79

Natural ResourcesDevelopment College

No Nutritionists 68

Dental Training School Yes Dentists, Dental Therapistsand Technologists

40 (take parallelstudents every 2yrs)

Department of NursingStudies

No BSc. Nurse, Distancelearning students

300

2012 NTOP Recommendations

The recommendations in the following tables were generated from the findings of the NTOPassessment. Information was gathered from key stakeholders at the surveyed health traininginstitutions, Health Professions Council of Zambia, General Nursing Council, CPs, and the Ministry ofHealth.

These recommendations have been structured to assist decision-makers to operationalize thetraining-related aspects of the Human Resources for Health Strategic Plan 2011-2015. They havebeen designed so that stakeholders are able to see where gaps exist in regard to training systemsand infrastructure, as well as various other programme needs. The progress made on the 2008NTOP recommendations and the current status found in 2012 are listed in annex 6. Updated costestimates (done by the Quantity Surveyor in 2013) for specific NTOP infrastructure projects arelisted in annex 5, and these have been added to the individual TI profiles (annex 2) specificallyidentified with a double asterix **. It is the hope that this NTOP will help funders, both GRZ andexternal contributors, to identify where investments within the health training sector should bemade.

While at times, these recommendations may reach beyond the NHRH SP 2011 – 2015 StrategicObjective B: Increase training outputs harmonized to the sector’s needs, all of the recommendations

26

presented here are related to training, be it pre-service, in-service, or the entry of health traininggraduates into the public sector following training.

Due to the scope of the NTOP assessment, these recommendations do not attempt to operationalizemost of the interventions laid out in NHRH SP’s other three strategic objectives on recruitment &placement, performance & productivity, and systems strengthening. Other assessments andanalyses may be required to provide the same level of detail on how to operationalize these otherNHRH SP strategic objectives.

As the Community Health Assistant program and the NEPI supported Registered Nurse Midwifeprogram were both pilot training programmes in 2012, they were not evaluated as part of thisprocess. Scales up plans for these cadres are therefore not included in the NTOP 2013 to 2016operational plan.

27

HRH STRATEGIC PLAN MATRIX, NTOP RECOMMENDATIONS ON TRAINING-RELATED ASPECTS

NTOP Implementation Steps Responsibility Rationale HRHSPActivity # Y1 Y2 Y3 Y4 Reference

HRH Strategic Plan OBJECTIVE A: Increase number of employed and equitably distributed health workforce with an appropriate skills mixHRH SP Intervention A.4: Implement and enforce bonding scheme for all pre- and in-service trainees

NT A.4.A MoH to review, finalize, and institute pre-servicecompulsory service (bonding) agreements for all cadres tobe signed by all students attending government institutions,and strengthen in-service bonding mechanisms for studentsleaving their posts for full-time study (regardless whether atGRZ or Private TI); this mechanism should include aprovision to bond students to locations that are in thegreatest need of HCWs

x A.4.2

1. Stakeholder meetings to review bonding agreements thathave been developed

2. Define length of bonding period for selected cadres

3. Identify institutions responsible for implementing andupholding bonding agreements, with mechanism to bedeveloped

4. Disseminate and implement the finalized policy anddocuments to relevant stakeholders, including healthfacilities from the private sector and NGOs, public andprivate health training institutions, to ensure support andadherence to policy

5. Ensure all students sign bonding agreements at start oftraining period as part of larger MoH/TI orientation process

6. Track deployment and movement of bonded graduates,through regulatory bodies databases

Timeline

MoHMCDMCHRegulatory BodiesMoEMoFPSMDTrade UnionsProfessionalAffi l iates

• Students who are recipients of public resources intheir training should be considered to have anobligation to work for the government

• Enforcing bonding will serve to reduce the number ofgraduating HCWs that are lost to the private and NGOsectors; it is estimated that approximately 16% of pre-service graduates (~350 HCWs annually), do not enterthe public sector, resulting in an estimated lostinvestment of $1.9-$2.7 mill ion spent on training forthese individuals

• Several programmes, including MoH's CommunityHealth Assistant programme and a UNFPA-sponsorednurse training scholarship programme haveimplemented bonding successfully, increasing HCWcoverage in targeted areas

28


HRH Strategic Plan OBJECTIVE A: Increase number of employed and equitably distributed health workforce with a appropriate skills mixHRH SP Intervention A.4: Implement and enforce bonding scheme for all pre- and in-service trainees

NT A.4.A(con't)

7. Orient HR staff on bonding program, incorporate this intothe training of MoH’s and MCDMCH Human ResourceOfficers at the district, provincial, and central levels.

x

8. Institute and enforce penalties for those not adhering tothe terms of their bonding agreement

9. Institute and enforce penalties for institutions hiring theseindividuals during their period of bonding

Timeline

HRH Strategic Plan OBJECTIVE B: Increase training outputs harmonized to the sector's needsHRH SP Intervention B. 1: Strengthen the coordination among the key actors in training of health workersNT B.1.A Organize and host Health Training Coordination

Conferencesx x x x B.1

1. Bring together relevant HRH stakeholders at large scale,well-publicized, bi-annual HRH forum to discuss currentprojects and goals2. Facilitate discussions about how all projects fit together inlarger HRH training landscape3. Donors, partners, and government to make furthercommitments of resources4.4. Stakeholders attending first bi-annual HRH forum to beincorporated in to the existing regular HRH coordinationmechanism (ex. HRHTWG and subcommittees) to braadenthe scope and mandate of these mechanisms

MoHMCDMCH

• A lack of communication between HRH stakeholderscreates challenges in ensuring that all parties areworking towards a common goal without significantduplication

• Plans and strategic objectives of MoH not alwaysincorporated into CP projects as well as couldpotentially be

29

NTOP Implementation Steps Responsibility Timeline Rationale HRHSPActivity # Y1 Y2 Y3 Y4 Reference

HRH Strategic Plan OBJECTIVE B: Increase training outputs harmonized to the sector's needsHRH SP Intervention B. 1: Strengthen the coordination among the key actors in training of health workersNT B.1.B TIs to report intake numbers for each program, bi-annually,

to GNC or HPCZ, so that MoH and MCDMCH is able toaccess information about the number of HCWs in thepipeline through the combined HCW databases

TI managementRegulatory BodiesDHRA

x x x x • MoH often unaware of which and how many HCWswill be graduating, and are not given enough lead timeto adjust the funded establishment to absorb all HCWgraduates interested in working in the public sector.

B.1

1. Create standard reporting template for TIs to report toregulatory bodies2. Establish deadline for TIs to submit report

3. Identify MoH focal point person in DHRA to report on thisdata bi-annually to the stakeholders at the relevant HRHforum

4. DHRA decisionmakers to use this data to inform the FErealignment on an annual basis, allowing for all graduatesthat wish to be absorbed into public sector at time of bi-annual induction posting

• Regulatory bodies required to oversee theprogrammes enroll ing students that will subsequentlyrequire registration

HRH SP Intervention B.2: Expand the national training capacity for production of HRHNT B.2.A Reorganize and streamline training so that combined

teaching across different cadres and different trainingprogrammes (pre- and in-service) is possible in the largerTIs

Regulatory bodies x B.2

1. Conduct assessment of all curricula to understandprogram commonalities, what aspects may be combined,and the settings in which this may be successful

2. Hold stakeholder's meeting with representatives fromMoH, MCDMCH, HPCZ, GNC, and each training program, topresent on findings of assessment and discuss possiblemeans of combining these aspects

All stakeholders -MoH, MCDMCH,CPs, GNC, HPCZ, TIreps

x

• Inadequate information at central level of TIenrolments makes it challenging for MoH to fullyunderstand the health training landscape and providedata-driven strategic guidance to individual TIs toassist them in planning and scaling up

• Training programs are currently highly segmented,with l ittle crossover between cadre trainingprogrammes, even within the same overall function,making it difficult to achieve economies of scale

• If certain aspects of training programmes can becombined, TIs can increase the size of teachingsessions, freeing up space in other classrooms andallowing for larger intakes

30

NTOP Implementation Steps Responsibility Rationale HRHSPActivity # Y1 Y2 Y3 Y4 ReferenceHRH Strategic Plan OBJECTIVE B: Increase training outputs harmonized to the sector's needsHRH SP Intervention B.2: Expand the national training capacity for production of HRHNT B.2.A(con't)

3. Hold larger review to reorganize existing curricula so thateach topic area is sequentially built on, getting progressivelymore complicated as you progress up the hierarchy of HCWtraining programmes, allowing for large-scale training andeconomies of scale

MoH, MCDMCH,GNC, HPCZ, externalconsultants,supporting CP, TIreps

x

4. Structure scheduling of reorganized training programs tomaximize student enrolments. TIs to consider secondstudent intake in the year.

x

NT B.2.B Introduce and/or scale-up of specialty training for priorityskil ls, coupled with clear direction from MoH to TIsregarding the number and mix of HCWs that should betrained by each TI

MoH, MCDMCHCPs, Tis, NGOsRegulatory Bodies

x x x x B.2

1. Nurses and MidwivesA. Review EN and RN curricula to strengthen obstetriccomponents so that a Zambian general nurse can beconsidered as a skil led birth attendant managing normaldeliveries, identifying complications, stabil ising andreferring.

x

B. Review and standardise the training curricula forDEM, EM, RM, and RN/RM to ensure standard coremidwifery competencies for management of l ife savingemergency obstetric and newborn care, includingadequate practical skil ls in all EmOC basic signalfunctions

x

C. Gradually upgrade EM programs to RM programs x x x

• In-service upgrade programme content may behighly duplicative for certain cadres (e.g. enrollednurse to registered nurse upgrade)

• Currently there is no means for in-service trainees topass out of portions of the curriculum in which theyhave already received adequate training / haveadequate experience

Timeline

• Focus on MDGs 4 & 5 places emphasis on mid-levelproviders and healthcare workers with midwiferyskil ls (Skil led Birth Attendants) & Community HealthAssistants

• For rural postings all nurses require somemidwifery skil ls and all midwifes require nursingskil ls

• Safe pregnancy and child birth is a basic humanright which all Zambian women should be able toaccess

• Scale-up in the training of midwifery cadres, bothpre- and in-service, has not been prioritized andpromoted adequately; the numbers of midwivesentering training programmes in 2012 reached only70% of Zambia's target enrolment for the year set inthe 2008 NTOP; 20% of those enroled were part of the3.5-year registered nurse/midwife program, and willnot graduate until 2016, making the gap in theproduction of midwives even more pronounced in theshort term

31


HRH Strategic Plan OBJECTIVE B: Increase training outputs harmonized to the sector's needsHRH SP Intervention B.2: Expand the national training capacity for production of HRHNT B.2.B(con't)

D. Introduce midwifery training in to the followingRegistered Nursing Schools• Kasama School of Nursing• Livingstone School of Nursing• Mansa School of Nursing

GNC, TIs

x x x

• Livingstone starting Jan 2014. Kasama and Mansaare waiting to meet with requirements - amongpending requirement is consultant obs/gynae. GNC toensure that all requirements are met before approvingfor the introduction or upgrade of programs.

E. Upgrade the following EN/EM schools to RN/RMschools • Kabwe • Lewanika •Kalene • St. Francis

GNC, TIs • Demand for enrolment in EN and EM programs hasdropped. Many nurse/midwifery schools alreadyasked GNC about upgrading from EN/EM to RN/RM.

• Chikankata • Solwezi • Mukinge • Chilonga• St. Paul's • Mwami • Macha • St. Luke's

x x x Chikankata has already been authorised by GNC tostart RN/RM in Jan 2014.

F. In the short term, selected TIs to increase capacity for1 year midwifery upgrades

MOHGNCTIs

x x x x

G. Develop bridging program for EMs to RMs GNC x x

H. Scale up combined 3.5 year Registered Nurse/Midwifeprogram

i. Evaluate the pilot programme and scale up ifevaluation positive and any necessary adaptations tothe program have been made

NEPIGNC x

ii. Streamline 2.5 years of course relating to registerednurse training to incorporate pre-service trainees andbridging programs for Direct Entry Midwives andEnrolled Nurses

GNC

x

• This is the fastest way to increase numbers ofnurse/midwives

• GNC already developed draft bridging curriculumfor EMs to RMs

• MOH are in support of GNC gradually transitioningEN schools to running the RN programme instead.This transition is expected to be completed by the endof 2016.

Timeline

32



iii. Approve and support DEM schools to teach combinedRN/RM program

GNC, MOHx

I. Scale up staff development for educators in the aboveschools i. Invest in staff accommodation at TIs so that new BScnurse tutors graduating can take up teaching roles

ii. Each TI to develop a faculty growth plan based onprojected enrolment. To include need for facultyrecruitment justified with tutor scheduling within minimumand maximum working hours and the needed expansionin infrastructure and materials to support additionalfaculty

iii. Work with GRZ, UNZA and CPs to support the abovefaculty growth plan

GRZGNCUNZACPs x

x

x x

• Additional BSc nurse tutors are graduating but notall are being util ised in Tis as there is a lack of staffaccommodation available

• Requests for additional faculty must be justified byscheduling that makes optimal use of availablefaculty

2. Clinical Officers--General (COG) and Clinical Officers -Anaesthesia

A. Review COG curriculum xi. Perform survey of present COG training to identifywhether core competencies are being taught to sufficientquality despite training scale up, and bring evidence toinform the subsesquent COG curriculum review. Includeaudit of COG clinical instructors to identify areas forimprovement.ii. Ensure emergency obstetric and neonatal care signalfunctions are strengthened (including practical skills inEmOC signal functions)iii. Include mentorship skills training

CCHSEducationalconsultantCPsMOHHPCZ

B. Review salary scale for CO - Anaesthesia and for ClinicalInstructors for Clinical Officers

MOHMoFPSMD

x

• Associate clinicians cadres (COGs & MLs) have notbeen scaled up enough to meet the needs of the healthsystem, especially in rural and hard-to-reach areas

• 55% of the funded positions for COGs are currentlyfi l led. The higher percentage of vacant positions forCOG are in rural than urban areas (August 2012)

• Concern raised about the quality of training withscale up , particularly in regard to acquisition ofpractical cl inical skil ls and clinical instruction atpracticum sites

• After two years additional in-service training CO -Anaesthesia are only one salary scale up from COG.FE positions for COG Clinical Instructors has nosalary increment attached to the additional teachingresponsibil ities, hence l ittle incentive to teach.

Timeline

33



C. Invest in infrastructure to increase output of COG andCO - Anaesthesia

i. Construct lecture theater for 250 students (to be usedby all CCHS programs), additional student hostels, andimprove skills lab at CCHS

MOHMoPPCPs x

• If Skil led Birth Attendants are scaled up to increaseaccess to Basic and Comprehensive EmergencyObstetric Care (including caesarean sections) thenmore Clinical Anaesthesia skil ls are also required

ii. Complete Kabwe satellite campusx x

iii. Identify location for third CO training school andconstruct or renovate facilities as needed (suggestedlocation: Northern/Muchinga Provinces)

x x • Consider Clinical Anaesthesia program open to bothCOG or RNs in future. May also consider direct entryclinical anaesthesia degree program in future

D. Accredit more COG practical sites, util izing level twohospitals where medical officers are present

x

i. Invest in accommodation infrastructure for studentsand dedicated clinical instructors at practicum sites

ii. CCHS to develop short training curriculum for clinicalinstructors so they are up-to-date on current teachingtechniques. Consider delivering this training through e-learning.

iii. CCHS to train and employ dedicated clinicalinstructors at increased number of practicum sites

CCHSEducationalconsultantCPsMOH

x

x

x

x

x x

• COG training institutions state that they facechallenges in having adequate numbers of clinicalinstructors and supervisors to oversee students atpractical sites

• There is a shortage of accommodation at practicumsites for both students and clinical instructors

34



E. Develop faculty development plan for COG training i. Enhance lecturers classroom teaching skills

a. Provide on-site coaching and mentoring to enablelecturers to effectively utilise a wide range of teachingmethodologies (eg. Participatory techniques, use of visualaids etc.) b. Consider short term expatriate volunteer pedagogyexpert to mentor lecturers

CCHSOther TIs nowtraining COGDHRACPsHPCZ

x x x x • Concern about the quality of training beingmaintained as student enrolment numbers increase

• Need to strengthen linkages between classroom /lecture theatre teaching, practical skil ls acquisitionin the skil ls lab and clinical training at practicumsites

ii. Provide specialized training to all lecturers who teach inskills lab, with specific emphasis on clinical teaching in thesimulated environment

iii. Strengthen clinical teaching skills of lecturers, clinicalinstructors and preceptors at practicum sites via amultifaceted approach a. Provide standardised workshops on clinical teachingmethods b. Provide expert 'faculty mentors' to work with facultyand staff at clinical sites/skills labs in order to strengthentheir clinical teaching skills. Consider expatriate volunteer'faculty mentors' for this task in the short term

• Educational attachments should not just be anapprenticeship, but should include tutorials, casepresentations, structured educational activities etc.

• All students require regular supervision andinstruction from their clinical instructor in the wards/ at clinical facil ities during their practicumattachments

• Expatriate volunteer 'faculty mentors' in the shortterm could help to teach the larger number of COGstudents in the practicum sites, and mentor faculty inmodern teaching methodologies and share theirexperiences in handling non communicable diseases

35


HRH Strategic Plan OBJECTIVE B: Increase training outputs harmonized to the sector's needsHRH SP Intervention B.2: Expand the national training capacity for production of HRH

3. Medical Licentiates (ML)NT B.2.B(con't)

A. Convert ML program from advanced diploma to degreelevel

MoH, MoE, UNZAx

B. Introduce direct-entry ML program (four years inschool and one year internship) totall ing five yeardegree program

x

i. Ensure that training incorporates full COG curriculum

ii. Consider short-term expatriate volunteer clinicalinstructors/mentors (eg. specialists in obstetrics andgynaecology or surgery) to allow increased number ofpractical sites to be fully utilizedfor ML training

CCHSMoHHPCZCPs

x x x

C. Invest in infrastructure to increase output of MLsi. Equip skills lab to provide required surgical skillstraining simulation

MoH, MoPP, CPs x

ii. Consider second training institution for production ofMLs, located in the same place (eg. Kabwe) that COGsare being trained

x x

• Pre-service ML graduates could be produced in fiveyears for deployment to rural hospitals, to increaseaccess to vital health services for the rural Zambianpopulation

• MLs and Medical Officers are the only cadrespossessing the surgical skil ls to providecomprehensive emergency obstetric and newborn care(eg. caesarian sections) that are critical for theachievement of MDGs 4 & 5

• This cadre was created specifically to serve at ruraldistrict level to provide basic medical and surgicalservice provision where it is difficult to recruit andretain medical officers, making the up-scale in theirtraining and deployment extremely important

• Cited barriers to ML scale up include a shortage ofacceptable practical training sites, as they areconstrained by a need for Master's-level instructors,and most specialist doctors are located in urbanareas--not the ideal setting for a cadre that is beingtrained to perform in rural areas. This is the reasonto consider bringing in expatriate volunteer specialistclinical instructors in the short / medium term

36



D. Staff development - i. Increase lecturer positions at CCHS in view of the MLscale up ii. Identify the personel in faculty requiring specifiedtraining iii. Mobilise resources for sponsorship of requiredfaculty training iv. CPs to support expatriate faculty support tomaintain quality of education provided whilst Zambianstaff development undertaken

CCHSMoHCPsUNZA

x x x • Teaching faculty may have Masters but not relevantto the competencies required to teach MLs. Guestlecturers are used now from UTH and UNZA, butinternal staff capacity requires development

• GRZ can allocated some funds for staff developmentbut CPs will also need to support

E. Accredit more ML practical sites, util izing level 2 andabove hospitals, where qualified consultants/medicalofficers are present

HPCZMOHCPs

i. In the mid-term, consider bringing in expatriate clinicalinstructors and mentors from outside theMOH/government payroll, until masters-level medicalofficers are more equitably distributed throughoutZambia x x x x

• MOH have commited themselves to upgrade all Level2 hopsitals to Level 3, and some of the Level 1hospitals to Level 2 and staff them with appropriateskil led manpower. To do this will require furthertraining of Zambian specialists, hence the gaps inClinical Instructors for MLs and the need to bring inexpatriate clinical instructors for the short/mediumterm

37


HRH Strategic Plan OBJECTIVE B: Increase training outputs harmonized to the sector's needsHRH SP Intervention B.2: Expand the national training capacity for production of HRH

4. Further priority cadres for scale up x x xNT B.2.B(con't)

A. Specialist crtical care nursing (1 yr in-service)i. Need to develop teaching faculty

ii. Need to develop second training site (only one nowat Lusaka School of Nursing) iii. Bring in expatriate faculty in the short term whilstZambian teaching capacity is developed

• MOH wish to have Intensive Care Units (ICUs) in allProvinical hospitals, and to strengthen critical careservices therefore the need to highlight the necessarypersonnel to provide this care

B. Develop emergency services personnel i . Consider introduction of a new cadre of EmergencyParamedics (1 yr in-service) a. Develop curriculum b. Identify and equip training site with requiredspecialized skil ls lab c. Develop teaching faculty d. Bring in expatriate faculty in the short term whilstZambian teaching capacity is developedii. Commence MMed Emergency Medicine a. Bring in expatriate faculty in the short term whilstZambian teaching capacity is developediii . Consider introduction of BSc Emergency Medicineprogram

• Ambulances are coming to strengthen emergencycare services - require the necessary healthcareworkers to man these vehicles

C. Paediatric Nurse (1 yr in-service) i. Develop teaching faculty ii. Bring in expatriate faculty in the short term whilstZambian teaching capacity is developed

D. Specialist doctors i. Bring in expatriate faculty in the short term whilstZambian specialist teaching capacity is developed

• MOH have commited themselves to upgrade all Level2 hopsitals to Level 3, and some of the Level 1hospitals to Level 2 and staff them with appropriateskil led manpower. To do this will require furthertraining of Zambian specialists

38


HRH Strategic Plan OBJECTIVE B: Increase training outputs harmonized to the sector's needsHRH SP Intervention B.2: Expand the national training capacity for production of HRHNT B.2.C MoH, Regulatory Bodies, and TIs to prioritize the number of

pre-service students enrolled in TIs, over in-service studentsGNCHPCZMOHTIs

x x x B.2

1. Determine and enforce maximum percentage of in-servicestudents that TIs are permitted to accept in full-time studyprograms that accept both pre- and in-service candidates

2. MoH to support TIs to recruit more pre-service students,especially from rural areas

• Programmes that are available to both pre- and in-service students produce the same credential ofhealth worker, but in-service students take 25% longeror more to reach the same level--time that they aretaken out of post and are not providing healthservices

• In-service training is more expensive than pre-service training due to lengthened time in training andsalary expense incurred during in-service trainingperiod. For example, the cost to train a pre-serviceregistered nurse is approximately ZMK 55mill ion,whereas the cost to train an in-service RN isapproximately ZMK 163 mill ion (includes cost of ENand RN trainings, salary cost during in-servicetraining period).

• MoH does not have abil ity to post in-servicegraduates, so cannot send them to areas identified ashighest need.

39


HRH Strategic Plan OBJECTIVE B: Increase training outputs harmonized to the sector's needsHRH SP Intervention B.2: Expand the national training capacity for production of HRHNT B.2.D Strategically build lecture theatres B.2.3

1. Identify suitable space in A) TIs running more than 3priority programmes and B) TIs training large numbers of asingle priority cadre:

• Chainama College of Health Sciences (250 seats +)• Evelyn Hone College (250+ seats)• Lusaka School of Nursing (250+ seats)• Ndola School of Nursing & Midwifery (250+ seats)• Livingstone School of Nursing (250+ seats)• Chipata School of Nursing & Midwifery (250+ seats)• Kabwe School of Nursing & Midwifery (250+ seats)• Kasama School of Nursing & Midwifery (250+ seats)

MoHTIsGNCHPCZ

x x

2. Build lecture theatres with modern audio-visual system;size to depend on physical space available and analysis ofpotential for TI expansion

x x

3. Consider review of lecture theatre plans to includesupportive structures (ex. toilets, staff offices, storeroom,tutorial rooms etc.)

x

Timeline

• Inadequate classroom space leads to overcrowdingand inability of TI to combine programs or cohortsinto one larger section

• Few TIs have functional lecture theatres that canaccommodate 100+ students, making it impossible toteach large numbers of students at one time and usethe smaller classrooms for small-group teaching,practical demonstrations, participatory tutorials, andself-directed learning

• Enlarged teaching capacity will allow TIs to free upsmaller classrooms for more specialized trainingmodules, and assist them in taking self-sponsoredstudents, as classroom space will cease to be aconstraining factor

40


HRH Strategic Plan OBJECTIVE B: Increase training outputs harmonized to the sector's needsHRH SP Intervention B.2: Expand the national training capacity for production of HRHNT B.2.E Build new or adapt existing infrastructure to increase and

improve number of fit-for-purpose skil ls labsMoHSupporting CPs

x x B.2.3

1. Build new skills labs: • Chainama • Mukinge • Chitambo • Kasama • Dental • Macha • Mufulira • Kitwe • St. Pauls • St. Francis

MoHTIsGNCHPCZCPs

2. Adapt from or renovate existing skills labs: x x• Chipata • Livingstone• Kabwe • Lusaka Schools of Nursing• Kalene • NRDC• Evelyn Hone • Mwami• Lewanika • Ndola• Solwezi • Mansa

3. Purchase new skills lab equipment for all schools exceptfor Chipata, Roan Antelope, & Nchanga

x x

Timeline

• Limited space and skil ls lab resources make itchallenging for each student to have adequate time topractice critical patient care and treatment skil ls

• High student numbers in practical teaching sessionslead to overcrowding, making it difficult for studentsto have the necessary physical space required topractice clinical skil ls

• Large practical teaching groups do not allow foradequate individual student-instructor interaction

• Many TIs have skil ls labs that are located in roomsdesigned to serve other functions, with layouts thatare not conducive to practical, interactive small-group learning

• Inadequate number of skil ls labs that haveequipment required to serve needs and numbers ofstudents.

• High cost of skil ls lab equipment prevents TIs frompurchasing needed amounts or keeping equipment upto date.

41


HRH Strategic Plan OBJECTIVE B: Increase training outputs harmonized to the sector's needsHRH SP Intervention B.2: Expand the national training capacity for production of HRHNT B.2.F Assess current standards and look for ways to increase

efficiency regarding instructor time and resourcesB.2

1. Work with HPCZ, GNC and Teveta to review and amendrequired student:teacher ratios, with contact hours taken into consideration, i n particular for large, lecture-basedsettings and the instruction of theoretical knowledge

HPCZ, GNC, Teveta x

2. Establish minimum and maximum tutor to studentcontact hours, to ensure optimal use of tutors

TIs, GNC, HPCZ x

3. TIs to implement two intakes in a year (eg. January andJuly) where possible

TIs, GNC, HPCZ,MoH

x x x

• Insufficient teaching staff for current teachingmethodologies/required student:tutor ratios in 71% ofTIs

• Innovative teaching methodologies are becomingmore readily available in Zambia, allowing foradaptation of required student:tutor ratios in selectsituations, to enhance instructor abil ity to teach agreater number of students in a more effective manner

• Even TIs that had adequate numbers of tutors facedchallenges, as many tutors time during the standardworking day at other institutions, reducing theirteaching time/time available to students at theirsalaried facil ity

• Classrooms often not used year-round; should befully util ized to maximize training outputs i.e. whenone group of students is out in the field for practicaltraining (Jan intake), another group can be trained inthe classroom in the theoretical course materials(July intake)

Timeline

42


HRH Strategic Plan OBJECTIVE B: Increase training outputs harmonized to the sector's needsHRH SP Intervention B.2: Expand the national training capacity for production of HRHNT B.2.G Introduce and correctly util ize virtual l ibraries (eg.

eGranary) and e-learningB.2.7

1. Implement large-scale e-learning program, open to all TIs,that includes virtual library technologies and otherinnovative e-learning methodologies

A. MoH to prepare presentation on virtual l ibraries andeLearning for presentation to TI principle tutors tofacil itate understanding and increase possibil ity ofutil ization if technology was made available

MoH, CHAI x

B. Identify TIs with the capacity and desire to implementand util ize a virtual l ibrary and e-learning

MOH, Tis x x

C. Invest in necessary IT infrastructure, includinghardware (server and computers), internet/intranetconnectivity, and maintenance packages, also ensuringavailable access to server for student owned laptops

CP support x x x

D. Establish IT Officer establishment positions at each TI x x x

E. Conduct acceptance and end-user trainings for both TIstaff and students, identifying individuals who are IT-knowledgable and can help to support other tutors andstudents

x x x

2. Develop partnerships and facilitate information sharingto create comprehensive and up-to-date e-resources

A. Identify overseas training institutions which arewill ing to share their training materials for minimal/nocost

CPD Lusaka hubs(see NT C.5.A.5)CHAI

x

Timeline

• For both students and trainers, accessingcourse/study-related information is time-consumingand expensive, with l imited resources available to theindividual

• Hard copies of learning resources over-stretched;for some programs, students are only permitted tocheck out texts for short periods of time from thelibrary

• Both students and faculty have insufficient access toup-to-date medical l iterature.

• Many free and low-cost learning resources areavailable that could be of great benefit, but arecurrently not being util ized by the Zambian system

• E-learning resources that do not require apermanent connection to the internet are available,allowing for articles and resources to be downloadedat one time, and accessed by students and instructorsat a later date

43


HRH Strategic Plan OBJECTIVE B: Increase training outputs harmonized to the sector's needsHRH SP Intervention B.2: Expand the national training capacity for production of HRHNT B.2.G(con't)

B. Collaborate with partner Universities in training - toshare training materials and faculty where possible

TIsCPsMOH

x x

C. Build virtual l ibrary with necessary texts for thecadres trained in that TI

External consultantTI

x x

D. Purchase Institutional subscription to on-linejournals

Tis x x

E. Identify an officer per TI tasked with the responsibil ityof implementing the necessary change process, so thatthis new technology is fully util ized by faculty andstudent body alike

External consultantTis

x x x

F. Collaborate with the Zambia Library Association andother Library Associations

• Zambia Library Association can l ink Tis with otherlibraries to access required teaching resources

NT B.2.H Increase number of clinical instructors to teach practicalskil ls, and mentors to provide post-qualification ongoingclinical supervision and mentorship support

B.2.9

1. Develop e-learning modules for clinical instructorsprogram and for training existing HCWs on how to be aneffective mentor

GNC, MoH, DNS,School of Medicine

x

Timeline

• Overall numbers of clinical instructors areinsufficient. Majority of Clinical Instructor course istheoretical; potential for much of course to be donevia distance and e-learning, as all participants areexisting HCWs that already have the clinicalknowledge required for the role. Not every HCW is anatural mentor, but mentorship skil ls can be taught

44


HRH Strategic Plan OBJECTIVE B: Increase training outputs harmonized to the sector's needsHRH SP Intervention B.2: Expand the national training capacity for production of HRHNT B.2.I Identify practical sites as close to the TI as possible where

students can attend daily and remain in their normalaccommodation.

B.2.8

1. Review, realign and reassign practical training sites basedon need and proximity to TI

x

A. Regulatory bodies to update selection criteria forappropriate practical sites, based on site capacity,services provided at site, and distance of site from TI,and, if necessary, accommodation available near thesiteB. Training institutions to conduct mapping exercise todetermine suitabil ity of sites and to considernew/different sitesC. Regulatory bodies to report on suitable practical sites,including private facil itiesD. TIs to review their existing practical sites to identifythose they wish to continue using, those that may bemore suitable for another TI and no longer suit theirneeds, and those they wish to stop using (those that donot meet selection criteria).E. TI to consider using practical sites not previouslyapproved due to lack of teaching personnel, if cl inicalinstructor accompanies the students

TIs x

• Practical sites often far from TI, leading to hightransport costs and difficulty in findingaccomodation, often at high cost to the TI orindividual student

• Insufficient number of practical sites, with too manystudents per clinical tutor or per site

• One TI may be using a practical site that may bebetter suited to a different school, or may havepossible new practical sites nearer by, but has notchanged due to historical reasons/practices

• Accomodation at practical sites often prohibitivelyexpensive to TI

Timeline

MoHMCDMCHGNCHPCZTI reps (both public& private)

45


HRH Strategic Plan OBJECTIVE B: Increase training outputs harmonized to the sector's needsHRH SP Intervention B.2: Expand the national training capacity for production of HRHNT B.2.I(con't)

2. Conduct analysis of costs associated with practicalassignments as a guide to pricing

GNC, HPCZCHAI

x

3. Provide guidelines on costs and charges health facilitiesassign to TIs (especially private TIs); work with private healthfacilities to determine appropriate pricing, especially in thecase of certain hard-to-find specialties

GNC, HPCZCHAI

x

A. Determine fair market price for use of public facil ities,in particular, the costs associated with accomodationand meals (when provided)

B. Encourage public private partnerships in developingTIs and health facil ities

NT B.2.J Consider public private partnerships (PPP) for out-sourcingof catering and other services not specifically associatedwith the provision of health training at TIs and practicalsites

B.2.8

1. TIs to evaluate catering needs and options availablewithin the local community

TIs x

A. TIs to consider outsourcing catering service provision,if available at lower costB. TIs to consider cross-program util ization of samedining area with staggered lunch times

2. TIs to explore other non-training related aspects that maybe outsourced at cheaper cost3. TIs to consider and sign MoU/Agreements with neighbourTIs / programmes situated on the same campus or close byto jointly signing contracts for out-sourcing of services whereappropriate

x x

Timeline

• A majority of TIs cited lack of transportation as abarrier to sending students on practical assignments

• Especially in urban areas, a variety of options forexternal catering exist, which may be more cost-effective than managing catering on-site

• Transport and catering are not core competencies ofhealth TIs and managers may not have the capacity tofind the best option for the school, making itchallenging to make economically wise decisionswhen it comes to these functions or achieveeconomies of scale

46


HRH Strategic Plan OBJECTIVE B: Increase training outputs harmonized to the sector's needsHRH SP Intervention B.3: Improve access to pre-service programmes for candidates / students from rural and remote areas

NT B.3.A Review selection criteria for admittance to HCW trainingprograms, for all cadres, to allow for a greater pool ofcandidates from rural based schools to be considered

x B.3.2

1. Enforce minimum ratio (30%) of students coming fromrural and hard-to-reach areas that TI is required to acceptfor government sponsorship

B.4

2. Review Ministry of Labor Aptitude test, required for pre-service nursing programs, including stakeholder meeting todiscuss relevance of exam and how it fits with overallselection criteria for nurses

MoL

x

NT B.3.B MoH to assist selected TIs to offer parallel programmes(self-sponsored) where teaching resources permit, withoutcommitment to providing accommodation, food andtransport to practical sites

MoHRegulatory Bodies

x B.3

1. TI’s management team to calculate their student capacitybased on the available teaching infrastructure and teachingfaculty, excluding the need to provide accommodation,catering and transportation for all students.

TIs x

2. TI’s management to then agree on what commitmentsthey should make to self-sponsored students, based on thecontext of their locality.

Tis x

• Ministry of Labour general knowledge ‘Aptitude Test’may limit the pre-service recruitment pool for nurses,forcing TIs to admit more in-service students;anecdotal evidence suggests that only 10% of pre-service applicants achieve the score required forentry to an RN program, and TIs complain that thestudents that pass this exam do not necessarily havethe appropriate characteristics of a good nurse.

HPCZGNCMoHTIs

• Bonding students to their province of origin maydiscourage urban students from making false claimsabout coming from a rural area, which they may do toincrease their chances of receiving GRZ sponsorshipor on-campus accommodation• To increase access to students from rural and hardto reach areas

• Parallel programs are an opportunity for TIs toincrease enrollment without waiting for governmentto increase the grant going to the institution

• If TIs do not have to support these non-teachingaspects, they may scale up enrolment without regardto these constraints

• Profits collected from self-funded students thatexceed the actual cost of training may bereprogrammed to enhance other aspects of trainingfor all students

47


HRH Strategic Plan OBJECTIVE B: Increase training outputs harmonized to the sector's needsHRH SP Intervention B.3: Improve access to pre-service programmes for candidates / students from rural and remote areas

NT B.3.C Review and change accommodation policy to reducenumber of housing placements available to students comingfrom nearby, and increase those available to studentscoming from a greater distance

MoHTIsRegulatory Bodies

x B.3

1. Change the policy of accommodating ALL students onGRZ sponsorship

A. Development of selection criteria for students to beprovided with on-campus housing

x x x

2. Implement selective housing policy x x x xA. Research the cost of accommodation options that areavailable within daily commuting distance of each TIB. Collect residential origin of all applicants beingconsidered for enrollment to the TI, informing allapplicants of this policyC. Provide those applicants not eligible for on-campusaccommodation under new policy with information onalternative housing options (to be subsequentlyarranged and paid for by the student)D. Encourage public private partnerships foraccommodation of students

• Students hail ing from rural and hard-to-reach areaslikely have fewer financial resources or the knowledgeto find un-sponsored accommodation outside the TI

Timeline

• At the time of the NTOP survey, fewer than half of allTIs would consider accepting non-accomodated daystudents

• 85% of TIs stated that over half of enroled studentsmaintain residential addresses within the samedistrict, usually within the district town

• Given that student housing is frequently cited to aconstraint in scale-up, requiring that some studentsfind their own housing will allow schools to scale upcapacity without investing in housing-relatedinfrastructure projects

TIsGRZMoH

TIs

48


HRH Strategic Plan OBJECTIVE C: Improved performance and utilization of HRHHRH SP Intervention C.1: Strengthen the leadership and management capacities of managers and supervisors at all levels

NT C.1.A Roll-out of standardized management training program;explore ways to adapt selected management trainingprogram to serve the needs of the TI manager

C.1

1. Roll out management training to ensure all TI managershave been equipped with these skills

x x x

2. Identify low performers, provide additional technicalsupport to those schools

x x x

HRH SP Intervention C.5: Strengthen planning of in-service training according to organizational needsNT C.5.A Introduce new methods for in-service training and

Continuing Professional Development (CPD) across allcadres, which l imits unneeded full-time, out-of-post returnto TIs

DHRACHAITEVETA

x x C.5

1. Develop innovative methods for train ing of HCWs thatsuits the needs of the Zambian setting.

A. Conduct review of best-practices in blended learningmethodologies that have been used in other resource-constrained settings similar to Zambia

Timeline

• All HCWs should have access to additional trainingthat allows them to develop and stay up-to-date ontheir skil ls, increase their qualifications, andprogress in their career to help them stay motivatedand improve the service they can provide to thepatient• If in-service training and CPD can be done in-post asmuch as possible, this will free up space in the TIs forscaled up enrollment for production of NEW HCWs, inline with the NHRH SP

• NTOP TIs have varying levels of experience andskil ls in managing people and institutions, leavingmany schools struggling in terms of logistics andorganizational management capacity

• Many TI managers are HCWs who do not have themanagerial or administrative experience needed torun a training instititution

• TIs that were able to scale up the most hadmanagement teams that were will ing to introducechange, consider innovative scheduling practices, andimplement new methodologies for teaching andrunning their respective institutions

49


HRH Strategic Plan OBJECTIVE C: Improved performance and utilization of HRHHRH SP Intervention C.5: Strengthen planning of in-service training according to organizational needsNT C.5.A(con't)

B. Identify existing in-service programmes in Zambiawhich are run through blended learning methodologies,including distance learning, eLearning, mentoring(delivering health services but under the supervision andguidance of a mentor), and the option of attending out-of-post short theoretical teaching blocks or eveningtheoretical training sessions after work.

DHRACHAI

x

C. Build on current foundation and leverage existingresources to extend to other in-service trainingprogrammes

CPs, DHRA, CHAI,TIs, UNZA

x

D. Hold stakeholder meeting to help adapt curricula forthese training programs

CPs, DHRA, CHAI,TIs, UNZA

x

E. Adopt and roll out MoH Clinical Mentorshipprogramme across all cadres to enhance in-facil itysupportive supervision and reduce need for in-classroom CPD activities

x x x

2. Develop and augment CPD for nurses/midwives withsupport from the GNC regulatory body, and for all otherHCWs with support from HPCZ

GNC, HPCZ,supporting CP,externalconsultants

x x

3. Link CPD requirements to renewal of all HCW licenses byutilizing the tracking ability of the new regulatory bodydatabases

GNC, HPCZ x

4. Pilot selected method(s) of providing in-service trainingand CPD among select cadres, then extend to all healthcadres once success has been demonstrated

GNC, HPCZ, externalconsultants,supporting CP

x

5. Establish Provincial in-service / CPD hubs to decentralizethe eventual recruitment and in-service training of all HCWs -utilise the existing level 2 in-service training departments

MoH. MCDMCH,GNC, HPCZ

x x

• HCW attitudes are often cited as a problem bypatients seeking health services

• There are currently l imited options for in-servicetraining outside of TIs, forcing HCWs that want toupgrade their credential to leave their post for longperiods of time

• Due to slow introduction of new text books andlearning materials, curriculum updates lag behindmedical advances, increasing need for additional in-service trainings

• Because of a lack of streamlined modules acrosstraining courses, HCWs have no means of testing/passing out of modules they have already taken,leading to more time out of post during in-servicetraining than necessary

Timeline

50

PART TWO: NTOP 2013 TO 2016

The key recommendations coming out of the NTOP 2008 evaluation process have been incorporatedin to a costed operational plan for moving forward in scaling up the production of healthcareworkers from 2013 to 2016. It is hoped that this operational plan will be helpful for budgetaryplanning purposes, for both GRZ and health CPs interested in supporting HRH.

51

PART TWO: Operational Plan 2013 to 2016Fx $1: 5.3 Budget Financial commitment

MainActivity

Sub Activity Responsibility

Period OutputIndicator

Indicatortarget

Total cost(ZMW)

Total cost($)

GRZ($)

Cooperatingpartners ($)

Gap($)

Comments

1 One day conference, 75 participants, 40accommodated

MOH,MCDMCH

Yearly Meetingminutes

Bi-annual 160,261 $30,238 $ - $ - $ 30,238 First meeting Aug 2013.Secure financialcommitment toimplementation ofNTOP (2013 - 2016).Subsequent meetingssmaller scale.

2 Stakeholder meetings, legal advice(MOJ), finalisedpolicy, orient HR staff and implement

MoH,MCDMCH

2013 Meetingminutes

Bonding policyimplementedby 2014

38,849 $7,330 $ - DFID $ - Orient MOH andMCDMCH HR staff in Q42013, through existingbudgeted Q4 GRZmeetings

3 Nurse and Midwifery curricula review GNC,MOH,CPs

2013 Revised,competencybased nurseandmidwiferycurricula,incorporatinge-learningmodules

All nursestrained to beskilled birthattendants(SBAs) withsufficientemergencyobstetric careskills

325,770 $61,466 $ - DFID,ChildFund,NEPI,UNFPA

$ - Tentatively scheduledfor September 2013.Incorporate e-learning into nurse and midwiferycurricula, whereappropriate.

Curricula reviews and development

Organise and host Health Training Coordination Conference

Implement and enforce bonding scheme for all pre- and in-service trainees

52

Budget Financial commitmentMainActivity



Indicatortarget

Total cost(ZMW)

Total cost($)

GRZ($)


Gap($)

Comments

4 Clinical Officer General - survey of training quality,and subsequent curriculum review

HPCZ,MOH,CCHS,CPs

2013 Revisedcompetencybased COGcurricula

All COGcompetent toperformBEmOC signalfunctions & tomanage NCD

338,357 $63,841 $ - $ - $ 63,841 Survey will informnecessary revision toCOG curriculum.Management of noncommunicable disease(NCD) is becomingincreasingly important.

5 Develop curriculum for Master of Medicine inEmergency Medicine

SOM,UNZA,HPCZ,MoE,MOH,CPs

2013 Newcompetencybasedcurriculum forMmed inEmergencyMedicine

New trainingprogram readyto enrol firststudents by2014

265,000 $50,000 $ - $ - $ 50,000 MOH wish to strengthenemergency and criticalcare services, so requirethis specialist cadre.

6 Develop curriculum for new cadre of EmergencyParamedics (1 year in-service program)

HPCZ,GNC,MOH,CPs

2014 Newcompetencybasedcurriculum forEmergencyParamedics


265,000 $50,000 $ - $ - $ 50,000 MOH wish to strengthenemergency careservices. Moreambulances are comingso require necessaryHCWs to man them.

7 Develop curriculum for BSc in Emergency Medicine SOM,LSN,UNZA,HPCZ,GNCMoE,MOH,CPs

2016 Newcompetencybasedcurriculum forBSc inEmergencyMedicine


265,000 $50,000 $ - $ - $ 50,000 MOH wish to strengthenemergency and criticalcare services, so requirethis specialist cadre.

53




Indicatortarget

Total cost(ZMW)

Total cost($)

GRZ($)


Gap($)

Comments

8 Develop curriculum for Masters of Dental Surgery SOM,UNZA,HPCZ,MoE,MOH,DentalSchool,CPs

2016 Newcompetencybasedcurriculum forMasters ofDentalSurgery


265,000 $50,000 $ - $ - $ 50,000 This masters programdoes not yet exist butwill be required as MOHplan to upgrade all level2 hospitals to level 3 andto create centres ofexcellence.

9 Introduce required e-learning hardware in tonursing and midwifery schools

MOH,ChildFund

2013 # of nursingschoolsequipped

16 nursingschoolsequipped byend 2016

Covered byChildFund

ChildFund $ -

10 Provide necessary training for utilisation of e-learning hardware and e-learning modules bytutors and students

MOH,ChildFund

2013 # of nursingschools'tutors trained

16 nursingschools' tutorstrained by end2016

Covered byChildFund

ChildFund $ -

11 Establish IT Officer establishment positions at eachpublic TI (annual salaries cost)

MOH,MoF,PSMD

2014 % of TIs withIT officerfundedestablishment positions

100% of TIswith IT officerFE positions byend 2016

1,977,669 $373,145 $0 $0 $373,145 Application for creationof IT Officerestablishment positionsneeds to be made in2013

12 Incorporate e-learning in to pre-service nurse andcertified midwife training

GNC,MOH,ChildFund

2014 -2017

# of nursestrained usinge-learning

6000 nursestrained or intrainingutilising e-learning by2017

Covered byChildFund

ChildFund/AMREF,DFID

$ - E-learning modules tobe developed at time ofnurse midwife curriculareview (Sept 2013)

Introduce and maximize the utilisation of e-learning

54




Indicatortarget

Total cost(ZMW)

Total cost($)

GRZ($)


Gap($)

Comments

13 Develop e-learning modules for clinical instructorsprogram and for training existing HCWs to beeffective mentors

GNC,HPCZ,MOH, CPs

2014 # of clinicalinstructorsand mentorstrained usinge-learning

All newclinicalinstructors andmentorstrainedutilising e-learning byend 2016

254,400 $48,000 $0 $ - $ 48,000

14 Establish Provincial in-service / ContinuingProfessional Development (CPD) hubs that utilisee-learning

MOH,GNC,HPCZ

2015 % ofProvinceswith in-service/CPDhubs utilisinge-learning

100 % ofProvinces within-service/CPDhubs utilisinge-learning byend 2016

265,000 $50,000 $0 $ - $ 50,000 Utilising the existinglevel 2 hospital in-service trainingdepartments

55




Indicatortarget

Total cost(ZMW)

Total cost($)

GRZ($)


Gap($)

Comments

Kasama School of NursingComplete existing lecture theatre (100 seater) 304,593 $57,470 $ - $ - $ 57,470Furnish lecture theatre (100 seater) 125,000 $23,585 $ - $ - $ 23,585Build skills lab 956,318 $180,437 $ - $ - $ 180,437Equip skills lab for midwifery training 113,346 $21,386 $ - $ - $ 21,386Classroom block (150 seats) with subdividers 1,146,602 $216,340 $ - $ - $ 216,340Furnish classroom block, with subdividers 26,500 $5,000 $ - $ - $ 5,000Purchase recommended and prescribedtextbooks/training materials for midwifery training

53,000 $10,000 $ - $ - $ 10,000

Tutors: 8 additional required (annual salaries cost) 859,512 $162,172 $ - $ - $ 162,172Clinical Instructors: 5 additional required (annualsalaries cost)

537,195 $101,358 $ - $ - $ 101,358

Semi-detached 3 bedroom staff house 1,262,187 $238,148 $ - $ - $ 238,148Student hostel for 80 beds (rural recruits) 2,571,975 $485,278 $ - $ - $ 485,278Furnish new student hostel (80 beds) 80,560 $15,200 $ - $ - $ 15,200Student fees / training costs (160 new SBAs peryear)

8,218,720 $1,550,702 $ - $ - $ 1,550,702

3 month midwifery internship* for 160 RNs to beSBAs, per year (3 week EmOC training thenpractical attachment in midwifery unit)

684,893 $129,225 $ - $ - $ 129,225

Consultant obstetrics and gynaecologist KasamaGeneral Hospital (Zambian or expatriate for shortterm until MMed Obs & Gynae produces specialistfor Kasama)

337,925 $63,759 $ - $ - $ 63,759

Study tour for 2 representaitives from school toNchanga Midwifery School to see midwifery skillslab in use

12,720 $2,400 $ - $ - $ 2,400

INTRODUCE AND/OR SCALE UP TRAINING FOR PRIORITY SKILLS: CADRE SPECIFIC COSTED NTOP (scale up with day scholars and two student intakes Jan & July, where possible)

Lecture theatre already95% complete butrequires plumbing,staircase and furnitureto be functional. Highpriority to complete this.

*Interim solution forgeneral nurses to betrained as skilled birthattendants, whilstwaiting forstrengthening of EmOCcomponent of RNcurricula and evaluationof RN/RM program in2016

MOHGNCMoFPSMDCPs

2014 # of skilledbirthattendants(SBA)studentsenrolled peryear

160 skilledbirthattendant(SBA) studentsenrolled peryear, by 2015.

(previousmaximumannualenrolment of66)

15

Introduce midwifery training in to the following Registered Nursing Schools

56




Indicatortarget

Total cost(ZMW)

Total cost($)

GRZ($)


Gap($)

Comments

Livingstone School of NursingOption A:

Equip existing skills lab for midwifery training 113,346 $21,386 $ - $ - $ 21,386

3 month midwifery internship for 75 new RNs tobe SBAs, per year (3 week EmOC training thenpractical attachment in midwifery unit)

321,044 $60,574 $ - $ - $ 60,574

Option B:Build and furnish new lecture theatre (250+ seats) 2,284,760 $431,087 $ - $ - $ 431,087Build new skills lab 1,017,663 $192,012 $ - $ - $ 192,012Equip new skills lab for midwifery training 113,346 $21,386 $ - $ - $ 21,386Tutors: 4 additional required (annual salaries cost) 429,756 $81,086 $ - $ - $ 81,086Clinical Instructors: 8 additional required (annualsalaries cost)

859,512 $162,172 $ - $ - $ 162,172


7,705,050 $1,453,783 $ - $ - $ 1,453,783


642,088 $121,149 $ - $ - $ 121,149

2013 75 SBAsenrolled peryear by 2014

# of SBAstudentsenrolled peryear

150 SBAstudentsenrolled peryear, by 2015

(previousannualenrolment of60)

Already approved byGNC to start midwiferytraining from January2014.

ZISSP has shown interestin equipping skills labfor midwifery training.

16

2014

MOHGNCMoFPSMDCPs

57




Indicatortarget

Total cost(ZMW)

Total cost($)

GRZ($)


Gap($)

Comments

Mansa School of NursingBuild lecture theatre (100 seater) 1,142,380 $215,543 $ - $ - $ 215,543Furnish lecture theatre (100 seater) 125,000 $23,585 $ - $ - $ 23,585Build skills lab 1,109,329 $209,307 $ - $ - $ 209,307Equip skills lab for midwifery training 113,346 $21,386 $ - $ - $ 21,386Build classroom block (100 seats) with subdividers 764,401 $144,227 $ - $ - $ 144,227Furnish classroom block, with subdividers 26,500 $5,000 $ - $ - $ 5,000Purchase recommended and prescribedtextbooks/training materials for midwifery training

53,000 $10,000 $ - $ - $ 10,000


537,195 $101,358 $ - $ - $ 101,358


7,191,380 $1,356,864 $ - $ - $ 1,356,864


599,282 $113,072 $ - $ - $ 113,072

Consultant obstetrics and gynaecologist MansaGeneral Hospital (Zambian or expatriate for shortterm until MMed Obs & Gynae produces specialistfor Mansa)

337,925 $63,759 $ - $ - $ 63,759

Study tour for 2 representaitives from school toNchanga Midwifery School to see midwifery skillslab in use

12,720 $2,400 $ - $ - $ 2,400

UNFPA are interested tosupport this school

17 MOHGNCMoFPSMDCPs

2014 # of SBAstudentsenrolled peryear

140 skilledbirthattendant(SBA) studentsenrolled peryear, by 2015.


58




Indicatortarget

Total cost(ZMW)

Total cost($)

GRZ($)


Gap($)

Comments

Kabwe School of Nursing and Midwifery18 Renovate existing skills lab 7,607 $1,435 $ - $ - $ 1,435

Equip skills lab 113,346 $21,386 $ - $ - $ 21,386Additional teaching materials for EM to RMupgrade

22,985 $4,337 $ - $ - $ 4,337

Build and furnish new lecture theatre (250+ seats) 2,392,086 $451,337 $ - $ - $ 451,337Tutors: 3 additional required (annual salaries cost) 322,317 $60,815 $ - $ - $ 60,815Clinical Instructors: 8 additional required (annualsalaries cost)

1,074,390 $202,715 $ - $ - $ 202,715

Student fees / training costs (120 new SBAs peryear)

6,164,040 $1,163,026 $ - $ - $ 1,163,026


513,670 $96,919 $ - $ - $ 96,919

Consultant obstetrics and gynaecologist KabweGeneral Hospital (Zambian or expatriate for shortterm until Mmed Obs & Gynae produced specialistfor Kabwe)

337,925 $63,759 $ - $ - $ 63,759

Upgrade the following EN/EM schools to RN/RM schools:

MOHGNCMoFPSMDCPs

Group 1: 2013/2014Kabwe, St. Paul's, Mwami, Chikankata, Solwezi, Mukinge


(previousmaximumannualenrolment of74)

DFID interested tosupport Kabwe to scaleup production of skilledbirth attendants, from2014.

Can scale up enrolmentnumbers further from2015, once lecturetheatre been completed

2013

2014


59




Indicatortarget

Total cost(ZMW)

Total cost($)

GRZ($)


Gap($)

Comments

St. Paul's School of Nursing and Midwifery19 Build new skills lab 2014 1,017,663 $192,012 $ - $ - $ 192,012

Equip skills lab for midwifery training 113,346 $21,386 $ - $ - $ 21,386Build new lecture theatre (100 seater) 1,142,380 $215,543 $ - $ - $ 215,543Furnish lecture theatre (100 seater) 125,000 $23,585 $ - $ - $ 23,585Build new student hostel for 80 beds (rural recruits) 2,571,975 $485,278 $ - $ - $ 485,278Furnish new student hostel (80 beds) 80,560 $15,200 $ - $ - $ 15,200Purchase recommended and prescribedtextbooks/training materials for midwifery trainingat RM level

53,000 $10,000 $ - $ - $ 10,000


644,634 $121,629 $ - $ - $ 121,629

Student fees / training costs (115 new SBAs peryear)

5,907,205 $1,114,567 $ - $ - $ 1,114,567


492,267 $92,881 $ - $ - $ 92,881




MOHGNCMoFPSMDCPs

60




Indicatortarget

Total cost(ZMW)

Total cost($)

GRZ($)


Gap($)

Comments

Mwami School of Nursing20 Option A:

Adapt from or renovate existing skills lab 26,500 $5,000 $ - $ - $ 5,000Equip skills lab for midwifery training 113,346 $21,386 $ - $ - $ 21,386Provide additional teaching materials for additionof midwifery program

53,000 $10,000 $ - $ - $ 10,000


256,835 $48,459 $ - $ - $ 48,459

Option B:Build and furnish new lecture theatre (250+ seats) 2,284,760 $431,087 $ - $ - $ 431,087Build new skills lab 1,017,663 $192,012 $ - $ - $ 192,012Equip new skills lab for midwifery training 113,346 $21,386 $ - $ - $ 21,386Classroom Block (150 seats) with subdividers 1,146,602 $216,340 $ - $ - $ 216,340Furniture for new classroom block (150 seats) 26,500 $5,000 $ - $ - $ 5,000Tutors: 4 additional required (annual salaries cost) 429,756 $81,086 $ - $ - $ 81,086Clinical Instructors: 6 additional required (annualsalaries cost)

644,634 $121,629 $ - $ - $ 121,629

Semi-detached 3 bedroom staff house 1,262,187 $238,148 $ - $ - $ 238,148Student fees / training costs (120 new SBAs peryear)

6,164,040 $1,163,026 $ - $ - $ 1,163,026


513,670 $96,919 $ - $ - $ 96,919


(previousmaximumannualenrolment of53 ENs)


2014


2013MOHGNCMoFPSMDCPs

61




Indicatortarget

Total cost(ZMW)

Total cost($)

GRZ($)


Gap($)

Comments

Chikankata School of Nursing and Midwifery21 Upgrade skills lab equipment for midwifery

training at RM levelMOH,GNC

2014 # of RMstudentsenrolled peryear

40 RMstudentsenrolled peryear, by 2014

56,673 $10,693 $ - $ - $ 10,693 Approved by GNC tostart midwifery in Jan2014

Solwezi School of Nursing22 Adapt from or renovate existing skills lab 26,500 $5,000 $ - $ - $ 5,000

Equip skills lab for EmOC training for RNs (andsubsequent midwifery training program whenadded)

113,346 $21,386 $ - $ - $ 21,386


428,058 $80,766 $ - $ - $ 80,766

Mukinge School of Nursing23 Build skills lab 1,186,213 $223,814 $ - $ - $ 223,814

Equip skills lab for EmOC training for RNs (andsubsequent midwifery training program whenadded)

113,346 $21,386 $ - $ - $ 21,386

3 month midwifery internship for 70 new RNs to beSBAs, per year (3 week EmOC training thenpractical attachment in midwifery unit)

299,641 $56,536 $ - $ - $ 56,536

Awaiting approval tostart RN in Jan 2014.UNFPA interested infurther supporting thisschool. Have 100 bedaccommodationavailable already. OnceRN program successfullyadded could also addmidwifery program.

MOH,GNC,CPs



(previousmaximumannualenrolment of50 ENs)



2014MOH,GNC,CPs

62




Indicatortarget

Total cost(ZMW)

Total cost($)

GRZ($)


Gap($)

Comments

24 Tutors: 30 additional required (annual salaries cost) 3,223,170 $608,145 $ - $ - $ 608,145Clinical Instructors: 48 additional required (annualsalaries cost)

5,157,072 $973,032 $ - $ - $ 973,032

Semi-detached 3 bedroom staff house x 6 7,573,122 $1,428,891 $ - $ - $ 1,428,891Build skills lab (St. Francis, Macha) 1,963,649 $370,500 $ - $ - $ 370,500Adapt from or renovate existing skills labs(Lewanika, Kalene)

53,000 $10,000 $ - $ - $ 10,000

Equip skills labs for EmOC training / midwiferytraining program

680,078 $128,317 $ - $ - $ 128,317

Build and furnish new staff office of capacity 2 -Chilonga

471,426 $88,948 $ - $ - $ 88,948

Group 2: 2015 St. Francis School of Nursing and Midwifery Macha School of Nursing St. Luke's School of Nursing Lewanika Nursing & Midwifery School Chilonga Nursing & Midwifery Kalene School of Nursing



Slab level for Chilongaoffices built but poorstandard so needs to bedemolished and startedagain.

2015

63




Indicatortarget

Total cost(ZMW)

Total cost($)

GRZ($)


Gap($)

Comments

Chainama College of Health Sciences (CCHS)25 Build and furnish new lecture theatre (250+ seats)

to include supportive structures (eg. toilets, staffoffices x 2, tutorial room/conference room)

3,939,234 $743,252 $ - $ - $ 743,252

Build skills lab (for COG, COA and ML training) 897,211 $169,285 $ - $ - $ 169,285Equip skills lab (for COG, COA and ML training) 113,346 $21,386 $ - $ - $ 21,386Build new library block / computer lab 1,231,141 $232,291 $ - $ - $ 232,291Build additional student hostels (80 bed) x 2 5,143,950 $970,557 $ - $ - $ 970,557Furnish additional student hostels (80 bed) x 2 161,120 $30,400 $ - $ - $ 30,400Build accommodation at 5 practicum sites forscaled up student numbers and clinical instructors

6,310,935 $1,190,742 $ - $ - $ 1,190,742

Furnish new accommodation at 5 practicum sites 161,120 $30,400 $ - $ - $ 30,400

Lecturers: 25 additional required (annual salariescost)

2,685,975 $506,788 $ - $ - $ 506,788

Clinical Instructors: 50 additional required (annualsalaries cost)

5,371,950 $1,013,575 $ - $ - $ 1,013,575

Bring 5 x expatriate volunteer 'faculty mentors' fortwo years; 1 per 5 largest COG practicum trainingsites (annual salaries cost)

1,060,000 $200,000 $ - $ - $ 200,000

CCHS to train dedicated clinical instructors atincreased number of practicum sites

413,400 $78,000 $ - $ - $ 78,000

Staff development at CCHS - sponsorship ofrequired faculty training in anatomy, physiologyetc. (4 existing staff per year)

2014,2015,2016

1,272,000 $240,000 $ - $ - $ 240,000

MOH,HPCZ,MoF,PSMD,CPs,

Total # of COGand COAstudentsenrolled peryear

400 COG andCOA studentsenrolled peryear, by 2015

(maximumannualenrolment of240 COswithoutinfrastructureinvestments)

2015,2016

2014,2015

2014

Scale up production of Clinical Officers General (COG) and Clinical Officers Anaesthesia (COA)

64




Indicatortarget

Total cost(ZMW)

Total cost($)

GRZ($)


Gap($)

Comments

Kabwe satellite campus, from CCHS26 Build and furnish new lecture theatre (250+ seats) 2013,

20142,284,760 $431,087 $ - $ - $ 431,087

Build skills lab (without the associated open plandemonstration classroom block due to limitedspace)

299,333 $56,478 $ - $ - $ 56,478

Equip skills lab 113,346 $21,386 $ - $ - $ 21,386Lecturers: 10 additional required (annual salariescost)

1,074,390 $202,715 $ - $ - $ 202,715


1,719,024 $324,344 $ - $ - $ 324,344

Transport for faculty between CCHS and Kabwe(double cab pick up)

85,000 $16,038 $ - $ - $ 16,038

Semi-detached 3 bedroom staff house 1,262,187 $238,148 $ - $ - $ 238,148Student hostel for 80 beds (rural recruits) 2,571,975 $485,278 $ - $ - $ 485,278Furnish student hostel for 80 beds 80,560 $15,200 $ - $ - $ 15,200Student fees / training costs (100 new COGs peryear)

2015,2016

4,733,500 $893,113 $ - $ - $ 893,113

Third large COG and COA training school - suggested location either Northern or Muchinga Province27 Build and furnish new lecture theatre (250+ seats) 2,284,760 $431,087 $ - $ - $ 431,087

Build skills lab 1,017,663 $192,012 $ - $ - $ 192,012Equip skills lab 113,346 $21,386 $ - $ - $ 21,386Lecturers: 10 additional required (annual salariescost)

1,074,390 $202,715 $ - $ - $ 202,715


1,719,024 $324,344 $ - $ - $ 324,344

Semi-detached 3 bedroom staff house 1,262,187 $238,148 $ - $ - $ 238,148Student hostel for 80 beds (rural recruits) 2,571,975 $485,278 $ - $ - $ 485,278Furnish student hostel for 80 beds 80,560 $15,200 $ - $ - $ 15,200

Total # of COGand COAstudentsenrolled peryear

100 COG andCOA studentsenrolled peryear, from2017

This additional trainingcentre can be developedas the Provincial hospitalin either Northern orMuchinga Province isupgraded

2014

Total # of COGstudentsenrolled peryear

MOH,HPCZ,MoF,PSMD,CPs

2016

MOH,HPCZ,MoF,PSMD,CPs

60 COGstudentsenrolled fromJuly 2014 (firstintake), and100 COGstudentsenrolled peryear, from2015

PEPFAR interested tosupport infrastructuredevelopment at Kabwefor CCHS satellitecampus

65




Indicatortarget

Total cost(ZMW)

Total cost($)

GRZ($)


Gap($)

Comments

28 Identify 7 new ML clinical training sites 13,568 $2,560 $ - $ - $ 2,560Minor repairs to theatres and accommodationoptions for ML clinical sites

1,113,000 $210,000 $ - $ - $ 210,000

Lecturers: 13 additional required, if MLs alsotrained in Kabwe satellite campus (annual salariescost)

2014 1,396,707 $263,530 $ - $ - $ 263,530

Bring in 20 expatriate volunteer clinicalinstructors/mentors who are specialists in generalmedicine, general surgery, obstetrics andgynaecology, paediatrics (annual salaries cost)

2015,2016

4,240,000 $800,000 $ - $ - $ 800,000

Scale up production of Medical Licentiates2014 Could share new lecture

theatre and skills lab atKabwe satellite campusfrom CCHS, with the COGprogramme

Total # of MLstudentsenrolled peryear

60 ML studentsenrolled peryear, from2016

CCHS,MOH,HPCZ,MoF,PSMD,CPs




Indicatortarget

Total cost(ZMW)

Total cost($)

GRZ($)


Gap($)

Comments

29 Develop present teaching faculty critical carenursing skills - send 1 staff member per year forMasters in Critical Care Nursing

2014to2016

# of existingfacultyenrolled toMasters inCritical CareNursing

3 of existingfaculty withMSc CriticalCare Nursingby end 2016

318,000 $60,000 $ - $ - $ 60,000 There is no Masters inCritical Care Nursingpresently available inZambia. One facultymember presentlyundergoing training inSouth Africa.

Create establishment postions for critical carenurse training program: 1 Principle tutor, 1 seniortutor, 4 tutors, 1 senior clinical instructor and 3clinical instructors (annual salaries cost)

2014,2015,2016

# fundedestablishment positions

100% ofestablishmentpositionsfilled by end2016

1,136,363 $214,408 $ - $ - $ 214,408 Have no establishmentto run the program. Planto start in 2014 but willdepend entirely onguest lecturers.

MOH,MoF,PSMD,GNC,HPCZ,CPs

Lusaka Schools of Nursing, Midwifery, & Operating TheatreScale up production of Specialist Critical Care Nurse

66




Indicatortarget

Total cost(ZMW)

Total cost($)

GRZ($)


Gap($)

Comments

29(cont) Build and furnish new lecture theatre (250+ seats)

2,284,760 $431,087 $ - $ - $ 431,087

Build skills lab (space available after demolishingold admin block and transport section)

1,017,663 $192,012 $ - $ - $ 192,012

Equip skills lab for critical care nursing 113,346 $21,386 $ - $ - $ 21,386Build student accommodation for 120 beds (3storeys due to space constraints)

13,572,545 $2,560,858 $ - $ - $ 2,560,858

Furnish new student accommodation for 120students

120,840 $22,800 $ - $ - $ 22,800

Build and furnish faculty offices of capacity 30 8,899,449 $1,679,141 $ - $ - $ 1,679,141Bring volunteer expatriate 2 x critical careconsultants + 4 x critical care tutors, with 1 beingspecialised in neonatal and paediatrics critical carenursing (annual salaries cost)

2014,2015

1,272,000 $240,000 $ - $ - $ 240,000

30 Develop present teaching faculty paediatric nurseskills - send 2 staff member per year for Masters inPaediatric Nursing in RSA

2014,2015

# of existingfacultyenrolled toMasters inPaediatricNursing

4 tutors withMScPaediatrics byend 2015

424,000 $80,000 $ - $ - $ 80,000

Create establishment postions for paediatric nursetraining program: 1 Principle tutor, 1 senior tutor, 4tutors, 1 senior clinical instructor and 3 clinicalinstructors (annual salaries cost)

2014,2015,2016



1,136,363 $214,408 $ - $ - $ 214,408

Skills lab equipment for paediatrics training 113,346 $21,386 $ - $ - $ 21,386Specialist paediatric equipment for additionalpracticum sites

169,600 $32,000 $ - $ - $ 32,000

Bring volunteer expatriate faculty 3 x paediatricnurse tutors over 2 year period*, whilst Zambianteaching capacity is developed (annual salariescost)

late2013toearly2015

636,000 $120,000 $ - THET $ -


Application for creationof new establishmentpositions for 2014, needto be made in 2013.

*Brighton University inUK and Lusaka School ofNursing already have aMOU for 2013/2014 toprovide expatriatepaediatric nurse tutors,facilitated by THET

2014 Total # ofPaediatricNursestudentsenrolled peryear

30 PaediatricNursestudentsenrolled peryear, fromAugust 2013

2014

Scale up production of Specialist Paediatric Nurse (programme starting August 2013)

Total # ofCritical CareNursestudentsenrolled peryear

35 Critical CareNursestudentsenrolled peryear, from2014

Enrolment numbers willbe able to increase from2015 if infrastructureinvestments made andexpatriate teachingfaculty made availableuntil Zambian faculty hasbeen developed.

67




Indicatortarget

Total cost(ZMW)

Total cost($)

GRZ($)


Gap($)

Comments

31 Identify training site with skills lab 13,568 $2,560 $ - $ - $ 2,560

Equip skills lab for Emergency Paramedic training 113,346 $21,386 $ - $ - $ 21,386

Develop present teaching faculty for teachingEmergency Paramedic program - train 2 staffmember per year

2014,2015

# of existingfacultytrained toteachEmergencyParamedicprogram

4 tutorsqualified toteachEmergencyParamedicprogram byend 2015

424,000 $80,000 $ - $ - $ 80,000

Create establishment postions for EmergencyParamedic training program: 1 Principle tutor, 1senior tutor, 4 tutors, 1 senior clinical instructorand 3 clinical instructors (annual salaries cost)

2014,2015,2016



1,136,363 $214,408 $ - $ - $ 214,408

Bring volunteer expatriate faculty 3 x EmergencyParamedic tutors over 2 year period, whilstZambian teaching capacity is developed (annualsalaries cost)

2015,2016

Total # ofEmergencyParamedicstudentsenrolled peryear

30 EmergencyParamedicstudentsenrolled peryear, from2015

636,000 $120,000 $ - $ - $ 120,000

New program requiringcurriculum developmentin 2014, before facultydevelopment andexpatriate facultysupport to be able toenrol by 2015

2014 # of Emer.Paramedictrainingschools

1 Emer.Paramedictraining schoolby 2015


Introduction of a new cadre of Emergency Paramedics (1 year in-service training)

68




Indicatortarget

Total cost(ZMW)

Total cost($)

GRZ($)


Gap($)

Comments

32 Bring 2 x volunteer expatriate consultants (1Internal Medicine and 1 Obstetrics andGynaecology) to support teaching faculty withexpanded enrolment numbers (annual salary cost)

424,000 $80,000 $ - $ - $ 80,000

Bring 30 x volunteer expatriate doctors to gap fillwhilst Zambian doctors are released for enrolmentto the Mmed programs (annual salary cost)

6,360,000 $1,200,000 $ - $ - $ 1,200,000

33 Bring 1 x volunteer expatriate consultant inOphthalmology for two years to support teachingfaculty with expanded enrolment numbers whilstdeveloping additional Zambian teaching faculty(annual salary cost)

MOH,HPCZ,SOM,UNZA,CPs

2014,2015

Total # ofMmedstudents inOphthal.enrolled, peryear

8 Mmedstudents inOphthal.enrolled peryear, from2014 (previousannualenrolment of4)

212,000 $40,000 $ - $ - $40,000

More specialistsrequired to staffupgraded Provincialhospitals.

As all MMed programsare 4 years long, allfuture graduates musthave been enrolled by2016 (ie. within the timeframe of this NTOP) tomeet the 2020 need forspecialists.

Master of Medicine in:Internal Medicine, General Surgery, Paediatrics and Child Health, Obstetrics and Gynaecology (4 year, in-service post graduate programs)

MOH,HPCZ,SOM,UNZA,CPs

2014,2015,2016

Total # ofMmedstudents inthese 4specialitiesenrolled, peryear

60 Mmedstudents inthese 4specialitiesenrolled peryear, from2014(previousannualenrolment of35)

Master of Medicine in Ophthalmology

Scale up production of Specialist Doctors

69




Indicatortarget

Total cost(ZMW)

Total cost($)

GRZ($)


Gap($)

Comments

34 Bring 3 x volunteer expatriate consultants part time(1 for each of above specialities) to supportteaching faculty (annual salary cost)

Covered byTHET

THET $ -

Provide additional teaching materials for theseMmed programs

Covered byTHET

THET $ -

Bring 1 x volunteer expatriate consultant inAnaesthesia and Intensive Care for two years tosupport teaching faculty with expanded enrolmentnumbers whilst developing additional Zambianteaching faculty (annual salary cost)

HPCZ,MOH,CPs

2014,2015

212,000 $40,000 $ - $ - $40,000

35 Bring 1 x volunteer expatriate consultant inEmergency Medicine to teach the program, whilstZambian teaching faculty is developed (annualsalary cost)

2014,2015,2016

212,000 $40,000 $ - $ - $ 40,000

Build new skills lab for use of scaled up MMedprograms

1,017,663 $192,012 $ - $ - $ 192,012

Equip new skills lab for speciality MMed trainingincluding new Emergency Medicine program

113,346 $21,386 $ - $ - $ 21,386

Equip MMed practicum sites with specialistequipment required

265,000 $50,000 $ - $ - $ 50,000

36 Maximum capacity of 3000 students (1000 enrolledper year) with lecture theatres, skills labs,computer labs, dining hall accommodating 1000students, student hostels accommodating 3000students, student recreational facilities etc.(Expected to train nurses, lab techs., lab scientists,physiotherapists, radiographers, biomedicalstudents)

MOH,CPs

2013,2014,2015

Total # ofstudentsenrolled, peryear

1000 studentsenrolled peryear, by 2016

80,000,000 $15,094,340 $ - $ - $15,094,340 Estimate infrastructurecost based on floor area.More detailed costingsnot yet available. Costsfor teaching staff,teaching materials,furniture, equipmentand fees not included.

Master of Medicine in:Psychiatry, Anaesthesia and Intensive Care, Pathology

Lusaka and CopperbeltProvinces need 5graduates each andother 8 Provinces need 3graduates each, totally34 graduates required by2020. Therefore mustenrol 36 students by2016 to meet 2020minimum need.

Total # ofMmedstudents inthese 3specialitiesenrolled, peryear

Commence new Master of Medicine in Emergency Medicine program

17 Mmedstudents inthese 3specialitiesenrolled peryear, from2014(previousannualenrolment of11)

MOH,HPCZ,SOM,UNZA,THET

2013,2014,2015,2016

MOH,HPCZ,SOM,UNZA,CPs 2014

Total # ofMmedEmergencyMedicinestudentsenrolled peryear

12 MmedEmergencyMedicinestudentsenrolled peryear, from2014

New large scale National Training Institution in Lusaka

70




Indicatortarget

Total cost(ZMW)

Total cost($)

GRZ($)


Gap($)

Comments

Kitwe School of Nursing & Midwifery37 Lecture theatre 200 seater -already built but

requires furniture, equipment and aircon to befunctional

444,859 $83,936 $ - $ - $ 83,936

Kitchen and dining area - already built but requiresfurniture and equipment to be functional

606,553 $114,444 $ - $ - $ 114,444

Build skills lab 1,017,663 $192,012 $ - $ - $ 192,012Equip skills lab for nurse and midwifery training 113,346 $21,386 $ - $ - $ 21,3863 month midwifery internship for 100 new RNs tobe SBAs, per year (3 week EmOC training thenpractical attachment in midwifery unit)

428,058 $80,766 $ - $ - $ 80,766

Monze School of Nursing & Midwifery38 Student accommodation for 40 -already built but

major remedial works required for it to be utilized188,217 $35,513 $ - $ - $ 35,513

Furnish student accommodation for 40 40,280 $7,600 $ - $ - $ 7,600Classroom block for 120 students - already built butmajor remedial works required for it to be utilized

161,860 $30,540 $ - $ - $ 30,540

Furnish classroom block for 120 students 26,500 $5,000 $ - $ - $ 5,000Semi detached staff housing - already built butmajor remedial works required for it to be utilized

187,478 $35,373 $ - $ - $ 35,373

Evelyn Hone College (produces Environmental Health Technologists, Biomedical Scientist, Pharmacy Technologist, Physiotherapy Technologist & Radiographers)39 Build and furnish new lecture theatre (250+ seats) 2,284,760 $431,087 $ - $ - $ 431,087

Adapt from or renovate existing skills labs 26,500 $5,000 $ - $ - $ 5,000Equip skills lab 113,346 $21,386 $ - $ - $ 21,386

Ndola School of Nursing and Midwifery40 Build and furnish new lecture theatre (250+ seats) 2,284,760 $431,087 $ - $ - $ 431,087

Adapt from or renovate existing skills labs 26,500 $5,000 $ - $ - $ 5,000Equip skills lab 113,346 $21,386 $ - $ - $ 21,386

Chipata School of Nursing and Midwifery41 Build and furnish new lecture theatre (250+ seats) 2,284,760 $431,087 $ - $ - $ 431,087

Adapt from or renovate existing skills labs 26,500 $5,000 $ - $ - $ 5,000

Under Ministry ofScience, Technology andVocational Training

MOH,GNC,CPs



MOH,GNC,CPs



Classroom capacitylimiting presentenrolment intake to 110

Classroom capacitylimiting presentenrolment intake to 130

MOH,GNC,CPs


160 SBAstudentsenrolled peryear, by 2014(previousannualenrolment of110)

MSTVT,CPs

2015 # of studentsenrolled, peryear

525 studentsenrolled, by2016

High priority tocomplete both lecturetheatre and newkitchen/dining area sothey can be utilised andreturns on theseinvestments can berealised.

MOH,GNC,CPs


180 SBAstudents (80RMs & 100RNs) enrolledper year, by2014(previousannualenrolment of122)

Other infrastructure investment required for TIs to scale up - carry over projects from 2008 NTOP

Construction practicallycomplete but poorworkmanship means notusable until pendingremedial work has beendone. High prioirty tocomplete.

71




Indicatortarget

Total cost(ZMW)

Total cost($)

GRZ($)


Gap($)

Comments

Chitambo Mission School of Nursing42 Build skills lab 1,017,663 $192,012 $ - $ - $ 192,012

Equip skills lab 113,346 $21,386 $ - $ - $ 21,386

Dental Training School43 Build skills lab 1,017,663 $192,012 $ - $ - $ 192,012

Equip skills lab 113,346 $21,386 $ - $ - $ 21,386

Mufulira School of Nursing & Midwifery44 Build skills lab 1,017,663 $192,012 $ - $ - $ 192,012

Equip skills lab 113,346 $21,386 $ - $ - $ 21,386

St. Francis / Katete School of Nursing & Midwifery45 Build skills lab 1,017,663 $192,012 $ - $ - $ 192,012

Equip skills lab 113,346 $21,386 $ - $ - $ 21,386Build semi detached staff house 1,115,706 $210,511 $ - $ - $ 210,511

Natural Resources Development College46 Adapt from or renovate existing skills labs 26,500 $5,000 $ - $ - $ 5,000

Equip skills lab 113,346 $21,386 $ - $ - $ 21,386

Roan Antelope School of Midwifery (Produces Certified Midwives)47 Build library MOH,

GNC,CPs



1,168,039 $220,385 $ - $ - $ 220,385 Library is required toenhance quality ofeducation offered

Chikankata School of Biomedical Sciences48 Build accomodation for 72 students - slab level

already prepared and structurally sound2,633,910 $496,964 $ - $ - $ 496,964

Furnish student accommodation for 72 72,504 $13,680 $ - $ - $ 13,680

312,286,133 $58,921,912

MOH,HPCZ,CPs

2015 # of studentsenrolled peryear


MOH,GNC,CPs



If build thisaccommodation will alsoneed additional tutors &tutors accommodationto scale up enrollments

MOH,GNC,CPs



MOH,GNC,CPs



MOH,GNC,CPs

2015 # of RNstudentsenrolled peryear

50 RN studentsenrolled peryear, by 2014

MOH,HPCZ

2015 # studentsenrolled peryear

75 studentsenrolled peryear by 2016

Better equiped andpurpose built skills labwould enhance qualityof training provided

Starting new 3 yearcourse for dentaltechnologists from 2015

Total estimated budget required

72

ANNEXES

73

Annex 1: Map of health training institutions assessed

74

Annex 2: Training Institution ProfilesANNEX 1: TRAINING INSTITUTION PROFILES

Chainama College of Health Sciences2008 2009 2010 2011 2012 Context: Chainama College of Health Science offers Pre-service training programs for Clinical Officers (COs) (General), CO (Psychiatry), and

Total Applicants for Enrollment: Health Sciences 1302 1703 1358 2051 1268 CO (Ophthalmology) and In-service Training programs for MLs, EHTs, RMHNs. Reduced GRZ funding and limited Infrastructure capacity had reducedTotal Enrolled Students: Diploma in Health Sciences 125 152 273 489 199 the annual intake of CO (General) students by more than doubled starting in 2011 from 2010 was which recorded increased due to the addition of the

Clinical Officer General 44 54 103 297 66 self-funded CO (General) parallel programClinical Officer Psychiatry 16 17 28 13 0

Environmental Health Technologist 24 32 70 109 40 Many of target estimated in the 2008 NTOP were based on investments being made into CCHS these included:(a) Construction of 2 Lecture Theatres withMedical Licentiate 24 21 24 30 30 200 student capacity; (b) refurbishing existing classroom space; (c) updating equipment in the 3 existing skills laboratory; (d) building of on- campus studentOphthalmic Nurse 9 5 12 9 12 accommodation for a total of 300 student by 2012 and; (e) off-campus student hostels at relevant practical sites for Clinical Officers attachment sessions

Ophthalmic Clinical Officer 8 8 5 3 3Registered Mental Health Nurses 0 15 31 28 48 Despite, receiving none of the NTOP funds, CCHS has continue to use initiatives, such as Parallel Programs and Lobby for Student Scholarships to increase

Percentage of Enrolled Student from Total Applicants 10% 9% 20% 24% 16% student intake and graduate numbers from 2008 - 2012. In 2013, CCHS plans to affiliate a number of programs to University of Zambia, School of Medical,Total Enrolled Students 125 152 273 489 199 this will enable the school to offer Degree Programs for Cos and MLs

The key challenges faced for CCHS to scale up production of key health cadres, such as, the Clinical Officers and Medical Licentiates include:Total Graduates: Diploma in Health Sciences 219 291 441 116 141 1 Renovation and refurbishing of existing buildings and skills lab equipment

Total Estimated/Projected Graduates from 2008 NTOP 275 275 275 400 400 2 Construction of Lecture Theatre and Skills Laboratory to accommodate larger intake numbers3 Financial and Funding Support for CCHS

Total Graduates 219 291 441 116 141 4 Support for career progression and upgrade of COs and MLs diploma to degree program

Classrooms Available 6Classrooms Capacity 210 21.9% Capacity to Student Ratio (Classroom)

Skills Labs Capacity Available 1Skills Labs Capacity 60 6% Capacity to Student Ratio (Skills lab)

Full-Time Tutors Available 103 1/9 Lecturer: Student RatioEstimated Full-Time Tutors Required in 2008 NTOP 145

Clinical Instructors Available 37 1/26 Clinical Instructor: Student RatioFull-Time Clinical Instructors Required in 2008 NTOP 20

Support Staff Available 46 1/21 Support Staff: Student RatioSupport Staff Required 186

Library Capacity Available 1000 13 Number of Hostels AvailableLibrary Capacity Required (Third of Student Population) 320 468 Student Beds Available

Dining Hall Capacity Available 522Dining Hall Capacity Required (Half of Student Population) 481

Vehicle Capacity Available 120Vehicle Capacity Required 2263 Reported total number of student on attachment in 2011

Computers Available 88Computers Required 320

Key Investments required for Scale - Up

Construction/Procurement of New Infrastructure/Equipment or Services Refurbishment/Optimization the Use of Existing Infrastructure/Equipment or Services

New Classrooms Needed for Scale-up Optimizing Classrooms Needed for Scale-upNew Lecture Theatre Needed for Scale-up Space for Skills Lab Available for Scale-up

New Skills Lab Capacity Needed for Scale-up Min. Renovation Work- Painting , Fittings Needed for Scale-upStudent Beds/Hostel Needed for Scale-up Furnishing of existing Lecture Theatre and Classroom Required for Scale-up

Additional Lecturers/Tutors Needed for Scale-up Revising Classroom Schedules Needed for Scale-upAdditional Clinical/Skills Lab Instructors Needed for Scale-up Utilizing exisiting "empty"" hospital or school buildings Needed for Scale-up

Additional Support Staff Needed for Scale-up Optimizing use of existing hospital or school buildings Needed for Scale-upUpdated Skills Laboratory Equipment Needed for Scale-up Optimizing use of existing hospital staff in teaching/practical sessions Needed for Scale-upUpdated textbooks and teaching aids Needed for Scale-up Fixing of available furniture - desks, tables, chairs Required for Scale-up

Library Seats Needed for Scale-up Potential site for distance teaching methods and equipment Needed for Scale-upDining Hall Seats Need for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-up36 seater Bus Needed for Scale-up Potential site for day scholar/parallel program or dual classes Needed for Scale-up

Computers Needed for Scale-up

219

291

441

116 141

275 275 275

400 400

0

50

100

150

200

250

300

350

400

450

2008 2009 2010 2011 2012

Chainama College of Health SciencesAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)

Total Estimated/Projected Graduates from 2008 NTOP

75

**Chainama College of Health Sciences not included in Phase I of NTOP funding, so received no funds through this process

Enrollment Graduates2008 2009 2010 2011 2012 2008 2009 2010 2011 2012

ChainamaCollege ofHealth Sciences

1 Expand intakes step-wise for allcadres from 2009 onwards

N Gone up, then down Clinical OfficerGeneral

44 52 113 295 66 118 123 181 43 52

2 Maintain current attrition rate of 5-10% going forward

y Average graduation rate of90% across all programs;some programs >95%graduation rate

Clinical OfficerPsychiatry

16 15 28 13 0 0 40 59 13 15

3 Produce >330 graduates annuallyfrom 2013 onwards

TBD 230 grads in 2012; peakedat 474 in 2010

EnvironmentalHealthTechnologist

23 33 70 109 40 75 74 115 23 32

Medical Licentiate 26 16 24 30 30 26 0 18 16 16

Ophthalmic Nurse 9 5 12 9 12 0 7 4 11 8OphthalmicClinical Officer

8 8 5 3 3 0 8 6 9 3

Registered MentalHealth Nurses

0 15 31 28 48 0 39 58 1 15

GeneralCounsellor

22 0 24 59 51 14 0 33 21 90

TrainingInstitution 2008 NTOP Target Achieved Current Status Cadre Trained

76

Chikankata School of Nursing & Midwifery2008 2009 2010 2011 2012 Context: Chikankata Nursing and Midwifery is located in Mazabuka District (in Southern Province) with College of Biomedical Science and Hospital.

Total Applicants for Enrollment: Registered Nurse 500 550 600 650 750 The 2008 NTOP funds was allocated to: student accommodation (capacity 36), faculty offices (capacity 10), 7 staff houses,, furnish existing classrooms andTotal Enrolled Students: Diploma in Registered Nurse 60 69 82 0 80 renovation of library roof. Through alternative funding in 2007 a classroom block of capacity 100 and skills lab was constructed.

Projected Enrolled Students Numbers in the 2008 NTOP 50 50 50 50 50 Over the past 2 years, the EM program has been phased out to upgrade to RM (starting in 2013)Percentage of Enrolled Student from Total Applicants 12% 13% 14% 0% 11% Priorities: (1) Expanding the dinning hall and kitchen (2) Skills Laboratory Equipment (3) Library Space

Total Enrolled Students 60 69 82 0 80

Total Graduates: Diploma in Registered Nurse 0 27 46 0 60Total Estimated/Projected Graduates from 2008 NTOP 47 47 47 47 47

Total Graduates 0 27 46 0 60






Summary of 2008 NTOP Funded Activities

Library Capacity Available 20 6 Number of Hostels Available Activity 2008 Costs 2008 Costs Amts ReceivedActual Expenditure Project TrackingLibrary Capacity Required (Third of Student Population) 54 125 Student Beds Available (USD) (ZMK) (ZMK) (ZMK)

Dining Hall Capacity Available 64 162 Student Beds Required Purchase furniture for existing classroom 5,000 17,000,000 17,000,000 20,000,000 Completed and In UseDining Hall Capacity Required (Half of Student Population) 81 Build student accommodation for 40 206,000 700,400,000 704,000,000 758,213,921 Completed and In Use

Vehicle Capacity Available 12 Purchase furniture for accommodation for 40 60,000 204,000,000 204,000,000 185,950,000 Completed and In UseVehicle Capacity Required 36 Reported 80 students for attachments in 2012 Fix leaky ceiling in library 2,000 6,800,000 6,800,000 6,800,000 Completed and In Use

Computers Available 15 Build and furniture 10 new staff offices 101,000 343,400,000 343,400,000 388,956,000 Completed and In UseComputers Required 54 Build and furnish 7 new teacher accommodation 300,000 1,020,000,000 1,020,000,000 3,410,419,209 Completed and In Use

TOTAL 674,000 2,291,600,000 2,295,200,000 4,770,339,130



New Classrooms Needed for Scale-up Optimizing Classrooms Needed for Scale-upNew Lecture Theatre Needed for Scale-up Optimizing Lecture Theatre Needed for Scale-up

New Skills Lab Capacity Needed for Scale-up Revising Skills Lab Scheduled Needed for Scale-upNew Full-Time Tutors Needed for Scale-up Utilizing/Increasing Practical Sites Needed for Scale-up

Additional Lecturers/Tutors Needed for Scale-up Revising Classroom Schedules Needed for Scale-upAdditional Clinical/Skills Lab Instructors Needed for Scale-up Utilizing existing "empty"" hospital or school buildings Needed for Scale-up

Additional Support Staff Needed for Scale-up Optimizing use of existing hospital or school buildings Needed for Scale-upUpdated Skills Laboratory Equipment Needed for Scale-up Optimizing use of existing hospital staff in teaching/practical sessions Needed for Scale-upUpdated textbooks and teaching aids Needed for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-up

Library Seats Needed for Scale-up Potential site for distance teaching methods and equipment Needed for Scale-upDining Hall Seats Need for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-upStudent Beds Needed for Scale-up Potential site for day scholar/parallel program or dual classes Needed for Scale-up

36 seater Bus Needed for Scale-upComputers Needed for Scale-up

0

27

46

0

60

47 47 47 47 47

0

20

40

60

2008 2009 2010 2011 2012

Chikankata School of Nursing & MidwiferyAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)

Projected Graduates in 2008 NTOP

77


ChikankataSchool ofNursing

1 Introduce RN program with intake of50 from Jan 2008 onwards

Y 80 in 2012; no intake in2011

Registered Nurses 60 69 82 0 80 27 46 0 60 62

2 End EN program after Jan 2007Intake

Y Completed Enrolled Midwives 8 0 0 0 0 11 8 0 7 0

3 Increase EM intake from 10 to 30from July 2009 onwards

N No EM intake after 2008

4 Produce >47 RN graduates from Dec2010 onwards

Y 60+ RN grads in 2011-2012

5 Produce >28 EM graduates from Jul2010 onwards

N No EM grads


Funding (ZMK)

2008 NTOP Planned ActivityProjectStatus Detailed Project Status

Summary of RemainingInfrastructure Needs Budget Received Actual

Funds Requiredto Complete (ifknown)

1 Purchase furniture for existingclassroom

Completed Including Classrm Block > 200 4 classrooms stil l needed (1-25RMs, 3-50RNs)

17,000,000 17,000,000 17,000,000 65,000,000

2 Build student accommodation for 40 Completed Built for 36; Equiping 2 skil ls lab(Classrm Blk)

700,400,000 704,000,000 758,213,921 -

3 Purchase furniture foraccommodation for 36

Completed Furnished 5X6 and 6X4 hostels;capacity 10-15 students

DH/Kitchen/ColdroomEquipment

204,000,000 204,000,000 204,000,000 -

4 Fix leaky ceil ing in l ibrary Completed 6,800,000 6,800,000 6,800,000 -5 Build and furnish 10 new staff offices Completed Desk/Chair/Cupboard/Fridge Renting Old Staff Block 343,400,000 343,400,000 40,000,000

6 Build and furnish 13 new teacheraccommodation

Completed 7/13 Staff Houses completed 6 additional staff houses to becompleted

1,020,000,000 1,020,000,000 1,684, 951, 960 1,956,777,286

7 Purchase 26-seater bus Notfunded/Notundertaken

88,400,000

Other notes Conversion Staff Block to Computer lab; computers donated by ZICTATOTAL 2,380,000,000 2,295,200,000 986,013,921 2,061,777,286

78

Chikankata College of Biomedical Sciences2008 2009 2010 2011 2012 Context: Chikankata College of Biomedical Sciences is located in Mazabuka District (in Southern Province) and run by The Government in Partnership

Total Applicants for Enrollment: Biomedical Sciences 68 234 342 475 485 with the Salvation Army . The 2008 NTOP funds were allocated to student accommodation (capacity of 36), kitchen, and dining facilities, and 2Total Enrolled Students: Diploma in Biomedical Sciences 20 38 37 47 64 classrooms. Additional funding was sourced for the construction of skills lab, which is yet to be completed and furnished. Some of the key achievementProjected Enrolled Students Numbers in the 2008 NTOP 30 30 50 50 50 over the past 5 years have been: increasing the biomedical diploma to 64 in 2012 (2008 NTOP target was 50 student intake in 2012).

Percentage of Enrolled Student from Total Applicants 29% 16% 11% 10% 13% Priorities: (1) Staff Recruitment and Housing (2) Skills Laboratory Equipment (3) Lecture TheatreTotal Enrolled Students 20 38 37 47 64

Total Graduates: Diploma in Biomedical Sciences 0 0 0 0 0Total Estimated/Projected Graduates from 2008 NTOP 48 48 48 48 48









Dining Hall Capacity Available 100 148 Student Beds Required Purchase furniture for accommodation for 40 60,000 204,000,000 777,088,200 777,088,200 Completed and In UseDining Hall Capacity Required (Half of Student Population) 74 Build and furnish new library of capacity 25 36,000 122,400,000 0 0 Completed and In Use

Vehicle Capacity Available 11 Build and furnish faculty offices of capacity 4 40,000 136,000,000 388,956,000 388,956,000 Completed and In UseVehicle Capacity Required 36 Purchase minibus of capacity 30 30,000 102,000,000 102,000,000 102,000,000 Delayed

Computers Available 50 TOTAL 166,000 564,400,000 1,268,044,200 1,268,044,200Computers Required 49


Construction/Procurement of New Infrastructure/Equipment or Services Renovations/Optimization the Use of Existing Infrastructure/Equipment or Services




Additional Support Staff Needed for Scale-up Max. Renovation Works- Electrification , Water, Sewerage Needed for Scale-upUpdated Skills Laboratory Equipment Needed for Scale-up Optimizing use of existing hospital staff in teaching/practical sessions Needed for Scale-upUpdated textbooks and teaching aids Needed for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-up



0

27

46

0

6047 47 47 47 47

0

25

50

75

2008 2009 2010 2011 2012

Chikankata College of Biomedical SciencesAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


79

** Indicates activity was evaluated by Quantity Surveyor as part of 2012 NTOP review; Funds required to complete for these projects were reported in thisassessment


ChikankataSchool ofBiomedicalSciences

1 Increase biomedical diploma intakefrom current 30 to 50 from July 2010onwards

Y Did not reach for 2010/11,but 64 in 2012

LaboratoryTechnologist

20 38 37 47 64 0 16 26 27 25

2 Reduce current 10% dropout rate to<5%

N Average 69% graduationrate over past 4 years

3 Produce >48 technologistsgraduates by July 2013

N 25 grads in 2012


Funding (ZMK)




1 Build new student accommodationfor 40**

Incomplete 2 Hostels completed (F/M), 36rooms (2/rm)

At slab level for 72 students;insufficient funds to proceed

700,400,000 0 0 2,633,910,000


Completed Purchased for 36 204,000,000 204,000,000 777,088,200 -

3 Build and furnish new library ofcapacity 25

Completed Combined library and staff offices 122,400,000 122,000,000 0 -

4 Build and furnish faculty offices ofcapacity 6

Incomplete Completed combined library andstaff offices for 3 faculty

3 faculty offices not constructed 207,400,000 136,000,000 388,956,000 -

5 Purchase minibus of capacity 30 Incomplete Part Payment (250mil) required Not paid in full 102,000,000 102,000,000 102,000,000 250,000,0006 Other notes Skil ls lab investment needed; 3/4 complete7 Other notes Dining hall/kitchen requires renovations

TOTAL 1,336,200,000 564,000,000 1,268,044,200 2,883,910,000

80

Chilonga School of Nursing & Midwifery2008 2009 2010 2011 2012 Context: Chilonga School of Nursing and Midwifery is located in Mpika District, Muchinga Province. The intake and graduates numbers have relatively the

Total Applicants: Enrolled Nurses and Midwives 300 300 400 500 500 same from 2004; mainly because of the limited infrastructure capacity. Much of the needs are centered around renovations to some of the key areas,Total Enrolled Students: Enrolled Midwives 35 36 35 40 30 such as, student hostels and new staff offices with the increased staffing levels from the last 5 years

Total Enrolled Students: Enrolled Nurses 30 38 40 45 40 Location of the school (30 km from Mpika) plays a huge role in operational costs towards practical sites; consideration of intake expansion throughProjected Enrolled Students Numbers in the 2008 NTOP 60 60 100 100 100 Parallel Programs; and Staff Retention where accommodation on-site is not available.

Percentage of Enrolled Student from Total Applicants 22% 25% 19% 17% 14% Priorities: (1) Completion of the staff offices (NTOP activity) (2) Construction of Lecture Theatre (capacity 120 students) (3) Transport-36 seater busTotal Enrolled Students 65 74 75 85 70

Total Graduates: Enrolled Midwives 26 35 33 30 34Total Graduates: Enrolled Nurses 29 30 35 35 36

Total Estimated/Projected Graduates from 2008 NTOP 96 96 96 96 96









Dining Hall Capacity Available 50 230 Student Beds Required Purchase furniture for existing classroom 2,000 6,800,000 6,000,000 11,500,000 Completed and In UseDining Hall Capacity Required (Half of Student Population) 115 Build and furnish new staff offices of capacity 2 20,000 68,000,000 68,000,000 68,000,000 Incomplete

Vehicle Capacity Available 12 Repair existing vehicle 7,000 23,800,000 23,000,000 0 IncompleteVehicle Capacity Required 36 Reported 56 students for attachments in 2012 TOTAL 29,000 98,600,000 97,000,000 79,500,000

Computers Available 15Computers Required 77 Comment: Funds for repairing the vehicle were diverted to the staff offices, the initial plan for the staff office was modified from 2 to a capacity of 8 - funds were

not enough to complete this project (which is currently at slab level), additional support is being sought from PHO (Mansa) to assist.





Additional Lecturers/Tutors Needed for Scale-up Revising Classroom Schedules Needed for Scale-upAdditional Clinical/Skills Lab Instructors Needed for Scale-up Extensive Completion Works- Slab/Window/Roof Level Needed for Scale-up

Additional Support Staff Needed for Scale-up Optimizing use of existing hospital or school buildings Needed for Scale-upUpdated Skills Laboratory Equipment Needed for Scale-up Optimizing use of existing hospital staff in teaching/practical sessions Needed for Scale-upUpdated textbooks and teaching aids Needed for Scale-up Furnishing of existing buildings - office blocks, hostels Required for Scale-up

Library Seats Needed for Scale-up Potential site for distance teaching methods and equipment Needed for Scale-upDining Hall Seats Need for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-upStudent Hostel Needed for Scale-up Potential site for day scholar/parallel program or dual classes Needed for Scale-up36 seater Bus Needed for Scale-up


5565 68 65 70

96 96 96 96 96

0

25

50

75

100

125

2008 2009 2010 2011 2012

Chilonga School of Nursing & MidwiferyAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


81



ChilongaNursing &Midwifery

1 Increase EN intake from current 30to 50 from July 2010 onwards

N Peaked at 45 in 2011; 30 in2012

Enrolled Midwives 35 36 35 40 30 35 33 30 34 26

2 Increase EM intake from current 30to 50 from July 2010 onwards

N Peaked at 40 in 2011; 30 in2012

Enrolled Nurses 30 38 40 45 40 30 35 35 36 36

3 Produce >48 EN gradates from Jun2012

N 36 in 2012

4 Produce >48 EM graduates from June2012

N 26 in 2012


Funding (ZMK)





Completed 20 purchased inadequate for 40 Plan Student rm = 60, cementdonation

6,800,000 6,000,000 11,500,000

2 Build and furnish new staff offices ofcapacity 2**

Incomplete Modified to 10 Staff Offices; Sitecleared, Construction Slab level;Delayed tender process by PHO

Project of poor quality & needsto be demolished

68,000,000 68,000,000 68,000,000 471,426,000

3 Repair existing vehicle Incomplete Unavailable parts - SOLD 23,800,000 23,000,000 Other Notes TOTAL 98,600,000 97,000,000 79,500,000 471,426,000

5,500,000 of Actual Expenditure spent on transportation:Lsk to Mpika

82

Chipata Schools of Nursing & Midwifery2008 2009 2010 2011 2012 Context: Chipata Schools of Nursing and Midwifery, at present, train Registered Nurse and Certificated Midwives (DEM). The DEM program started in

Total Applicants: Registered Nurses and Certified Midwives 300 400 350 400 600 2008 with targeted intake of 40 which has reduced to 24 in the past 3 years; mainly because of increase in RNs and schools requirements to accommodateTotal Enrolled Students: Certified Midwives 40 0 26 24 24 all students placing an increased demand to construct student hostels. Staff levels are a key challenge, during the assessment only 3 of the 6 reportedTotal Enrolled Students: Registered Nurses 42 42 52 48 40 full-time staff were available (others on study leave). Location of the school (within Chipata Main Town) would make it an ideal center to introduce and

Projected Enrolled Students Numbers in the 2008 NTOP 60 60 100 100 100 some of the "innovative teaching approaches" of e-learning and parallel programsPercentage of Enrolled Student from Total Applicants 27% 11% 22% 18% 11% Priorities: (1) Demonstration/Skills laboratory (2) Tutor and Clinical Instructors (3) Staff accommodation

Total Enrolled Students 82 42 78 72 64

Total Graduates: Certified Midwives 0 0 0 37 0Total Graduates: Registered Nurses 17 42 48 40 52










Dining Hall Capacity Available 40 214 Student Beds Required Build and furnish new faculty offices of capacity 4 40,000 136,000,000 137, 541,600 137,541,600 Completed and In UseDining Hall Capacity Required (Half of Student Population) 107 Build and furnish faculty accommodation of capacity 3 128,000 435,200,000 456,221,470 142,929,360 Completed and In Use

Vehicle Capacity Available 12 Build Student accomodation for 40 206,000 700,400,000 671,975,640 671,975,640 Completed and In UseVehicle Capacity Required 36 Reported 90 students for attachments in 2012 Build and furnish library 61,000 207,400,000 154,145,880 154,145,880 Completed

Computers Available 75 Total 435,000 1,479,000,000 1,282,342,990 1,106,592,480Computers Required 71

Comment: Additional funds were sourced to complete faculty accommodation (3), the library and faculty offices are yet to be furnished.



New Classrooms Needed for Scale-up Optimizing Classrooms Needed for Scale-upNew Lecture Theatre Needed for Scale-up Space for Skills Lab Needed for Scale-up


Additional Lecturers/Tutors Needed for Scale-up Revising Classroom Schedules Needed for Scale-upAdditional Clinical/Skills Lab Instructors Needed for Scale-up Fixing of available furniture - desks, tables, chairs Required for Scale-up

Additional Support Staff Needed for Scale-up Furnishing of existing buildings - office blocks, hostels Required for Scale-upUpdated Skills Laboratory Equipment Needed for Scale-up Optimizing use of existing hospital staff in teaching/practical sessions Needed for Scale-upUpdated textbooks and teaching aids Needed for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-up



17

42 48

77

5247 47

85 85 85

0

25

50

75

100

2008 2009 2010 2011 2012

Chipata Schools of Nursing & MidwiferyAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


83


Chipata Schoolof Nursing &DEM

1 Increase RN intake from current 37to 50 from Jul 2008 and 50 to 70from Jul 2010 onwards

N Peaked at 52 in 2010 Certified Midwives 40 0 26 24 24 0 0 37 0 26

2 Maintain DEM at current intake of40; consider expansion of programafter evaluation of pilot phase

N DEM intake of 24 in 2012 Registered Nurses 42 42 52 48 40 42 48 40 52 48

3 Produce >47 RN graduates from Jun2011 and >66 RN graduates from Jun2013 onwards

Y 48 graduates in 2012

4 Produce >38 DEM graduates fromDec 2009 onwards

N 26 DEM grads in 2012


Funding (ZMK)




1 Build and furnish new faculty officesof capacity 4

Completed Old Staff Offices in use > 10 137,541,600 137,541,600 20,000,000

2 Build and furnish facultyaccommodation of capacity 3

Completed Staff accomodation sti l l required 456,221,470 142,929,360 -

3 Build Student accomodation for 40 Completed DEM block required 59M inadditional funds; deducted fromstaff accommodation project

Existing Student Hostels needrehabilitation

700,400,000 671,975,640 671,975,640 80,000,000

4 Purchase furniture for studentaccommodation

Notfunded/Notundertaken

207,300,000

5 Build and furnish library Completed Furniture not procured 154,145,880 154,145,880 37,500,0006 Build classroom Not

funded/Notundertaken

200,600,000

7 Purchase furniture for classroom Notfunded/Notundertaken

13,600,000

8 Purchase furniture for existing dininghall


1,700,000

Other notes Lecture Theatre needed to scale upTOTAL 1,123,600,000 1,419,884,590 1,106,592,480 137,500,000

84

Chitambo School of Nursing2008 2009 2010 2011 2012 Context: Chitambo School of Nursing located in Serenje District in Central Province with an RN program. The school was recently re-opened in 2010, it was

Total Applicants: Registered Nurses 0 0 0 75 75 initially an EN school, several initiatives to scale - up infrastructure in the 2 years - construction of 2 classroom block (with 45 capacity), 4 staff offices and 2Total Enrolled Students: Registered Nurses 0 0 0 27 0 staff houses. Chitambo is located in rural part of Serenje District approximately 20km from Great North Road

Target Enrolled Students Numbers 40 40 40 40 40Percentage of Enrolled Student from Total Applicants - - - 36% 0% With the rural location of Chitambo, scaling up intake and graduate number will require expanding the current student accommodation, in 2012 has no RN intake

Total Enrolled Students 0 0 0 27 0 because all student need to be accommodated the current hostel 28 bed space was filled by the first RN student (now in 2nd year), staff houses arealso needed for teaching faculty that will be posted, Chitambo Hospital does not have high patient turnover. A main challenge is practical sites attachments as the school does not have ant bus and all transport is through the utility 12 seater land cruiser for clinical sites in Serenje Hospital (90km), Mpelembe RHC

Total Graduates: Registered Nurses 0 0 0 0 0 (124km) and Chibale HC (160km).

Total Graduates 0 0 0 0 0 The introduction of RN program will require investment in library space and textbooks, skills lab and equipment and computers. The current staff numbers areless than a third of target, 3 tutors and clinical instructor (target is 10), staff recruitment and retention will depend on housing being made available.

Classrooms Available 3 Priorities: (1) Student accommodation (2) Staff houses (3) Transport-36 seater busClassrooms Capacity 135 500.0% Capacity to Student Ratio (Classroom)






Dining Hall Capacity Available 27 27 Student Beds RequiredDining Hall Capacity Required (Half of Student Population) 14

Vehicle Capacity Available 12Vehicle Capacity Required 24 Reported 27 students for attachments in 2013





New Skills Lab Capacity Needed for Scale-up Min. Renovation Work- Painting , Fittings Needed for Scale-upNew Full-Time Tutors Needed for Scale-up Appraisal of Additional Practical Sites Required for Scale-up


Additional Support Staff Needed for Scale-up Fixing of available furniture - desks, tables, chairs Required for Scale-upUpdated Skills Laboratory Equipment Needed for Scale-up Optimizing use of existing hospital staff in teaching/practical sessions Needed for Scale-upUpdated textbooks and teaching aids Needed for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-up



0 0 0

27

00 0 0

75 75

0

25

50

75

100

2008 2009 2010 2011 2012

Chitambo School of NursingAnnual Vs Target Intake Numbers (2008 - 2012)

Total Applicants for the Program(s)

85

Dental Training School2008 2009 2010 2011 2012 Context: Dental Training School offers 3 year diploma programs for both dental therapists and technologists. Ndola School of Medicine, in 2012,

Total Applicants: Dental Therapy and Technologists 700 750 825 850 1000 introduced a 7 year degree level Dental Surgeon Program, DTS plans to open a similar program in 3 years time. Only 2 of the 7 NTOP funded activitiesTotal Enrolled Students: Dental Technologists 0 0 0 8 0 have been completed and in use, many of the construction projects - lecture theatre, skills lab, library and staff offices were started but are yet to

Total Enrolled Students: Dental Therapy 30 30 80 22 80 be completed.Projected Enrolled Students Numbers in the 2008 NTOP 28 28 58 58 58 One of the key challenges (and lessons learnt) were the activities were severely underestimated and budgeted for, and especially in Lusaka the

Percentage of Enrolled Student from Total Applicants 4% 4% 10% 4% 8% tendering procedures were delayed for lengthy periods of time and many of the activities were tendered to different contractors.Total Enrolled Students 30 30 80 30 80 DTS has made some progress, with the introduction of parallel program accepting an additional 40 student intake every 2 years, however The school

initial plans to increase technologists from an intake of 8 every 3 years to 8 every year, and increase the therapist to 50 annual intake from 2010 have not been metLocation of the school (within Lusaka) would make it an ideal center to introduce the e-learning and parallel programs

Total Graduates: Dental Technologists 8 0 0 0 6 Priorities: (1) Completion of Lecture Theatre (capacity 100) (2) Completion of Computer and Skills lab (Slab level)Total Graduates: Dental Therapy 28 20 28 0 22 (3) Student accommodation






Clinical Instructors Available 2 1/95 Clinical Instructor: Student RatioEst. Full-Time Clinical Instructors Required in 2008 NTOP 5

Support Staff Available 8 4/95 Support Staff: Student Ratio Summary of 2008 NTOP Funded ActivitiesSupport Staff Required 12

Activity 2008 Costs 2008 Costs Amts ReceivedActual Expenditure Project Tracking(USD) (ZMK) (ZMK) (ZMK)

Build lecture theatre 118,000 401,200,000 401,200,000 399,200,000 DelayedLibrary Capacity Available 40 2 Number of Hostels Available Purchase furniture for lecture theatre 8,000 27,200,000 27,200,000 0 Incomplete

Library Capacity Required (Third of Student Population) 63 70 Student Beds Available Build new skills lab of capacity 25 27,000 91,800,000 91,800,000 37,400,900 IncompleteDining Hall Capacity Available 40 190 Student Beds Required Purchase furniture for existing student accommodation 5,000 17,000,000 17,000,000 16,187,520 Completed and In Use

Dining Hall Capacity Required (Half of Student Population) 95 Build and furnish library of capacity 43 61,000 207,400,000 207,400,000 341,400,000 DelayedVehicle Capacity Available 12 Purchase new kitchen equipment 26,000 88,400,000 88,400,000 82,478,767 Completed and In UseVehicle Capacity Required 36 Reported 80 students for attachments in 2012 Purchase dining hall furniture 4,000 13,600,000 13,600,000 13,570,000 Completed and In Use

Computers Available 50 Build and furnish faculty offices of capacity 4 40,000 136,000,000 136,000,000 0Computers Required 63 TOTAL 289,000 982,600,000 982,600,000 890,237,187

Comment: Additional funds from GRZ have been source to complete the Lecture Theatre, these will not cover costs for the sewerage system and furniture.




New Skills Lab Capacity Needed for Scale-up Space for Skills Lab Needed for Scale-upNew Full-Time Tutors Needed for Scale-up Utilizing/Increasing Practical Sites Needed for Scale-up


Additional Support Staff Needed for Scale-up Fixing of available furniture - desks, tables, chairs Required for Scale-upUpdated Skills Laboratory Equipment Needed for Scale-up Furnishing of existing Lecture Theatre and Classroom Required for Scale-upUpdated textbooks and teaching aids Needed for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-up



3620 28

028

53 53 53 53 53

0

25

50

75

100

2008 2009 2010 2011 2012

Dental Training SchoolAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


86


Dental TrainingSchool

1 Incrase dental therapist intake fromcurrent 20 to 50 from July 2010onwards

N Increased to 80 every 2years

DentalTechnologists

0 0 0 8 0 0 0 0 6 0

2 Increase current dental technologistfrom intake of 8 every 3 years tointake of 8 every year

N No change from baseline Dental Therapy 30 30 80 22 80 20 28 0 22 30

3 Produce >48 dental therapistgraduates from Jun 2013 onwards

N 30 for 2012, have not yetreached 2013


Funding (ZMK)




1 Build lecture theatre Incomplete Plastering & final fittingscompleted; expenditure amtincludes LT furniture

Sewarage System yet to bestarted

401,200,000 401,200,000 1,151,140,820 1,151,140,800

2 Purchase furniture for lecture theatre Incomplete Construction works incomplete MoH= 450mill does not includefurniture

27,200,000 27,200,000

3 Build new skil ls lab of capacity 25 Incomplete Slab level, Insufficient Funds **Skil ls lab, 4/10 fxn dentalunits

91,800,000 91,800,000 37,400,900 1,500,000,000

4 Purchase furniture for existingstudent accommodation

Completed Capacity of 16(M)-20(F) students Additional Student Hostels sti l lneeded

17,000,000 17,000,000 16,187,520 -

5 Build and furnish l ibrary of capacity43

Incomplete BoQs PHO inlcuded Staff Offices;insufficient funds

Student l ibrary and computerlab are same facil ity; 42 PCsdonated by ZICTA; In process ofcompleting Staff Library

207,400,000 207,400,000 341,400,000 926,398,640

6 Purchase new kitchen equipment Completed Chiil ler, Fridges and Pot Expansion of DH 88,400,000 88,400,000 82,478,767 -7 Purchase dining hall furniture Completed Boardrm Tables, Capacity = 30 13,600,000 13,600,000 13,570,000 -8 Build and furnish faculty offices of

capacity 4Incomplete Slab level,Insufficient Funds Complaints Tendering/Contract 136,000,000 136,000,000 1,269,798,640

9 Purchase 30 seater bus Notfunded/Notundertaken

102,000,000 0 0

Other notes Contractor's Fee > K1billTOTAL 1,084,600,000 982,600,000 1,642,178,007 4,847,338,080

87

Evelyn Hone College of Health Sciences2008 2009 2010 2011 2012 Context: Evelyn Hone College of Health Science offers Pre-service training programs for Environmental Health Technologists, Pharmacy Technologists

Total Applicants for Enrollment: Health Sciences 1444 2896 5268 7302 8687 Laboratory Technicians and Radiography. It is one of the few multi-cadre Training institutions, the Health Science is one of four Departments with Evelyn Hone.Total Enrollment: Health Sciences 328 413 416 752 610

Environmental Health Technologist 33 33 50 67 74 One of the key challenges is significant funding and support for Health Sciences Department which in recent years has severely lost staff from 46 ( in 2008)Laboratory Technician 56 97 125 125 130 to a reported 24 full-time staff members in 2012Many of target estimated in the 2008 NTOP were based on investments being made into CCHS these included.

Pharmacy Technologist 93 81 103 110 115 (a) Construction of 6 Lecture Theatres with 100 student capacity each (b) Construction of Student Accommodation of 1,000 capacityPhysiotherapy Technologist 40 66 79 94 99 (c) Building of library ( 400 student capacity); kitchen and dinning hall (1000 student capacity); and faculty offices for 50 teaching and support staff

Radiography 49 76 96 105 107 (d) Equipment and Reagents' for Skills Lab and Practical Sessions (e) Transport for students during attachmentPercentage of Enrolled Student from Total Applicants 23% 14% 8% 10% 7%

Total Enrolled Students 328 413 416 752 610 Despite, these setbacks students, intake and graduate numbers have steadily increases from 2008 - 2012; mainly because of a health science multi-purpose building (include 4 laboratories and 4 classrooms) that was constructed in 2010 with support from the World Bank. There is need to consider providingsignificant additional support, such as, secondment of teaching staff, equipment and learning resources, financial support, for significant HCWs output from EH

Total Graduates: Diploma in Health Sciences 232 220 314 391 329Total Estimated/Projected Graduates from 2008 NTOP 470 470 470 470 470 The key challenges to scale up production of key health cadres, such as, EHTs, and Pharmacy Technologists from EH, include:

1 Updated Skills Lab Equipment, and regular maintenance of existing functional equipmentTotal Graduates 232 220 314 391 329 2 Lecture Theatre to support the larger number of intakes

3 Dedicated Health Science Library, Student Accommodation and Staff Offices4 Transport for the Health Sciences Department

Classrooms Available 12 5 Recruitment and Retention of Teaching StaffClassrooms Capacity 600 33.7% Capacity to Student Ratio (Classroom)







Vehicle Capacity Available 72Vehicle Capacity Required 525 Reported total number of student on attachment in 2011





New Skills Lab Capacity Needed for Scale-up Revising Skills Lab Scheduled Needed for Scale-upNew Full-Time Tutors Needed for Scale-up Appraisal of Additional Practical Sites Required for Scale-up


Additional Support Staff Needed for Scale-up Maintenance of existing equipment - skills, computer Required for Scale-upUpdated Skills Laboratory Equipment Needed for Scale-up Furnishing of existing buildings - office blocks, hostels Required for Scale-upUpdated textbooks and teaching aids Needed for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-up

Library Seats Needed for Scale-up Potential site for distance teaching methods and equipment Needed for Scale-upDining Hall Seats Need for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-up

Student Beds/Hostel Needed for Scale-up Potential site for day scholar/parallel program or dual classes Needed for Scale-up36 seater Bus Needed for Scale-up


232 220

314391

329

470 470 470 470 470

0

100

200

300

400

500

2008 2009 2010 2011 2012

Evelyn Hone College of Health SciencesAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


88

**Evelyn Hone College not included in Phase I of NTOP funding, so received no funds through this process


Evelyn HoneCollege

1 Expand intakes to 80 forradiography and to 100 for all otherpre-service cadres from 2011onwards

Y all cadres but EHTincreased to 100, radio hittarget as well

EnvironmentalHealthTechnologist

33 33 50 67 74 46 24 23 26 33

2 Reduce current attrition of ~10-15%to <10% from 2011 onwards

N Average graduation rate <90% annually

LaboratoryTechnician

56 97 125 125 130 27 18 53 45 53


TBD On track to reach targets PharmacyTechnologist

93 81 103 110 115 47 89 55 88 55

PhysiotherapyTechnologist

40 66 79 94 99 30 22 42 50 59

Radiographer 49 76 96 105 107 23 14 39 56 39


89

Kabwe Schools of Nursing & Midwifery2008 2009 2010 2011 2012 Context: Kabwe School of Nursing and Midwifery is upgraded the EN program to RN in 2010 and the first graduates will be in 2013, at present the school is in

Total Applicants: Enrolled Midwives and Registered Nurses 615 620 720 720 820 the process of phasing out the EM program and introducing a RM program.Total Enrolled Students: Enrolled Midwives 30 24 21 17 18 The NTOP activities of constructing staff offices, staff accommodation and procurement of furniture for existing student accommodation were completed. There

Total Enrolled Students: Registered Nurses 44 0 36 35 40 is potential to scale up numbers with existing infrastructure, upgrading the skills lab equipment and introducing Parallel ProgramsProjected Enrolled Students Numbers in the 2008 NTOP 60 60 100 100 100 Priorities: (1) Equipment in Skills Laboratory (2) Construction of Lecture Theatre (capacity 120 students) (3) Kitchen -Cold room

Percentage of Enrolled Student from Total Applicants 12% 4% 8% 7% 7%Total Enrolled Students 74 24 57 52 58

Total Graduates: Enrolled Midwives 31 0 27 21 8Total Graduates: Registered Nurses 0 0 0 0 0






Clinical Instructors Available 4 1/42 Clinical Instructor: Student Ratio Full-Time Clinical Instructors Required in 2008 NTOP 5




Dining Hall Capacity Available 120 167 Student Beds Required Purchase furniture for existing student accommodation 18,000 61,200,000 61,200,000 8,700,000 Completed and In UseDining Hall Capacity Required (Half of Student Population) 84 Build and equip new kitchen to feed 120 people 94,000 319,600,000 319,600,000 232,102,319 Modified

Vehicle Capacity Available 36 Build and furnish faculty offices of capacity 3 30,000 102,000,000 102,000,000 185,755,318 Completed and In UseVehicle Capacity Required 36 Reported 30 students for attachments in 2012 Build and furnish faculty accommodation of capacity 4 171,400 582,760,000 582,760,000 503,143,380 Completed and In Use

Computers Available 15 Total 313,400 1,065,560,000 700,422,140 929,701,017Computers Required 56




New Skills Lab Capacity Needed for Scale-up Space for Skills Lab Available for Scale-upNew Full-Time Tutors Needed for Scale-up Utilizing/Increasing Practical Sites Needed for Scale-up





310

27 218

96 96 96 96 96

0

25

50

75

100

125

2008 2009 2010 2011 2012

Kabwe School of Nursing & MidwiferyAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


90



Kabwe School ofNursing &Midwifery

1 Increase EN intake from current 30to 50 from July 2010 onwards

N Changed EN program to RN;approx 40 enrolled in 2012


2 Increase EM intake from current 30to 50 from July 2010 onwards

N EM intake ~20 from 2010-2012


3 Reduce current 10% EN dropout rateto <5%

N Low graduation rates from2011 on

4 Produce >48 EN graduates by July2012

N no RN grads in 2011

5 Produce >48 EM graduates from July2011

N 8 EM grads in 2011


Funding (ZMK)





Incomplete Lounge Capacity 38 Vs 150 students 10,200,000 61,200,000 8,700,000

2 Build and equip new kitchen to feed120 people

Completed Repair/Painting Roof and Stove 319,600,000 232,102,319


Completed Occuped by RN and Support Staff 136,000,000 102,000,000 185,755,318


Completed Accomodates 4 staff Vs 7 FT staff 582,760,000 503,143,380

5 Additional Project: Lecture theatre** Proposed Lecture theatre required for scale-up: 250 Seater

Space available on-site 2,393,066,000

6 Additional Project: Renovate skillslab**

Proposed Renovations required to beadequate for student use

Space available on-site 7,607,000

Other notes 42 PCs donated by ZICTAOther notes Skil ls lab; equipment for RM program planned for 2013TOTAL 146,200,000 1,065,560,000 929,701,017 2,400,673,000

91

Kalene School of Nursing2008 2009 2010 2011 2012 Context: Kalene School of Nursing located in Mwinilunga District, Northwestern Province; with an EN programs. Planned activities under the 2008 NTOP

Total Applicants for Enrollment: Enrolled Nurses 350 300 350 350 350 included: 4 staff houses. There is need to invest in more infrastructure: lecture theatre ,skills lab, library and student accommodation to achieve the set targetTotal Enrolled Students: Enrolled Nurses 29 27 39 33 35 intake numbers. The Hospital has expanded the Surgical/Operations Department, there is an opportunity to pilot an Operating Theatre Nurse Program.

Projected Enrolled Students Numbers in the 2008 NTOP 30 30 50 50 50Percentage of Enrolled Student from Total Applicants 8% 9% 11% 9% 10% Priorities: (1) Complete and furnishing of Lecture Theatre (capacity 120 students) (2) Skills Lab Equipment

Total Enrolled Students 29 27 39 33 35 (3) Transport-36 seater bus

Total Graduates: Enrolled Nurses 0 27 31 29 26Total Estimated/Projected Graduates from 2008 NTOP 47 47 47 47 47








Dining Hall Capacity Available 25 107 Student Beds Required Summary of 2008 NTOP Funded ActivitiesDining Hall Capacity Required (Half of Student Population) 54

Vehicle Capacity Available 12 Activity 2008 Costs 2008 Costs Amts ReceivedActual Expenditure Project TrackingVehicle Capacity Required 36 Reported 68 students for attachments in 2012 (USD) (ZMK) (ZMK) (ZMK)

Computers Available 3 Build Four Staff Housing Units 206,000 700,400,000 700,400,000 700,422,140 Completed and In UseComputers Required 23 Total 206,000 700,400,000 700,400,000 700,422,140









0

27 31 29 26

47 47 47 47 47

0

25

50

75

2008 2009 2010 2011 2012

Kalene School of NursingAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


92


Kalene School ofNursing

1 Increase EN intake from current 30to 50 from Jan 2010 onwards

N Reached 35 in 2012 Enrolled Nurses 29 27 39 33 35 27 31 29 26 38

2 Produce >47 EN graduates from Dec2012 onwards

N 38 grads in 2012





1 Build 2 Staff Housing Units Completed 4 units constructed; Occuped StaffSharing Houses

292,400,000 700,400,000 700,422,140 -

2 Build new skil ls lab Notfunded/Notundertaken

91,800,000

3 Build student accomodation for 40 Notfunded/Notundertaken

700,400,000

4 Purchase furniture for new studentaccomodation


204,000,000

5 Build & furnish faculty officescapacity 6


204,000,000

TOTAL 1,492,600,000 700,400,000 700,422,140 -

93

Kasama School of Nursing2008 2009 2010 2011 2012 Context: Kasama School of Nursing located in Northern Province; with an RN programs and plans underway to introduce RM program in 2013

Total Applicants: Registered Nurses 500 500 520 550 550 Planned activities under the 2008 NTOP included: staff offices (capacity of 12), lecture theatre, and purchase furniture for existing student accommodation.Total Enrolled Students: Registered Nurses 54 56 51 66 60 Contractual disputes have delayed completion of lecture theatre, there is potential to expand intake capacity by investing in existing infrastructure, such as,

Projected Enrolled Students Numbers in the 2008 NTOP 50 50 70 70 60 the "old midwifery" hostel currently under Kasama General Hospital. A main challenge is practical sites attachments for student having to travel to LusakaPercentage of Enrolled Student from Total Applicants 11% 11% 10% 12% 11% and other districts, there operational costs for covering transport, logistics and accommodation

Total Enrolled Students 54 56 51 66 60Priorities: (1) Complete and furnishing of Lecture Theatre (capacity 120 students) (2) Skills Lab Equipment

(3) Transport-36 seater busTotal Graduates: Registered Nurses 56 45 55 51 54










Dining Hall Capacity Available 75 177 Student Beds Required Build lecture theatre 118,000 401,200,000 401,200,000 399,723,900 DelayedDining Hall Capacity Required (Half of Student Population) 89 Purchase furniture for lecture theatre 8,000 27,200,000 27,000,000 27,000,000 Delayed

Vehicle Capacity Available 36 Purchase furniture for existing student accommodation 24,000 81,600,000 81,600,000 93,593,000 ModifiedVehicle Capacity Required 36 Reported 60 students for attachments in 2012 Purchase new kitchen equipment 44,000 149,600,000 149,600,000 149,600,000 Incomplete

Computers Available 15 Build and furnish faculty offices of capacity 12 121,000 411,400,000 411,400,000 398,131,046 ModifiedComputers Required 59 TOTAL 315,000 1,071,000,000 1,070,800,000 1,068,047,946









5645

55 51 5467 67 67 67 67

0

25

50

75

100

2008 2009 2010 2011 2012

Kasama School of NursingAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


94



Kasama Schoolof Nursing

1 Increase RN intake from current 50to 70 from Jan 2010 onwards

N Reached 66 in 2011, 60 in2012


2 Introduce DEM program in Jan 2009with annual intake of 40

N No DEM programimplemented

3 Produce >67 RN graduates from Jan2013

N 56 grads in 2012 (peak)

4 Produce > 38 DEM graduates formDec 2010 onwards

N No DEM programimplemented

5 Accept 15 day students per RN intakefrom Jan 2009 onwards

N No day students


Funding (ZMK)




1 Build lecture theatre** Incomplete Plastering/Electricity/Sewerage;requires adjustments for additionalplumbing needs, staircase

Complaints Tendering/Contract;delayed tender, poor design

401,200,000 401,200,000 399,723,900 304,593,000

2 Purchase furniture for lecture theatre Incomplete Balance 109mil; @PHO level Refurbish old LT (> 70 students);issues with same contractor forLT works

27,200,000 27,000,000 27,000,000


Completed 1 of 4 blks (15 with 2/rm) furnished Convert intern houses to hostels 81,600,000 81,600,000 93,593,000 -

4 Purchase new kitchen equipment Incomplete Coldrm needed, Maintainance;insufficient funds

149,600,000 149,600,000 149,600,000 56,000,000


Completed 8 of 12 completed; Officefurniture/yet to be handed

411,400,000 411,400,000 398,131,046 22,000,000

6 Additional Project: Build new skil lslab**

Proposed Space available on-site Current skil ls lab equipmentonly sufficient for 56 vs 159

956,317,000

Other notes Computer lab needed to decongest l ibraryTOTAL 1,071,000,000 1,070,800,000 1,068,047,946 1,338,910,000

95

Kitwe School of Nursing and Midwifery2008 2009 2010 2011 2012 Context: Kitwe School of Nursing and Midwifery offers 3 year diploma programs for RNs and RMs. With plans, in 2013, to introduce Operating Theatre Nurses

Total Applicants: Registered Midwives and Nurses 860 726 973 650 1078 Program. The school has had the advantage of existing infrastructure and support from the 2008 NTOP to construct 2 lecture theatres, a staff office blockTotal Enrolled Students: Registered Midwives 31 32 29 61 62 and student hostels. This urban school is well placed to consider scaling -up intake and graduate numbers through parallel or distance learning programs,

Total Enrolled Students: Registered Nurses 55 57 73 82 60 even without additional investment, Kitwe Schools of Nursing and Midwifery has the capacity to double the current intake numbersProjected Enrolled Students Numbers in the 2008 NTOP 85 85 160 160 160

Percentage of Enrolled Student from Total Applicants 10% 12% 10% 22% 11% The 2012 assessment of the schools noted some renovations and completion of works are required to achieve the targets for increased number of RNs andTotal Enrolled Students 86 89 102 143 122 RMs graduates the school, however a key challenge was the limited number of pre-service numbers in the first year intake. This was attributed the low pass rate

of the aptitude test (less than 8% percent of the 1,078 applicants passed the test), this meant a larger part of the first years comprised of in-service nurses/midwives

Total Graduates: Registered Midwives 30 30 31 24 59 Priorities: (1) Completion of Lecture Theatre 1 (capacity 100) (2) Updating Skills lab Equipment (3) Library and Computer RoomTotal Graduates: Registered Nurses 47 47 52 57 51









Build lecture theatre 1 118,000 401,200,000 252,000,000 468,361,040 IncompleteLibrary Capacity Available 50 5 Number of Hostels Available Purchase furniture for new lecture theatre 2 8,000 27,200,000 0 0 Delayed

Library Capacity Required (Third of Student Population) 122 227 Student Beds Available Build new student accommodation for 40 206,000 700,400,000 704,000,000 697,510,320 Completed and In UseDining Hall Capacity Available 150 367 Student Beds Required Build lecture theatre 2 118,000 0 401,200,000 428,000,000 Completed and In Use

Dining Hall Capacity Required (Half of Student Population) 184 Purchase furniture for new lecture theatre 2 8,000 0 0 250,000,000 DelayedVehicle Capacity Available 36 Purchase furniture for accommodation for 40 60,000 204,000,000 210,000,000 242,788,000 Completed and In UseVehicle Capacity Required 72 Reported 110 students for attachments in 2012 Build and equip new kitchen of capacity to feed 180 141,000 479,400,000 479,400,000 453,582,775 Delayed

Computers Available 60 Build and furnish faculty offices of capacity 8 101,000 343,400,000 343,400,000 341,656,624 ModifiedComputers Required 92 TOTAL 760,000 2,155,600,000 2,390,000,000 2,881,898,759 0

Comment: Contractual Disputes have stalled the completion of LT 1 ,though additional funds from GRZ have been source to complete the Lecture Theatre, these will not cover costs for furniture.



New Classrooms Needed for Scale-up Optimizing Classrooms Needed for Scale-upNew Lecture Theatre Needed for Scale-up Classrooms Space Available for Scale-up

New Skills Lab Capacity Needed for Scale-up Lecture Theatre Available for Scale-upNew Full-Time Tutors Needed for Scale-up Space for Skills Lab Needed for Scale-up

Additional Lecturers/Tutors Needed for Scale-up Min. Renovation Work- Painting , Fittings Needed for Scale-upAdditional Clinical/Skills Lab Instructors Needed for Scale-up Extensive Completion Works- Slab/Window/Roof Level Needed for Scale-up

Additional Support Staff Needed for Scale-up Optimizing use of existing hospital or school buildings Needed for Scale-upUpdated Skills Laboratory Equipment Needed for Scale-up Furnishing of existing Lecture Theatre and Classroom Required for Scale-upUpdated textbooks and teaching aids Needed for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-up



77 77 83 81110

75 80 100 100

160

0255075

100125150175200225

2008 2009 2010 2011 2012

Kitwe School of Nursing and MidwiferyAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


96



Kitwe School ofNursing &Midwifery

1 Increase RN intake from current 55to 100 from Jan 2010 onwards

N 60 in 2012; peaked at 82 in2011

RegisteredMidwives

31 32 29 61 62 30 31 24 59 50

2 Increase RM intake fro mcurrent 30to 60 from Jan 2010 onwards

Y 62 in 2012 Registered Nurses 55 57 73 82 60 47 52 57 51 55

3 Produce >95 RN graduates from Dec2012

N 55 in 2012

4 Produce >57 graduates from Dec2010

N 50 in 2012


Funding (ZMK)




1 Build lecture theatre 1** Incomplete Furniture/Electricity/Handover Complaints Tendering/Contract 401,200,000 252,000,000 349,487,250 448,858,7502 Purchase furniture for new lecture

theatreIncomplete Balance 227mill; Contract Dispute;

insufficient fundsVariations in BoQs/Payment 27,200,000 0 0 *included in

lecture theatrecost above

3 Build new student accommodationfor 40

Completed Total 80(n)/ 62(m) boarded 700,400,000 704,000,000 639,776,120 -

4 Build lecture theatre 2 Completed Capacity of >200 students, not in2008 plan

401,200,000 428,000,000 163,987,801

5 Purchase new furniture for lecturetheatre 2

Incomplete Delivery/installation of LT chairs,not in 2008 plan

Completion of 2LT = >500students

0 250,000,000 250,000,000


Completed 204,000,000 210,000,000 242,788,000 -

7 Build and equip new kitchen ofcapacity to feed 180**

Incomplete Construction completed Requires furniture & equipment 479,400,000 479,400,000 483,153,774 606,553,200


Completed Staff # = 26, G.floor in Hostels 343,400,000 343,400,000 333,872,719 -

9 Repair existing minibus Notfunded/Notundertaken

23,800,000

Other projects Need to renovate existing dining hall/kitchenOther notes 42 PCs donated by ZICTAOther notes Skil ls lab equipment sti l l requiredTOTAL 2,179,400,000 2,390,000,000 2,727,077,863 1,469,399,751

97

Lewanika School of Nursing & Midwifery2008 2009 2010 2011 2012 Context: Lewanika School of Nursing and Midwifery, currently has 2 - year EN and EM programs. The EM program was introduced in 2010 with the first 2012

Total Applicants for Enrollment: Enrolled Nurses/Midwives 650 570 620 540 600 graduates expected in. The 2008 NTOP funds were allocated to furnishing the existing classroom and dinning hall, build student accommodation for 36Total Enrolled Students: Enrolled Midwives 0 0 36 34 34 new staff offices with the increased staffing levels and 4 staff houses have retained teaching faculty during the last 5 years. An additional hostel was built in

Total Enrolled Students: Enrolled Nurses 64 62 69 76 74 2011 with additional donor support . The location of the school (within Mongu Town) would allow consideration of intake expansion through Parallel ProgramProjected Enrolled Students Numbers in the 2008 NTOP 63 63 80 80 80

Percentage of Enrolled Student from Total Applicants 10% 11% 17% 20% 18% Priorities: (1) Renovations to optimize existing building (2) Skills Lab Equipment (3) Transport-36 seater busTotal Enrolled Students 64 62 105 110 108











Dining Hall Capacity Available 50 323 Student Beds Required Purchase furniture for existing classroom 6,000 20,400,000 20,000,000 19,000,000 Completed and In UseDining Hall Capacity Required (Half of Student Population) 162 Purchase furniture for existing dining hall 5,000 17,000,000 17,000,000 17,000,000 Completed and In Use

Vehicle Capacity Available 40 Build student accommodation for 40 0 0 0 0 ModifiedVehicle Capacity Required 36 Reported 100 students for attachments in 2012 Build and furnish faculty offices of capacity 8 40,000 136,000,000 136,000,000 338,000,000 Modified

Computers Available 52 Build and furnish faculty accommodation of capacity 3 128,000 435,200,000 435,000,000 430,000,000 Completed and In UseComputers Required 81 Purchase 26-seater minibus 26,000 88,400,000 88,400,000 90,000,000 Completed and In Use

Total 205,000 697,000,000 696,400,000 894,000,000









38 39 4352

85

60 60 60 60 60

0

25

50

75

100

2008 2009 2010 2011 2012

Lewanika School of Nursing & MidwiferyAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


98


LewanikaNursing &MidwiferySchool

1 Increase EN intake from 50 to 63 byJuly 2008 and to 80 by Jul 2010

PARTIAL 64 in 2010, but only 74 by2012


2 Produce >60 EN graduates form2010 onwards and >76 from 2012onwards

N 65 in 2012 Enrolled Nurses 64 62 69 76 74 39 43 52 52 65


Funding (ZMK)





Completed Total 4 Classrm; 2(n)+2(m), total of45 students

20,400,000 20000000 19000000 -


Completed Funds spent to furnish studentblock, purchase books

Dining hall furniture sti l l needed 17,000,000 17,000,000 50,000,000

3 Build Student Accomodation for 36(budgeted for 2009)

Incomplete Add to 3 Hostels, 15rm (4/rm) CHEZ Hostel 2011 18rm (2/rm) 700,400,000

4 Build and furnish faculty offices ofcapacity 8 (budgeted for 2008/2010in 2 smaller blocks)

Completed MoH pledge 170mil to complete 207,400,000 136,000,000 338,000,000 50,000,000


Completed Total 5 staff houses occupied byPTs; sti l l is need for more housing

Painting/renovation of buildingrequired

584,800,000 435,000,000 430,000,000

6 Purchase 26-seater minibus(budgeted for 2009)

Completed Second hand bus purchased for80M

Stil l have issues withTransportation/Util ity Vans

105,000,000 88,400,000 90,000,000 -

7 Other projects Skil ls lab equipment required Old staff block to be convertedto skil ls lab

Other notes 42 PCs donated by ZICTATOTAL 1,618,000,000 696,400,000 894,000,000 100,000,000

99

Livingstone School of Nursing2008 2009 2010 2011 2012 Context: Livingstone School of Nursing and Midwifery is located in Southern Province has a 3 year RN program. The 2008 NTOP funds were allocated to:

Total Applicants for Enrollment: Registered Nurse 450 485 500 500 550 student accommodation (capacity 36), faculty offices (capacity 10), classroom (capacity (100) and furnish existing classrooms and dinning hall.Total Enrolled Students: Diploma in Registered Nurse 71 110 72 40 60 Through additional support and revenue(rental of house and practical site fee) a classroom block of capacity 100 has been constructed. The school

Projected Enrolled Students Numbers in the 2008 NTOP 65 65 90 90 90 over the past 2 years, has registered a decline in intake numbers mainly because of limited capacity of 2 classrooms and skills areas the EM programPercentage of Enrolled Student from Total Applicants 16% 23% 14% 8% 11% has been phased out to upgrade to RM (starting in 2013)

Total Enrolled Students 71 110 72 40 60 Priorities: (1) Computer and Library rooms (2) Skills Laboratory Equipment (3) Construction of Lecture Theatre

Total Graduates: Diploma in Registered Nurse 80 79 69 73 87Total Estimated/Projected Graduates from 2008 NTOP 95 95 95 95 95







Summary of 2008 NTOP Funded ActivitiesLibrary Capacity Available 20 5 Number of Hostels Available Activity 2008 Costs 2008 Costs Amts ReceivedActual Expenditure Project Tracking

Library Capacity Required (Third of Student Population) 57 134 Student Beds Available (USD) (ZMK) (ZMK) (ZMK)Dining Hall Capacity Available 40 172 Student Beds Required Purchase furniture for exisitng classrooms 2,000 6,800,000 0 0 Completed and In Use

Dining Hall Capacity Required (Half of Student Population) 86 Purchase furniture for existing dining hall 6,000 20,400,000 0 0 Completed and In UseVehicle Capacity Available 12 Build Student Accomodation for 40 206,000 700,400,000 700,400,000 768,715,788 Completed and In UseVehicle Capacity Required 36 Reported 172 students for attachments in 2012 Build Classroom 59,000 200,600,000 200,600,000 361,292,174 Completed and In Use

Computers Available 55 Build and furnish faculty offices of capacity 12 181,000 615,400,000 615,400,000 388,993,760 ModifiedComputers Required 57 TOTAL 454,000 1,543,600,000 1,516,400,000 1,519,001,722

Comment: Faculty Offices have a capacity of 10, activity was modified to building of a classroom and additional GRZ funds required







Library Needed for Scale-up Potential site for distance teaching methods and equipment Needed for Scale-upDining Hall Seats Need for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-upStudent Beds Needed for Scale-up Potential site for day scholar/parallel program or dual classes Needed for Scale-up


80 7969 73

8795 95 95 95 95

0

25

50

75

100

125

2008 2009 2010 2011 2012

Livingstone School of NursingAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


100


LivingstoneSchool ofNursing

1 Increase RN intake from current 65to 90 from Jul 2010 onwards

N peaked in 2010 at 2001,dropped to 60 in 2012


2 Introduce annual DEM intake of 30in Jan 2009

N No DEM program

3 Produce >95 RN graduates from Jun2013

Y 98 in 2012


N No DEM program

5 Accept 20 day scholars per RNintake from July 2009 onwards

N No day scholars


Funding (ZMK)




1 Purchase furniture for exisitngclassrooms

Completed Desks/Chairs procured forclassrooms

6,800,000


Completed Chairs procured as part ofclassroom order; Need for benchesvs chairs

Non functional stove/ oven;stove & coldroom donated byZISSP

20,400,000

3 Build Student Accomodation for 38(budgeted for 2010)

Completed 4 hostels = 189 bedspace; Fundsdiverted from other projects tocomplete

700,400,000 700,400,000 768,715,788 80,065,000

4 Build Classroom Completed Capacity of >100 students; Fundsdiverted from other projects tocomplete

200,600,000 361,292,174 -


Completed 12 offices completed (additional 4)GRZ funds 203mill completed

615,400,000 615,400,000 388,993,760 58,891,050

Other notes Lecture Theatre required to scale up

Other notes

Other notes 42 PCs donated by ZICTATOTAL 1,343,000,000 1,516,400,000 1,519,001,722 138,956,050

2 classrooms converted to PC room and skil ls lab; skil ls labequipment donated by ZISSP

101

Lusaka Schools of Nursing, Midwifery and Operating Theatre2008 2009 2010 2011 2012 Context: Lusaka School of Nursing, Midwifery and Operating Theatres offers 3 year diploma programs for RMs, RNs and OTNs. Over the last 3 years,,

Total Applicants: Registered Nurses, Midwives and OTN 900 950 950 1000 1200 the Schools has introduced an additional 3 programs Critical Care Nursing, HIV Practitioner and the Combined Nurse-Midwives ProgramTotal Enrolled Students: Operating Nurses 36 35 32 36 32 With plans to affiliate to School of Medicine and also possibly became a site of Clinical Instructor Training Program, the school is stretched to capacity with little

Total Enrolled Students: Registered Midwives 38 41 40 39 32 adjustment to teaching staff, other than those made by 2008 NTOP recommendations, there is need to consider diversifying other Nursing Programs toTotal Enrolled Students: Registered Nurses 64 69 64 81 80 equally competent Schools around the country

Projected Enrolled Students Numbers in the 2008 NTOP 110 110 200 200 200 One of the key challenges (and lessons learnt) were the activities were severely underestimated and budgeted for, and especially in Lusaka, the delays inPercentage of Enrolled Student from Total Applicants 11% 11% 10% 12% 9% tendering and procurement lead to many activities being modified, only 2 of the 5 activities planned were completed, works on the staff offices have yet to begin.

Total Enrolled Students 100 104 96 117 112 This, and the introduction of several programs without the upgrading in Establishments are some of the reasons the projected targets are yet to be metThe location of the school (within Lusaka) would make it an ideal center to introduce the e-learning and parallel programs, other self sustaining activities could be piloted at the school

Total Graduates: Operating Theatre Nurses 32 35 64 81 72Total Graduates: Registered Midwives 39 39 40 31 31 Priorities: (1) Construction of Staff Offices (Delayed NTOP activity) (2) Equipment for Skills lab

Total Graduates: Registered Nurses 55 63 64 81 72 (3) Renovation of Skills Lab and "Old" ClassroomsTotal Estimated/Projected Graduates from 2008 NTOP 100 110 100 100 100








Library Capacity Available 70 5 Number of Hostels Available Build and furnish lecture theatre 118,000 401,200,000 401,200,000 2,429,470,360 ModifiedLibrary Capacity Required (Third of Student Population) 108 234 Student Beds Available Purchase furniture for existing student accommod 8,000 27,200,000 136,000,000 284,350,020 Delayed

Dining Hall Capacity Available 150 325 Student Beds Required Build Student accomodation for 40 40,000 136,000,000 0 0 IncompleteDining Hall Capacity Required (Half of Student Population) 163 Build and furnish new faculty offices of capacity 30 206,000 700,400,000 1,026,800,000 0 Delayed

Vehicle Capacity Available 72 Build and furnish new library of capacity 30 302,000 1,026,800,000 200,600,000 524,273,600 Completed and In UseVehicle Capacity Required 36 Reported 117 students for attachments in 2012 TOTAL 674,000 2,291,600,000 1,764,600,000 3,238,093,980

Computers Available 30Computers Required 108 Comment: Construction of Lecture Theatre was modified, as the allocated amount could not cover the ZMK 1.3 billion quote for the works, instead a block with

2 classroom and a skills lab (which is now being used as staff offices) was constructed with a new library.






Additional Support Staff Needed for Scale-up Furnishing of existing Lecture Theatre and Classroom Required for Scale-upUpdated Skills Laboratory Equipment Needed for Scale-up Fixing of available furniture - desks, tables, chairs Required for Scale-upUpdated textbooks and teaching aids Needed for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-up



87 98128

162 144100 110 100 100 100

0

50

100

150

200

2008 2009 2010 2011 2012

Lusaka Schools of Nursing, Midwifery and Operating TheatreAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


102


Lusaka Schoolsof Nursing,Midwifery, &OperatingTheater

1 Increase RN intake from current 70once a year to 60 twice per year byJan 2010

N 80 RN students, but only 1xper year

Operating TheatreNurses

36 35 32 36 32 36 35 32 36 32

2 Increase RM intake from current 40once a year to 30 twice per year byJan 2010

N 30+ 1/year, but introducednew RN/RM program

RegisteredMidwives

38 41 40 39 31 39 40 31 31 32

3 Produce >114 RN graduatesannually from 2013 onwards

TBD Registered Nurses 64 69 64 81 80 63 64 81 72 0

4 Produce > 57 RM graduates annuallyfrom 2011 onwards

N 32/year in 2012 0 0 0 0 120

5 Increase intake from current 35 OTRNs once a year to 30 twice per yearby Jul 2010 (1-year program)

N ~30 1/year RegisteredNurse/Midwives

0 0 31 30 34

6 Produce > 28 graduates from jul2012 onwards

Y 32 in 2012 HIV NursePractitioner

0 0 30 30 34


103


Funding (ZMK)




1 Build and furnish lecture theatre Incomplete Funds diverted to classroom/officeproject

Lecture Theatre to scale up 401,200,000 401,200,000


Incomplete Funds diverted to classroom/officeproject

136,000,000 136,000,000 124,000,000 90,000,000

3 Build Student accomodation for 40(originally part of Lusaka Theatreactivities)**

Incomplete Funds diverted to classroom/officeproject

Space available on-site toconstruct student hostel for 120students (adjusted cost)

700,400,000 13,572,545,140

4 Furnish student accomodation (BothLusaka SNM * and Lusaka OTactivities)


340,000,000

5 Build and furnish new faculty officesof capacity 30**

Incomplete Awaiting tender process:PHO;amounts required to be determinedfollowing tender

Balance of 99mill at PHO level 1,026,800,000 1,026,800,000 8,899,499,000

6 Build and furnish library capacity of30

Completed Computer lab needed todecongest l ibrary

200,600,000 2,429,470,360

7 Build classroom (Lusaka OT activity) Notfunded/Notundertaken

200,600,000

8 Furnish classroom (Lusaka OTactivity)


13,600,000

9 Build & equip skil ls lab for 30(Lusaka OT activity)


108,000,000

10 Purchase 30-seater minibus Notfunded/Notundertaken

102,000,000

11 Purchase 10-seater land cruiser Notfunded/Notundertaken

51,000,000

Other notes Skil ls lab equipment neededOther notes Refurbishment of 4 old classrooms requiredTOTAL 3,079,600,000 1,764,600,000 2,553,470,360 22,562,044,140

Lusaka School of Nursing, Midwifery, & Operating Theatre(combines LSNM & Lusaka School of Operating Theatre, evaluated separately in 2008 NTOP)

104

Macha School of Nursing2008 2009 2010 2011 2012 Context: Macha School of Nursing located in Southern Province currently has an EN program. Planned activities under the 2008 NTOP included 6 staff

Total Applicants for Enrollment: Enrolled Nurses 300 300 350 400 420 houses; student accommodation (capacity 40), purchase 30 seater bus and furnish existing accommodation, dinning hall and kitchen. The critical areasTotal Enrolled Students: Enrolled Nurses 78 80 43 50 65 to consider in scale-up are: skills lab equipment, expansion of library, consideration of attachment site, currently the school uses macho Mission Hospital, the

Projected Enrolled Students Numbers in the 2008 NTOP 30 30 50 50 50 patient numbers are low relative to students, the school is considering other practical sites- Choma General Hospital but this would require a newer bus.Percentage of Enrolled Student from Total Applicants 26% 27% 12% 13% 15% Priorities: (1) Renovation/Extension of existing buildings-"old hostels", staff offices, dining hall and kitchen

Total Enrolled Students 78 80 43 50 65 (2) Skills Lab Equipment (3) Transport-36 seater bus









Activity 2008 Costs 2008 Costs Amts ReceivedActual Expenditure Project TrackingLibrary Capacity Available 15 3 Number of Hostels Available (USD) (ZMK) (ZMK) (ZMK)

Library Capacity Required (Third of Student Population) 53 71 Student Beds Available Purchase furniture for existing classrooms 2,000 6,800,000 6,800,000 0 Completed and In UseDining Hall Capacity Available 50 158 Student Beds Required Purchase furniture for existing dining hall 4,000 13,600,000 13,600,000 0 Completed and In Use

Dining Hall Capacity Required (Half of Student Population) 79 Build and furnish faculty offices of capacity 3 30,000 102,000,000 102,000,000 190,758,400 IncompleteVehicle Capacity Available 32 Build teacher accomodation for capacity 6 257,000 873,800,000 873,800,000 1,364,000,000 Completed and In UseVehicle Capacity Required 36 Reported 88 students for attachments in 2012 Purchase 230-seater minibus 30,000 102,000,000 102,000,000 0 Completed and In Use

Computers Available 41 Build student accommodation for 40 206,000 700,400,000 700,400,000 754,741,000 ModifiedComputers Required 38 Purchase furniture for accommodation for 40 60,000 204,000,000 204,000,000 0 Incomplete

Purchase furniture for existing student accommod 6,000 20,400,000 10,200,000 10,200,000 Completed and In UseTOTAL 595,000 2,023,000,000 2,012,800,000 2,319,699,400




New Skills Lab Capacity Needed for Scale-up Space for Skills Lab Available for Scale-upNew Full-Time Tutors Needed for Scale-up Min. Renovation Work- Painting , Fittings Needed for Scale-up





3038 41 43 4548 48 48 48 48

0

25

50

75

100

2008 2009 2010 2011 2012

Macha School of NursingAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


105



Macha Schoolof Nursing

1 Increase EN intake from current 30to 50 from Jul 2010 onwards

Y 65 in 2012 Enrolled Nurses 78 80 43 50 65 38 41 43 78 65

2 Produce >48 EN graduates by Jul2012

Y 65 ib 2912


Funding (ZMK)




1 Purchase furniture for existingclassrooms

Completed Pulled funds from other projects 6,800,000 6800000 -

2 Purchase furniture for studentaccommodation

Incomplete Funds diverted to furniture forclassrooms


Completed Need to increasecoldroom/storage space toincrease capacity >50; dininghall space sti l l l imited

13,600,000 13,600,000 -

4 Build and furnish faculty offices ofcapacity 3**

Incomplete Insufficient, Funds diverted toclassroom furniture

New contract just awarded 102,000,000 102,000,000 190,758,400 88,758,400

5 Build faculty accomodation forcapacity 6

Completed 5/6 houses occupied - PTs Complaints Tendering/Contract;infrastructure repairs needed

873,800,000 873,800,000 1,364,000,000

6 Purchase 23-seater minibus Completed Second hand bus - Poor condition Minibus and Util ity Van stil lneeded

102,000,000 102,000,000

7 Build student accommodation for 36 Completed Renovation of old hostel with 8blocks (4/rm) completed

700,400,000 700,400,000 754,741,000 54,341,000


Completed 7/9 Phase 1 activities carried out **Skil ls lab, Staff Est- AA & IT/Lib 204,000,000 204,000,000 -

9 Additional Project: Build Skills Lab** Proposed Space available on-site for construction

Other projects Updated/renovated skil ls lab neededOther projects Computer lab and Library space neededTOTAL 2,002,600,000 2,002,600,000 2,309,499,400 143,099,400

106

Mansa School of Nursing2008 2009 2010 2011 2012 Context: Mansa School of Nursing currently has a 3 pre-service RN programs and plans underway to introduce RM program in 2013, However only 60 pre-service

Total Applicants: Registered Nurses 250 280 300 350 350 are in the 157 student population, because of the poor pass rate of the Aptitude Tests, the school has to accept in-service students for additional intake numbersTotal Enrolled Students: Registered Nurses 49 77 22 68 66 Since upgrading from En to RN in 2000, the school infrastructure has remained mostly the same and some critical areas are support in transport and operational

Projected Enrolled Students Numbers in the 2008 NTOP 36 60 80 80 80 costs for practical site attachments in Kitwe and Lusaka for RN students. Like many of the other schools, Mansa has higher application for the RN program thanPercentage of Enrolled Student from Total Applicants 20% 28% 7% 19% 19% the numbers taken in for first year despite an estimated 100 accommodated students are from the same and/or surrounding district as the school.

Total Enrolled Students 49 77 22 68 66Priorities: (1) Transport-36 seater bus (2) Skills Lab Equipment

(3) Renovation and furnishing of Lecture Theatre (capacity 80 students), classrooms and student hostelsTotal Graduates: Registered Nurses 26 30 35 52 48










Dining Hall Capacity Available 50 156 Student Beds Required Purchase furniture for existing student accommodation 3,000 10,200,000 10,200,000 478,000,000 Completed and In UseDining Hall Capacity Required (Half of Student Population) 78 Build and furnish faculty offices of capacity 4 40,000 136,000,000 136,000,000 378,000,000 Completed and In Use

Vehicle Capacity Available 32 Total 43,000 146,200,000 146,200,000 856,000,000Vehicle Capacity Required 36 Reported 66 students for attachments in 2012

Computers Available 11 Comment: Funds for student furniture has diverted to support the construction of staff office block (capacity of 4) additional GRZ funds were sourced toComputers Required 52 complete the project, support from donors had helped in updating library textbook and skills lab equipment and, building of one staff house.




New Skills Lab Capacity Needed for Scale-up Lecture Theatre Available for Scale-upNew Full-Time Tutors Needed for Scale-up Space for Skills Lab Available for Scale-up


Additional Support Staff Needed for Scale-up Furnishing of existing Lecture Theatre and Classroom Required for Scale-upUpdated Skills Laboratory Equipment Needed for Scale-up Optimizing use of existing hospital staff in teaching/practical sessions Needed for Scale-upUpdated textbooks and teaching aids Needed for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-up



26 30 35

52 4857 57 57 57 57

0

25

50

75

2008 2009 2010 2011 2012

Mansa School of NursingAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


107


Mansa Schoolof Nursing

1 Increase RN intake from current 36to 60 from Jul 2009 and to 80 fromJul 2010 onwards

N 77 in 2009, only 66 in 2012 RegisteredNurses

49 77 22 68 66 26 30 35 52 48

2 Produce > 57 RN graduates from Jun2012

N 48 in 2012

3 Pilot day schooling with 5 studentsper intake from Jul 2009

N No day students


Funding (ZMK)





Completed 4 blocks; 15rms (2/rm); old internhostels

81,600,000 10,200,000 478,000,000


Completed Completed 4/8; structure includes 4offices, boardroom; originaltendered amount 374,511,800

272,000,000 146,000,000 378,000,000 238,511,800

3 Purchase furniture for existinglibrary


17,000,000



20,400,000

Other notes Renovations needed to lecture theatre, skil ls labOther notes Staff housing for 7; 1 completed

with funding from THET6 housing units sti l l needed

TOTAL 391,000,000 156,200,000 856,000,000 238,511,800

108

Monze School of Nursing & Midwifery2008 2009 2010 2011 2012 Context: Monze School of Nursing and Midwifery has the EM and recently introduced, in 2012, the combined Nurse-Midwifery Program. The intake numbers

Total Applicants: Enrolled Nurses and Midwives 300 300 350 350 400 have same from 2004. Much of the needs are centered around completion of the NTOP funded activities: the 100 capacity classroom, student hostels and 2Total Enrolled Students: Enrolled Midwives 18 18 17 20 0 staff houses located 10 km off-site from the school (located in Monze Mission Hospital) to scale up the intake numbers.

Total Enrolled Students: Enrolled Nurses 36 40 51 11 50 The school requires some renovation to existing buildings, original built for a 40 nurse and midwifery intake, the introduction of the combined nurse-midwiferyProjected Enrolled Students Numbers in the 2008 NTOP 50 50 80 80 80 program requires the school to better their text-book, library, skills lab equipment and dinning hall facilities.

Percentage of Enrolled Student from Total Applicants 18% 19% 19% 9% 13%Total Enrolled Students 54 58 68 31 50 Priorities: (1) Completion of the classroom, student hostels, and staff houses (NTOP activities) (2) Skills Lab Equipment

(3) Transport-36 seater bus










Library Capacity Required (Third of Student Population) 50 124 Student Beds Available (USD) (ZMK) (ZMK) (ZMK)Dining Hall Capacity Available 50 149 Student Beds Required Build student accommodation for 40 206,000 700,400,000 700,400,000 739,506,506 Incomplete

Dining Hall Capacity Required (Half of Student Population) 75 Update kitchen equipment 27,000 91,800,000 0 0 IncompleteVehicle Capacity Available 12 Purchase furniture for dining hall 3,000 10,200,000 0 0 IncompleteVehicle Capacity Required 36 Reported 40 students for attachments in 2012 Build 2 semi detached houses 60,000 204,000,000 204,000,000 398,499,300 Modified

Computers Available 6 Build Classroom 37,000 125,800,000 125,800,000 378,313,916 IncompleteComputers Required 50 TOTAL 333,000 1,132,200,000 1,030,200,000 1,516,319,722

Comment: The student hostels, classroom and staff houses require to be connected to the electric grid, funds were diverted to complete the buildings.




New Skills Lab Capacity Needed for Scale-up Appraisal of Additional Practical Sites Required for Scale-upNew Full-Time Tutors Needed for Scale-up Furnishing of existing buildings - office blocks, hostels Required for Scale-up

Additional Lecturers/Tutors Needed for Scale-up Revising Classroom Schedules Needed for Scale-upAdditional Clinical/Skills Lab Instructors Needed for Scale-up Max. Renovation Works- Electrification , Water, Sewerage Needed for Scale-up

Additional Support Staff Needed for Scale-up Handover/Certificate of Completion Needed for Scale-upUpdated Skills Laboratory Equipment Needed for Scale-up Optimizing use of existing hospital staff in teaching/practical sessions Needed for Scale-upUpdated textbooks and teaching aids Needed for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-up



47 54 51

70 6876 76 76 76 76

0

25

50

75

100

2008 2009 2010 2011 2012

Monze School of Nursing & MidwiferyAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


109

** Indicates activity was evaluated by Quantity Surveyor as part of 2012 NTOP review; Funds required to complete for these projects were reported in this assessment


Monze School ofNursing &Midwifery

1 Increase EN intake from current 30to 50 (transition to RN) from July2010 onwards

N Enrolling RN/M pilot in2012, but otherwise noconversion to RN; EN intakereached 50 in 2012

EnrolledMidwives

18 18 17 20 0 18 18 18 18 17

2 Increase EM intake from current 20to 30 (transition to RM) from July2010 onwards

N Stil l enroll ing EMs otherthan RN/M program;enrolled 20 in 2011

Enrolled Nurses 36 40 51 11 50 29 36 33 52 51

3 Reduce midwifery (EM to RM) dropout rate from 25% to <5%

Y Annual graduation rate >95%

4 Produce >48 RN graduates by Jul2013

Y 51 EN grads in 2012

5 Produce >28 RM graduates by Jul2011

N 17 EM grads in 2012


Funding (ZMK)




1 Build & furnish studentaccommodation for 40** Incomplete Electrification/Sewerage/Furniture 904,400,000 700,400,000 739,506,506 188,217,190

2Remove partition & furnish existingclassroom

Notfunded/Notundertaken 10,200,000

3

Update kitchen equipment


4

Purchase furniture for dining hall

Notfunded/Notundertaken Kitchen equipment sti l l needed 10,200,000

5

Build & furnish faculty offices for 6


6Build semi detached house** Completed

Handover in July, contract issues;not in 2008 plan Complaints Tendering/Contract 398,499,300 187,478,170

7Build classroom block** Incomplete

Electrification/Sewerage/Partition;not in 2008 plan 378,313,916 161,859,190

8

Purchase 36 seater bus


Other projectsOther notes New/updated Fencing, Borehole sti l l neededTOTAL 1,346,400,000 700,400,000 1,516,319,722 537,554,550

Registered Nurse/Midwife program stil l requires classroom, l ibrary,and skil ls lab space

110

Mufulira Schools of Nursing & Midwifery2008 2009 2010 2011 2012 Context: Mufulira School of Nursing and Midwifery has upgraded RM and RN, at present the school staff levels are low with half of the tutors and clinical

Total Applicants: Registered Midwives and Nurses 648 840 947 780 885 instructors on study leave. The schools capacity has improved with the construction of the student hostels, however library and one of the classrooms haveTotal Enrolled Students: Registered Midwives 26 30 31 27 40 been converted to a computer room, the larger classroom (capacity of 100) doubles as space rented for workshops and dinning hall seating area. There is

Total Enrolled Students: Registered Nurses 70 49 55 55 92 potential to scale up numbers with renovating existing infrastructure, upgrading the skills lab equipment and introducing Parallel ProgramsProjected Enrolled Students Numbers in the 2008 NTOP 105 105 105 105 105

Percentage of Enrolled Student from Total Applicants 15% 9% 9% 11% 15% Priorities: (1) Equipment in Skills Laboratory (2) Construction of Lecture Theatre (capacity 120 students) (3) Transport - 36 seaterTotal Enrolled Students 96 79 86 82 132

Total Graduates: Registered Midwives 25 28 31 24 31Total Graduates: Registered Nurses 55 54 47 85 50










Dining Hall Capacity Available 90 300 Student Beds Required Build classroom 59,000 200,600,000 205,852,272 205,852,272 Completed and In UseDining Hall Capacity Required (Half of Student Population) 150 Purchase furniture for new classroom 4,000 13,600,000 147,490,000 147,490,000 Completed and In Use

Vehicle Capacity Available 36 Build student accommodation for 40 206,000 700,400,000 700,000,000 702,491,216 Completed and In UseVehicle Capacity Required 36 Reported 240 students for attachments in 2012 Purchase furniture for new student accoommodation 60,000 204,000,000 30,296,000 30,296,000 Completed and In Use

Computers Available 52 Purchase furniture for exisiting student accommodation 1,000 3,400,000 28,861,727 25,424,000 Completed and In UseComputers Required 100 Purchase furniture for exisiting dining hall 500 1,700,000 11,200,000 11,200,000 Completed and In Use

Total 330,500 1,123,700,000 1,123,699,999 1,122,753,488









80 82 78

109

8196 96 96 96 96

0

25

50

75

100

125

2008 2009 2010 2011 2012

Mufulira School of Nursing & MidwiferyAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


111


Mufulira Schoolof Nursing &Midwifery

1 Maintain RN intake at currentaverage 65 from Jan 2008 onwards

Y RN intake to 92 in 2012 RegisteredMidwives

26 30 31 27 40 25 28 31 24 31

2 Maintain RM intake at currentaverage 40 from Jan 2008 onwards

PARTIAL RM intake at 40 in 2012,but dipped in previousyears

RegisteredNurses

70 49 55 55 92 55 54 47 85 50

3 Produce >57 graduates from Dec2010

N 87 RN grads in 2011, butonly 50 in 2012

4 Produce >38 EM graduates from Dec2008 onwards

N 31 RM grads in 2012


Funding (ZMK)




1 Build & furnish lecture theatre Notfunded/Notundertaken

Lecture theatre sti l l needed toscale up

401,200,000

2 Build classroom Completed Diverted funds from lecture theatreproject; no lecture theatreconstructed

205,852,272 205,852,272 -

3 Purchase furniture for new classroom Completed Diverted funds from lecture theatreproject

147,490,000 147,490,000 -

4 Build student accommodation for 36 Completed Midwifery Hostels doubled intakeno

700,400,000 700,000,000 702,491,216 -

5 Purchase furniture for new studentaccommodation

Completed Desk/Chair and MattressesProcured

204,000,000 30,296,000 30,296,000 -

6 Purchase furniture for exisitingstudent accommodation

Completed Rehabilitation needed forexisting student hostels

68,000,000 28,861,727 25,424,000 -

7 Purchase kitchen equipment &furniture for exisiting dining hall

Completed Space for Dh to acc. Student no 204,000,000 11,200,000 11,200,000 -



272,000,000

Other notes Furnishing from 1 classroomdiverted to furnish computer lab

42 PCs donated by ZICTA

Other notes Skil ls lab equipment neededTOTAL 1,448,400,000 1,123,699,999 1,122,753,488 -

112

Mukinge School of Nursing2008 2009 2010 2011 2012 Context: Mukinge School of Nursing located in Northwestern Province currently has an EN program. Of the planned activities under the 2008 NTOP the skills lab

Total Applicants for Enrollment: Enrolled Nurses 232 270 260 325 170 have yet to be furnished and equipped. to consider in scale-up are: skills lab equipment, expansion of library, and considering increasing number of attachmentTotal Enrolled Students: Enrolled Nurses 40 54 55 54 36 sites as patient numbers are low relative to students, the school is considering other practical sites but this would require a newer bus.

Projected Enrolled Students Numbers in the 2008 NTOP 45 45 60 60 60Percentage of Enrolled Student from Total Applicants 17% 20% 21% 17% 21% Priorities: (1) Renovation/Extension of existing buildings-"old hostels", staff offices, dining hall and kitchen

Total Enrolled Students 40 54 55 54 36 (2) Skills Lab Equipment (3) Transport-36 seater bus










Library Capacity Required (Third of Student Population) 48 71 Student Beds Available Build new skills lab 27,000 91,800,000 91,800,000 136,200,000 IncompleteDining Hall Capacity Available 50 145 Student Beds Required Build student accommodation for 40 206,000 700,400,000 700,400,000 904,000,000 Modified

Dining Hall Capacity Required (Half of Student Population) 73 Purchase furniture for new student accoommodation 60,000 204,000,000 0 0 IncompleteVehicle Capacity Available 12 Build and furnish faculty offices of capacity 6 60,000 204,000,000 204,000,000 204,000,000 Completed and In UseVehicle Capacity Required 36 Reported 36 students for attachments in 2012 Build and furnish faculty accommodation of capacity 2 86,000 292,400,000 292,400,000 204,000,000 Completed and In Use

Computers Available 30 Total 439,000 1,492,600,000 1,288,600,000 1,448,200,000Computers Required 30

Comment: funds to furnish the student accommodation was diverted to complete the skills laboratory, however these were insufficient to equipment skills lab









26 2940

53 5557 57 57 57 57

0

25

50

75

100

2008 2009 2010 2011 2012

Mukinge School of NursingAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


113



Mukinge Schoolof Nursing

1 Increase EN intake from current 35to 60 from Jul onwards

N EN enroll. peaked in 2011 to54; 2012 enrolled 36

Enrolled Nurses 40 54 55 54 36 26 29 40 53 55

2 Produce > 57 EN graduates by Jul2012 onwards

N 55 in 2012


Funding (ZMK)




1 Build new skil ls lab (budgeted in2010)**

Incomplete Built l ibrary of capacity 30 91,800,000 91,800,000 136,200,000 1,186,213,000

2 Build student accommodation for 36(budgeted in 2010)

Completed Beds for the student roomsprocured

700,400,000 700,400,000 904,000,000 70,000,000

3 Purchase furniture for new studentaccommodation (budgeted in 2010)

Incomplete Furniture (desks/chairs/mattress)not procured

204,000,000

4 Build & equip new kitchen capacity120


Possibil ity of funds divertedelsewhere

319,600,000


Completed Modified 5 offices built 204,000,000 204,000,000 204,000,000 100,000,000


Completed Modified 2 faculty housing unitsbuilt

292,400,000 292,400,000 204,000,000

7 Purchase minibus capacity 30 Notfunded/Notundertaken

102,000,000

Other notes Need improvements to water/ sewerage connectionOther notes Need improvements to TI electrificationOther notes 40 PCs donated from InterlinkTOTAL 1,914,200,000 1,288,600,000 1,448,200,000 1,356,213,000

114

Mwami School of Nursing2008 2009 2010 2011 2012 Context: Mwami School of Nursing currently has an EN program. Of the planned activities under the 2008 NTOP the faculty office capacity of 8 and furnishing

Total Applicants for Enrollment: Enrolled Nurses 250 275 300 325 355 of student hostels been completed. The schools infrastructure has limited the intake numbers of the 3 classrooms: one has been converted to staff room theTotal Enrolled Students: Enrolled Nurses 45 53 45 53 43 other to skills lab. To consider in scale-up are: skills lab equipment, expansion of library, and considering increasing staff numbers and houses to retain existing

Projected Enrolled Students Numbers in the 2008 NTOP 45 45 60 60 60 numbers, major renovation works (water supply and sewerage works) for the male hostels at the school.Percentage of Enrolled Student from Total Applicants 18% 19% 15% 16% 12%

Total Enrolled Students 45 53 45 53 43 Priorities: (1) Renovation/Extension of existing buildings-"old hostels", staff offices, dining hall and kitchen (2) Skills Lab Equipment (3) Transport-36 seater bus










Library Capacity Required (Third of Student Population) 47 110 Student Beds Available Purchase furniture for existing accommodation 24,000 81,600,000 81,600,000 81,600,000 Completed and In UseDining Hall Capacity Available 80 141 Student Beds Required Build and furnish faculty offices of capacity 8 80,000 272,000,000 272,000,000 272,000,000 Completed and In Use

Dining Hall Capacity Required (Half of Student Population) 71 Total 104,000 353,600,000 353,600,000 353,600,000Vehicle Capacity Available 12Vehicle Capacity Required 36 Reported 69 students for attachments in 2012 Comment: funds to furnish the student accommodation were only sufficient for the female student accommodation, much of the school building were built in

Computers Available 11 the 1970's when the 7th Day Adventist Hospital was constructed and a number of renovation and expansion works maybe required if increased intakeComputers Required 32 numbers are to be achieved. The school is still have plans to upgrade to RNs programs, with only 20 km to Chipata General Hospital as a practical site, the

critical areas would be transport and operational costs.





Additional Lecturers/Tutors Needed for Scale-up Min. Renovation Work- Painting , Fittings Needed for Scale-upAdditional Clinical/Skills Lab Instructors Needed for Scale-up Fixing of available furniture - desks, tables, chairs Required for Scale-up




41 43 3850

4357 57 57 57 57

0

25

50

75

2008 2009 2010 2011 2012

Mwami School of NursingAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)

Projected Graduates in 2008 NTOP Diploma in Specialty

115


Mwami 7th DayAdventist Schoolof Nursing

1 Increase EN intake from 45 to 60from Jul 10 onwards

N EN intake to 43 in 2012 Enrolled Nurses 45 53 45 53 43 41 43 38 50 43

2 Produce >57 EN graduates from Jun2011 onwards

N En grads to 43 in 2012

Consider pilot to test day scholars N No day scholars


Funding (ZMK)




1 Build and furnish faculty office ofcapacity 4

Completed Faculty offices for 8 constructed ** Space for LT next to Offices 136,000,000 272,000,000 272,000,000

2 Remove partition & purchasefurniture for existing classroom(budgeted for 2009)

Completed Information not available on NTOP **M hostels rehab,skil ls lab 17,000,000 81,000,000 81,000,000

3 Build and furnish facultyaccommodation capacity 3


435,200,000

4 Repair existing minibus Notfunded/Notundertaken

30,600,000

Other notes Space for lecture theatre available next to officesOther notes Midwifery hostels need rehabilitationOther notes Skil ls lab requires renovation/updatingTOTAL 618,800,000 353,000,000 353,000,000 -

116

Natural Resource Development College (NRDC)2008 2009 2010 2011 2012 Context: Natural Resource Development College (NRDC) has a 3 year diploma program in Food and Nutrition. The school has an average intake of

Total Applicants: Food and Nutrition 205 265 290 320 364 approximately 45 student intake per year; it has an average of over 400 annual applicants for the program. The institution is under Ministry of Agriculture andTotal Enrolled Students: Nutritionists 64 93 104 204 45 Livestock and is composed of 10 academic departments. In spite the importance of Nutritionist in health, graduates from the Food and Nutrition program are

Target Enrolled Students Numbers 40 40 40 40 40 not being immediately absorbed into health facilities and clinics were they are most needed, therefore are “lost” into the private health sector.Percentage of Enrolled Student from Total Applicants 31% 35% 36% 64% 12%

Total Enrolled Students 64 93 104 204 45 The department of Food and Nutrition has initiated several activities to expand the enrollment numbers, these include: the parallel program which accepted 68 students in 2011 and the same numbers are expected this year allowed NRDC to double its intake using the existing infrastructure capacity; and thedistance learning program with 86 students in 2011, there still remain some challenges to maintain output

Total Graduates: Nutritionists 34 22 42 33 451 Updated Skills Lab Equipment, and renovation of Nutrition Laboratory

Total Graduates 34 22 42 33 45 2 Transport to assess some of practical sites3 Recruitment and Retention of Teaching Staff4 Support in operational and maintenance costs

Classrooms Available 3Classrooms Capacity 135 38.2% Capacity to Student Ratio (Classroom) Much of the funding and infrastructure at the school is "shared" with other department, such as the library, laboratory, accommodation, transport, etc.

Skills Labs Capacity Available 1 However, support to the Department of Food and Nutrition is still required.Skills Labs Capacity 45 13% Capacity to Student Ratio (Skills lab) graduates numbers

Priorities: (1) Renovation of Nutrition Lab, Equipment and Reagents' (2) Updated Textbooks and Resource MaterialFull-Time Tutors Available 4 1/88 Lecturer: Student Ratio

Estimated Full-Time Tutors Required in 2008 NTOP 5Clinical Instructors Available 1 1/353 Clinical Instructor: Student Ratio

Est. Full-Time Clinical Instructors Required in 2008 NTOP 3Support Staff Available 2 2/353 Support Staff: Student RatioSupport Staff Required 10

Library Capacity Available 50 5 Number of Hostels AvailableLibrary Capacity Required (Third of Student Population) 118 > 100 Student Beds Available






New Classrooms Needed for Scale-up Optimizing Classrooms Needed for Scale-upNew Lecture Theatre Needed for Scale-up Appraisal of Additional Practical Sites Required for Scale-up



Additional Support Staff Needed for Scale-up Optimizing use of existing hospital or school buildings Needed for Scale-upUpdated Skills Laboratory Equipment Needed for Scale-up Maintenance of existing equipment - skills, computer Required for Scale-upUpdated textbooks and teaching aids Needed for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-up



64 93 104

204

45

205265 290 320

364

0

50

100

150

200

250

300

350

400

2008 2009 2010 2011 2012

Natural Resource Development CollegeAnnual Vs Target Intake Numbers (2008 - 2012)


117

Nchanga Schools of Nursing & Midwifery2008 2009 2010 2011 2012 Context: Nchanga Schools of Nursing and Midwifery, at present, train Certificated Midwives (DEM). The DEM program started in 2008 with 28 students, over

Total Applicants for Enrollment: Certified Midwives 150 173 176 153 260 the last 3 years targeted intake of 40 has been met; Schools plans to introduce an RN program have stalled because of the low staff numbers.Total Enrolled Students: Certified Midwives 28 32 40 40 38 Scale up targets of students intake numbers have placed an increased demand to construct student hostels. Staff levels are a key challenge, as are

Projected Enrolled Students Numbers in the 2008 NTOP 35 50 50 50 50 accommodation to retain full-time staff. Location of the school (within Chingola Main Town) would make it an ideal center to introduce and some of thePercentage of Enrolled Student from Total Applicants 19% 18% 23% 26% 15% "innovative teaching approaches" of e-learning and parallel programs

Total Enrolled Students 28 32 40 40 38Priorities: (1) Tutor and Clinical Instructors (2) Staff accommodation (3) Updated textbooks and teaching materials

Total Graduates: Certified Midwives 0 23 33 29 38Total Estimated/Projected Graduates from 2008 NTOP 47 47 47 47 47






Support Staff Available 11 7/75 Support Staff: Student RatioSupport Staff Required 13 Summary of 2008 NTOP Funded Activities


Library Capacity Available 25 2 Number of Hostels Available Build classroom 59,000 200,600,000 0 0 Completed and In UseLibrary Capacity Required (Third of Student Population) 39 78 Student Beds Available Purchase furniture for classroom 4,000 13,600,000 200,600,000 198,561,988 Completed and In Use

Dining Hall Capacity Available 40 118 Student Beds Required Build new student accommodation for 40 206,000 700,400,000 13,600,000 16,260,000 Completed and In UseDining Hall Capacity Required (Half of Student Population) 59 Purchase furniture for accommodation for 40 60,000 204,000,000 800,000,280 779,291,156 Completed and In Use

Vehicle Capacity Available 12 Purchase study tables/chairs for existing accommodation10,000 34,000,000 204,000,000 95,553,600 Completed and In UseVehicle Capacity Required 36 Reported 44 students for attachments in 2012 Build and furnish new library of capacity 25 36,000 122,400,000 34,000,000 35,496,000 Completed and In Use

Computers Available 12 Purchase new kitchen equipment 8,000 27,200,000 122,400,000 126,500,000 Completed and In UseComputers Required 39 Build and furnish new faculty offices of capacity 4 40,000 136,000,000 27,200,000 37,000,000 Completed and In Use

TOTAL 423,000 1,438,200,000 1,401,800,280 1,288,662,744









0

2333 29

3847 47 47 47 47

0

25

50

2008 2009 2010 2011 2012

Nchanga Schools of Nursing & MidwiferyAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


118


Nchanga Schoolof Midwifery

1 Increase DEM intake from current 35to 50 from Jan 2009 onwards

N DEM enrolment remainedsteady ~40

CertifiedMidwives

28 32 40 40 38 0 23 33 29 38

2 Introduce RN program in Jan 2010with annual intake of 44

N No RN program introduced


N 38 DEM grads in 2012

4 Produce >42 RN graduates from Dec2012 onwards

N No RN program introduced


Funding (ZMK)




1 Build classroom Completed Capacity of 45-50 students 200,600,000 200,600,000 198,561,988 -2 Purchase furniture for classroom Completed Desks/Chairs Procured 13,600,000 13,600,000 16,260,000 -3 Build new student accommodation

for 36Completed Modified to include laundry/

showers700,400,000 800,000,280 779,291,156 -


Completed Desks/Chairs Procured 204,000,000 204,000,000 95,553,600

5 Purchase study tables/chairs forexisting accommodation

Completed Desks/Chairs Procured 34,000,000 34,000,000 35,496,000 -

6 Build and furnish new library ofcapacity 25

Completed Shelve/Tables yet to be done 122,400,000 122,400,000 126,500,000

7 Purchase new kitchen equipment Completed Repair/Painting Roof and Stove 27,200,000 27,200,000 37,000,0008 Build and furnish new faculty offices

of capacity 4Completed Desk/Chair/Cupboard 136,000,000 136,000,000 136,000,000

9 Purchase 36-seater minibus Notfunded/Notundertaken

125,800,000

Other notes Lecture theater sti l l needed for scale-upOther notes Staff housing sti l l requiredOther notes Skil ls lab equipment donated by ZISSP

Other notesExpansion of Library/ Computer labneeded Only 12 functioning PCs for TI

TOTAL 1,564,000,000 1,537,800,280 1,424,662,744 -

119

Ndola School of Nursing and Midwifery2008 2009 2010 2011 2012 Context: Kitwe School of Nursing and Midwifery offers 3 year diploma programs for RNs and RMs. With plans, in 2013, to introduce Operating Theatre Nurses

Total Applicants: Registered Midwives and Nurses 860 900 950 1050 1200 Program. The school has had the advantage of existing infrastructure and support from the 2008 NTOP to construct 1 classroom , a staff office blockTotal Enrolled Students: Registered Midwives 47 40 42 54 51 and student hostels. This urban school is well placed to consider scaling -up intake and graduate numbers through parallel or distance learning programs,

Total Enrolled Students: Registered Nurses 65 55 62 120 127 even without additional investment, Ndola Schools of Nursing and Midwifery has the capacity to double the current intake numbersProjected Enrolled Students Numbers in the 2008 NTOP 102 102 180 180 180

Percentage of Enrolled Student from Total Applicants 13% 11% 11% 17% 15% The 2012 assessment of the schools noted some renovations and completion of works are required to achieve the targets for increased number of RNs andTotal Enrolled Students 112 95 104 174 178 RMs graduates the school, however a key challenge was the limited number of pre-service numbers in the first year intake. This was attributed the low pass rate

of the aptitude test, this meant a larger part of the first years comprised of in-service nurses/midwives

Total Graduates: Registered Midwives 45 40 41 54 40 Priorities: (1) Construction of Lecture Theatre 1 (capacity 100) (2) Updating Skills lab EquipmentTotal Graduates: Registered Nurses 43 54 92 55 86 (3) Renovation of "old" midwifery hostels








Library Capacity Available 50 3 Number of Hostels Available Summary of 2008 NTOP Funded ActivitiesLibrary Capacity Required (Third of Student Population) 152 324 Student Beds Available

Dining Hall Capacity Available 100 456 Student Beds Required Activity 2008 Costs 2008 Costs Amts ReceivedActual Expenditure Project TrackingDining Hall Capacity Required (Half of Student Population) 228 (USD) (ZMK) (ZMK) (ZMK)

Vehicle Capacity Available 36 Purchase furniture for existing dining hall 2,000 6,800,000 272,000,000 6,800,000 ModifiedVehicle Capacity Required 45 Reported 178 students for attachments in 2012 Build Student Accomodation for 40 206,000 700,400,000 6,800,000 674,300,540 Completed and In Use

Computers Available 16 Build and furnish new staff offices of capacity 8 80,000 272,000,000 700,400,000 338,460,065 Completed and In UseComputers Required 114 TOTAL 288,000 979,200,000 979,200,000 1,019,560,605

Comment: The school is surrounded by several other schools: Ndola Biomedical, School of Medicine and share much of building with Ndola General Hospital






Additional Support Staff Needed for Scale-up Optimizing use of existing hospital or school buildings Needed for Scale-upUpdated Skills Laboratory Equipment Needed for Scale-up Furnishing of existing Lecture Theatre and Classroom Required for Scale-upUpdated textbooks and teaching aids Needed for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-up



88 94

133109

12695 95

150 150 150

0

50

100

150

200

2008 2009 2010 2011 2012

Ndola School of Nursing and MidwiferyAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


120

Funding(ZMK)



FundsRequired toComplete (ifknown)

1 Purchase furniture for existingdining hall

Completed 6,800,000 6,800,000 6,800,000

2 Build Student Accommodation for40

Completed Originally planned to renovate &furnish existing accommodation

Desks/Chairs/WardrobesProcured; No funding forfurniture

85,000,000 700,400,000 674,300,540

3 Build and furnish new staff officesof capacity 8

Completed 343,400,000 343,400,000 338,460,065

Other notes Classroom constructed capacity80

Other notes Old hostel block renovationneeded

Other notes Lecture theatre needed to scale up furtherOther notes Skills lab equipment still neededOther notes Kitchen/dining hall equipment & furniture still neededTOTAL 435,200,000 1,050,600,000 1,019,560,605

-


Ndola School ofNursing &Midwifery, &Theatre

1 Increase RN intake from current 65to 100 from Jan 2010 onwards (twointakes of 50 each in Jan and Jul)

Y Intake of RNs to 120+ from2011

RegisteredMidwives

47 40 42 54 51 45 40 41 54 40

2 Increase RM intake from current 47to 80 from Jan 2010 onwards (twointakes of 40 each in Jan and Jul)

N RM intake to 51 in 2012 RegisteredNurses

65 55 62 120 127 43 54 92 55 86

3 Produce > 95 RN graduates annuallyby Jul 2013

N 86 RN grads in 2012

4 Produce > 75 RM graduates annuallyby Jul 2011

N 54 RM grads in 2011,dropped to 40 in 2012


121

Ndola College of Biomedical Sciences2008 2009 2010 2011 2012 Context: Ndola College of Biomedical Sciences is one of the two schools Training diploma Biomedical Scientist. The infrastructure capacity has increased

Total Applicants for Enrollment: Biomedical Sciences 300 325 350 375 400 with support from Irish government till 2005 . The 2008 NTOP funds were allocated to student accommodation (capacity of 72), lecture theatre (capacity of 100)Total Enrolled Students: Diploma in Biomedical Sciences 62 71 77 80 85 and staff offices (4). One of the key challenges has been the introduction of the School of Medicine - Ndola and sharing the laboratory, staff offices and hostelsProjected Enrolled Students Numbers in the 2008 NTOP 30 74 74 74 74 with the MB ChB and Dental Surgeons 7 year degree program, this will affect 2013 intake numbers.

Percentage of Enrolled Student from Total Applicants 21% 22% 22% 21% 21%Total Enrolled Students 62 71 77 80 85 Priorities: (1) Planning classroom schedules with newly introduced MB ChB program (2) Library and Computers (3) Staff

Total Graduates: Diploma in Biomedical Sciences 33 29 30 30 29Total Estimated/Projected Graduates from 2008 NTOP 48 48 48 48 48





Clinical Instructors Available 0 - Clinical Instructor: Student RatioFull-Time Clinical Instructors Required in 2008 NTOP 10




Dining Hall Capacity Available 100 242 Student Beds Required Build new student accommodation for 40 206,000 700,400,000 136,000,000 136,000,000 Completed and In UseDining Hall Capacity Required (Half of Student Population) 121 Purchase furniture for accommodation for 40 60,000 204,000,000 700,400,000 1,498,600,172 Completed and In Use

Vehicle Capacity Available 28 Purchase furniture for existing accommodation 15,000 51,000,000 204,000,000 223,271,400 Completed and In UseVehicle Capacity Required 36 Reported 180 students for attachments in 2012 Build and furnish faculty offices of capacity 4 40,000 136,000,000 51,000,000 54,210,000 Completed and In Use

Computers Available 35 TOTAL 321,000 1,091,400,000 1,091,400,000 1,912,081,572Computers Required 81 0




New Skills Lab Capacity Needed for Scale-up Lecture Theatre Available for Scale-upNew Full-Time Tutors Needed for Scale-up Utilizing/Increasing Practical Sites Needed for Scale-up





33 29 30 30 29

48 48 48 48 48

0

25

50

75

2008 2009 2010 2011 2012

Ndola College of Biomedical SciencesAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


122


Ndola School ofBiomedicalSciences

1 Increase biomed day program intakefrom current 30 to 44 from Jan 2009onwards

Y increased to 80+ as of 2011 LaboratoryTechnologist

62 71 77 80 85 33 29 30 30 29

2 Maintain biomed night programintake of 30 annually

N Stopped after TI conversionto Ndola Medical School

3 Produce >70 biomed graduatesannually from 2012 onwards

N 29 grads for 2012


Funding (ZMK)




1 Build new student accommodationfor 40 (budgeted for in 2009)

Completed 2011 MoH Support 1.4bil l - med.Students

700,400,000 700,400,000 1,498,600,172 798,200,172

2 Purchase furniture foraccommodation for 40 (budgeted forin 2009)

Completed Desk/Chairs/Mattresses 204,000,000 204,000,000 223,271,400 -

3 Purchase furniture for existingaccommodation

Completed Intro. Parallel Prog. - 40 students 51,000,000 51,000,000 54,210,000 -


Completed Completed for capacity 4; IncludesBoardroom (Fundraising)

272,000,000 272,000,000 259,060,433 -

5 Furnish existing dining hall Notfunded/Notundertaken

6,800,000

TOTAL Contractor paid 813,819,249 1,234,200,000 1,227,400,000 2,035,142,005 798,200,172

123

Roan Antelope School of Midwifery2008 2009 2010 2011 2012 Context: Roan Antelope School of Midwifery, at present, train Certificated Midwives (DEM). The DEM program started in 2008 with 30 students, over

Total Applicants for Enrollment: Certified Midwives 150 173 176 153 260 the last 3 years targeted intake of 60 and graduate target of 57 have yet to be met, mainly because the 2008 NTOP activities of construction of lecture theatre,Total Enrolled Students: Certified Midwives 30 40 40 40 40 student hostels . Despite a high number of applicants, the school has limited its intake numbers as a result of few practical sites ( with limit to students numbers)

Projected Enrolled Students Numbers in the 2008 NTOP 30 60 60 60 60 complete infrastructure capacity and staff numbers. If schools NTOP activities are completed there is a possibility that intake numbers can be doubled.Percentage of Enrolled Student from Total Applicants 20% 23% 23% 26% 15%

Total Enrolled Students 30 40 40 40 40 Priorities: (1) Completion of Lecture Theatre (capacity 80) and student hostel (capacity 36) (2) Tutor and Clinical Instructors (3) Space for Library and Skills Laboratory

Total Graduates: Certified Midwives 0 0 20 40 36Total Estimated/Projected Graduates from 2008 NTOP 47 47 57 57 57






Support Staff Available 5 1/24 Support Staff: Student RatioSupport Staff Required 10 Summary of 2008 NTOP Funded Activities


Library Capacity Available 25 2 Number of Hostels Available Build lecture theatre 118,000 401,200,000 343,400,000 338,460,065 Completed and In UseLibrary Capacity Required (Third of Student Population) 40 68 Student Beds Available Purchase furniture for new lecture theatre 8,000 27,200,000 401,200,000 563,362,595 Incomplete

Dining Hall Capacity Available 40 120 Student Beds Required Build new student accommodation for 40 206,000 700,400,000 27,200,000 82,000,000 IncompleteDining Hall Capacity Required (Half of Student Population) 60 Purchase furniture for accommodation for 40 60,000 204,000,000 700,400,000 750, 665,339 Incomplete

Vehicle Capacity Available 12 Purchase furniture for existing student accommodation 20,000 68,000,000 204,000,000 236,000,000 CompletedVehicle Capacity Required 36 Reported 44 students for attachments in 2012 Build and furnish faculty offices of capacity 8 80,000 272,000,000 68,000,000 68,000,000 Delayed

Computers Available 52 TOTAL 492,000 1,672,800,000 1,744,200,000 1,287,822,660Computers Required 40

Comment: Completion works on the lecture theater include painting and furnishing, the student hostels require electrification upgrade and desks and chairs



New Classrooms Needed for Scale-up Optimizing Classrooms Needed for Scale-upNew Lecture Theatre Needed for Scale-up Lecture Theatre Available for Scale-up


Additional Lecturers/Tutors Needed for Scale-up Revising Classroom Schedules Needed for Scale-upAdditional Clinical/Skills Lab Instructors Needed for Scale-up Max. Renovation Works- Electrification , Water, Sewerage Needed for Scale-up




0 020

40 3647 47

57 57 57

0

25

50

75

2008 2009 2010 2011 2012

Roan Antelope School of MidwiferyAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


124



Roan AntelopeSchool ofMidwifery

1 Increase annual DEM intake fromcurrent 30 to 60 from Jul 2009onwards

N DEM intake increased to 40from 2009

CertifiedMidwives

30 40 40 40 40 0 0 20 40 36

2 Produce >57 DEM graduates fromjun 2010 onwards

N Grads peaked at 40 in 2011;dropped to 36 in 2012


Funding (ZMK)




1 Build lecture theatre (budgeted for in2009)

Incomplete Nearing completion Painting, upgrades to electricalwiring required

401,200,000 401,200,000 563,362,595 10,000,000

2 Purchase furniture for new lecturetheatre (budgeted for in 2009)

Incomplete Nearing completion 20 extra chairs/fittings needed 27,200,000 27,200,000 82,000,000 20,000,000


Incomplete **Completed at time of QuantitySurveyor visit

700,400,000 700,400,000 750, 665,339 -


Completed Desks/Chairs/Mattresses Procured 204,000,000 204,000,000 236,000,000 -

5 Purchase furniture for existingstudent accommodation**

Incomplete Desks/Chairs/Mattresses Procured 68,000,000 68,000,000 68,000,000 -


Completed 7 offices & conference roomcompleted; Funds diverted fromother projects to complete

Furniture sti l l to be procured;funding required

136,000,000 272,000,000 161, 631,112 71,000,000

7 Purchase new kitchen equipment Notfunded/Notundertaken

61,200,000

8 Purchase 30-seater minubus Notfunded/Notundertaken

102,000,000

9 Additional Project--Library** Proposed Space available on-site for l ibrary 1,168,553,200Other notes 42 PCs donated by ZICTAOther notes ZISSP donation of skil ls lab equipTOTAL 1,700,000,000 1,672,800,000 949,362,595 1,269,553,200

125

School of Anesthesia2008 2009 2010 2011 2012 Context: School of Anesthesia offers 3 year diploma programs for Clinical Officers Anesthesia. The School now located at Chainama College of Health

Total Applicants: Clinical Officer Anesthesia 25 25 30 40 40 Sciences. The infrastructure capacity of the school was significantly improved from 2008 with investment into: student hostels (capacity 32); other activitiesTotal Enrolled Students: Clinical Officer Anesthesia 12 10 12 21 12 classroom block, skills lab and library have yet to be completed, as the funds for the activities were insufficient.

Projected Enrolled Students Numbers in the 2008 NTOP 15 15 30 30 30Percentage of Enrolled Student from Total Applicants 48% 40% 40% 53% 30% School of Anesthesia has made some progress, from 15 student intake every 2 year to 12 students every year, however NTOP projections of a 30 student

Total Enrolled Students 12 10 12 21 12 intake every year and 28 graduates from 2013 has not yet been met. The school still staff restrained with 13 part-time lab instructors and 03 part-time lecturerscompared to only 2 full -time staff. To significantly scale up numbers completion of the NTOP projects and staff recruitment would be required

Total Graduates: Clinical Officer Anesthesia 12 10 0 6 12 Priorities: (1) Completion of classroom block, skills lab and library (NTOP activities) (2) Staff recruitmentTotal Estimated/Projected Graduates from 2008 NTOP 28 28 28 28 28 (3) Skills lab equipment





Clinical Instructors Available 0 0 Clinical Instructor: Student RatioFull-Time Clinical Instructors Required in 2008 NTOP 12



Build classroom 59,000 200,600,000 272,000,000 161, 631,112 Completed and In UseLibrary Capacity Available 15 1 Number of Hostels Available Purchase furniture for classroom 4,000 13,600,000 200,600,000 0 Incomplete

Library Capacity Required (Third of Student Population) 15 32 Student Beds Available Build skills lab of capacity 30 32,000 108,800,000 13,600,000 13,600,000 CompletedDining Hall Capacity Available 40 33 Student Beds Required Build new student accommodation for 40 206,000 700,400,000 108,000,000 0 Incomplete

Dining Hall Capacity Required (Half of Student Population) 23 Purchase furniture for accommodation for 40 60,000 204,000,000 704,400,000 1,730,400,000 Completed and In UseVehicle Capacity Available 8 Build and furnish library of capacity 15 21,000 71,400,000 204,000,000 200,400,000 Completed and In UseVehicle Capacity Required 22 Reported 12 students for attachments in 2012 Build and furnish faculty offices of capacity 2 20,000 68,000,000 71,400,000 599,885,880 Incomplete

Computers Available 5 TOTAL 402,000 1,366,800,000 1,574,000,000 2,544,285,880Computers Required 15

Comment: Additional funds from GRZ have been source to complete the Lecture Theatre, these will not cover costs for the sewerage system and furniture.









12 10 0 6 12

28 28 28 28 28

0

25

50

2008 2009 2010 2011 2012

School of AnesthesiaAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


126


School ofAnesthesia

1 Increase intake from current 15every two years to 30 every year byJul 2010 (for a 2-year program)

N 1 intake, 12 studentsenrolled in 2012

Clinical OfficerAnesthesia

12 10 12 21 12 12 10 0 6 12

2 Produce >28 graduates from Jul2013 onwards

TBD


Funding (ZMK)




1 Build classroom Incomplete Window levels, insufficient funds;using space at Chainama

200,600,000 200,600,000 596, 930,000 396,330,620

2 Purchase furniture for classroom Incomplete 13,600,000 13,600,000 -3 Build skil ls lab of capacity 30 Incomplete Not tendered yet, insufficient funds;

amount required dependent onBOQs

108,000,000 108,000,000


Completed Occupied by 20 students 700,400,000 704,400,000 1,530,400,000 1,030,000,000


Completed Desk/Chair/Wardrobe/Fridge 204,000,000 204,000,000 200,400,000

6 Build and furnish l ibrary of capacity15

Incomplete Window levels, insufficient funds 13,600,000 71,400,000 599,885,880 528,485,880


Completed 204,000,000

TOTAL 1,444,200,000 1,302,000,000 2,330,685,880 1,954,816,500

127

School of Medicine - UNZA2008 2009 2010 2011 2012 Context: School of Medicine (SoM) offers degree programs for Medical Doctors, Pharmacists, Biomedical Scientist, Physiotherapy, Environmental Health

Total Applicants for Enrollment: Natural Sciences 5444 5896 5268 7302 8687 Technologist and Nurses. It is one of the few multi-cadre Training institutions, the School of Medicine is one of the three schools under the Ministry of EducationTotal Enrollment: Degrees in School of Medicine 139 200 326 298 460 - University of Zambia. School of Medicine did not directly benefit from Phase 1 of the NTOP funds and over the past years, constraints in funding from

Biomedical Scientist 18 25 46 43 50 Ministry of Education has limited the target and yet it has continued to support overall scale-up of production of HCWs by affiliation of several programs inMedical Doctor 35 56 118 76 130 various schools ( accredited by GNC and HPCZ )

Environmental Health Scientist 15 23 30 27 50Physiotherapist 19 20 23 25 50 One of the key challenges is significant funding and support for School of Medicine which in recent years has failed to retain key staff for various department

Pharmacist 35 44 59 50 50 the establishment requirement have yet to be filled. There have been some support to expand school infrastructure over the past 5 years, such as:Post Basic Nurse - Bsc 17 32 50 77 130 (a) Construction of 1 Lecture Theatres with 100 student capacity - DNS (b) Construction of Student Accommodation of 1,000 capacity

Percentage of Enrolled Student from Total Applicants 3% 3% 6% 4% 5% (c) Rehabilitation of Skills Lab, Equipment and Reagents' for Skills Lab and Practical Sessions (d) Transport for students during attachmentTotal Enrolled Students 139 200 326 298 460 (e) Staff Development Programs to scale up the staff numbers in departments (f) support with the piloting of E-granary in the SoM library

(g) Affiliations of other schools of Nurses and Midwifery (Lusaka, Kitwe, Ndola), Biomedical Colleges (Chikankata, Ndola), Evelyn Hone and Chainama

Total Graduates: School of Medicine 172 155 185 218 171 With these investments, and the introduction of the Parallel Program, intake and graduate numbers have steadily increases from 2008 - 2012; the projectedTotal Estimated/Projected Graduates from 2008 NTOP 200 200 250 300 350 graduates from 2016 onwards was placed at 585. SoM can reach this target with additional support, such as, recruitment and retention of teaching staff,

investing in "innovative teaching methods", equipment and learning resources, financial support, for significant HCWs output from SoMTotal Graduates 172 155 185 218 171

The key challenges to scale up production of key health cadres at School of Medicine include:1 Updated Skills Lab Equipment, and regular maintenance of existing functional equipment

Classrooms Available 15 2 Attachment sites and Operational Costs involved in Practical SessionsClassrooms Capacity 1000 92.3% Capacity to Student Ratio (Classroom) 3 Lecture Theatre to support the larger number of intakes

Skills Labs Capacity Available 3 4 Expansion Health Science Library, Student Accommodation and Staff OfficesSkills Labs Capacity 75 7% Capacity to Student Ratio (Skills lab) 5 Transport for the Departments under SoM

6 Recruitment and Retention of Teaching StaffFull-Time Tutors Available 72 1/15 Lecturer: Student Ratio

Estimated Full-Time Tutors Required in 2008 NTOP 86Clinical Instructors Available 15 1/72 Clinical Instructor: Student Ratio

Full-Time Clinical Instructors Required in 2008 NTOP 20Support Staff Available 62 2/35 Support Staff: Student RatioSupport Staff Required 75

Library Capacity Available 150 7 Number of Hostels AvailableLibrary Capacity Required (Third of Student Population) 361 > 1025 Student Beds Available


Vehicle Capacity Available 72Vehicle Capacity Required 72





New Skills Lab Capacity Needed for Scale-up Revising Skills Lab Scheduled Needed for Scale-upNew Full-Time Tutors Needed for Scale-up Lecture Theatre Available for Scale-up

Additional Lecturers/Tutors Needed for Scale-up Revising Classroom Schedules Needed for Scale-upAdditional Clinical/Skills Lab Instructors Needed for Scale-up Appraisal of Additional Practical Sites Required for Scale-up


Library Seats Needed for Scale-up Potential site for distance teaching methods and equipment Needed for Scale-upDining Hall Seats Need for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-up

Student Beds/Hostel Needed for Scale-up Potential site for day scholar/parallel program or dual classes Needed for Scale-up36 seater Bus Needed for Scale-up


172 155 185 218171200 200

250300

350

0

100

200

300

400

2008 2009 2010 2011 2012

School of Medicine - UNZAAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


128

**School of Medicine not included in Phase I of NTOP funding, so received no funds through this process


School ofMedicine atUNZA / DNS

1 Expand intakes step-wise for allcadres from 2009 onwards

Y Generally yes, but with afew exceptions

BiomedicalScientist

18 25 46 43 50 36 31 31 35 0

2 Maintain current attrition rate of~10%

N Slight increase in attritionto ~15%

Medical Doctor 35 56 118 76 130 67 50 48 73 50


TBD EnvironmentalHealth Scientist

15 23 30 27 50 0 0 20 20 25

Physiotherapist 19 20 23 25 50 10 15 15 20 18

Pharmacist 35 44 59 50 50 38 35 42 38 43Post BasicNurse - Bsc

17 32 50 77 130 21 24 29 32 35

Post BasicNurse - Msc2

6 19 4 4 4 0 0 9 4 0


129

Solwezi School of Nursing2008 2009 2010 2011 2012 Context: Solwezi School of Nursing located in Northwestern Province with an EN program. The school did not benefit from the 2008 NTOP funds, it has

Total Applicants: Enrolled Nurses 175 180 200 220 250 however, has used several initiatives to scale - up infrastructure in the last years - construction of 2 student hostel blocks (each with a 36 student capacity), 4Total Enrolled Students: Enrolled Nurses 41 41 50 40 45 staff houses and an additional house for the exchange program with THET has been supported by Public Administration (PA) Offices with GRZ support.

Projected Enrolled Students Numbers in the 2008 NTOP 45 45 45 45 45Percentage of Enrolled Student from Total Applicants 23% 23% 25% 18% 18% The schools has potential to scaling up the intake numbers, with key considerations of expanding the intake number from only UNFPA sponsored students,

Total Enrolled Students 41 41 50 40 45 introduction of Parallel Program that would take advantage of the school's location in the Town center, rehabilitation of the "old" EN hostels locatedin the Solwezi General Hospital. A main challenge is practical sites attachments as the school does not have ant bus and all transport is through the utility12 seater land cruiser, additional support of staff, operational costs, and staff/student accommodation may need to be considered to increase graduate numbers.

Total Graduates: Enrolled Nurses 34 36 40 40 50Total Estimated/Projected Graduates from 2008 NTOP 43 43 43 43 43 Priorities: (1) Renovation of existing Lecture Theatre (capacity 70 students) (2) Skills Lab Equipment

(3) Transport-36 seater busTotal Graduates 34 36 40 40 50


















34 36 40 4050

43 43 43 43 43

0

25

50

75

2008 2009 2010 2011 2012

Solwezi School of NursingAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


130


Solwezi Schoolof Nursing

1 Maintain current EN intake of 45 Y 2012 intake of 45 Enrolled Nurses 41 41 50 40 45 34 36 40 40 50

2 Produce >43 EN graduates by Jul2010 onwards

PARTIAL 40 grads in 2010/11, but 50in 2012


Funding (ZMK)






20,400,000 0

2 Purchase furniture for exisitng dininghall


17,000,000 0

3 Build and furnish facultyaccomodation for capacity 3


435,200,000 0

4 Build and furnish faculty offices forcapacity 4


136,000,000 0

5 Purchase 26 - seater minibus Notfunded/Notundertaken

88,400,000

Other notes Renovation of EN hostels could double intakeOther notes Classroom converted to Computer

lab42 PCs donated by ZICTA 0

TOTAL 697,000,000 0 0 0

131

St. Francis School of Nursing & Midwifery2008 2009 2010 2011 2012 Context: St. Francis School of Nursing and Midwifery has an EN program and recently introduced (in 2012) EM program, in 2012. The school infrastructure

Total Applicants: Enrolled Nurses and Midwives 345 548 548 540 861 needs are mostly in the areas of classroom space, space for the library, skills lab, and staff offices.Total Enrolled Students: Enrolled Midwives 24 13 9 15 17

Total Enrolled Students: Enrolled Nurses 57 52 49 55 70 The school requires some renovation to existing buildings, original built for a 40 EN intake, the expansion and introduction of EM program requires the schoolProjected Enrolled Students Numbers in the 2008 NTOP 83 105 105 105 105 to better the text-books and teaching material in the library, skills lab equipment and dinning hall facilities.

Percentage of Enrolled Student from Total Applicants 23% 12% 11% 13% 10%Total Enrolled Students 81 65 58 70 87 Priorities: (1) Completion of one staff house (NTOP activity) (2) Skills Lab Equipment (3) Library, Skills lab and Staff Office Block










Library Capacity Required (Third of Student Population) 72 126 Student Beds Available (USD) (ZMK) (ZMK) (ZMK)Dining Hall Capacity Available 75 215 Student Beds Required Purchase furniture for existing classrooms 14,000 47,600,000 0 0 Completed and In Use

Dining Hall Capacity Required (Half of Student Population) 108 Build and furnish faculty offices of capacity 2 20,000 68,000,000 297,485,440 103,269,153 Completed and In UseVehicle Capacity Available 12 Build and furnish faculty accommodation of capacity 2 85,600 291,040,000 64,600,000 62,990,000 Completed and In UseVehicle Capacity Required 36 Reported 87 students for attachments in 2012 Build Student accomodation for 40 206,000 700,400,000 290,022,000 264,462,029 Delayed

Computers Available 14 Total 325,600 1,107,040,000 652,107,440 430,721,182Computers Required 72

Comment: Furnishing of the built student accommodation is still required and only one of the two staff houses have been constructed.





Additional Lecturers/Tutors Needed for Scale-up Extensive Completion Works- Slab/Window/Roof Level Needed for Scale-upAdditional Clinical/Skills Lab Instructors Needed for Scale-up Utilizing existing "empty"" hospital or school buildings Needed for Scale-up


Library Needed for Scale-up Potential site for distance teaching methods and equipment Needed for Scale-upStaff Offices Need for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-up

Student Hostel Needed for Scale-up Potential site for day scholar/parallel program or dual classes Needed for Scale-up36 seater Bus Needed for Scale-up


6076 66 60 6460

80

127 127 127

0

25

50

75

100

125

150

2008 2009 2010 2011 2012

St. Francis School of Nursing & MidwiferyAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


132


St. Francis /Katete School ofNursing &Midwifery

1 Increase EN intake from current 65to 75 from Jul 2009 onwards

N Intake to 70 in 2012;dropped as low as 49 in2010

EnrolledMidwives

24 13 9 15 17 17 22 12 9 15

2 Increase EM intake from current 18to 30 and add Jan intake from Jan2010 onwards

N EM intake 17 in 2012 Enrolled Nurses 57 52 49 55 70 43 54 54 51 49

3 Produce >71 EN graduates from Jun2011

N 51 grads in 2011

4 Produce >56 EM graduates annuallyfrom Dec 2010 onwards

N 15 grads in 2012

5 Enroll 10 day scholars per yearstarting Jan 2009

N No day scholars


Funding (ZMK)




1 Purchase furniture for existingclassrooms Completed 50 desks/chairs procured 2 classrm Vs 150 EM/EN intakes 297,485,440 103,269,153 -

2 Build and furnish faculty offices ofcapacity 8 Completed

2 constructed; 1 occuped, otherstorage space 272,000,000 64,600,000 62,990,000 -

3 Build and furnish facultyaccommodation of capacity 3** Incomplete

Plan changed to construct 2;insufficient funding

** Completed at time of QuantitySurveyor visit 436,900,000 290,022,000 264,462,029 -

4 Build Student accommodation for 40(budgeted for in 2009) Completed Completed for Midwifery students 700,400,000 669,134,340 700,960,390 -

5 Additional Project--Construct semi-detached staff housing** Proposed 1,115,706,450Other notes Dining hall/kitchen requires renovationOther notes Expansion needed for skil ls lab, equipment neededOther notes Existing hostels require renovationTOTAL 1,409,300,000 1,321,241,780 1,131,681,572 1,115,706,450

133

St. Luke's School of Nursing (Mpanshya)2008 2009 2010 2011 2012 Context: St. Luke School of Nursing located in Chongwe District (Rural) in Lusaka. The school was reopened in 2009 and has a 2 year EN program has used

Total Applicants: Enrolled Nurses 0 380 400 420 420 several initiatives to scale - up infrastructure in the last years, - conversion of a classroom to a lecture theatre (capacity 80 seats)Total Enrolled Students: Enrolled Nurses 0 30 40 42 65 The schools has potential to scaling up the intake numbers, with key considerations of expanding the intake number from building staff houses to retain numbers

Projected Enrolled Students Numbers in the 2008 NTOP 65 65 65 65 65 because of school's rural construction of EN hostels is required to increase intake numbers,Percentage of Enrolled Student from Total Applicants 0% 8% 10% 10% 15% A main challenge is practical sites attachments as the school does not have a bus and all transport is through the utility vehicle seating only 7 student at a time

Total Enrolled Students 0 30 40 42 65Priorities: (1) Renovation of existing Lecture Theatre (capacity 70 students) (2) Staff houses

(3) Transport-36 seater busTotal Graduates: Enrolled Nurses 0 0 0 28 39
















Additional Support Staff Needed for Scale-up Furnishing of existing Lecture Theatre and Classroom Required for Scale-upUpdated Skills Laboratory Equipment Needed for Scale-up Fixing of available furniture - desks, tables, chairs Required for Scale-upUpdated textbooks and teaching aids Needed for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-up



0

3040 42

6565 65 65 65 65

0

25

50

75

100

2008 2009 2010 2011 2012

St. Luke's School of NursingAnnual Vs Projected Intake Numbers (2008 - 2012)

Projected Numbers

134

St. Paul's School of Nursing & Midwifery2008 2009 2010 2011 2012 Context: St. Paul's School of Nursing and Midwifery has an EN program and recently introduced (in 2012) EM program, in 2012. The school suffered a major

Total Applicants: Enrolled Nurses and Midwives 345 548 548 540 861 set back in 2011, when a fire at the school destroyed the kitchen, 3 student hostels (capacity of 100), library and many of the textbooks and computers.Total Enrolled Students: Enrolled Midwives 0 0 0 0 13 The school is currently using the staff offices as skills lab, while the few demonstration rooms have been converted to student rooms and quarters. There

Total Enrolled Students: Enrolled Nurses 52 84 30 58 48 dinning hall is now been used as classroom for both EN and EM theory sessions and a "make-shift" kitchen as been constructed at the entrance of the schoolProjected Enrolled Students Numbers in the 2008 NTOP 95 95 95 95 95 St. Paul's have an estimated costs of over ZMK 1.5 billion to reconstruction a major portion of hostels, classrooms, and kitchen area.

Percentage of Enrolled Student from Total Applicants 15% 15% 5% 11% 7%Total Enrolled Students 52 84 30 58 61 Priorities: (1) Reconstruction of student hostels, classroom/ lecture theatre, and kitchen (2) Skills Lab Equipment

(3) Library, Skills lab and Staff Office Block










Library Capacity Required (Third of Student Population) 30 106 Student Beds Available (USD) (ZMK) (ZMK) (ZMK)Dining Hall Capacity Available 1 149 Student Beds Required Purchase furniture for existing classrooms 6,000 20,400,000 669,134,340 700,960,390 Completed and In Use

Dining Hall Capacity Required (Half of Student Population) 120 Build and furnish faculty offices of capacity 4 40,000 136,000,000 20,400,000 19,800,000 Completed and In UseVehicle Capacity Available 12 Build and furnish faculty accommodation of capacity 4 172,000 584,800,000 136,000,000 110, 986,000 Completed and In UseVehicle Capacity Required 36 Reported 61 students for attachments in 2012 Total 218,000 741,200,000 825,534,340 720,760,390

Computers Available 10Computers Required 50 Comment: An assessment into the actual costing to the buildings will need to be verified by quantity surveyor






Additional Support Staff Needed for Scale-up Extensive Completion Works- Slab/Window/Roof Level Needed for Scale-upUpdated Skills Laboratory Equipment Needed for Scale-up Furnishing of existing buildings - office blocks, hostels Required for Scale-upUpdated textbooks and teaching aids Needed for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-up

Library Needed for Scale-up Potential site for distance teaching methods and equipment Needed for Scale-upStaff Offices Need for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-up

Student Hostel Needed for Scale-up Potential site for day scholar/parallel program or dual classes Needed for Scale-up36 seater Bus Needed for Scale-up


32 3451

86

3240 40

85 85 85

0

25

50

75

100

2008 2009 2010 2011 2012

St. Paul's' School of Nursing & MidwiferyAnnual Vs 2008 NTOP Projected Graduates (2008 - 2012)


135


St. Paul’s Schoolof Nursing &Midwifery

1 Increase EN intake from past 35 to55 from Jul 2008 onwards

Y averaged >55 in recentyears


2 Introduce DEM intake of 40 from Jun2010

N No DEM programintroduced

Enrolled Nurses 52 84 30 58 48 32 34 51 86 32

3 Produce > 52 EN graduates from jun2010

PARTIAL 50+ in 2010 & 11, butdropped to 32 in 2012

4 Produce > 38 DEM graduates formDec 2010 onwards

N No DEM program


Funding (ZMK)




1 Purchase furniture for existingclassrooms Completed 47,600,000 20,400,000 19,800,000 -

2 Build and furnish faculty offices ofcapacity 4 Completed

Offices also being used for studenthostels/skil ls lab 68,000,000 136,000,000 110, 986,000 -

3 Build and Furnish facaultyaccomodation of capacity 4 Completed **Halved intake no./lib books 291,040,000 584,800,000 605,714,965 -

Other notesSept. 2011 fire destroyed 4 hostels+admin

Lecture Theatre/Hostels/StaffOffices/Library all needed

Other notesTI forced to halve intakes followingfire

TOTAL 406,640,000 741,200,000 625,514,965 -

136

*Note: Individual tables with 2008 NTOP targets for Private TIs following Western University of Nursing TI profile; TIs not listed had no targets set in 2008NTOP

Agape School of Nursing (Private)2008 2009 2010 2011 2012 Context: Agape School of Nursing located in Central Province with an EN program. The school was opened in 2008, it was initially run a RN program, the

Total Applicants: Enrolled Nurses 50 100 100 200 200 school currently is renting buildings for staff offices, hostels, classroom and library. With plans to secure land for construction of new school, until then littleTotal Enrolled Students: Enrolled Nurses 0 26 65 50 25 renovations works can be made to the dilapidated structures.

Target Enrolled Students Numbers 40 40 40 40 40Percentage of Enrolled Student from Total Applicants 0% 26% 65% 25% 13% In 2012, only one intake in January is planned because of tradition of accommodating all students in Nursing and Midwifery schools, this tediously

Total Enrolled Students 0 26 65 50 25 increases the operational costs, another limiting factor in scaling up numbers from Agape is the limited infrastructure and Costs attached to Practical's -theAffiliation Fees and Transport to the two main practical sites: Kabwe General Hospital (4km) and Mwachisompola (160km).

Total Graduates: Enrolled Nurses 0 0 0 12 20 Increasing the output would require investment in library space and textbooks, skills lab and equipment and computers. The current staff numbers are3 tutors and clinical instructor (target is 8). Even more important would be securing land to build school to met target numbers.

Total Graduates 0 0 0 12 20Priorities: (1) School Infrastructure and Space (2) Skills lab Equipment and Space

(3) Updated textbooks and reference materialsClassrooms Available 3Classrooms Capacity 90 64.3% Capacity to Student Ratio (Classroom)


Full-Time Tutors Available 1 1/140 Lecturer: Student RatioEstimated Full-Time Tutors Required 4

Clinical Instructors Available 2 1/70 Clinical Instructor: Student RatioEstimated Full-Time Clinical Instructors Required 4









New Skills Lab Capacity Needed for Scale-up Space for Skills Lab Available for Scale-upNew Full-Time Tutors Needed for Scale-up Appraisal of Additional Practical Sites Required for Scale-up



Library Needed for Scale-up Potential site for distance teaching methods and equipment Needed for Scale-upDining Hall Seats Need for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-upStudent Hostel Needed for Scale-up Potential site for day scholar/parallel program or dual classes Needed for Scale-up36 seater Bus Needed for Scale-up


0 26

6550

2550

100 100

200 200

0

50

100

150

200

2008 2009 2010 2011 2012

Agape School of NursingAnnual Vs Target Intake Numbers (2008 - 2012)


137

Chengelo Nursing College (Private)2010 2011 2012 Context: Chengelo School of Nursing is a newly opened private school located in Northern Province with a RN program. The school was opened in 2011,

Total Applicants: Registered Nurses 0 100 100 and does not lack infrastructure, however there is a distant lack of teaching material and equipment for faculty and student use. Attaining the target intakeTotal Enrolled Students: Registered Nurses 0 11 21 numbers, support in computers, skills lab equipment and teaching material would be required

Target Enrolled Students Numbers 0 45 45Percentage of Enrolled Student from Total Applicants 0% 11% 21% The school, currently, relies on part time tutors and networking with Kasama School of Nursing and Midwifery for clinical sessions. There could potential be

Total Enrolled Students 0 11 21 more collaboration between the school's to utilize staff and infrastructure. The school has potential to increase intake numbers with plans to expand andconstruct hostels.

Priorities: (1) Full-time teaching staff (2) Updated textbooks and reference materials (3) Skills lab Equipment and ComputersClassrooms Available 3Classrooms Capacity 120 375.0% Capacity to Student Ratio (Classroom)














Additional Support Staff Needed for Scale-up Extensive Construction- Site for Classroom, Library, Skills Lab Needed for Scale-upUpdated Skills Laboratory Equipment Needed for Scale-up Optimizing use of existing hospital staff in teaching/practical sessions Needed for Scale-upUpdated textbooks and teaching aids Needed for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-up



0 1121

0

100 100

0

25

50

75

100

2010 2011 2012

Chengelo School of NursingAnnual Vs Target Intake Numbers (2008 - 2012)

Total Applicants for the Program(s) Diploma in Specialty

138

Copperbelt RN Polytechnic (Private)2008 2009 2010 2011 2012 Context: Copperbelt RN Polytechnic is one of the oldest private nursing trainings school opened in 2008. Currently the RN program is run in a rented facility

Total Applicants: Registered Nurses 122 130 132 171 241 with plans to secure land for construction of new school and student hostels. Over the past 5 years, the annual applicants for enrollment have increased, theTotal Enrolled Students: Registered Nurses 43 40 23 57 41 intake capacity is limited by infrastructure constraints and the "unavailability" of student accommodation

Target Enrolled Students Numbers 50 50 50 50 50Percentage of Enrolled Student from Total Applicants 35% 31% 17% 33% 17% The school is managed has an experienced team, comprising of "retired" nurses and former Principal Nurse Education Officers is in charge, it however lacks

Total Enrolled Students 43 40 23 57 41 space for library and skills lab for study and practical sessions (respectively). As in the case with majority of private schools, full time teaching staff are in shortsupply, a large proportion are part time. Increasing the output would require investment in library space and textbooks , skills lab and equipment and computers.

Total Graduates: Registered Nurses 0 21 46 45 23 Priorities: (1) School Infrastructure and Space (2) Skills lab Equipment and Space(3) Updated textbooks and reference materials



















43 4023

5741

122 130 132

171

241

0

25

50

75

100

125

150

175

200

225

250

2008 2009 2010 2011 2012

Copperbelt RN PolytechAnnual Vs Target Intake Numbers (2008 - 2012)


139

Dovecot College of Nursing (Private)2008 2009 2010 2011 2012 Context: Dovecot College of Nursing is a private nursing trainings school located in Lusaka and has been opened in 2008. Over the last 4 years, the school

Total Applicants: Registered Nurses 50 70 100 125 150 has secured land for construction and student hostels and classroom block . The annual applicants for enrollment have equally increased, the intake capacityTotal Enrolled Students: Registered Nurses 22 46 40 28 31 is limited by the student accommodation which the school plans to provide for each accepted candidate.

Target Enrolled Students Numbers 45 45 45 45 45Percentage of Enrolled Student from Total Applicants 44% 66% 40% 22% 21% The school plans to expand its program to include Clinical Officers (general), it however lacks skills lab equipment, library space and reference material, and

Total Enrolled Students 22 46 40 28 31 a large proportion of the teaching staff are part time. Increasing the output would require investment in library space and textbooks , skills lab and equipment,computers and focus on acquiring full-time staff

Total Graduates: Registered Nurses 0 0 0 17 17 Priorities: (1) Student accommodation (2) Skills lab Equipment and Space (3) Updated textbooks and reference materials



















43 4023

5741

122 130 132

171

241

0

25

50

75

100

125

150

175

200

225

250

2008 2009 2010 2011 2012

Dovecot College of NursingAnnual Vs Target Intake Numbers (2008 - 2012)


140

Kafue College of Health Sciences(Private)2011 2012 Context: Kafue College of Health Sciences is one of the few 'non-nurse" private trainings school to have opened. The school trains Clinical Officers and the

Total Applicants: Clinical Officers 480 520 first intake was in 2011. Currently, the school has no full time staff and the reported 15 lecturers and 3 skills lab instructors are part-time. The intake capacity isTotal Enrolled Students: Clinical Officers 39 49 further limited by infrastructure constraints, such as classroom space, medicals and skills lab and updated text books.

Target Enrolled Students Numbers 100 100Percentage of Enrolled Student from Total Applicants 8% 9% It is run primarily as a day school by experience management, and is looking to expand its boarding services to accommodate all students. Plans to invest in

Total Enrolled Students 39 49 space for library and skills lab for study and practical sessions (respectively) are in place. Other than the need for full time teaching to scale up the intakenumbers, the schools require transport for off-site practical locations (this will reduce on the current practical site - transport expenses)

Total Graduates: Clinical Officers 0 0 Program commenced in 2011 Priorities: (1) Full-time teaching staff (2) Skills lab Equipment and Space(3) Transport - 36 seater bus

Total Graduates 0 0


















39 49

480520

0

50

100

150

200

250

300

350

400

450

500

550

2011 2012

Kafue College of Health ScienceAnnual Vs Target Intake Numbers (2008 - 2012)


141

Lusaka Apex Medical University (Private)2011 2012 Context: Lusaka Apex Medical University has it's first intake in 2011. The school offers Pre-Med ( A-levels) and MB ChB (7 year degree for Medical Doctors)

Total Applicants: Medical Doctors 150 220 Currently, has 4 full time staff and the reported 50 part time lecturers. It is run primarily as a day school, plans are to expand its boarding services to provideTotal Enrolled Students: Medical Doctors 39 49 accommodate for students to pay for. The student drop-out rate has been approximately 40 percent, one of main reasons are student fees and academic .

Target Enrolled Students Numbers 100 100 performance, the school has introduced liberal payment of tuitions fees and strengthening theory and practical sessions to reduce it to less than 10 percent in 2013Percentage of Enrolled Student from Total Applicants 26% 22%

Total Enrolled Students 39 49 Further investments into infrastructure and equipment are needed, key reported areas include: lecture theatre, medicals/skills lab and reagents and updated text books, numbers, the schools require transport for off-site practical locations (this will reduce on the current practical site - transport expenses)

Total Graduates: Medical Doctors 0 0 Program commenced in 2011 Priorities: (1) Full-time teaching staff (2) Skills lab Equipment and Space (3) Construction of Lecture Theatre

Total Graduates 0 0




Clinical Instructors Available 0 0 Clinical Instructor: Student RatioEstimated Full-Time Clinical Instructors Required 0














39 49

150

220

0

50

100

150

200

250

300

2011 2012

Lusaka Apex Medical UniversityAnnual Vs Target Intake Numbers (2008 - 2012)


142

Lusaka Institute of Applied Sciences (Private)2008 2009 2010 2011 2012 Context: Lusaka Institute of Applied Sciences located in Lusaka with RN in 2008, and in 2012 have added a Clinical Officer (CO) program. The double intake

Total Applicants: Registered Nurses and Clinical Officers 230 256 155 205 295 (one intake in January, other in July) has increased the demand for bed space and because of tradition of accommodating all students in Nursing andTotal Enrolled Students: Registered Nurses 72 71 45 32 55 Midwifery schools, this has increased the need for student hostels to be built. The school is in an ideal location to consider day scholars to add to intake

Total Enrolled Students: Clinical Officers 0 0 0 0 21 numbers.Percentage of Enrolled Student from Total Applicants 31% 28% 29% 16% 19%

Total Enrolled Students 72 71 45 32 76 The operational costs attached to Practical's -the Affiliation Fees, Rental/Accommodation and Transport to the main practical sites: St. Francis MissionHospital (500km) and Mpanshya Mission Hospital (175km) play a role in determining the ceiling number of first years. Increasing the output would require investment in library space and textbooks, skills lab and equipment and computers; even more so in trying to optimize closer practical sites to reduce the overall

Total Graduates: Registered Nurses 7 14 35 42 24 cost in training students at private schools.

Total Graduates 7 14 35 42 24 Priorities: (1) Full time Teaching Staff (2) Skills lab Equipment and Space(3) Updated textbooks and reference materials













New Skills Lab Capacity Needed for Scale-up Space for Skills Lab Available for Scale-upNew Full-Time Tutors Needed for Scale-up Appraisal of Additional Practical Sites Required for Scale-up





72 7145 32

76

230256

155205

295

0255075

100125150175200225250275300325350

2008 2009 2010 2011 2012

Lusaka Institute of Applied SciencesAnnual Vs Target Intake Numbers (2008 - 2012)


143

Lusaka Health Institute (Private)2008 2009 2010 2011 2012 Context: Lusaka Health Institute is a private school, that currently runs a RN program. The school has made significant progress increasing to a double intake

Total Applicants: Registered Nurses 34 45 50 42 57 from 2008, it has not been able to introduce the RM program because of infrastructure constraints and distant short of teaching material and equipment forTotal Enrolled Students: Registered Nurses 23 40 24 18 34 faculty and student use. Attaining the target intake numbers, expanding the current classroom space, support in computers, skills lab equipment and

Target Enrolled Students Numbers 60 60 60 60 60 teaching material would be requiredPercentage of Enrolled Student from Total Applicants 68% 89% 48% 43% 60%

Total Enrolled Students 23 40 24 18 34 The school, currently, relies on part time tutors and networking with nursing schools for clinical sessions. The school has potential to increase intake numbers with plans to expand and construct hostels.

Priorities: (1) Full-time teaching staff (2) Updated textbooks and reference materialsClassrooms Available 3 (3) Classroom space, desks and chairsClassrooms Capacity 50 65.8% Capacity to Student Ratio (Classroom)



Clinical Instructors Available 0 0 Clinical Instructor: Student RatioEstimated Full-Time Clinical Instructors Required 2










Additional Lecturers/Tutors Needed for Scale-up Revising Classroom Schedules Needed for Scale-upAdditional Clinical/Skills Lab Instructors Needed for Scale-up Extensive Construction- Site for Classroom, Library, Skills Lab Needed for Scale-up




23

40

2418

343445

5042

57

0

25

50

75

2008 2009 2010 2011 2012

Lusaka Health InstituteAnnual Vs Target Intake Numbers (2008 - 2012)


144

Makeni School of Nursing (Private)2008 2009 2010 2011 2012 Context: Makeni School of Nursing is a private nursing trainings school located in Lusaka and has been opened in 2008. Over the last 4 years, the school

Total Applicants: Registered Nurses 50 70 100 125 150 has expanded with construction and student hostels and classroom block . The annual applicants for enrollment have equally increased, the intake capacityTotal Enrolled Students: Registered Nurses 20 30 13 15 14 is dropped from 30 (in 2009) to 13-15 students as the schools provides accommodation for all students in the 3 year RN program it limits the number of first year

Target Enrolled Students Numbers 45 45 45 45 45 intakePercentage of Enrolled Student from Total Applicants 40% 43% 13% 12% 9%

Total Enrolled Students 20 30 13 15 14 The school plans to expand its program to include Registered Midwives, it however lacks skills lab equipment, library space and reference material, anda large proportion of the teaching staff are part time. Increasing the output would require investment into mentioned areas, however doubling the currentintake numbers to 30 could occur if the school would consider day scholars

Total Graduates: Registered Nurses 0 0 0 34 40Priorities: (1) Teaching Staff (2) Skills lab Equipment and Space (3) Updated textbooks and reference materials



















2030

13 15 14

5070

100

125

150

0

25

50

75

100

125

150

175

2008 2009 2010 2011 2012

Makeni Nursing of NursingAnnual Vs Target Intake Numbers (2008 - 2012)


145

Mufulira Nursing College (Private)2011 2012 Context: Mufulira nursing College is a private institution with 3 year RN program established in 2012. The school is located on a rented plot, with plans of

Total Applicants: Registered Nurses 0 24 purchasing land to construct more classrooms and student hostels. The school rents out houses to accommodate the students, its library has a capacity of 10Total Enrolled Students: Registered Nurses 0 11 and skills lab is currently being used as a additional classroom space for the next first years

Target Enrolled Students Numbers 35 35Percentage of Enrolled Student from Total Applicants 0% 46% Further investments into infrastructure and equipment are needed, key reported areas include: lecture theatre, medicals/skills lab and reagents and updated

Total Enrolled Students 0 11 text books, numbers, the schools require transport for off-site practical locations (this will reduce on transport expenses from hiring buses)

Priorities: (1) Securing land for construction of the school (2) Full-time teaching staffTotal Graduates: Registered Nurses 0 0 Program commenced in 2012 (3) Skills lab Equipment, textbooks and teaching materials

Total Graduates 0 0


















0

11

0

24

0

10

20

30

2011 2012

Mufulira Nursing CollegeAnnual Vs Target Intake Numbers (2011- 2012)


146

Mukuni Nursing Trust Institute (Private)2011 2012 Context: Mukuni Nursing Trust Institution is a private institution with a 2 year RN program. The school opened in 2011 and is located on a rented building

Total Applicants: Enrolled Nurses 50 40 and rents out houses to accommodate the students, desk and chairs have been purchased for existing 2 classrooms (one has a 50 student capacity,Total Enrolled Students: Enrolled Nurses 20 20 the other 25) and skills lab is currently being used as a additional classroom space for the next first years.

Target Enrolled Students Numbers 40 40Percentage of Enrolled Student from Total Applicants 40% 50% Further investments into infrastructure and equipment are needed, key reported areas include: skills lab equipments and updated text books/teaching aids.

Total Enrolled Students 20 20 The schools has plans to secure land for their own structure, this will reduce on operations cost paid towards rent and acquiring transport for off-site practicallocations (this will reduce on transport expenses from hiring buses)

Total Graduates: Enrolled Nurses 0 0 Program commenced in 2011 Priorities: (1) Securing land for construction of the school (2) Full-time teaching staff (3) Skills lab Equipment, textbooks and teaching materials

Total Graduates 0 0















Additional Support Staff Needed for Scale-up Extensive Construction- Site for Classroom, Library, Skills Lab Needed for Scale-upUpdated Skills Laboratory Equipment Needed for Scale-up Optimizing use of existing hospital staff in teaching/practical sessions Needed for Scale-upUpdated textbooks and teaching aids Needed for Scale-up Potential site for e-learning teaching methods and equipment Needed for Scale-up



20 20

5040

0

25

50

75

2011 2012

Mukuni Nursing Trust InstitutionAnnual Vs Target Intake Numbers (2011- 2012)


147

Nkana College of Nursing (Private)2011 2012 Context: Nkana College of Nursing opened in 2011 has a 3 year RN program. The school has great potential in achieving its target of 120 intake, over the past

Total Applicants: Registered Nurses 69 80 1 year has built an additional 2 classrooms to add to the existing 2 classrooms (each with 45 student capacity), furnished classrooms and purchased more skillsTotal Enrolled Students: Registered Nurses 69 45 equipment. The school with started construction of a 80 bed space hostel a few meter from it's location and has acquire a new 32 seater bus to ferry student

Target Enrolled Students Numbers 120 120 to the main practical site: Kitwe Central HospitalPercentage of Enrolled Student from Total Applicants 100% 56%

Total Enrolled Students 69 45 To further support Nkana College of Nursing, the following were listed as priority areas: skills lab equipments, updated text books/teaching aids andaccreditation of more practical sites for attachments. The school management also highlighted the need for standardizing practical fees and charges made byhospitals and other health facilities to private schools when carrying out practical sessions

Total Graduates: Registered Nurses 0 0 Program commenced in 2011Priorities: (1) Full-time teaching staff (2) Asses to more clinical sites for practical skills

Total Graduates 0 0 (3) Skills lab Equipment, textbooks and teaching materials








Vehicle Capacity Available 40Vehicle Capacity Required 0






Additional Lecturers/Tutors Needed for Scale-up Appraisal of Additional Practical Sites Required for Scale-upAdditional Clinical/Skills Lab Instructors Needed for Scale-up Utilizing existing "empty"" hospital or school buildings Needed for Scale-up




6945

69 80

0

25

50

75

100

125

150

175

200

2011 2012

Nkana College of NursingAnnual Vs Target Intake Numbers (2011- 2012)


148

Western School of Nursing (Private)2008 2009 2010 2011 2012 Context: Western School of Nursing is located in Livingstone (the Mongu Campus was closed in 2011). This has reduced the overall intake numbers which

Total Applicants: Registered Nurses 100 100 100 125 150 has dropped from 30 (in 2009) to 13-15 students as the schools provides accommodation for all students in the 3 year RN program it limits the number of first yearTotal Enrolled Students: Registered Nurses 37 32 14 15 20 The school plans to expand its program to include Registered Midwives, it however lacks skills lab equipment, library space and reference material, and

Target Enrolled Students Numbers 100 100 100 100 100 a large proportion of the teaching staff are part time. Increasing the output would require investment into mentioned areas, however doubling the currentPercentage of Enrolled Student from Total Applicants 37% 32% 14% 12% 13% intake numbers to 30 could occur if the school would consider day scholars

Total Enrolled Students 37 32 14 15 20Western School of Nursing currently renovating a few parts of the rental building the school is currently located in. Securing a plot to construct a school isor should be a priority as the classrooms, hostels, library and skills lab are located in an old run down building.

Total Graduates: Registered Nurses 5 0 11 0 14Priorities: (1) Secure land to construct the school (2) Skills lab Equipment and Space

Total Graduates 5 0 11 0 14 (3) Updated textbooks and reference materials


















37 3214 15 20

100 100 100125

150

0

25

50

75

100

125

150

175

2008 2009 2010 2011 2012

Western School of NursingAnnual Vs Target Intake Numbers (2008 - 2012)


149


Agape School ofNursing

1 Increase annual RN intake from 30in 2008 to 35 by July 2012

Y Achieved, but for ENs not RN Enrolled Nurses 0 26 65 50 25 0 0 0 12 20

2 Produce >28 RN graduates from Jun2011

N 20 in 2012

Cobberbelt RNPolytech

1 Increase RN intake from current 30to 50 by Jan 2010

N Reached in 2011, butreduced in 2012 to 41

RegisteredNurses

43 40 23 57 41 0 21 46 45 23

2 Produce >28 RN graduates from Dec2009 and >48 RN graduates fromDec 2011 onwards

N Almost reached in2010/11, but reduced to 23in 2012

Dovecot Collegeof Nursing Trust

1 Increase each bi-annual RN intakefrom current 30 to 45 from Jan 2009onwards

N intake of 12 in 2012 RegisteredNurses

30 16 23 12 0 0 0 0 0

2 Produce > 86 RN graduates annuallyfrom Jun 2012 onwards

N No graduates in recentyears

1 Continue RN bi-annual intake of 25 Y 55 in 2012 RegisteredNurses

72 71 45 32 55 7 14 35 42 24

2 Produce >47 RN graduates annuallyfrom Jun 2011 onwards

N 42 in 2011, but dropped to24 in 2012

Clinical OfficerGeneral

0 0 0 0 21 0 0 0 0 0

Lusaka NursingInstitute

1 Increase individual bi-annual RNintake from current 40 to 50 fromJan 2010 onwards

N only 1 intake of 14 for 2012 RegisteredNurses

20 30 13 15 14 10 0 10 10 24

2 Introduce January RM intake of 30starting in Jan 2009, incrase to 40 inJan 2010

N no RM program

3 Introduce Jan RN conversion intakeof 25 starting Jan 2009 to 40 in Jan2010

N Intake < 40

4 Produce >47 RN graduates from dec2008 onwards

N ~10 grads/year, 24 in 2012

5 Produce >28 RM graduates from Dec2008 onwards

N no RM program

6 Produce >24 in-service RN graduatesfrom Dec 2010 onwards

N Total graduates < 24

7 Enroll 50 day students per year inall programs starting in Jan 2009

N Total graduates < 24


Lusaka HealthInstituteNursing School

150


Makeni Schoolof Nursing

1 Increase each bi-annualy RN intakefrom current 30 to 50 from Jul 2009onwards

N 54 enrolled in 2012 RegisteredNurses

51 36 41 23 54 0 0 0 34 40

2 Produce >94 RN graduates annuallyfrom Jun 2012 onwards

N 40 grads in 2012

Western Schoolof Nursing

1 Increase RN intake from current 30twice a year to 40 twice a year fromJan 2010 onwards

N 2012 intake of 14 RegisteredNurses

5 0 11 0 14 5 0 11 0 14

2 Initiate annual RM intake of 35 inJul 2010; consider expansion ofprogram after initial pilot phase

N No RM program

3 Produce >76 RN graduates annuallyfrom Dec 2012 onwards

N 14 grads in 2012

4 Produce >33 RM graduates annuallyfrom Jul 2011 onwards

N no RM program


151

152

Training Institution Data Collection Form (A)National Operational Plan (NTOP) 2012

Ministry of Health

May-June 2012

Annex 3: 2012 NTOP Survey Tool

153

A. Contact InformationName of School Primary ContactName of Principal TitleAddress EmailProvince MobileDistrictType (i.e.. public, private or mission) Secondary Contact

TitleDate of Visit EmailDate of last NTOP visit Mobile

B. Program OverviewNote: Please list where option is not available

Program Name Years

Enrolled Nurse 3Enrolled Midwife 3Registered Nurse 5Registered Midwife 4Registered Mental Health Nurse 4Direct Entry Midwife 2BSc Nurse 6MSc Nurse 8Medical Licentiate 3Dental Technologists 2Dental Therapy 3Biomedical Scientist 3Radiography 3Clinical Officer Anesthesia 3Biomedical Scientist 3Medical Doctor 7

C. Student Details1. Enrollment and GraduationNote: Information gathered to provide data - over the past 5 years on (a) applications received (b) enrollments(c) graduates and (d) number of students in programs offered by the schoolApplicants

1 2 1 2 1 2 1 2 1 2 1 2 Total

First-Year EnrollmentComplete if necessary to illustrate existing double-intake model

1 2 1 2 1 2 1 2 1 2 1 2 Total

Programs Offered Number of First Year Students Enrolled

Program:2008 2009 2010 2011 2012 Total

TotalProgram:

2008 2009 2010 2011 2012

Programs Offered Number of Total Qualified Applicants (Historical)

Offered?Y/N

Est. no.applicants

CurrentIntake no.

TargetIntake

154

Total Student Enrollment (Male/Female Breakdown)

Number of Students

M F Total M F Total M F Total M F Total M F Total

Number of Students


Number of Students


Number of Students


Graduates

1 2 1 2 1 2 1 2 1 2 1 2 TotalTotal2008 2009 2010 2011 2012

Year 2Year 3Year 4Total

Programs Offered Number of Graduates

2008 2009 2010 2011 2012

Year 1

Year 3Year 4Total

Select Program

Year

Applicable Year

2009 2010 2011 2012

Year 1Year 2

Year 4Total

Select Program

Year

Applicable Year2008

2010 2011 2012

Year 1Year 2Year 3

Total

Select Program

Year

Applicable Year2008 2009

2011 2012

Year 1Year 2Year 3Year 4

Select Program

Year

Applicable Year2008 2009 2010

155

D. Staffing Information

1. Current Staffing

General Questions:

Q1. How many admin staff (i .e. principal, vice principal) currently double as tutors?

Q2. How many nurse tutors also work as clinical instructors?

Q3. Are your schools employing strategies to increase contact hours during clinical instruction? If so how?

Strengthening coordination with clinical sitesIncreasing the number of clinical sites or days or hours at clinical instructionScheduling the timetable to increase contact hours

Others ...

Q4. What strategies has the school employed to ensure the theory work is aligned to the clinical work done at practical sites?

Strengthening coordination in curricula between theory and clinical workImprove communication between tutor and clinical instructors at siteRevising student tests to asses both the theory and practical componentsOthers ...

2. Retention

Q1. What are the most popular reasons for nurse tutors leaving the TI?

Rank Most (5) to Least (1) Common Reasons for Leaving:

Distance from FamilySalary DissatisfactionGoing back to schoolPoor PerformanceDid not enjoy teachingOthers

Q2. How many tutor, cl inical instructors and other teaching staff have received correct appointments in the following years?

TutorsClinical InstructorsTeaching Staff

2011 20122008 2009 2010

Other Staff (cooks, cleaning, etc)DriversFinance and Admin StaffSkil ls Lab InstructorsClinical InstructorsAssistant TutorsNurse/Midwife Lecturers (PhD)Nurse/Midwife Lecturers (MScN)

Staff TargetNurse/Midwife Tutors (BSC)Staff Categories FT Staff PT Staff On Leave Total

156

Q3. How many lecturers retired, resigned or were dismissed in the following years?

Lecturers RetiredLectures ResignedLecturers Dismissed

Q4. How many students dropped out (2010, 2011, expected in 2012) for the following reasons?

Reason

Q5. What strategies have been successful in reducing the drop out rate?

E. Quality of Education1. Scheduling

Note: where possible please provide Classroom / Practical Classroom Schedule

Q1. Approximate teaching hours (fill in program name) :

Average hours / week of theory instruction by tutor

Average hours / week of lab instruction

Average hours / week of practical site instruction by clinical instructor

Average hours / week of other instruction

Q2. Classroom space and availabil ity

Average hours / week classroom is used during theory session of the term/semester

Average hours / week classroom is used during theory session of the term/semester

Q3. Does the school oversee student attend theory classes and practical sessions? If so, how?

Student Register/Log booksTeaching staff have register circulated during classOthers ...

Other (specify)Total

Living ConditionsMedical Reasons

Academic PerformanceLearning Environment

2010 2011 ExpectedStudent Fees

2008 2009 2010 2011 2012

157

Q4. Does the school monitor tutor attendance? If so how?

Tutors have a log-in registerAdministration has scheduling system for tutorsOthers ...

Q5. What scheduling strategies can you think of that could increase capacity with l imited changes to infrastructure?

Improving lecture theatre or classroom space usage during the term/semesterScheduling the timetable to increase classroom use, for example, dual classesRevising the school scheduling systemOthers ...

2. Non Classroom Based Teaching

Q1. Are there any courses are currently supported by e-learning and/ or distance facil ities?If yes, please give more details of which course, type of teaching method, and to whom it is focused on.

Course

Q2. Please give details of e-learning facil ities/materials?

Q3. Please give details of distance learning facil ities/materials?

E-learning Distance Supplied by Pre Service In Service

158

3. General Qualitative AssessmentThe following are directed to educators and administrators at the school to provide a high-level assessment on education quality.

Q1. Is the dean or principle of the school a nurse/midwife? Yes: No:

Q2. Does staff from your school participate in curriculum review? Yes: No:

Q3. How often is curriculum updated? < 1yr 1-2yr 2-3yrs >3yrs

Q4. On average, what is the student-textbook ratio? < 10:1 20:1 50:1

100:1 >100:1

Q5. What are your schools needs, in terms of teaching information and textbooks?

Improving the student - text book ratioTextbooks and learning material for certain topics/subjectsOut of date textbook and teaching materialOthers ...

Q6. Are there certain topics/subjects where there is acute shortage of textbooks? If so please l ist

Q7. On average, in the skil ls lab, what is the student-equipment ratio? <5:1 10:1

20:1 >20:1

Q8. What are your schools needs, in terms of skil ls lab equipment?

Improving the student - skil ls equipment ratioEquipment, supplies and materials for certain topics/subjectsUp to date skil ls laboratory equipmentOthers ...

Q9. Do students have access to online research and learning information? Yes: No:

Q10. Do faculty members have access to online research and teaching information?Yes: No:

Q11. How many functioning computers does the school have?

Q12. What percentage of computers are not functioning?

159

F. Infrastructure1. Reporting on Existing and NTOP funded InfrastructureExisting Infrastructure

Item

Lecture TheatreLecture HallClassroomSkills LabLibraryDigital LibraryHostel bedsAdmin OfficesNurse Tutor HousingKitchen/Dining HallOther (specify)

Infrastructure Planned or In ProgressNote: Please use the key below to provide information on possible status of infrastructure at the school

Levels: Possible Status: Financial Status:

Level I-Tendering I - Slab level Funds dispersedLevel II- Signed Contract II - Roof level Funds not dispersedLevel III- Contractor on Site III - Window level Funds at MoHLevel IV- Certificate of practical completion IV - Painting Funds at PHOLevel V- Building complete V - Procuring equipment/furnitureLevel VI- Certificate of completion VI - Sewerage systemLevel VII-Contractual dispute VII - Fixing and fittings

VIII - Waiting for certification of completionIX - Completed and Handover

Detailed Analysis of NTOP Infrastructure Progressa. Buildings

Select..

Activity

Has theproj. beencompleted(yes/no)

If yes,is thebuildingbeingused?

Receivedamount (ZMK)

Total cost ofconstruction(ZMK)

If constructionremains, what is theestimated costs (ZMK)

Costs(USD)

Select..Select..

Select..Select..

Status Funds allocated (ZMK) Financial StatusSelect..Item Level

Number ofdamaged

Shortfall of essentials(beds/desks/chairs etc)

Units

AvgCapacity

Infrastructure built in2009-2011 with NTOPfunds (Yes/No)

160

b. Student Capacity/ IntakeNote: student numbers planned for/ to be benefiting from NTOP infrastructure

2. Accommodation and Transportation

Clinical SitesNote: Please fill in information on clinical sites students are affiliated to and where necessary estimated costs

Hostel Breakdown

Capacity

Vehicles

Type CapacityConditionof Vehicle Comments

Housing BlockTotal

StudentsStudents

per Room Males Females

Site Specialization?Clinical Site Name Distance StudentsDaily Transport

orTransport

CostsAccommodation

Costs

Activity

Studentsoriginallyplannedfor

Studentnow/expect tobenefit

Comments

161

Accommodation Preferences

Q1. How many non-residential students are enrolled?

Q2. How many residential, no-food students are currently enrolled?

Q3. How do non-residential students get to their clinical sites. How is this organized and paid for?

Q4. Would l iving off campus affect the quality of student education? If so how?

Q5. Has the school considered options for evening classes? dual/parallel classes?

Student & Tutor Residency

Q6. How many students l ive in the same district as the school? < 50 50-100 100-150 >150

Q7. How many students l ive in immediately surrounding districts? < 50 50-100 100-150 >150

Q8. How many tutors l ive in the same district as the school? < 2 2-5 5-10 >10

Q9. How many tutors l ive in immediately surrounding districts? < 2 2-5 5-10 >10

Q10. What are your 3 greatest challenges as a TI?

Infrastructure, Equipment and FurnitureAssess to clinical sites for practical skil lsTextbook and teaching materialsOthers ...

Q11. What are the 2 critical areas of need in the following categories

Infrastructure

Classroomcapacity

Staff andmaterials

162

G. FinancesFinancial Year End

Income

Student Fees Student Fees Breakdown

Income from MoH

Donor 1 (specify) Specify areas where money allocated to

Donor 2 (specify) Specify areas where money allocated to

Other (specify) Specify income generating activities

Total Income

Expenses

Salaries

Infrastructure Maintenance

Equipment Maintenance

Practical Site - Transport

Practical Site - Accommodation

Practical Site - Other

Other Operating Expenditures

Total Expenses

Surplus (Deficit)

2010 2011 2012 Expected

163

Annex 4: Cost of Training, by Cadre

These costs were collected from the TIs for all budget line items contributing to the overall costs oftraining each cadre. The cost of meals and accommodation varied enormously so could not becompared like with like, hence were left out for comparisons between cadres to be made. Someprograms that are run in smaller TIs, with no economies of scale and larger overhead costs inproportion to the number of students, are relatively more expensive on a yearly basis than otherprograms that are actually training more highly qualified healthcare workers (eg. Enrolled Nurse vMedical Doctor).

GRZ-Sponsored Trainees

Cost /Student /

Year(ZMK)

Length ofTraining

Total Cost ofTraining w/o Meals& Accommodation

(ZMK)

Total Cost oftraining(USD)

Pre-Service TraineesDirect Entry Midwife 14,770,064 2 29,540,127 $ 5,908Enrolled Nurse 15,481,949 2 30,963,899 $ 6,193Environmental Health Technician 15,778,574 2 31,557,148 $ 6,311Clinical Officer General 15,778,574 3 47,335,722 $ 9,467Environmental Health Technologist 16,370,564 3 49,111,693 $ 9,822Registered Nurse 17,122,501 3 51,367,504 $ 10,274Radiographer 19,722,964 3 59,168,893 $ 11,834Biomedical Technologist 23,847,564 3 71,542,693 $ 14,309Dental Technologist 26,668,172 3 80,004,517 $ 16,001Anaesthetist 36,937,105 3 110,811,316 $ 22,162Bachelors Biomedical Sciences 15,656,951 4 62,627,802 $ 12,526Bachelors Physiotherapy 16,204,977 4 64,819,907 $ 12,964Bachelors Environmental Health 16,652,486 4 66,609,945 $ 13,322Bachelors Pharmacy 15,979,026 5 79,895,128 $ 15,979Bachelors Nursing Sciences 15,740,263 6 94,441,578 $ 18,888MBChB (Medical Doctor) 14,258,651 7 99,810,555 $ 19,962

GRZ-Sponsored Trainees

Cost /Student /

Year

In-ServiceSalary Cost

/ year

Lengthof

Training

Total Cost ofTraining w/o

Meals &Accommodation

(ZMK)

Total Costof

training(USD)

In-Service Trainees (PreviousPosition)

Counselor(Registered Nurse)

15,778,574 52,547,616 1 68,326,190 $ 13,665

Registered Mental HealthNurse

15,878,574 52,547,616 1 68,426,190 $ 13,685

Registered Midwife(Registered Nurse)

21,700,492 52,547,616 1 74,248,108 $ 14,850

Registered Critical CareNurse (Registered Nurse)

22,703,184 52,547,616 1 75,250,800 $ 15,050

164

Registered Theatre NurseRegistered Nurse

23,612,559 52,547,616 1 76,160,175 $ 15,232

Enrolled Midwife(Enrolled Nurse)

28,285,632 45,221,976 1 73,507,608 $ 14,702

Registered Nurse(Enrolled Nurse)

17,122,501 45,221,976 2 124,688,955 $ 24,938

Bachelors Biomedical**Sciences (Lab Technologist)

15,656,951 52,547,616 2 136,409,133 $ 27,282

Medical Licentiate(Clinical Officer)

21,598,574 52,547,616 2 148,292,380 $ 29,658

Bachelors Pharmacy(Pharmacy Technologist)

15,979,026 108,802,402 3 374,344,285 $ 74,869

**Biomedical Scientist is an example of specialty cadre than can upgrade from Technologist level,others include Environmental Health Technologist to Environmental Health Scientist andPhysiotherapy Technologist to Physiotherapist. The annual salary and time of upgrade training is thesame for these cadres.

165

Annex 5: List of Assessed Infrastructure Projects from Contracted Quantity Surveyor5

TrainingInstitution

Province Ownership Project Current projectstatus

Cost EstimateNet of VAT(ZMW)

Cost EstimateInclusive ofVAT (ZMW)

1 Kabwe School ofNursing &Midwifery

Central GRZ Lecture theatre-250 seater

Site available 2,392,086.44 2,774,820.27

2 Kabwe School ofNursing &Midwifery

Central GRZ Adapt orrenovateexisting skill lab

Renovationsrequired

7,607.00 8,824.12

3 Kabwe satellitecampus (forCCHS)

Central GRZ Adapt orrenovateexisting skill lab

Build new skillslab and siteavailable

299,333.08 347,226.37

4 Kitwe School ofNursing andMidwifery

Copperbelt GRZ Build lecturetheatre 1 (200students)

Due forhandoverrequiresfurniture andequipment

444,858.75 516,036.15

5 Kitwe School ofNursing &Midwifery

Copperbelt GRZ Build and equipnew kitchen ofcapacity 180

Requiresfurniture andequipment

606,553.20 703,601.71

6 Roan AntelopeSchool ofMidwifery

Copperbelt GRZ Existing studentaccommodation

Built andoccupied

0 0

7 Roan AntelopeSchool ofMidwifery

Copperbelt GRZ Build library Site available 1,168,039.33 1,354,925.62

8 St. Francis/Katete School ofNursing &Midwifery

Eastern FBO Build and furnishaccommodationof capacity 2

Built andoccupied

0 0

9 St. Francis/Katete School ofNursing &Midwifery

Eastern FBO Build semidetached staffhouse

Site available 1,115,706.45 1,294,219.48

10 Lusaka Schoolsof Nursing,Midwifery &OperatingTheatre

Lusaka GRZ Build studentaccommodationfor 40

Site available -accommodationfor 120

13,572,545.14 15,744,152.36

11 Lusaka Schoolsof Nursing,Midwifery &OperatingTheatre

Lusaka GRZ Build and furnishfaculty offices ofcapacity 30

Site available 8,899,449.42 10,323,361.33

12 Chilonga Nursing& Midwifery

Northern GRZ Build and furnishnew staff officeof capacity 2

Slab level for 10staff -but poorstandard needsto bedemolished

471,426.04 546,854.21

13 Kasama Schoolof Nursing

Northern GRZ Build lecturetheatre (100students

95% completerequiresalterations forplumbing andstaircase

304,593.30 353,328.23

14 Kasama Schoolof Nursing

Northern GRZ Adapt orrenovateexisting skill lab

Build new skillslab and siteavailable

956,317.89 1,109,328.75

15 Mukinge Schoolof Midwifery

North western FBO Build new skillslab

Site available 1,186,213.03 1,376,007.11

16 ChikankataSchool ofBiomedicalSciences

Southern FBO Build studentaccommodationfor 40

Slab level for72students

2,633,910.45 3,055,336.12

5 Complete Quantity Surveyor’s Report will be released separately as NTOP 2012 Supplementary Document

166

TrainingInstitution

Province Ownership Project Current projectstatus

Cost EstimateNet of VAT(ZMW)

Cost EstimateInclusive ofVAT (ZMW)

17 Macha School ofNursing

Southern FBO Build and furnishfaculty offices ofcapacity 3

Contract justawarded

0 0

18 Macha School ofNursing

Southern FBO Build skills lab Site available 945,986.45 1,097,344.28

19 Monze School ofNursing &Midwifery

Southern FBO Build studentaccommodationfor 40

Major remedialworks required

188,217.19 218,331.94


Southern FBO Build classroomblock (120students)


161,859.60 187,757.14


Southern GRZ Completion ofsemi detachedstaff house


187,478.17 217,474.68

22 Chainama Schoolof HealthSciences

Lusaka GRZ Builddemonstration/skills laboratory

Site available forconstruction

897,210.77 1,040,764.49

23 Chainama Schoolof HeathSciences

Lusaka GRZ Build 250 seaterlecture theatre

Site available forconstruction

3,939,233.51 4,569,510.87

Total Estimated Cost 40,378,625.21 46,839,205.24

167

Annex 6: Progress on 2008 NTOP Recommendations by 2012 Evaluation

CHALLENGES & RECOMMENDATIONS FROM 2008 NTOP CURRENT STATUS/PROGRESS 2008-->2012 2012 NTOP REC(when applicable)

CHALLENGE 1. Difficulty recruiting and retaining faculty from available teacher pool due to lack of incentives1.1. Support faculty to find housing Staff Housing Constructed at TIs

• 7 of planned projects completed; 5 incomplete1.2. Support faculty in rural areas (category C&D) to buy a car byoffering subsidized loans

Vehicle loans made available to tutors through retentionscheme

1.3. Increase difference in retention allowance per category to providegreater incentives for rural areas (category C&D)

Additional ZR 800 per month for tutors in C districts; no TIsin D districts

• 254 total on retention scheme in March 2012; up from 150 inNovember 2008

1.4. Speed-up the process of tutor appointment to provide incentivesfor practicing nurses with teaching qualifications to apply

No formal process implemented to address this, butimproved promotion processes have reduced time to someextent

1.5. Include clinical teachers in the retention scheme. Adjust retentionallowances to reflect lower salary levels of clinical teachers

Not implemented

CHALLENGE 2. Limited pool of qualified teaching staff restricts ability to scale-up2.1. Expand pool of qualified tutors Scale up of Bachelor's Degree in Nursing

• Enrolment increase from 17 in 2008 to 130 in 20122.2. Expand pool of qualified clinical teachers Creation of in-service clinical instructor program for nursing

• To start in early 2013CHALLENGE 3 . Limited capacity at practical sites negatively impacts ability to scale-up

3.1. Purchase vehicles for TIs Many TIs still cite transport as a barrier to scale up

• 1 of 5 vehicle investments planned in the 2008 NTOP werecompleted

*For specific comparisons between 2008 targets and 2012 achievements per individual TI, please see the individual TI profiles

168


3.2. Lack of staff and available staff rarely qualified to teach; 1)develop and implement a 3 month curricula for health workers atpractical sites to improve ability to teach students, & 2) shortencurricula at practical sites for in-service students who arestrengthening/upgrading skills

1 year clinical instructor program developed; no change onpractical time for in-service students

• 35 students enrolled in Feb 2013, but only 25 have actuallyattended to class

3.3. Lack of equipment and furniture; procure equipment/furniture forTIs

Furniture procured for general infrastructure projects(classrooms, accomodation, etc.), but most skills labprojects not completed to facilitate student use of clinicalequipment

• 34 of 46 furnishing projects completed; only 1 of 4 planned skillslab projects completed• Skills lab equipment procured by external donor for 3 DEMschools

3.4 Lack of accommodation for students; Renting temporal housing forstudents and clinical instructors

Student housing constructed at TIs; non-nursing TIsencourage students to live off-campus and pay for ownaccomodation

• 10 of 14 planned student housing projects planned in 2008NTOP completed

CHALLENGE 4. Weak management capabilities at selected schools4.1. Improve management capabilities Principle Tutors Meeting (annual) has helped with sharing of experiences

- Fostering exchange programs across schools Not implemented- Provide training and advice to TI management teams focused onoverall TI management and optimization of available resourcesthrough improved planning and techniques

Program has been implemented by BRITE for hospitaladministrators. Yet to be done for TI managers

CHALLENGE 5. Ensuring that graduates from the training institutions are retained by Zambia MoH5.1. Strengthening bonding measures Discussions commenced but progress stalled NT A.4.A5.2. Pre posting of graduates before final graduation Not Implemented5.3. Add all graduates to the National Retention scheme Not Implemented; high (unsustainable) costs

*For specific comparisons between 2008 targets and 2012 achievements per individual TI, please see the individual TI profiles

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CHALLENGE 6. Difficulty accessing government funds6.1. Develop clear mechanism for rapid, transparent disbursement ofavailable TI funding from government

Mechanism is there, but grants may not be adequate tomeet upscaled enrolment numbers

CHALLENGE 7. Construction is slowed by long bureaucratic tendering requirements7.1. Explore possibilities of waivers from Ministry of Works and Supplyin light of “HR crisis”

Not implemented; no high-level oversite, districtsprocured own services with uncoordinated tenderingefforts that led to high costs and limited quality controlover projects

CHALLENGE 8. Most schools lack access to affordable technology8.1. Facilitate access to reduced price computer equipment andinternet services for all TIs

Not implemented

• ICT donation from ZICTA to TIs in Copperbelt, Northwestern, andSouthern provinces

CHALLENGE 9. The procurement process for books and other teaching materials/aids is inefficient and unclear9.1. Develop centralized clearing house for ordering textbooks andother teaching aids

Not implemented

9.2. Explore opportunities to realize bulk-discounts Not implemented9.3. Make procurement process easy and clear to all schools Not implemented

CHALLENGE 10. Health Sciences training departments in TI not under MoH hinder easy access to funds and coordinated scale-up10.1. Strengthen coordination between MSTVT, MOE and MOH Few improvements seen10.2. In the long-term consider shifting the responsibility for School ofMedicine at UNZA and Evelyn Hone College of Health Sciences to theMinistry of Health

MSTVT and MOE merged so Evelyn Hone College now fallsunder this merged Ministry

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CHALLENGE 11. Building of additional student hostels slow and not responding to demand10.3. Substitute building of student hostels with search for vacantproperty that can be rented in the short term and once the targetestablishment has been reached contracts can be easily terminated

Student housing constructed at TIs; non-nursing TIsencourage students to live off-campus and pay for ownaccomodation

• 10 of 14 planned student housing projects planned in 2008NTOP completed

CHALLENGE 12. Progression within cadre lengthy and redundant11.1. Streamline curricula and ensure modular design allowing healthworkers to upgrade skills without unnecessary repetition. Examplesinclude:

Not implemented NT B.2.A

- Upgrading of Enrolled Nurses to Registered Nurses. Several TI’sinclude EN’s in their 3 year RN program. In future, upgrading of EN’sto RN’s should be limited to schools which offer a shortened, 2 yearcurriculum for upgrading

2 year upgrade implemented; potential for greater degreeof streamlining and reduction in program time

- Upgrading of Laboratory Technicians to Laboratory Technologists.Again, upgrading should only be undertaken where a shortenedcurriculum exists

Lab technologist program promoted in most schools;technician program largely no longer available

CHALLENGE 13. Curricula outdated, lacking essential topics and skills13.1. Update curricula to include new trends in HIV/AIDS, TB, Malaria aswell as essential skills such as Management and Leadership

Introduction of HIV Nurse Practitioner upgrade

CHALLENGE 14. Upgrading of skills takes the health workers away from their work place14.1. Offer distance learning programs for upgrading of skills Increased number of distance learning programs, especially

for nursing; room for more teaching modules to be donevia distance and e-learning methodologies

14.2. Put greater emphasis on keeping pre-service curricula updated toavoid/reduce need for in-service training

Curriculum reviews occur every 5 years, but do not happenat the same time, so virtually no coordination betweenvarious cadres

NT B.2.B

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CHALLENGE 15. Curricula do not optimize utilization of classroom space, faculty and practical sites15.1. Redesign curricula to stagger intakes Not implemented

CHALLENGE 16. General Nursing Council (GNC) and Health Professions Council of Zambia (HPCZ) under-resourced and unable to cope with work load16.1 Procure vehicles for GNC and HPCZ to allow better regulation of TIcompliance with quality standards

Purchased vehicle for regulatory bodies outside of NTOPfunding

16.2. Strengthen staffing levels at GNC IT roles introduced at both HPCZ and GNC16.3. Strengthen and support HPCZ Development of computerized databases for both HPCZ

and GNCCHALLENGE 17. Limited attention to Health worker training at TEVETA and sub-optimal sharing of responsibilities between TEVETA and HPCZ

17.1. Increase focus on health workers at TEVETA and reviewcompliance with quality standards at all health training institutions notfalling under GNC control

Not implemented

17.2. Clarify roles and responsibilities between TEVETA and HPCZ toavoid duplication of functions

Not implemented

CHALLENGE 18. Insufficient number of applicants for selected courses18.1. Analyze which courses receive low numbers of applicants (eg.Enrolled Midwife & Clinical Officer Anesthesia) in order to review posttraining incentives

No formal analysis, but discussions occuring at MoH andregulatory bodies; anecdotal evidence exists

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Annex 7: Estimated student enrolment numbers from health training institutions assumingexpected infrastructure projects are completed, days scholars accepted where possible and e-learning incorporated

Cadre 2014 2015 2016 2017 2018 2019 2020 Total

1 Biomedical Scientist 180 180 180 180 180 180 180 12602 Certified Midwife 406 552 552 645 270 270 270 29653 Clinical Officer Anesthesia 40 80 80 80 80 80 80 5204 Clinical Officer General 490 700 700 700 700 700 700 46905 Clinical Officer Opthamology 10 20 20 20 20 20 20 1306 Clinical Officer Psychiatry 30 30 30 30 30 30 30 2107 Community Health Assistants 500 500 800 800 800 800 800 50008 Critical Care Nurse 35 35 35 70 70 70 70 3859 Dental Attendant 20 20 20 20 20 20 20 140

10 Dental Technologist 0 15 15 15 15 15 15 9011 Dental Therapist 40 40 40 40 40 40 40 28012 Enrolled Midwife 230 230 230 230 230 230 230 161013 Enrolled Nurse 1009 1098 1098 1160 910 910 910 709514 Environmental Health Technologist 225 225 225 225 225 225 225 157515 Food and Consumer Science 200 200 200 200 200 200 200 140016 Food and Nutrition 80 80 80 80 80 80 80 56017 General Counsellor 50 50 60 60 60 60 60 40018 HIV Nurse Practitioner 40 40 40 40 40 40 40 28019 Laboratory Technologist 130 140 140 140 140 140 140 97020 Medical Doctor 290 500 500 500 500 500 500 329021 Medical Licentiate 40 50 50 60 60 60 60 380

22Mmed Anesthesia and intensivecare 8 8 8 8 8 8 8 56

23 Mmed Emergency Care 6 10 10 10 10 10 10 6624 Mmed Family Medicine 6 10 10 10 10 10 10 6625 Mmed Gastroenterology 5 5 5 5 5 5 5 3526 Mmed General Surgery 5 5 5 5 5 5 5 3527 Mmed Infectious Diseases 4 4 4 4 4 4 4 2828 Mmed Internal Medicine 8 8 8 8 8 8 8 5629 Mmed Neurosurgery 3 5 5 5 5 5 5 3330 Mmed Obs & Gynae 12 12 12 12 12 12 12 8431 Mmed Opthalmology 4 4 4 4 4 4 4 2832 Mmed Orthopaedic Surgery 5 5 5 5 5 5 5 3533 Mmed Paeds & Child Health 10 10 10 10 10 10 10 7034 Mmed Pathology 4 4 4 4 4 4 4 2835 Mmed Psychiatry 3 4 4 4 4 4 4 2736 Mmed Urology - surgery 5 5 5 5 5 5 5 3537 MPH 50 50 50 50 50 50 50 35038 MPH Population Studies 8 8 8 8 8 8 8 5639 MSc Biochemistry 5 5 5 5 5 5 5 35

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40 MSc Chemical Pathology 5 5 5 5 5 5 5 3541 MSc Clinical Pathology 5 5 5 5 5 5 5 3542 MSc Clinical Pharmacy 12 12 12 12 12 12 12 8443 MSc Epidemiology 10 10 10 10 10 10 10 7044 MSc Haematology 5 5 5 5 5 5 5 3545 MSc HIV Medicine 4 5 5 5 5 5 5 3446 MSc Human Anatomy 8 8 8 8 8 8 8 5648 MSc Human Physiology 5 5 5 5 5 5 5 3549 MSc Medical Microbiology 5 5 5 5 5 5 5 3565 MSc Medical Parasitology 2 2 2 2 2 2 2 1466 MSc Neuropsychology 10 10 10 10 10 10 10 7067 MSc Pharmacology 5 5 5 5 5 5 5 3568 MSc Physiotherapy in Orthopaedics 5 5 5 5 5 5 5 3550 Nutrition Bsc 25 25 25 25 25 25 25 17547 Operating Theatre Nurse 105 105 105 105 105 105 105 73551 Ophthalmic Nurse 10 20 20 20 20 20 20 13052 Optometry Technologist 15 20 20 20 20 20 20 13553 Pharmacist 50 120 120 120 120 120 120 77054 Pharmacy Technologist 115 115 115 115 115 115 115 80555 Physiotherapist 50 50 50 50 50 50 50 35056 Physiotherapy Technologist 100 100 100 100 100 100 100 70057 Post Basic Nurse - Bsc 70 220 570 220 220 220 220 1740

58 Post Basic Nurse - Msc2 10 10 10 10 10 10 10 7061 Public Health Diploma 50 50 70 80 80 80 80 49062 Radiography 105 105 105 105 105 105 105 73563 Registered Clinical Instructor 40 100 100 100 100 100 100 64064 Registered Mental Health Nurse 40 80 80 80 80 80 80 52059 Registered Midwife 230 230 230 230 230 230 230 161060 Registered Nurse/Midwife 210 210 210 210 210 210 210 147069 Registered Nurse 2165 2581 2581 2933 1558 1558 1558 14934

70 Registered Paediatric Nurse 30 60 60 60 60 60 60 390

Totals 7697 9230 9910 10122 8122 8122 8122 61325

Documents

National Training Operational Plan 2013 to 2016 · National Training Operational Plan 2013 to 2016. 1 ... This National Training Operational Plan ... capacity of existing training