March The Nursing Education Partnership Initiative (NEPI) in the Federal Democratic Republic of Ethiopia:

Size: px
Start display at page:

Download "March 2015. The Nursing Education Partnership Initiative (NEPI) in the Federal Democratic Republic of Ethiopia:"

Transcription

1 The Nursing Education Partnership Initiative (NEPI) in the Federal Democratic Republic of Ethiopia: Cost Analysis of the Nursing and Midwifery Education Programs at University of Gondar College of Medicine and Health Sciences and Arbaminch College of Health Sciences March 2015 Sophie Faye, Abt Associates Inc., Rebecca Bailey, IntraHealth International, Sr Azeb Admasu, Federal Ministry of Health, and Yemesrach Adamu, Federal Ministry of Education

2 ACKNOWLEDGEMENTS This costing study was conducted under the leadership of the Federal Ministry of Health (FMOH) and the Federal Ministry of Education (FMOH) Ethiopia, and in partnership with the PEPFARfunded Nursing Education Partnership Initiative (NEPI). The core study team was composed of the following persons: Sr. Azeb Admasu, Chair, NEPI Core Group, and Midwifery Training Officer and Accelerated Midwifery Training Coordinator, Human Resources Directorate (HRD), Federal Ministry of Health (FMOH) Yemesrach Adamu, Member, NEPI Core Group, and Senior Expert, Higher Education Relevance and Quality Agency (HERQA), Federal Ministry of Education (FMOE) Rebecca Bailey, Health Workforce Development Team Lead, CapacityPlus Project, IntraHealth International Sophie Faye, Costing and Economics Expert, CapacityPlus Project, Abt Associates Inc. Wendy Wong, Associate Analyst, Costing, CapacityPlus Project, Abt Associates Inc. Elias Asfaw, Consultant, CapacityPlus Project, Health Economics Researcher, Health System Research Directorate, Ethiopian Public Health Institute (EPHI) Stephen Musau, Principal Associate, Public Financial Management Advisor, CapacityPlus Project, Abt. Associates Inc. The report was prepared by Sophie Faye, Costing and Economics Expert, CapacityPlus Project, Abt Associates Inc.; and Rebecca Bailey, Health Workforce Development Team Lead, CapacityPlus Project, IntraHealth International. The following persons reviewed, validated, and contributed to the finalization of the report: Sr. Azeb Admasu, Chair, NEPI Core Group, and Midwifery Training Officer and Accelerated Midwifery Training Coordinator, Human Resources Directorate (HRD), Federal Ministry of Health (FMOH) Yemesrach Adamu, Member, NEPI Core Group, and Senior Expert, Higher Education Relevance and Quality Agency (HERQA), Federal Ministry of Education (FMOE) Abebayehu Haile, Policy and Planning Officer, Policy and Planning Directorate, Federal Ministry of Health (FMOH) Elias Asfaw, Consultant, CapacityPlus Project, Health Economics Researcher, Health System Research Directorate, Ethiopian Public Health Institute (EPHI) Stephen Musau, Principal Associate, Public Financial Management Advisor, CapacityPlus Project, Abt. Associates Inc. College of Medicine and Health Sciences and Arbaminch College of Health Sciences i

3 We also gratefully acknowledge the significant contributions of the data collection team, without whom this report would not have been possible: Addisalem Mihret, Monitoring and Evaluation Officer, IntraHealth International, Ethiopia Takele Yeshiwas, Data Collector and Advisor, MNCH Advisor, IntraHealth International/ CapacityPlus, Ethiopia Leah McManus, Program Officer, CapacityPlus Yoseph Sonko, Dean, Arbaminch College of Health Sciences Ashenafi Abossie, Teaching & Learning Core Process Owner, Arbaminch College of Health Sciences Tesfaye Guja, Nursing Department Head, Arbaminch College of Health Sciences Wakgari Biru, Midwifery Department Head, Arbaminch College of Health Sciences Tesfaye Debebe, Planning and Programming Process Coordinator, Arbaminch College of Health Sciences Dr. Sisay Yifru, Dean, University of Gondar College of Medicine and Health Sciences Solomon Nigusie, Head of Finance, Purchase & Procurement, University of Gondar College of Medicine and Health Sciences Anteneh Messele, Nursing Department Head, University of Gondar College of Medicine and Health Sciences Abdela Amano, Midwifery Department Head, University of Gondar College of Medicine and Health Sciences Endale Haile, Finance Officer, University of Gondar College of Medicine and Health Sciences. College of Medicine and Health Sciences and Arbaminch College of Health Sciences ii

4 TABLE OF CONTENTS Acknowledgements... i Table of Contents... iii List of Acronyms... v Executive Summary... vi Unit Costs... vii Fixed Asset Utilization... vii Effect of Quality Improvement Interventions on Unit Costs... vii Uses of the Study... viii Recommendations... viii Study Limitations... x Introduction... 1 Nursing and Midwifery in Ethiopia... 1 The Nursing Education Partnership Initiative (NEPI)... 1 The Costing Study Team and Report... 2 Costing Study Objectives, Methodology, and Data Collection... 3 Study Objectives... 3 Methodology... 3 Data Collection... 4 Costing Study Data Analysis... 6 Objective 1: Estimate the Current Cost to Produce a Graduate... 6 Clinical preceptor costs... 8 Student clinical practicum costs... 8 Objective 2: Identify Current Constraints in Fixed Resources... 9 Objective 3: Estimate Post-Intervention Unit Cost of a Graduate University of Gondar College of Medicine and Health Sciences Background Information Objective 1: Unit Cost of Producing Graduates Cost per graduate for the nursing and midwifery programs Analysis of costs by input category Analysis of clinical practicum costs relative to student direct costs Analysis of costs per academic year Objective 2: Fixed Assets Constraints Space constraints College of Medicine and Health Sciences and Arbaminch College of Health Sciences iii

5 Faculty constraints Materials constraints for skills labs Conclusions and recommendations Objective 3: Interventions and New Unit Cost for Graduates Arbaminch College of Health Sciences Background Information Objective 1: Unit Cost of Producing Graduates Cost per graduate for the nursing and midwifery programs Analysis of costs by input category Analysis of clinical practicum costs relative to student direct costs Analysis of costs per academic year Objective 2: Fixed Assets Constraints Space constraints Faculty constraints Materials constraints for skills labs Conclusions and recommendations Objective 3: Interventions and New Unit Cost for Graduates Cost of AMCHS Private Nursing and Midwifery Programs Summary Conclusions and Recommendations Unit Costs Fixed Asset Utilization Effect of Quality Improvement Interventions on Unit Costs Study Limitations Recommendations References Annex 1: Details of Estimations Relating to Objective Annex 2: Details of Estimations Relating to Objective Annex 3: Estimation of the Costs of the Private Programs at AMCHS Annex 4: Estimation of the Costs of Public Programs at AMCHS under a Cost-Sharing Assumption Annex 5: Material Constraint Analysis for Skills Labs College of Medicine and Health Sciences and Arbaminch College of Health Sciences iv

6 LIST OF ACRONYMS AMCHS BSc ETB FMOH FMOE GNCBP HRH HRSA HSDP ESDP OGAC NEPI PEPFAR TVET US UGCMHS USAID WHO Arbaminch College of Health Sciences Bachelor of science Ethiopian birr Federal Ministry of Health Federal Ministry of Education Global Nursing Capacity Building Program Human resources for health US Department of Health and Human Services/Health Resources and Services Administration Health Sector Development Program Education Sector Development Program US Department of State/Office of the US Global AIDS Coordinator Nursing Education Partnership Initiative US President's Emergency Plan for AIDS Relief Technical and vocational education and training United States University of Gondar College of Medicine and Health Sciences United States Agency for International Development World Health Organization College of Medicine and Health Sciences and Arbaminch College of Health Sciences v

7 EXECUTIVE SUMMARY The human resources for health (HRH) landscape in Ethiopia is similar to other resourceconstrained countries in sub-saharan Africa, with challenges related to the quality and quantity of health workers available and the geographical distribution and retention of the health workforce (African Health Workforce Observatory 2010). According to the fourth phase of the Health Sector Development Program (HSDP), the Federal Ministry of Health plans to increase the number of nurses to 41,009 and the number of midwives to 8,635 by the end of The general objective is to scale up the number and quality of health workers through increased and improved preservice education. The Nursing Education Partnership Initiative (NEPI) is a US government initiative that aims to strengthen nursing and midwifery education systems in sub-saharan Africa in order to increase access to quality health care in the region. A number of partners contribute to this goal. In Ethiopia, NEPI is being implemented with the overarching goal of increasing the number, quality, and relevance of nursing and midwifery graduates through the introduction of evidencebased, cost-effective, and innovative nursing and midwifery education models in selected schools. Oversight for NEPI-Ethiopia is provided by the NEPI Core Group, which is situated within the HRH Directorate of the Federal Ministry of Health. This study, led by the NEPI Core Group, is a retrospective cost assessment of the undergraduate nursing and midwifery programs at two institutions: University of Gondar College of Medicine and Health Sciences (UGCMHS) and Arbaminch College of Health Sciences (AMCHS). The NEPI Core Group chose these colleges because each offers one of the two main undergraduate programs for nursing and midwifery (the four-year bachelor s and the three-year diploma programs) and both are participating in the NEPI initiative in Ethiopia. The colleges offer a variety of programs in different specialties related to health, but our interest was solely the nursing and midwifery programs. The costing study had three objectives: 1. Estimate the current unit cost to the educational institution and its associated clinical practice facilities of producing a nursing and midwifery graduate 2. Identify constraints in the institutions fixed assets to scaling up the quantity of graduates and/or improving their quality 3. Simulate the potential new unit cost to the educational institution and its associated clinical practice facilities if a scenario of interventions is introduced to increase the quality and/or quantity of graduates. The analysis included the financial cost of all resources used in producing a graduate and reported by the education institutions and their associated clinical practice facilities, regardless of the funding sources. The study used data from the 2004 Ethiopian calendar, which College of Medicine and Health Sciences and Arbaminch College of Health Sciences vi

8 corresponds to the 2011/2012 Gregorian calendar and was considered as the base year for the cost estimation. A top-down costing approach was used. It consisted of an allocation of costs first from the college to the department level and then from the department level to each program offered in that department. Unit Costs The costs per enrolled student and graduate, based on financial data from 2011/12, were calculated using the 2012 average exchange rate of 1 ETB (Ethiopian birr) = 0.05 US$ ( as follows: Four-year Bachelor of Nursing program at UGCMHS: The total cost of the program was 2,743,431 ETB (137,172 US$). The unit cost per new enrolled student was 27,994 ETB (1,400 US$) and per graduated nurse was 34,292 ETB (1,714 US$). Four-year Bachelor of Midwifery program at UGCMHS: The total cost of the program was 1,906,318 ETB (95,316 US$). The unit cost per new enrolled student was 27,627 ETB (1,381 US$) and per graduated midwife was 34,661 ETB (1,733 US$). Three-year Diploma of Nursing program at AMCHS: The total cost of the program was 3,635,934 ETB (181,796 US$). The unit cost per new enrolled student was 20,543 ETB (1,027 US$) and per graduated nurse was 21,017 ETB (1,051 US$). Three-year Diploma of Midwifery program at AMCHS: The total cost of the program was 3,283,095 ETB (164,154 US$). The unit cost per new enrolled student was 21,045 ETB (1,052 US$) and per graduated midwife was 22,334 ETB (1,117 US$). Fixed Asset Utilization Both colleges were operating at or above capacity with respect to their physical infrastructure, leaving no room to improve the efficiency of fixed assets usage. Furthermore, the availability and use of key fixed assets such as space, materials, and teaching faculty did not adhere to national or school-level standards. The skills labs in particular (also known as demonstration rooms) constitute an acute constraint. In both colleges, the number of students using the demonstration rooms at any one time was far beyond the official recommended standards. In addition, the skills labs lacked many of the standard required materials and equipment, and the ratio of teaching faculty to students during demonstration room sessions did not always meet the standards defined by the colleges. In order to ensure quality education for the number of students currently enrolled, additional space, materials, equipment, and teaching hours need to be allocated for skills lab sessions. If the number of students admitted increases, there is also a need to increase the number of teachers, teachers offices, and classrooms. Effect of Quality Improvement Interventions on Unit Costs To increase the quality of education for nursing and midwifery students, the colleges in collaboration with NEPI identified a set of high-priority interventions. The interventions focused on the procurement and maintenance of equipment; financial support to students and College of Medicine and Health Sciences and Arbaminch College of Health Sciences vii

9 instructors for field practice and research; and hiring of part-time faculty. (No new infrastructure costs were considered because NEPI funds cannot be used for building infrastructure.) In addition to the NEPI interventions, we estimated the market cost of relaxing the identified space and material constraints, which would involve building and equipping new skills labs as well as purchasing missing materials for existing skills labs. Implementing the NEPI interventions plus overcoming constraints related to skills labs would increase the cost per nursing graduate by around 31% in Gondar and 16% in Arbaminch. It would increase the cost per midwifery graduate by 37% in Gondar and 21% in Arbaminch. The new cost to produce a nurse and a midwife graduate, after implementing a set of interventions designed to overcome the identified fixed assets constraints, would respectively increase to 44,821 ETB (2,241 US$), and 47,677 ETB (2,384 US$) in Gondar, and 24,463 ETB (1,223 US$) and 27,135 ETB (1,357 US$) in Arbaminch. These estimates assume that the number of enrolled students remains the same. University of Gondar (4-year bachelor program) Arbaminch (3-year diploma program) Nursing unit cost (per graduate) Preinterventioninterventions Post- % increase ETB 34,292 ETB 44,821 ($1,714) ($2,241) 31% ETB 21,017 ETB 24,463 ($1,051) ($1,223) 16% Midwifery unit cost (per graduate) Preinterventioninterventions Post- % increase ETB 34,661 ETB 47,677 ($1,733) ($2,384) 37% ETB 22,334 ETB 27,135 ($1,117) ($1,357) 21% Uses of the Study This study estimates the cost to two educational institutions and their associated clinical practice facilities of educating and training a nurse and a midwife. The information provided is critical for guiding policy and decision-making, especially related to scaling up the quality of nursing and midwifery graduates in Ethiopia. Studies of this type can play a key role in increasing investments and ensuring the quality of the education provided in Ethiopian universities and colleges. The results of the study can be used to support planning and management of nursing and midwifery education programs at the two colleges and their associated clinical practice facilities, and at government offices such as the Federal Ministry of Health, the Federal Ministry of Education, and the Federal Ministry of Finance and Economic Development. The results will also support advocacy for increased funding for nursing and midwifery education and provide an evidence base on the cost implications of investments in nursing and midwifery education. Recommendations According to the costing study, there should be no increases in the number of new students enrolled at the two colleges until the fixed asset constraints related to space, materials, College of Medicine and Health Sciences and Arbaminch College of Health Sciences viii

10 equipment, and teaching hours in the skills labs are addressed. Even after the skills lab constraints are addressed, the colleges should carefully assess the impact that increasing student enrollment would have on financial aid and clinical site costs, as well as on other fixed assets that are currently used at or near maximum capacity, such as teachers offices and classrooms. While it would be possible to achieve space and faculty-to-student ratio standards in the skills labs by decreasing the number of students enrolled, the study did not consider this option for several reasons. First, the need to procure missing equipment and materials for the skills labs would remain. Second, decreasing student enrollment would lead to an inefficient use of other fixed assets such as classrooms, which would then be used below their maximum capacity. Most importantly, the federal government s policy supports training of more personnel in a number of targeted health professions including midwifery. Therefore, in addition to implementing the set of NEPI interventions, we recommend the following actions to overcome the fixed asset constraints that both colleges face in terms of space, materials, and equipment for skills labs, as well as the faculty constraints to skills lab teaching found at Arbaminch. Maintain the number of students enrolled and invest in new skills labs. Given the current number of students enrolled, the space available for skills labs does not meet national standards for quality education. There is a need to construct or identify space for one new skills lab for each nursing and midwifery program (i.e., two labs per college) and supply them with the recommended equipment and materials. Building and equipping according to standards two more skills labs one for the nursing department and one for the midwifery department would respectively cost 778,720 ETB (38,936 US$) and 914,100 ETB (45,705 US$) at UGCMHS and 1,003,720 ETB (50,186 US$) and 1,139,100 ETB (56,955 US$) at AMCHS. These cost estimates were incorporated into the new unit cost estimates reported above. The estimates might be decreased if the colleges opted to rent space or convert existing rooms (such as unused classrooms) into skills labs, rather than constructing new rooms. Maintain the number of students enrolled and invest in materials and equipment for existing skills labs. In addition to the need for more skills labs, the analysis against recommended standards for skills labs showed that the existing skills labs lacked important materials and equipment, such as anatomical models, medical equipment, and furniture. The absence of recommended materials and equipment should be resolved as it constitutes an important obstacle to the quality of education. Bringing the existing nursing and midwifery skills labs up to standard in terms of materials and equipment would respectively cost 538,480 ETB (26,924 US$) and 487,960 ETB (24,398 US$) at UGCMHS and 278,280 ETB (13,914 US$) and 601,440 ETB (30,072 US$) at AMCHS. These cost estimates were incorporated into the new unit cost estimates reported above. They are most likely underestimates, however, because they include the market cost of only one of each item on the standard equipment and materials lists. It was not possible to College of Medicine and Health Sciences and Arbaminch College of Health Sciences ix

11 estimate larger quantities because the standard lists do not indicate the number of each item required. Maintain the number of students enrolled and increase the number of demonstration sessions at AMCHS. This recommendation assumes that the skills labs are NOT currently used the maximum number of hours per week. The number of students per instructor in the skills lab sessions at Arbaminch College exceeds the recommended standard (25 students per faculty per session) by 55 students in the nursing sessions and by 15 students in the midwifery sessions. The number of students per faculty in the skills labs could be decreased if the number of teaching sessions were increased, and the students were divided into smaller groups per session. This would imply increasing the number of faculty hours available to teach the sessions, which could entail hiring additional qualified full- or part-time faculty members, or leveraging more teaching hours from present faculty. For the nursing program, two additional rotations for each academic year would require 1,086 more faculty hours. For the midwifery program, one additional rotation for each academic year would amount to 485 more faculty hours. With a part-time hourly wage of 100 ETB (5 US$) (using a rate taken from the NEPI workplan developed by the colleges), these additional hours would cost the nursing program 108,600 ETB (5,430 US$) and 48,500 ETB (2,425 US$) for the midwifery program. These cost estimates were NOT incorporated into the new unit cost estimates reported above, because additional faculty hired through the NEPI initiative could assist in implementing this recommendation, depending on the number and types of faculty hired. It should be noted that before increasing the number of faculty, fixed asset constraints related to faculty office space should be addressed. Currently, the office space is being utilized at or near maximum capacity. Study Limitations The limitations of this study pertain mainly to data availability: Estimation of costs was based on the key assumption of a relatively steady number of annual student enrollment. We did not estimate the potential financial benefit of the nonclinical services provided by students at health facilities during their practical training (especially for students in their final years of study), which could possibly offset some of the training costs to those facilities. The unit cost estimation from objective 1 of this study did not take into consideration in-kind donations made during of materials and training of teachers from government, donors, or other sources. The costs were based exclusively on actual expenditures made by the colleges and their associated clinical practice facilities. The interventions costed under objective 3 did not include any scenarios to increase or decrease the student populations. Instead, they focused on ensuring the quality of education for the number of students currently enrolled. While some scenarios and their costs are presented for increasing the space, materials, and equipment for skills labs, it was not possible to estimate the new unit cost to fully College of Medicine and Health Sciences and Arbaminch College of Health Sciences x

12 overcome the identified fixed asset constraints, because that would require a strategic decision by the schools regarding the intervention options (e.g., increase the number of teachers, decrease the number of students, or increase the infrastructure). The official standards document on skills lab requirements defined the necessary materials but did not indicate how many of each item are necessary. For this reason, we used one unit of each required item in our cost estimates for the missing skills lab materials, which is most likely an underestimate. At the time of the study, there were no official standards for nursing skills lab materials. The team used a list of standard materials for nursing schools developed in Tanzania (Republic of Tanzania 2011) with technical assistance from Jhpiego, an affiliate of Johns Hopkins University in the US. The team s assumption was that the required materials would be comparable between the two contexts. The list was used to estimate the cost of fully equipping nursing skills labs. College of Medicine and Health Sciences and Arbaminch College of Health Sciences xi

13 INTRODUCTION Nursing and Midwifery in Ethiopia The human resources for health (HRH) landscape in Ethiopia faces challenges similar to other resource-constrained countries in sub-saharan Africa, with issues related to the quality and quantity of health workers available and the geographical distribution and retention of the workforce (African Health Workforce Observatory 2010). There are about 29,550 nurses and 2,416 midwives working in Ethiopia s public health sector (Federal Democratic Republic of Ethiopia Ministry of Health 2012). The current ratio of health workers to population of 0.84 is still far from meeting the World Health Organization (WHO) threshold of 2.3 doctors, nurses, and midwives per 1,000 people to reach 80% coverage for deliveries by skilled birth attendants (WHO 2006). The Ethiopian government implements the country s health strategy through a Health Sector Development Program (HSDP), which is now in its fourth phase (Federal Democratic Republic of Ethiopia Ministry of Health 2010). The number of nurses and midwives has increased over the past three phases of the HSDP. According to the HSDP-IV, the Federal Ministry of Health plans to increase the number of nurses to 41,009 and the number of midwives to 8,635 by the end of 2015 (Federal Democratic Republic of Ethiopia Ministry of Health 2010). The general objective is to scale up the number and quality of health workers through increased and improved preservice education. Ethiopia has 25 universities that educate and train health science professionals. In addition, there are 22 public-sector health science colleges, which are classified as technical and vocational education and training (TVET) institutions and offer diploma-level training (A. Admassu, FMOH Human Resource Development, personal communication, 9 October 2014). There has been significant growth in the number of health professional education and training institutions (Federal Ministry of Education 2010). This growth is reflected in the general trend of increased enrollment in health training programs. There is still much work to be done, however, to meet WHO recommendations regarding the density and distribution of health workers. The Nursing Education Partnership Initiative (NEPI) The Nursing Education Partnership Initiative (NEPI) is a US government initiative that aims to strengthen nursing and midwifery education systems in sub-saharan Africa in order to increase access to quality health care in the region. A number of partners contribute to this goal. NEPI is administered by the US Department of Health and Human Services/Health Resources and Services Administration (HRSA), under the leadership of the US Department of State/Office of the US Global AIDS Coordinator (OGAC). NEPI is a component of HRSA s Global Nursing Capacity Building Program (GNCBP); its current awardee is Columbia University s ICAP Nurse Capacity Initiative, which serves as the NEPI Coordinating Center for all the NEPI countries. In Ethiopia, NEPI is being implemented with the overarching goal of increasing the number, quality, and relevance of nursing and midwifery graduates through the introduction of evidencebased, cost-effective, and innovative nursing and midwifery education models in selected College of Medicine and Health Sciences and Arbaminch College of Health Sciences 1

14 schools. This goal is closely aligned with two important targets within the HSDP-IV, which are to increase the number of nurses to 41,009 by the end of 2015 from 29,640 in 2010/11, and the number of midwives to 8,635 from 3,866 in 2010/11. ICAP-Ethiopia and the NEPI Regional Nursing Advisor provide technical and strategic planning and leadership for NEPI-Ethiopia. Oversight for NEPI-Ethiopia is provided by the NEPI Core Group, which is situated within the HRH Directorate of the Federal Ministry of Health. In 2012, CapacityPlus, funded by USAID and led by IntraHealth International, a NEPI partner, collaborated with the NEPI Coordinating Center, ICAP-Ethiopia, and the NEPI-Ethiopia Core Group to conduct baseline nursing and midwifery education capacity assessments at three colleges of health sciences: Addis Ababa University, the University of Gondar, and Arbaminch College of Health Sciences. The results of the assessment were used to guide the NEPI Core Group, which includes national policy-makers and relevant partners including the colleges, in the development of a strategic response aimed at gradually expanding the quantity and quality of nurses and midwives in the country. Two institutions were selected to complete costing studies because they represent the primary types of nursing and midwifery education programs in the country. The University of Gondar College of Medicine and Health Sciences (UGCMHS) is under the authority of the Federal Ministry of Education and offers a four-year bachelor s degree, while the Arbaminch College of Health Sciences (AMCHS) is under the Federal Ministry of Health Regional Health Bureau and offers a three-year diploma program. In the Ethiopian higher learning institutes classification of degrees, a bachelor s is a higher-level degree, preparing students to take on more responsibility than diploma students. The Costing Study Team and Report The costing study team included a principal investigator and costing expert from CapacityPlus, a co-principal investigator from the Federal Ministry of Health, a co-principal investigator from the Federal Ministry of Education, a local health economist consultant, and three CapacityPlus staff members. In addition, several focal persons at each of the colleges actively contributed to the data collection process (see acknowledgements). This report outlines the study s objectives, methodology, data collection process, and results. For each of the two schools, the results are presented in relation to the three objectives of the study. The main findings are illustrated in summary tables and graphs, with further details provided in the annexes. College of Medicine and Health Sciences and Arbaminch College of Health Sciences 2

15 COSTING STUDY OBJECTIVES, METHODOLOGY, AND DATA COLLECTION This study was a retrospective cost assessment of two undergraduate nursing and midwifery programs: University of Gondar College of Medicine and Health Sciences and Arbaminch College of Health Sciences. The NEPI Core Group chose these two colleges because each offers one of the two main undergraduate programs for nursing and midwifery (the four-year bachelor s and three-year diploma programs) and both are supported by the NEPI initiative in Ethiopia. Study Objectives The costing study had three objectives: 1. Estimate the current unit cost to the educational institution and its associated clinical practice facilities of producing a nursing and midwifery graduate 2. Identify current constraints in the institutions fixed assets to scaling up the quantity of graduates and/or improving their quality 3. Simulate the potential new unit cost to the educational institution and its associated clinical practice facilities if a scenario of interventions is introduced to increase the quality and/or quantity of graduates Methodology The analysis included the financial cost of all resources used in producing a graduate and formally reported by the education institutions and their associated clinical practice facilities, regardless of the funding sources. The study used data from the 2004 Ethiopian calendar, which corresponds to the 2011/2012 Gregorian calendar. The following assumptions were made during this costing exercise: The costs of the education program were estimated using total institution expenditures for the most recently completed fiscal/academic year (2011/2012), assuming all the education components during the three-year period (for diploma program) or four-year period (for bachelor s program) were offered in the most recently completed fiscal year. A set number of students (the total number currently enrolled in 2012) was used for the cost analysis throughout the entire education period. This means the cost of graduates in 2012 from the four-year bachelor s program, for example, was assumed to be equal to the cost of first-year students in 2012 plus the cost of second-year students in 2012 plus the cost of third-year students in 2012 plus the cost of fourth-year students in The fourth-year students in 2012 were the ones graduating. In other words, this approach used a snapshot of 2012 expenditures to estimate the cost of the whole program rather than tracking the costs of a cohort of students over three or four years from admission until graduation. Financial and accounting information was the main source of information for the cost estimation. This did not include the costs of services provided by volunteers, in-kind College of Medicine and Health Sciences and Arbaminch College of Health Sciences 3

16 donations of equipment, materials or training courses for teachers, and/or other opportunity costs that were not included in the financial legers of the institutions. However, it did include costs of supporting teachers research activities. The cost analysis was performed from the perspective of the providers of the education program the colleges and their affiliated health facilities for clinical practice. Therefore, the analysis excluded all costs paid directly by students, such as tuition, housing, subsistence, and out-of-pocket expenses for books and supplies. Where more specific information was not obtained from accounting records or from the focal persons, it was assumed that expenditures for a degree/diploma program or an individual course were proportional to the total teachers instruction contact hours. Financial costs to the health facilities were measured in terms of the commodities used by students (e.g., gloves, gowns), the contact time that clinical staff specifically spent teaching students, and the space used in facilities for clinical teaching (e.g., meeting rooms). Students are not able to legally perform clinical tasks alone and must work under supervision. Because students do not replace the clinician who is supervising them and are not legally authorized to perform clinical tasks on their own, we did not consider the clinical activities of students as having a monetary added value to the facility or possible cost savings implications. The nonclinical services provided by students could constitute a benefit for the health facility because, in theory, as it frees up time for qualified staff to perform more clinical tasks. These benefits would offset some of the costs that the facilities incur due to students training. However, this study is a costing analysis and not a cost-benefit analysis, and thus we did not include the value added from students. The number of graduates in 2012 was used to estimate the unit cost per graduate for each program. The cost of different intervention scenarios were estimated based on market prices for the year Data Collection Data were collected in three phases. A first phase in June 2013 focused on gathering cost information from the two colleges. The second phase in August 2013 focused on collecting cost information from the affiliated clinical practice facilities of the two colleges. In March 2014, the study team met in Addis Ababa to review and discuss the preliminary findings and make recommendations for finalizing the study and disseminating the results. During the review meeting, the team agreed to develop additional estimates that reflect the cost of increasing the availability of fixed assets in order to comply with national standards for space, equipment, and materials. For this reason, the team completed a third phase of data collection from April through August 2014 to gather relevant standards for space, materials, equipment, and teaching faculty as well as the market costs to increase the availability of these resources in order to comply with national and school-level standards. College of Medicine and Health Sciences and Arbaminch College of Health Sciences 4

17 The data collection team consisted of a costing expert from CapacityPlus, two CapacityPlus/Ethiopia staff, and a local economist consultant. The team traveled and worked under the supervision of representatives from both the ministries of health and education, who led the study and were instrumental in facilitating interactions and collaboration with the colleges and health facilities officials. Data were collected at the college level and at the nursing and midwifery department level (Table 1). The team worked with designated focal persons who had extensive knowledge about the institutions and could provide most of the necessary information or direct the team to the appropriate source. Whenever possible, the team collected documents to support the data, such as curricula and financial reports. In addition to visiting the two colleges, the team visited six main clinical practicum sites, consisting of hospitals and health centers, for each college studied. For Arbaminch, the team collected data from Arbaminch Hospital, Gidole Hospital, and four health centers: Arbaminch, Sodo, Konso, and Mirabe Abaya. For Gondar, the team visited Gondar University Hospital, Debark Hospital, and four health centers: Poly, Maraki, Debark, and Azezo. At each site, the data collection team gathered information from different departments in the health facilities: outpatient, inpatient, pediatric, medical, surgical, emergency, obstetrics and gynecology, orthopedic, and pharmacy. The team interviewed the personnel in those departments who work with students and are responsible for their training. The goal was to have them estimate the amount of resources used by students during their practica (Table 1). Once collected, data were entered into preformatted Microsoft Excel templates. The Excel tools were previously pilot tested in South Africa and extensively revised after the pilot based on the results and lessons learned. They were then presented to and reviewed by the NEPI Core Group and two local economists in Ethiopia and adapted to the Ethiopian context. Table 1: Data Needed to Estimate the Unit Cost of Training a Nurse or Midwife Data Needed 1 General information about the college: contact information, ownership, location, organizational structure, and characteristics 2 Information on students enrollment and graduation for the midwifery and nursing department Why To define the study context To calculate the cost per graduate and per enrolled student for nurses and midwives 3 Expenditure reports at the college level To allocate the shared expenditures (such as maintenance and utilities) to individual departments, including the nursing and midwifery programs 4 Expenditure reports at the department level To map expenditures into four predefined input cost categories (faculty, students direct costs, infrastructure and equipment, materials and services) and get the total program cost by input category 5 Expenditure reports of the associated clinical To allocate and attribute expenditures related to College of Medicine and Health Sciences and Arbaminch College of Health Sciences 5

18 Data Needed facilities for each degree included in the analyses 1 6 Information about students use of consumables (gloves, syringes, etc.), utilization of materials and equipment (for demonstrations), and contact time spent with staff during clinical practica 7 Curricula for all programs being offered in each department 8 Curriculum of the program being assessed, including credit hours of individual courses 9 Information on the fixed resources available for the departments (classrooms, laboratories, etc.) Why student clinical practica and map them to the corresponding input categories To add the corresponding cost to the estimation of expenditures related to student clinical practica To allocate the shared costs among programs if a department offers more than one education program To allocate the cost centers of that program to individual courses and hence for the academic year of each program To assess their utilization rate and how they might constrain scale-up of the programs 10 Payroll information To allocate teachers salaries to the degrees assessed and to individual courses of that program 11 Information about the number of students and faculty in each department To serve as cost allocation criteria (when appropriate) 1 Expenditures are also incurred in health facilities where students complete their clinical practica, which are separate from the college itself. COSTING STUDY DATA ANALYSIS Objective 1: Estimate the Current Cost to Produce a Graduate The costs of the education program were estimated using total institution and corresponding clinical sites expenditures for 2012, assuming all the education components of the program were offered in that year. The current total number of enrolled students was used for the cost analysis throughout the entire education period. Considering past enrollment trends in the colleges, the method assumed that the number of students enrolled was fairly constant across years. Depending on the program costed, this assumption was of variable accuracy. The details are discussed separately for each program in the results section. The following steps were used to produce the unit cost for each program of interest. The process is illustrated in Figure 1. Step 1: Allocate college-level shared expenditures to individual departments based on their number of students or their proportion of credit/contact hours depending on the nature of the expenditure. For example, if a department had 2% of students, 2% of the financial aid given to students would go to that department. Step 2: Calculate the cost of instructors and staff using payroll data and information about the number and type of faculty in each department. For shared cost centers such as miscellaneous College of Medicine and Health Sciences and Arbaminch College of Health Sciences 6

19 payment to faculty, the official number of teachers in each department was used as allocation criteria. Step 3: Allocate the costs further to specific programs using both the number of students and the proportion of credit/contact hours as criteria when the department offered more than one program. Step 4: Calculate the financial cost of the student clinical practica (for the program being costed) using data collected at the health facilities. Step 5: Identify the resulting total expenditures for the program being costed using cost codes and map them to four major input categories selected to facilitate the interpretation of results and identify the areas where more (or less) is spent by the corresponding programs. (A complete list of the types of costs included in each of the four categories is available in Annex 1.) i. Faculty, educators and administrators: All costs related to faculty, staff or clinical preceptors (for example, salary of permanent staff, wages of contract staff, permanent staff allowances, permanent staff pension, and per diems). ii. iii. iv. Student direct costs: All variable costs directly related to students (for example, financial aid, clinical practicum costs, food, educational supplies, and entertainment). Infrastructure and equipment: All building and equipment-related costs (for example, utilities, maintenance, purchase of building equipment, communications, and insurance). Materials and services: All supplies, materials, and service costs related to the day-to-day functioning of the program (for example, printing, fuel, office supplies, uniforms and clothing, and contracted services). Step 6: Sum the four major input categories across each program to get the total cost and the contribution of each input category. Step 7: Divide the total cost and disaggregated input category costs by the number of graduates in 2012 to obtain the cost per graduate. Step 8: Allocate input costs to individual courses of the academic program costed based on credit and/or contact hours to obtain the cost per course and hence per academic year. College of Medicine and Health Sciences and Arbaminch College of Health Sciences 7

20 Figure 1: Cost per Graduate Using Top-Down Estimation Process Clinical preceptor costs Clinical preceptors are staff chosen from the health facilities by the schools to coordinate students clinical practica. They have the responsibility of teaching, supervising, and grading the students while on training. They receive a stipend from the school for this work, which we included in the faculty, educators, and administrators cost category. For the purposes of this study, clinical preceptors were only found in hospitals; health centers did not have designated clinical preceptors. Student clinical practicum costs In Ethiopia, public health facilities are responsible for training students from the public schools and do not receive any compensation in return. Both types of structures (schools and health facilities) receive subsidies from the federal and regional administrative governments, but student practicum costs are directly incurred by health facilities without any contributions from the schools. In contrast, students from private colleges pay a fee (variable from facility to facility) to be able to do clinical practica in public health facilities. For the study, clinical practicum costs were mainly related to resource consumption by students in the different wards/units through which they rotated. Interviews with staff of those College of Medicine and Health Sciences and Arbaminch College of Health Sciences 8

21 departments produced the following observations, which are worth noting although we did not have the level of detailed data needed to verify them. 1. Because of student consumption, the consumables (gloves, syringes, etc.) allocated monthly to each department depleted faster than usual. This situation was pointed out by many staff members because they had to wait until the following month to get supplies. Meanwhile, as care continued for a patient, frequently the cost of those consumables would be transferred to patients. The solution found to prevent this was to ration the consumables, which further limited students practice opportunities. 2. The amount of consumables used by students was different between the years of study, mainly related to the type of tasks performed. For example, fourth-year bachelor of midwifery students used more surgical gloves than second- and third-year students because they were more likely to actively assist in a delivery or a family planning procedure. 3. The amount of consumables students used also depended on the department in which the students were doing their clinical practice. More surgical gloves are used in the delivery room compared to the family planning unit. Five categories of results are presented for this objective: Total cost, cost per graduate, and cost per enrolled student for the nursing and midwifery programs of the two colleges Cost per input type (faculty, educators, and administrators; student direct costs; infrastructure and equipment; materials and services) Breakdown of costs for the student direct costs category Cost per academic year of the program Cost per course for each year of the program. Objective 2: Identify Current Constraints in Fixed Resources To assess the potential fixed resource constraints to expanding enrollment, we collected data on the standard capacity (how many students should be accommodated) and current utilization level (how many students are actually using the asset in a given time slot) of the primary fixed assets used by the program such as classrooms, skills labs, and faculty offices. The information on standard capacity was obtained from official national standards or college-defined standards. The data on current utilization levels of the fixed assets were provided by the focal persons and staff in each department. These data were analyzed to determine potential constraints by comparing the current utilization levels to national or school-level standards. A gap between current utilization level and standard capacity indicates that resources are still available to maximize efficiency and enroll additional students without having to make new investments. If the utilization level is higher than standard capacity, the assets are overutilized, and new investments are needed to relax the constraints to ensure the quality of education for the students currently enrolled. When College of Medicine and Health Sciences and Arbaminch College of Health Sciences 9

22 data were available, estimations of how much it would cost to relax existing fixed-asset constraints were offered. Objective 3: Estimate Post-Intervention Unit Cost of a Graduate As part of the NEPI initiative, UGCMHS and AMCHS defined a set of high-priority interventions that could be funded within the limits of the NEPI program to increase the quality of the education they provide. These interventions are included in the workplans developed by NEPI and each college. They include three categories of interventions: purchase and maintenance of equipment; financial support to students and faculty for field practice and research; and hiring part-time faculty. (No new infrastructure costs were considered because NEPI funding does not cover building infrastructure.) The third objective of this study was to apply the 2012 market costs of the NEPI interventions and estimate the new cost per graduate after implementation of the interventions. To this end, the detailed market cost estimates of the proposed interventions were collected from the colleges. To estimate the new unit costs after interventions, the yearly operational costs and the depreciation costs (when necessary) were broken down by input category and subcategory and added to the corresponding cost from objective 1. We then recalculated the total costs and unit costs to provide an estimated post-intervention unit cost. The interventions in the NEPI workplans represent a limited set of activities among a larger set of interventions needed to increase the quality of education provided. To provide a more complete cost estimate for ensuring the quality of education, the study explored a scenario in addition to the NEPI workplans, which was the cost of bringing the skills lab sessions up to standard with respect to space, materials and equipment, and teaching hours. College of Medicine and Health Sciences and Arbaminch College of Health Sciences 10

23 UNIVERSITY OF GONDAR COLLEGE OF MEDICINE AND HEALTH SCIENCES Background Information This section describes the clinical training programs at the UGCMHS, which of the programs were included in the analysis, the cost centers used, and how costs were allocated to produce the unit costs of each program. UGCMHS is a higher education institution under the authority of the Federal Ministry of Education that administers three schools and one institute: the Schools of Medicine, Health Sciences, and Pharmacy; and the Institute of Public Health. Under these three schools and one institute, there are 45 departments delivering 11 undergraduate and 34 postgraduate degree programs (CapacityPlus 2012a). As with other health science programs, the Federal Ministry of Education recruits and assigns students to different universities of the country, selecting among students who pass the Ethiopian Higher Education Entrance Certificate Examination from preparatory schools of the country. Upon their arrival at the university level, and based on their interest and entrance examination results, candidates are assigned to departments such as midwifery and nursing. In addition to midwifery and nursing, there are many other departments within the health sciences category (laboratory technology, physiotherapy, anesthesia, occupational health, health officer, environmental health, and psychiatric nursing). Midwifery and nursing are two independent departments. Individuals graduating with a Bachelor of Science (BSc) degree in midwifery or nursing have different responsibilities after graduation. Graduates in midwifery are responsible for services related to maternal and child health, including other reproductive health services. Nursing graduates are responsible for disease prevention, care of adults and children, and treatment for communicable and noncommunicable diseases. The two departments also offer different types and numbers of courses. The BSc in midwifery requires a total of 52 courses. Of these, 28 courses are taken by midwives only, and the remaining 24 courses are shared with the nursing department. The courses that are specific to the midwifery department include professional ethics, reproductive anatomy and physiology, pathology, medical surgical care, obstetrics, pediatrics, neonatology, communicable disease, operating room techniques, gynecology, psychiatry, essential surgery, teaching methodology and curriculum development, obstetric ultrasound, and research methodology. Likewise, the BSc in nursing requires a total of 49 courses to graduate. Of these courses, 26 courses are specific to nurses only and the remaining 23 courses are shared with the nursing department. The courses that are specific to the nursing department include pathophysiology, fundamentals of nursing, medical-surgical nursing, obstetrics and gynecology nursing, pediatric nursing, communicable disease control, operating theater technique, advanced nursing art, psychiatric nursing, health service planning and management, nursing theory, nursing service College of Medicine and Health Sciences and Arbaminch College of Health Sciences 11

24 administration and leadership, nursing education and curriculum development, nursing service administration and leadership, and nursing research methodology. The College of Medicine and Health Sciences also offers four Master s degree programs in clinical midwifery and medical, surgical, and pediatric nursing. However, as agreed with the UGCMHS, the costing study only covered the two undergraduate programs in nursing and midwifery. UGCMHS is currently restructuring its academic units. A new school will be established to combine the two departments of nursing and midwifery, which will offer bachelor of nursing (BSN) and bachelor of midwifery (BSM) degree programs. Objective 1: Unit Cost of Producing Graduates Cost per graduate for the nursing and midwifery programs Table 2 presents the total and unit costs of the nursing program. Using the 2012 average exchange rate of 1 Ethiopian birr (ETB) = 0.05 US$ ( the total cost of the 4-year nursing program in 2012 was 2,743,431 ETB (137,172 US$). Divided by the number of graduates for 2012 (N=80), the estimated unit cost per graduated nurse over the 4-year program was 34,292 ETB (1,714 US$). Divided by the average annual number of first-year nurses (N=98), and assuming that all first-year students make it to the fourth year, the estimated unit cost per enrolled nurse over the 4-year program was 27,994 ETB (1,400 US$). The cost per enrolled nurse was calculated to highlight the possible efficiency gain that would occur if the attrition/dropout rate decreased and a higher proportion of enrolled students graduated. Here we used the average number of enrolled students instead of the actual number of enrolled students for a single year because there were slight differences in the annual number of students enrolled in the past four academic years. More details about the estimations for objective 1 can be found in Annex 1. Table 2: Total and Unit Costs of the Four-Year BSc in Nursing by Input Category (ETB) Cost Code Input Cost Category Total Cost Per Graduate (N=80) Per Enrolled Student (N=98) I Faculty, educators, and administrators 1,805,711 22,571 18,426 II Student direct costs 612,588 7,657 6,251 III Infrastructure and equipment 174,668 2,183 1,782 IV Materials and services 150,464 1,881 1,535 TOTAL 2,743,431 34,292 27,994 Table 3 shows the total and unit cost of the midwifery program by input cost categories. The total cost of the 4-year program in 2012 was 1,906,318 ETB (95,316 US$). Divided by the number of graduates for that year (N=55), the estimated unit cost per graduated midwife over the 4- College of Medicine and Health Sciences and Arbaminch College of Health Sciences 12

25 year program was 34,661 ETB (1,733 US$). If we divide by the average annual number of firstyear midwifery students (N=69), assuming they all reach the fourth year, the estimated unit cost per enrolled midwife over the 4-year program was 27,627 ETB (1,381 US$). Table 3: Total and Unit Costs of the Four-Year BSc in Midwifery by Input Category (ETB) Cost Code Input Cost Category Total Cost Per Graduate (N=55) Per Enrolled Student (N=69) I Faculty, educators, and administrators 1,051,301 19,115 15,236 II Student direct costs 547,957 9,963 7,941 III Infrastructure and equipment 185,049 3,365 2,682 IV Materials and services 122,011 2,218 1,768 TOTAL 1,906,318 34,661 27,627 At UGCMHS, the costs of producing a nurse graduate or a midwife graduate were very similar: 34,292 ETB (1,714 US$) for a nurse versus 34,661 ETB (1,733 US$) for a midwife. This slight difference in cost can be linked to the small difference in the estimated graduation rate (number of students starting the program/number of students who graduated), which is around 82% for nursing and 80% for midwifery. When we considered the cost per student enrolled, there was also not much difference between costs for nursing students (27,994 ETB or 1,400 US$) and midwifery students (27,627 ETB or 1,381 US$). Analysis of costs by input category Figures 2 and 3 show the proportion of total program cost per input category. The faculty, educators, and administrators input category was the largest category for both the nursing and midwifery programs, accounting, respectively, for 66% and 55% of the total cost. The second most important input cost category was student direct costs, with 22% and 29%, respectively. The materials and services and infrastructure and equipment cost categories were less than (or equal to) 10% of the total cost for both programs. There were seven clinical preceptors for the UGCMHS nursing and midwifery programs, all in Gondar University Hospital. These clinical preceptors received from the college a stipend of 200 ETB (10 US$) per month, resulting in a yearly cost of 16,800 ETB (840 US$) for all preceptors. Because there were very few clinical preceptors, they accounted for a tiny portion (around 0.5%) of the faculty, educator, and administrator costs of the two programs. The lack of sufficient clinical preceptors was an issue raised by many staff members from the clinical practice health facilities. This lack of organized supervision can also have a direct impact on the quality of clinical practica and the overall quality of graduates. It should be noted, however, that for some courses the students went to clinical practica accompanied by an instructor (on the school payroll) who supervised them on site and to some extent played the role of a clinical preceptor. College of Medicine and Health Sciences and Arbaminch College of Health Sciences 13

26 Figure 2: Proportion of Total Cost of the Bachelor in Nursing Program by Input Category Figure 3: Proportion of Total Cost of the Bachelor in Midwifery Program by Input Category Analysis of clinical practicum costs relative to student direct costs Figure 4 shows the breakdown in the student direct costs category. The clinical practicum costs were 80,202 ETB (4,010 US$), accounting for 13% of nursing students direct costs. For midwifery, clinical practicum costs were 58,706 ETB (2,935 US$), which was 11% of direct student costs (Figure 5). These costs were incurred by the clinical health facilities, and the absolute amount in ETB is quite significant. The financial impact of student training on clinical sites should be taken into account when using the total cost and considering the policy implications of student training. Student financial aid expenses accounted for a very small amount of total student direct costs. For both programs, it was around 1% of student costs. College of Medicine and Health Sciences and Arbaminch College of Health Sciences 14

27 Figure 4: Breakdown of Student Direct Costs Category for Nursing Students (ETB) Figure 5: Breakdown of Student Direct Costs Category for Midwifery Students (ETB) Analysis of costs per academic year Figure 6 presents the total cost of the nursing program by academic year. (A detailed listing of the cost of each course within each academic year is provided in Annex 1.) The higher cost of the fourth year in both cases seems to be driven by more field practice and community work in that year compared to earlier years. The higher total cost of the nursing program compared to the midwifery program could be partly driven by the higher number of students in nursing compared to midwifery. College of Medicine and Health Sciences and Arbaminch College of Health Sciences 15

28 Figure 6: Total Cost of the BSc in Nursing and Midwifery per Academic Year Total cost of the BSc in Nursing and Midwifery per academic year (ETB) Total cost Midwifery Total cost Nursing 159, , , , , , , ,652 First Year Second Year Third year Fourth Year When we look in detail at the top three most expensive courses per year (Figures 7 and 8), the field practice-related courses were some of the most costly courses for each academic year. The team training program, which had a goal of allowing students to give back to their communities, was also one of the most expensive courses. For this course, students (accompanied by an instructor) visited rural and urban schools and communities to provide health care and health education. Figure 7: Cost per Course for Bachelor of Nursing College of Medicine and Health Sciences and Arbaminch College of Health Sciences 16

29 Figure 8: Cost per Course for Bachelor of Midwifery Objective 2: Fixed Assets Constraints Space constraints This analysis of space constraints is based on data obtained from the school and focuses on infrastructure used exclusively by the students and faculty of the nursing and midwifery departments. Infrastructure shared with other programs in AMCHS (e.g., library, conference room, computer room) is not taken into account. This is because data on utilization from every department would be needed in order to perform such an analysis, and our data collection focused primarily on the nursing and midwifery departments. We compare the data obtained to the official space standards for higher education infrastructure in Ethiopia (Federal Democratic Republic of Ethiopia 2010) in Table 4 below. Classrooms Assuming that there are enough chairs and desks for all students, the classrooms constitute a space constraint for both programs, but not a severe one. As shown in Table 4, there is a slight gap in all classrooms in terms of space. For both programs, the classrooms are accommodating on average three more students than what is advised under the standards. While students from the nursing and midwifery programs use other classrooms in the university that are not in their department, the number of excess students remains the same on average. Skills labs Each program uses two skills labs. One of the skills labs (type 2) is shared with other programs, and the second one is exclusively for the nursing or midwifery program (type 1). Assuming that each skills lab is used at its maximum available hours per week, none of the skills labs are College of Medicine and Health Sciences and Arbaminch College of Health Sciences 17

30 complying with the official standards in terms of space. For both programs, more students occupy the skills labs in a single session than is recommended by the official standards. The excess number of students in each skills lab is up to nine for both programs. Considering both skills labs for each program, this translates to up to 51 and 48 missing square meters, respectively, for nursing and midwifery. Using the price estimate per square meter provided by the college of 6,500 ETB (325 US$), building the missing skills lab space would cost 312,000 ETB (15,600 US$) for the midwifery program and 331,500 ETB (6,630 US$) for the nursing program. However, according to the standards listed in the national guidelines for midwifery education, a skills lab should be 75 square meters and accommodate up to 25 students at the space standard of 3 meters per student. If building is an option, each program should exceed its missing space based on the current number of students and construct a full skills lab (75 square meters), which would cost each program 487,500 ETB (24,375 US$). Constructing new skills labs is not the only option to relax this constraint. Other options include the following: If not already done, the scheduling of the skills labs could be modified to allow for more rotations, but this implies increasing the number of faculty teaching hours to accommodate the additional rotations. The necessary space could be rented to avoid the investment cost of construction and more flexibly accomodate possible fluctuations in the number of students. However, the rented space should be conveniently located relative to the school (i.e., within walking distance). An existing available room could also be converted into a skills lab as long as the space requirements are met. The nursing and midwifery programs could construct a shared skills lab or leverage the skills labs of other education programs, provided they have the adequate materials and unused capacity. In conclusion, there is no room for increased student admissions in terms of skills lab space. In addition, given the current number of students enrolled, the space available for skills labs does not meet the standards for quality education. Teachers offices In general, the teachers space is in accordance with official standards for the nursing program but allows no room for increasing the number of faculty. For the midwifery program, one of the teacher rooms accommodates two more faculty members than recommended, translating into a gap of four square meters. If both the nursing and midwifery programs were to increase the number of faculty members, they could each build or acquire additional office space on their own or share additional space between them. That additional space could be built or acquired at the rate of 6,500 ETB (325 US$) per square meter. College of Medicine and Health Sciences and Arbaminch College of Health Sciences 18

31 Table 4: Space Constraints Analysis Program Midwifery Nursing Fixed Asset Lecture room type 1 Skills lab type 1 Skills lab type 2 Teachers room Lecture room type 1 Skills lab type 1 Skills lab type 2 Teachers room Number of units for fixed asset Current space of each unit (square meters) Actual capacity of each unit (number of individuals) Official space guidelines (square meters per individual) Capacity of each unit according to standards (number of individuals) Surplus of individuals compared to standards Shortage of space (square meters) Faculty constraints Given the absence of national faculty-to-student ratios for nursing and midwifery education, we used standards for faculty-to-student ratios defined by the colleges and provided by the nursing and midwifery departments. In UGCMHS, the standard faculty-to-student ratio for a classroom session is one teacher for up to 80 students. Classroom sessions for both the nursing and midwifery programs have up to 70 students per teacher. Therefore, the number of students per classroom session meets the defined standard. For demonstration sessions, the standard ratio is 1 teacher for students. In both programs, one faculty member taught up to 30 students in a demonstration session. This number of students per faculty aligns with the school s standards. Table 5: Faculty-to-Student Ratio Analysis Type of Teaching School Standards Midwifery (actual) Nursing (actual) Classroom lecture 1 teacher for up to 80 students Skills lab 1 teacher for students 1 teacher for 70 students 1 teacher for students 1 teacher for 70 students 1 teacher for students As we can see from the above analysis, space and faculty constraints are very interdependent and, where they both exist, it can be hard to define the direction of causality. College of Medicine and Health Sciences and Arbaminch College of Health Sciences 19

32 Materials constraints for skills labs A skills lab needs not only to be spacious enough but also to have the necessary materials for demonstration and practice of the skills needed to become a nurse or midwife. The objective of this analysis was to compare the existing materials in each program s skills lab to the required materials listed in the official country guidelines (Federal Democratic Republic of Ethiopia 2014). According to the official guidelines for midwifery, a skills lab should have adequate lighting and ventilation, possess enough storage space (shelves and cupboards), and be equipped with sinks and water taps. Moreover, the official standards document defines required materials for a skills lab and organizes them into groups. The two main groups considered in this analysis were anatomical models, and equipment and furniture. Each group lists the items that are deemed necessary for a quality midwifery education but does not indicate how many of these items are necessary. For this reason, we only analyzed the presence or absence of an anatomical model or equipment and did not take into consideration the quantity of each item. In the midwifery program, 65% of the required anatomical models were available (13 items out of 20) and 37% of the required equipment was available (21 items out of 57). Details on the available items can be found in Annex 5. Conclusions and recommendations Since most of the fixed assets were being used over their maximum capacity, there was no room for efficiency gains in this area. In fact, our analysis found a need to invest in additional fixed assets in order to meet locally-defined standards for space and materials. The following are the primary recommendations related to the constraints analysis: Even if the space constraint for classrooms is relatively small, no increase in the number of students should be made before finding more classroom space. To ensure the quality of education for the number of students currently enrolled, more space should be acquired for skills lab sessions and equipped with the necessary materials. The number of nursing and midwifery faculty cannot be increased without borrowing office space from other departments, building new space, or renting space. We found no faculty constraints in the nursing and midwifery programs at UGCHMS, but the faculty-to-student ratio was close to the recommended standards and should be monitored closely. The equipment and material constraints in skills labs should be addressed in order to increase the quality of the education provided. Within the context of NEPI, a capacity assessment of UGCMHS nursing and midwifery programs led to the development of a workplan to strengthen the teaching and learning infrastructure and improve the capacity of clinical and academic faculty to design and deliver quality education. Some of the activities in the workplan aimed to address the materials and faculty constraints identified earlier. However, none of the workplan activities address the space, College of Medicine and Health Sciences and Arbaminch College of Health Sciences 20

33 materials, and equipment constraints related to skills labs. Therefore, in addition to implementing the NEPI workplan, it is recommended that the college construct and equip new infrastructure (skills labs) in order to meet locally-defined educational standards and ensure the quality of education for the students currently enrolled in the nursing and midwifery programs. Objective 3: Interventions and New Unit Cost for Graduates The nursing and midwifery departments at UGCMHS, with NEPI collaboration, identified and estimated the 2012 market cost of a set of high-priority activities that could be funded within the limits of the NEPI program and designed to increase the quality of the education provided to their students. The interventions focused on the purchase and maintenance of equipment; financial support to students and faculty for field practice and research; and hiring part-time faculty. Because NEPI funding does not cover building infrastructure, the workplan activities did not include interventions needed to overcome fixed assets constraints. For example, they did not include the expansion of infrastructure needed to reduce the overcrowding of skills labs. To better represent the unit cost of a quality education, we also estimated the cost of overcoming skills lab constraints through: (1) construction and equipment of one new lab for each department; and (2) procurement of materials and equipment for the existing skills labs in order to bring them up to recommended standards. For midwifery skills labs, the cost of construction using the cost per square meter was added to the unit cost of the required materials and equipment based on the country s standards for midwifery skills labs. The cost per square meter was also used to estimate the construction cost of a nursing skills lab. However, at the time of the study there were no official standards for nursing skills lab materials. The team used a list of standard materials and equipment for nursing schools developed in Tanzania (Republic of Tanzania 2011) with technical assistance from Jhpiego (an affiliate of Johns Hopkins University in the US) to estimate the cost of equipping nursing skills labs. When these costs are added to the cost of implementing the NEPI workplan, the new unit cost of educating a student is more accurate (Table 6). However, the new unit cost should be interpreted with caution as it does not take into account the full set of investments needed to address all constraints to the quality of education. It is also important to note that the interventions did not include increasing or decreasing the number of students enrolled each year in the programs. For this reason, it was not necessary to adjust the number of students entering and graduating from the program when calculating the new unit costs per graduate and student enrolled. Most of the interventions are at the level of the combined midwifery and nursing departments and will benefit both of them. Other interventions, such as those related to the central skills laboratory (skills lab) or the library will benefit other departments as well. Each intervention cost was allocated according to its potential beneficiaries. After assessing more detailed budgets for each intervention, we separated each intervention into recurrent and nonrecurrent costs. Nonrecurrent costs were depreciated depending on their useful life in years (in other words, the number of years they are expected to be used before a replacement is needed for planning and College of Medicine and Health Sciences and Arbaminch College of Health Sciences 21

34 accounting purposes). Shared costs were further allocated between the nursing and midwifery departments (and other departments as appropriate) to simulate the postintervention unit cost. More details about the estimation of postintervention costs can be found in Annex 2. Table 6: Intervention Costs for the UGCMHS for Nursing and Midwifery Total Intervention Cost (ETB) 1 Allocated Annual Cost for BSc Nursing (ETB) Allocated Annual Cost for BSc Midwifery (ETB) Interventions NEPI workplan interventions Purchase of 1 small bus (25 seats) 980,000 28,490 21,024 Purchase of 7 laptop computers for faculty members 105,000 18,806 13,756 Purchase of 20 desktop computers for computer labs 140,000 25,075 18,342 Purchase of 4 LCD projectors for classrooms 56,000 10,030 7,337 Purchase of 4 printers 24,000 4,299 3,144 Purchase of 1 heavy-duty printer and copier 57,000 10,209 7,468 Purchase of 2 water coolers 8,000 1,433 1,048 Purchase of other furniture and equipment 23,624 4,231 3,095 Purchase of books and journal subscriptions 305,307 22,189 16,374 Purchase of other office supplies 13,104 7,041 5,150 Student financial support for field practice 300, , ,910 Teacher per diems and accommodation for field practice 68,000 36,537 26,726 Car rental for field practice 6,666 3,582 2,620 Faculty and student research support 120,000 64,478 47,164 Five new part-time staff 81,000 43,522 31,836 Repair and maintenance of skills labs 150,000 80,597 58,955 Repair and maintenance of faculty offices 150,000 80,597 58,955 Communication (telephone/mobile card) 26,400 14,185 10,376 Wireless Internet 17,280 9,285 6,792 Other utilities 10,920 5,867 4,292 Subtotal NEPI interventions 2,642, , ,364 (132,115 US$) (31,582 US$) (23,118 US$) Necessary skills lab interventions One new nursing skills lab 778, ,918 0 One new midwifery skills lab 914, ,993 Missing materials in nursing skills lab 2 538, ,683 0 Missing materials in midwifery skills lab 3 487, ,863 Subtotal necessary skills lab interventions 2,719, , , (135,963 US$) (10,530 US$) (12,693 US$) Total interventions 5,361, , ,220 (268,078 US$) (42,112 US$) (35,811 US$) Cost of the intervention before depreciation and allocation. Estimated cost of missing materials from the two existing skills labs used by the nursing department. Estimated cost of missing materials from the two existing skills labs used by the midwifery department. College of Medicine and Health Sciences and Arbaminch College of Health Sciences 22

35 Taking into account the allocated cost of the interventions, the new unit cost of a nurse graduate was estimated to be 44,821 ETB (2,241 US$) and 47,677 ETB (2,384 US$) for a midwife graduate. There was an average increase of 30% and 37%, respectively, compared to the beforeinterventions (objective 1) values of 34,292 ETB (1,714 US$) for a nurse graduate and 34,661 ETB (1,733 US$) for a midwife graduate. Figure 9 shows a breakdown of the total cost per input category, before and after interventions. We can see that the bulk of the investments went to the infrastructure and equipment category, which, if we recall from objective 1, accounted for a low percentage of the total cost: 6% for nursing and 10% for midwifery. After interventions, these percentages increased to 19% and 25%, respectively, translating the interventions focus into solving the lack of equipment and infrastructure and thereby increasing the quality of education. Figure 9: Cost per Input Category: Before and After Intervention Comparison College of Medicine and Health Sciences and Arbaminch College of Health Sciences 23

36 ARBAMINCH COLLEGE OF HEALTH SCIENCES Background Information This section describes medical training programs at the AMCHS, which of the programs were included, the cost centers used, and how costs were allocated to produce unit costs of each program. Arbaminch College of Health Sciences was established in October 1996, under the authority of the Federal Ministry of Health, as a training institute for producing junior health professionals. After seven years, the institute upgraded to the college level. While the college s accountability is to the regional council and health bureau, it follows and is guided by Ethiopian higher institute (university) rules and regulations. To recruit students, the Zonal Health Office makes a regional announcement for each program separately. In addition, the entrance examination is made both by Arbaminch College of Health Sciences and the Regional Health Bureau. The college offers seven, three-year diploma programs: 1. Public health nurse 2. Clinical nurse 3. Midwifery 4. Medical laboratory 5. Pharmacy 6. Health information technology 7. Health extension program. Midwifery and nursing are two independent departments with different major professional courses and responsibilities after graduation (CapacityPlus 2012b). After their graduation, midwives are responsible for services related to maternal and child health, including reproductive health services. Nurses are responsible for prevention of diseases, caring for adults and children, and treating communicable and noncommunicable diseases. Diploma midwives take a total of 42 courses. Of these, 18 courses are taken only by midwives and 24 courses are shared with other departments including nursing. The courses that are specific to midwifery include, among others: family planning, antenatal care, physical diagnosis, human nutrition, ethics, physiology, microbiology, management of labor and delivery, postnatal care, pharmacology, operating room techniques, reproductive health, health action management, health planning, and gynecology. Similarly, diploma clinical nurses take a total of 43 courses to graduate. Fifteen courses are specific to nurses only, and 28 courses are shared with other departments including the department of midwifery. The courses that are specific to the nursing department include, among others: advanced nursing arts, emergency and intensive care, ethics and legal aspects of College of Medicine and Health Sciences and Arbaminch College of Health Sciences 24

37 nursing, microbiology and parasitology, maternity nursing care, pre/intra/post operation care, introduction to psychology, nutrition, nursing health service management, rural health management, nursing health research, psychosocial nursing, and psychiatric nursing. For both midwifery and nursing, the AMCHS, besides its mandate of public education, has a parallel private program (purposely for resource mobilization) where students are required to cover the cost of their training courses through tuition fees. It is worth bearing in mind that the focus of this costing study is on the public programs: the Diploma of Nursing and Diploma of Midwifery for which students do not have to pay tuition. However, at the college s request, we also costed the private programs in nursing and midwifery and briefly summarize the results. Objective 1: Unit Cost of Producing Graduates Cost per graduate for the nursing and midwifery programs Table 7 presents the total and unit costs of the AMCHS nursing program. The total cost of the three-year nursing program in 2012 was 3,635,934 ETB (181,796 US$). Divided by that year s number of graduates (N=173), the estimated unit cost per graduated nurse over the three-year program was 21,017 ETB (1,051 US$). If we divide by the average number of enrolled students (N=177), the estimated unit cost per enrolled nursing student was 20,543 ETB (1,027 US$). The cost per enrolled nurse was calculated to highlight the possible efficiency gain that would occur if the attrition rate decreased and a higher proportion of enrolled students was graduating. For Arbaminch, the annual number of enrolled students was fairly constant over the past two years, bearing in mind that the students enrolled two years ago were the ones graduating in Table 7: Total and Unit Costs of the Nursing Diploma by Input Category (ETB) Cost Code Input Cost Category Total Cost Per Graduate (N=173) Per Enrolled Student (N=177) I Faculty, educators, and administrators 1,387,333 8,019 7,838 II Student direct costs 1,336,640 7,726 7,552 III Infrastructure and equipment 528,639 3,056 2,987 IV Materials and services 383,322 2,216 2,166 TOTAL 3,635,934 21,017 20,543 Table 8 shows the total and unit cost of the Diploma in Midwifery program by input cost categories. The total cost of the three-year program in 2012 was 3,283,095 ETB (164,154 US$). Divided by the number of graduates that year (N=147), the estimated unit cost per graduated midwife over the three-year program was 22,334 ETB (1,117 US$). Divided by the number of enrolled students (N=156), the estimated unit cost per enrolled midwife for the three-year program was 21,045 ETB (1,052 US$). College of Medicine and Health Sciences and Arbaminch College of Health Sciences 25

38 Table 8: Total and Unit Costs of the Midwifery Diploma by Input Category (ETB) Cost Code I Total Cost Per Graduate (N=147) Per Enrolled Student (N=156) Input Cost Category Faculty, educators and administrators 883,819 6,012 5,666 II Student direct costs 1,459,286 9,927 9,354 Infrastructure and III equipment 543,863 3,700 3,486 IV Materials and services 396,127 2,695 2,539 TOTAL 3,283,095 22,334 21,045 At AMCHS, the cost of producing a graduate nurse is slightly less than for a graduate midwife: 21,017 ETB (1,051 US$) versus 22,334 ETB (1,117 US$). This difference in cost can be explained in large part by the slight difference in the graduation rate: around 98% for nursing and 94% for midwifery. When we consider the cost per new enrollee, there is less difference between the two unit costs: 20,543 ETB (1,027 US$) for a nurse and 21,045 ETB (1,052 US$) for a midwife. Analysis of costs by input category Figures 10 and 11 show that the faculty, educators, and administrators input category was an important component for both programs, accounting for 38% and 27% of the total cost, respectively, for nursing and midwifery. The student direct costs were also an important cost, representing 37% of the total costs for nursing and 44% of the total cost for midwifery (the largest cost category). Student direct costs were inflated by financial aid to students. The financial aid cost alone represented 30% of the total cost for the nursing program and 37% for the midwifery program. (More details can be found in Annex 1.) The infrastructure/equipment cost category and the materials/services cost category were each less than 20% of the total cost. The importance of the latter two categories for the quality of education provided can explain the strong focus of the designed interventions discussed in objective 3 on infrastructure remodeling and equipment purchases. For AMCHS, there were two clinical preceptors for both the nursing and midwifery programs, both in Arbaminch Hospital. These clinical preceptors received from the college a stipend of 200 ETB (10 US$) per month resulting in a yearly cost of 4,800 ETB (240 US$) for all preceptors. Because there were very few clinical preceptors, they accounted for a tiny portion of the faculty, educator, and administrator costs of the two programs (less than 0.5%). The lack of sufficient clinical preceptors was an issue raised by many staff members from the health facilities. This lack of organized supervision can also have a significant effect on the quality of clinical practica and the overall quality of graduates. However, we should note that for some courses, the students went to their clinical practicum accompanied by an instructor (from the school payroll) who supervised them on site and to some extent played the role of a clinical preceptor. College of Medicine and Health Sciences and Arbaminch College of Health Sciences 26

39 Figure 10: Proportion of Total Cost of the Diploma in Nursing Program by Input Category Figure 11: Proportion of Total Cost of the Diploma in Midwifery Program by Input Category Analysis of clinical practicum costs relative to student direct costs When we broke down the student direct costs category (Figures 12 and 13), the clinical practicum costs accounted for 2% of the student direct costs for both nursing and midwifery. Note that these costs were incurred by the clinical facilities. In health facilities visited, the interviewees brought to our attention that the students from AMCHS bring with them some consumables (mainly gloves) provided by the school. This fact could explain the relatively low percentage for clinical practicum costs. Even though the percentage was not high, the absolute amount in Ethiopian Birr (27,175 ETB or 1,359 US$ for nursing and 30,668 ETB or 1,533 US$ for midwifery) is significant and could impact the clinical sites finances. This possible burden of clinical practica on health facilities should be taken into account by policy-makers when using the total cost of training a student. College of Medicine and Health Sciences and Arbaminch College of Health Sciences 27

LEGACY SERIES. Transforming Health Professional Preservice Education to Meet National Needs

LEGACY SERIES. Transforming Health Professional Preservice Education to Meet National Needs LEGACY SERIES 1 September 2015 Transforming Health Professional Preservice Education to Meet National Needs Rebecca Bailey, Kate Tulenko, Heather Ross, Rachel Deussom, and Kate Gilroy, IntraHealth International

More information

Nursing Education Partnership Initiative (NEPI)

Nursing Education Partnership Initiative (NEPI) Nursing Education Partnership Initiative (NEPI) Jennifer Dohrn DNP, CNM Columbia University Mailman School of Public Health ICAP Nurse Capacity Initiative-NEPI Co-Investigator and Program Director A Critical

More information

MASTER OF SCIENCE PROGRAM IN CLINICAL TROPICAL INFECTIOUS DISEASES AND HIV MEDICINE AT THE UNIVERSITY OF GONDAR IN ETHIOPIA

MASTER OF SCIENCE PROGRAM IN CLINICAL TROPICAL INFECTIOUS DISEASES AND HIV MEDICINE AT THE UNIVERSITY OF GONDAR IN ETHIOPIA MASTER OF SCIENCE PROGRAM IN CLINICAL TROPICAL INFECTIOUS DISEASES AND HIV MEDICINE AT THE UNIVERSITY OF GONDAR IN ETHIOPIA filling in the gaps to address a major health care challenge Nebiyu Mesfin Gedlu,

More information

Country Case Study E T H I O P I A S H U M A N R E S O U R C E S F O R H E A L T H P R O G R A M M E

Country Case Study E T H I O P I A S H U M A N R E S O U R C E S F O R H E A L T H P R O G R A M M E Country Case Study E T H I O P I A S H U M A N R E S O U R C E S F O R H E A L T H P R O G R A M M E GHWA Task Force on Scaling Up Education and Training for Health Workers S U M M A R Y Ethiopia suffers

More information

RAPID ASSESSMENT OF THE QUALITY OF PRE-SERVICE EDUCATION IN PRIVATE MEDICAL COLLEGES IN ETHIOPIA

RAPID ASSESSMENT OF THE QUALITY OF PRE-SERVICE EDUCATION IN PRIVATE MEDICAL COLLEGES IN ETHIOPIA PEPFAR RAPID ASSESSMENT OF THE QUALITY OF PRE-SERVICE EDUCATION IN PRIVATE MEDICAL COLLEGES IN ETHIOPIA September 2012 This publication was produced for review by the United States Agency for International

More information

Human Resources Policy

Human Resources Policy Islamic Republic of Afghanistan Ministry of Public Health Human Resources Policy Kabul 2006 National Human Resources Policy Page 1 Contents Pages Glossary of Terms 3 List of Acronyms 3 Background to HR

More information

MEPI Connect An Open Source Graduate Tracking Software System: Resource Requirements to Customize and Implement the System

MEPI Connect An Open Source Graduate Tracking Software System: Resource Requirements to Customize and Implement the System MEPI Connect An Open Source Graduate Tracking Software System: Resource Requirements to Customize and Implement the System Version 1.0: January 2015 Michael Drane, Rebecca Bailey, and Rachel Deussom, IntraHealth

More information

Testimony of Patsy L. Ruchala, DNSc, RN before the Nevada State Legislative Committee on Health Care January 10, 2006

Testimony of Patsy L. Ruchala, DNSc, RN before the Nevada State Legislative Committee on Health Care January 10, 2006 Exhibit L Testimony of Patsy L. Ruchala, DNSc, RN before the Nevada State Legislative Committee on Health Care January 10, 2006 Mr. Chairman, members of the Committee, for the record I am Patsy Ruchala,

More information

SCHOOL OF NURSING FINANCIAL MODEL

SCHOOL OF NURSING FINANCIAL MODEL SCHOOL OF NURSING FINANCIAL MODEL The following tables illustrate the financial performance of the School of Nursing Camden for the three year period of FY2011/12 through FY2013/14. Table 1 The School

More information

Ministerial Ordinance on Schools and Training Schools for Public Health Nurses, Midwives and Nurses

Ministerial Ordinance on Schools and Training Schools for Public Health Nurses, Midwives and Nurses Ministerial Ordinance on Schools and Training Schools for Public Health Nurses, Midwives and Nurses (Ordinance of the Ministry of Education, Science and Culture and the Ministry of Health and Welfare No.

More information

Deepening the Collective Handprint of Nursing: Transformative Education Models in Sub Saharan Africa Jennifer Dohrn Project Director Global Nurse

Deepening the Collective Handprint of Nursing: Transformative Education Models in Sub Saharan Africa Jennifer Dohrn Project Director Global Nurse Deepening the Collective Handprint of Nursing: Transformative Education Models in Sub Saharan Africa Jennifer Dohrn Project Director Global Nurse Capacity Building Program Overview of Presentation Why

More information

Executive Summary. Introduction

Executive Summary. Introduction Eecutive Summary Introduction Nurses often are referred to as the backbone of health care in the United States. They are frequently the most visible practitioners in a hospital, school, home, or long-term

More information

MCMASTER UNIVERSITY FACULTY OF HEALTH SCIENCES BY-LAWS

MCMASTER UNIVERSITY FACULTY OF HEALTH SCIENCES BY-LAWS MCMASTER UNIVERSITY FACULTY OF HEALTH SCIENCES BY-LAWS I (i) THE FACULTY OF HEALTH SCIENCES Members of the Faculty: (a) Voting Members Ex Officio: Full-time Faculty Staff Student Dean and Vice-President

More information

COMMONWEALTH OF MASSACHUSETTS BOARD OF REGISTRATION IN NURSING

COMMONWEALTH OF MASSACHUSETTS BOARD OF REGISTRATION IN NURSING COMMONWEALTH OF MASSACHUSETTS BOARD OF REGISTRATION IN NURSING FACULTY VACANCIES AMONG BOARD APPROVED NURSING EDUCATION PROGRAMS IN MASSACHUSETTS 2010 2011 and 2011 2012 Spring 2010 Survey Summary Nursing

More information

STANDARDS FOR NURSING EDUCATION PROGRAMS. (a) The purpose of the board in adopting rules and regulations in this Chapter

STANDARDS FOR NURSING EDUCATION PROGRAMS. (a) The purpose of the board in adopting rules and regulations in this Chapter CHAPTER VI STANDARDS FOR NURSING EDUCATION PROGRAMS Section 1. Statement of Purpose. is: (a) The purpose of the board in adopting rules and regulations in this Chapter programs. (i) To serve as a guide

More information

Florida Can Use Several Strategies to Encourage Students to Enroll in Areas of Critical Need

Florida Can Use Several Strategies to Encourage Students to Enroll in Areas of Critical Need February 2005 Report No. 05-09 Florida Can Use Several Strategies to Encourage Students to Enroll in Areas of Critical Need at a glance Florida is projected to face critical shortages of teachers and nurses

More information

CHAPTER 6 STANDARDS FOR NURSING EDUCATION PROGRAMS

CHAPTER 6 STANDARDS FOR NURSING EDUCATION PROGRAMS CHAPTER 6 STANDARDS FOR NURSING EDUCATION PROGRAMS Section 1: Statement of Purpose. (a) To foster the safe and effective practice of nursing by graduates of nursing education programs by setting standards

More information

Healthcare Workforce Development Grant. Don Richards

Healthcare Workforce Development Grant. Don Richards Healthcare Workforce Development Grant Don Richards Nurse Practitioner Pipeline DNP PN ADN BSN ARNP MSN High School Health Science Students, General Public Some Nursing Program Completers exiting and some

More information

Formative Evaluation of the Midwifery Education Programme. Terms of Reference

Formative Evaluation of the Midwifery Education Programme. Terms of Reference Formative Evaluation of the Midwifery Education Programme Terms of Reference 1.0 BACKGROUND Investment in midwifery is crucial for national development and is of international interest. It has strong links

More information

MICHIGAN NURSING CORPS WEBINAR/RFP Questions/Answers:

MICHIGAN NURSING CORPS WEBINAR/RFP Questions/Answers: MICHIGAN NURSING CORPS WEBINAR/RFP Questions/Answers: Question: With regards to a budget for model A, can the budget include the tuition cost for each student as well as a stipend? Or is the University

More information

Title VIII Reauthorization Statutory Language Changes

Title VIII Reauthorization Statutory Language Changes Section 801: Definitions 1 Current Authority Recommendation Rationale Amend the Definition of School of Nursing Section 296(2) (2) School of nursing The term school of nursing means a collegiate, associate

More information

AGENDA ITEM III A PROPOSED ACADEMIC PROGRAMS LOUISIANA STATE UNIVERSITY HEALTH SCIENCE CENTER M.S. IN NURSING - NURSE ANESTHESIA OPTION

AGENDA ITEM III A PROPOSED ACADEMIC PROGRAMS LOUISIANA STATE UNIVERSITY HEALTH SCIENCE CENTER M.S. IN NURSING - NURSE ANESTHESIA OPTION AGENDA ITEM III A PROPOSED AADEMI PROGRAMS LOUISIANA STATE UNIVERSITY HEALTH SIENE ENTER M.S. IN NURSING - NURSE ANESTHESIA OPTION BAKGROUND INFORMATION Since the early 1900s, a post-baccalaureate ertificate

More information

Statement on the Redirection of Nursing Education Medicare Funds to Graduate Nurse Education

Statement on the Redirection of Nursing Education Medicare Funds to Graduate Nurse Education Statement on the Redirection of Nursing Education Medicare Funds to Graduate Nurse Education To the National Bipartisan Commission on the Future of Medicare Graduate Medical Education Study Group (January

More information

DRUG SAFETY AND HUMAN RESOURCES SUBSECTORS ANALYSIS

DRUG SAFETY AND HUMAN RESOURCES SUBSECTORS ANALYSIS Additional Financing of Fourth Health Sector Development Project (RRP MON 41243) DRUG SAFETY AND HUMAN RESOURCES SUBSECTORS ANALYSIS I. Drug Safety Subsector A. Drug Safety Issues 1. Lack of coordination.

More information

Oklahoma State Regents for Higher Education NEW PROGRAM REQUEST FORM FOR TRADITIONAL AND ONLINE PROGRAMS

Oklahoma State Regents for Higher Education NEW PROGRAM REQUEST FORM FOR TRADITIONAL AND ONLINE PROGRAMS Oklahoma State Regents for Higher Education NEW PROGRAM REQUEST FORM FOR TRADITIONAL AND ONLINE PROGRAMS Page 1 of 11 Institution Submitting Proposal Formal Degree (Level I) (e.g. Bachelor of Science,

More information

Guidelines for Departmental Faculty Compensation Plans. University of Massachusetts Medical School & UMass Memorial Healthcare, Inc.

Guidelines for Departmental Faculty Compensation Plans. University of Massachusetts Medical School & UMass Memorial Healthcare, Inc. Guidelines for Departmental Faculty Compensation Plans University of Massachusetts Medical School & UMass Memorial Healthcare, Inc. September 12, 2008 1 I. INTRODUCTION The University of Massachusetts

More information

Section 3 Module 5 Human Resources for Health. Module 5

Section 3 Module 5 Human Resources for Health. Module 5 Section 3 Module 5 Human Resources for Health 207 Module 5 Human Resources for Health This module presents a framework for human resources for health and outlines specific indicators to measure to understand

More information

Institution Submitting Proposal. Degree Designation as on Diploma (Level II) in

Institution Submitting Proposal. Degree Designation as on Diploma (Level II) in Oklahoma State Regents for Higher Education NEW PROGRAM REQUEST FORM FOR TRADITIONAL AND ONLINE PROGRAMS (Created for Consideration of Programs Outside Institutional Function) Revised June 2015 Institution

More information

NURSING SCHOOL GRANT PROGRAM FISCAL YEAR 2009 AWARD ALLOCATION

NURSING SCHOOL GRANT PROGRAM FISCAL YEAR 2009 AWARD ALLOCATION Item #15 January 27, 2009 NURSING SCHOOL GRANT PROGRAM FISCAL YEAR 2009 AWARD ALLOCATION Submitted for: Action. Summary: This item presents recommended grant awards under the Nursing School Grant Program.

More information

Nursing Workforce. Primary Care Workforce

Nursing Workforce. Primary Care Workforce Key Provisions Related to Nursing: The Patient Protection and Affordable Care Act (Public Law 111-148) clearly represents a movement toward much-needed, comprehensive and meaningful reform for our nation

More information

GENERAL INSTRUCTIONS FOR COMPLETING THE DATABASE

GENERAL INSTRUCTIONS FOR COMPLETING THE DATABASE GENERAL INSTRUCTIONS FOR COMPLETING THE DATABASE Each of the standards in this section is followed by relevant questions. In some cases, two closely related standards are placed together, followed by a

More information

Quality Home Care Workforce Pilot Program (Phase I): Program Guidelines

Quality Home Care Workforce Pilot Program (Phase I): Program Guidelines Quality Home Care Workforce Pilot Program (Phase I): Program Guidelines Program: Quality Home Care Workforce Pilot Program (Phase I) Contact: Hannah Weinstock, Director of External Relations and Communications,

More information

UNITED STATES DEPARTMENT OF EDUCATION OFFICE OF INSPECTOR GENERAL BACKGROUND

UNITED STATES DEPARTMENT OF EDUCATION OFFICE OF INSPECTOR GENERAL BACKGROUND UNITED STATES DEPARTMENT OF EDUCATION OFFICE OF INSPECTOR GENERAL July 23, 2013 AUDIT SERVICES Control Number ED-OIG/A09L0001 James W. Runcie Chief Operating Officer Federal Student Aid U.S. Department

More information

Doctor of Nursing Practice (DNP)

Doctor of Nursing Practice (DNP) REQUEST FOR NEW PROGRAM APPROVAL Catalog Copy for New Program Doctor of Nursing Practice (DNP) The doctor of nursing practice (DNP) degree prepares nurses with a blend of clinical, organizational, economic,

More information

REGIONAL GUIDELINES FOR ASSESSMENT AND RECOGNITION OF MEDICAL SCHOOLS

REGIONAL GUIDELINES FOR ASSESSMENT AND RECOGNITION OF MEDICAL SCHOOLS REGIONAL GUIDELINES FOR ASSESSMENT AND RECOGNITION OF MEDICAL SCHOOLS INTRODUCTION: The guidelines were developed by Medical Regulatory Boards and Councils following a directive by the 3 rd EAC Sectoral

More information

Assessment Plan Undergraduate Major in Accounting J. M. Tull School of Accounting Terry College of Business

Assessment Plan Undergraduate Major in Accounting J. M. Tull School of Accounting Terry College of Business Assessment Plan Undergraduate Major in Accounting J. M. Tull School of Accounting Terry College of Business The major: Accounting majors prepare for careers in business and accounting and increasingly

More information

Measurement of Economic Costs in School Programs for Children and Youth Introduction Opportunity Cost and Resource Use

Measurement of Economic Costs in School Programs for Children and Youth Introduction Opportunity Cost and Resource Use Measurement of Economic Costs in School Programs for Children and Youth Eric Slade, Ph.D. Center for School Mental Health Analysis and Action Division of Child and Adolescent Psychiatry University of Maryland

More information

Preparation of the Education Sector Development Program in Ethiopia

Preparation of the Education Sector Development Program in Ethiopia Preparation of the Education Sector Development Program in Ethiopia Preparation of the Education Sector Development Program in Ethiopia John Martin Riitta Oksanen Tuomas Takala The views and opinions expressed

More information

Priority Areas in Human Resources for Health Research in Sudan

Priority Areas in Human Resources for Health Research in Sudan Priority Areas in Human Resources for Health Research in Sudan Dr. Amel Abdu Abdalla Research and Publications Department-NHRHO October-2009 Page 1 Table of Contents: Item Page Executive Summary 3 Introduction:

More information

North Dakota State University College of Pharmacy, Nursing, and Allied Sciences Strategic Plan 2013 2016

North Dakota State University College of Pharmacy, Nursing, and Allied Sciences Strategic Plan 2013 2016 North Dakota State University College of Pharmacy, Nursing, and Allied Sciences Strategic Plan 2013 2016 CRITICAL ISSUE I Secure sufficient financial, physical and human resources to maintain high quality

More information

TEACHER PREPARATION PROGRAMS

TEACHER PREPARATION PROGRAMS July 2015 United States Government Accountability Office Report to the Ranking Member, Subcommittee on Health, Employment, Labor, and Pensions, Committee on Education and the Workforce, House of Representatives

More information

I-TECH Ethiopia Clinical Mentoring Program: Field-Based Team Model

I-TECH Ethiopia Clinical Mentoring Program: Field-Based Team Model a I - T E C H P R O J E C T P R O F I L E I-TECH Ethiopia Clinical Mentoring Program: Field-Based Team Model Background In 2003, the Centers for Disease Control s Ethiopia Global AIDS Program (CDC GAP)

More information

MCPS Graduates Earning College Degrees in STEM-Related Fields

MCPS Graduates Earning College Degrees in STEM-Related Fields Graduates Earning College Degrees in -Related Fields September 2012 Natalie Wolanin & Julie Wade OFFICE OF SHARED ACCOUNTABILITY Adrian B. Talley, Associate Superintendent 850 Hungerford Drive Rockville,

More information

HEALTH PROFESSIONAL WORKFORCE (SECTION-BY-SECTION ANALYSIS)

HEALTH PROFESSIONAL WORKFORCE (SECTION-BY-SECTION ANALYSIS) HEALTH PROFESSIONAL WORKFORCE (SECTION-BY-SECTION ANALYSIS) (Information compiled from the Democratic Policy Committee (DPC) Report on The Patient Protection and Affordable Care Act and the Health Care

More information

Please complete this brief proposal and submit an electronic copy to Claire Rammel@oakland.edu

Please complete this brief proposal and submit an electronic copy to Claire Rammel@oakland.edu OAKLAND UNIVERSITY GRADUATE COUNCIL Graduate Education 520 O Dowd Hall Proposal for a New and Modified Graduate Certificate Program Approved Graduate Certificate programs are planned programs limited to

More information

CNL Academic Policies and Procedures 2015-2016

CNL Academic Policies and Procedures 2015-2016 CNL Academic Policies and Procedures 2015-2016 CNL Academic Policies and Procedures rev. 2015 Page 1 Table of Contents Degree Requirements... 3 Plan of Study... 4 PART I. REGISTERED NURSE ENTRY... 4 PART

More information

Standards for the Academic Accreditation of Professional Athletic Training Programs

Standards for the Academic Accreditation of Professional Athletic Training Programs Standards for the Academic Accreditation of Professional Athletic Training Programs Commission on Accreditation of Athletic Training Education, July 1, 2012 Standards for the Academic Accreditation of

More information

Applicants are expected to thoroughly review the Funding Opportunity Announcement (FOA) HRSA-15-042 in its entirety.

Applicants are expected to thoroughly review the Funding Opportunity Announcement (FOA) HRSA-15-042 in its entirety. Applicants are expected to thoroughly review the Funding Opportunity Announcement (FOA) HRSA-15-042 in its entirety. CLARIFICATIONS TO FOA: Please note the following clarifications in the FOA Structured

More information

Academic Consulting Group. Get the Grant: Writing a Powerful and Persuasive Grant Proposal EXAMPLES OF GRANT COMPONENTS

Academic Consulting Group. Get the Grant: Writing a Powerful and Persuasive Grant Proposal EXAMPLES OF GRANT COMPONENTS Academic Consulting Group Get the Grant: Writing a Powerful and Persuasive Grant Proposal Objectives of Presentation: Susan Sportsman, RN, PhD, ANEF, FAAN 1. Evaluate the effectiveness of a basic logic

More information

September 2005 Report No. 06-009

September 2005 Report No. 06-009 An Audit Report on The Health and Human Services Commission s Consolidation of Administrative Support Functions Report No. 06-009 John Keel, CPA State Auditor An Audit Report on The Health and Human Services

More information

http://www.bls.gov/oco/ocos014.htm Medical and Health Services Managers

http://www.bls.gov/oco/ocos014.htm Medical and Health Services Managers http://www.bls.gov/oco/ocos014.htm Medical and Health Services Managers * Nature of the Work * Training, Other Qualifications, and Advancement * Employment * Job Outlook * Projections Data * Earnings *

More information

BACHELOR OF APPLIED SCIENCE with a major in Health Science with an Option in Physician Assistant Studies

BACHELOR OF APPLIED SCIENCE with a major in Health Science with an Option in Physician Assistant Studies PROPOSAL BACHELOR OF APPLIED SCIENCE with a major in Health Science with an Option in Physician Assistant Studies Submitted to: The Florida Department of Education by MIAMI DADE COLLEGE School of Health

More information

Using Partial Capitation as an Alternative to Shared Savings to Support Accountable Care Organizations in Medicare

Using Partial Capitation as an Alternative to Shared Savings to Support Accountable Care Organizations in Medicare December 2010 Using Partial Capitation as an Alternative to Shared Savings to Support Accountable Care Organizations in Medicare CONTENTS Background... 2 Problems with the Shared Savings Model... 2 How

More information

College of Nursing Budget System Survey

College of Nursing Budget System Survey College of Nursing Budget System Survey 1. From the perspective of your college, do you feel that the guiding principles of the University budget system have been observed? Explain reasons why or why not?

More information

Preface STANDARDS FOR NURSING EDUCATION. POST-REGISTRATION: Advanced/Specialist Diploma, Degree and Master Degree (Nursing)

Preface STANDARDS FOR NURSING EDUCATION. POST-REGISTRATION: Advanced/Specialist Diploma, Degree and Master Degree (Nursing) Preface The Nurses and Midwives Act (Chapter 209) [May 2000] empowers Singapore Nursing Board (SNB) to make regulations for matters relating to the accreditation of educational programmes in nursing and

More information

Possible Opportunities for Collaboration in Health Care Reform

Possible Opportunities for Collaboration in Health Care Reform MEDICARE EXTENDERS Part B Payments to Indian Hospitals and Clinics. (Sec. 2902) Spends $200 million over 10 years. Section 630 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003

More information

REPORT TO THE BOARD OF GOVERNORS TUITION PROPOSAL FOR NEW PROGRAM: DOCTOR OF PHARMACY FLEXIBLE PROGRAM

REPORT TO THE BOARD OF GOVERNORS TUITION PROPOSAL FOR NEW PROGRAM: DOCTOR OF PHARMACY FLEXIBLE PROGRAM Agenda Item #1.11b REPORT TO THE BOARD OF GOVERNORS SUBJECT TUITION PROPOSAL FOR NEW PROGRAM: DOCTOR OF PHARMACY FLEXIBLE PROGRAM MEETING DATE FEBRUARY 12, 2015 Forwarded to the Board of Governors on the

More information

Guidelines on Employment of Graduate Assistants Third Edition. The Graduate School, New Mexico State University Revised August 1, 2008

Guidelines on Employment of Graduate Assistants Third Edition. The Graduate School, New Mexico State University Revised August 1, 2008 Guidelines on Employment of Graduate Assistants Third Edition The Graduate School, New Mexico State University Revised August 1, 2008 Our graduate assistants are engaged in the teaching and research mission

More information

Controlling Our Critical Path: A CDOT Guide to Better Project Management Practices

Controlling Our Critical Path: A CDOT Guide to Better Project Management Practices : A CDOT Guide to Better Project Management Practices Project Management practices have been a part of the CDOT culture for many years. However, with a transitioning workforce and increasing demands, it

More information

Senate Finance Committee. Transforming the Health Care Delivery System: Proposals to Improve Patient Care and Reduce Health Care Costs.

Senate Finance Committee. Transforming the Health Care Delivery System: Proposals to Improve Patient Care and Reduce Health Care Costs. Senate Finance Committee Transforming the Health Care Delivery System: Proposals to Improve Patient Care and Reduce Health Care Costs May 15, 2009 Comments Presented on Behalf of the American Association

More information

HEALTH PROFESSIONAL WORKFORCE

HEALTH PROFESSIONAL WORKFORCE HEALTH PROFESSIONAL WORKFORCE (SECTION-BY-SECTION ANALYSIS) (Information compiled from the Democratic Policy Committee (DPC) Report on The Patient Protection and Affordable Care Act and the Health Care

More information

EDUCATIONAL STANDARDS IN CREDIT COURSES AND PROGRAMS

EDUCATIONAL STANDARDS IN CREDIT COURSES AND PROGRAMS EDUCATIONAL STANDARDS IN CREDIT COURSES AND PROGRAMS POLICY NUMBER ED 8-0 APPROVAL DATE JANUARY 26, 2009 PREVIOUS AMENDMENT NOVEMBER 27, 2006 REVIEW DATE NOVEMBER 2014 AUTHORITY PRIMARY CONTACT SENATE

More information

Complete College America Common College Completion Metrics Technical Guide

Complete College America Common College Completion Metrics Technical Guide Complete College America Common College Completion Metrics Technical Guide April, 2014 All major changes from previous years are highlighted and have a * indicator that can be searched for. April 2, 2014:

More information

POLICY ON TEACHING ASSOCIATES. This policy is intended to provide a guide to appointment, classification, and evaluation of Teaching Associates.

POLICY ON TEACHING ASSOCIATES. This policy is intended to provide a guide to appointment, classification, and evaluation of Teaching Associates. POLICY ON TEACHING ASSOCIATES This policy is intended to provide a guide to appointment, classification, and evaluation of Teaching Associates. I. DEFINITIONS AND RESPONSIBILITIES 1. "Teaching Associate"

More information

GRADUATE FACULTY COUNCIL DOC. NO. 861 APPROVED May 14, 2001

GRADUATE FACULTY COUNCIL DOC. NO. 861 APPROVED May 14, 2001 GRADUATE FACULTY COUNCIL DOC. NO. 861 APPROVED May 14, 2001 RECOMMENDATION OF THE GRADUATE CURRICULUM COMMITTEE AND THE FACULTY OF THE SCHOOL OF NURSING FOR CHANGES IN THE REQUIREMENTS OF THE MASTER OF

More information

Staff Analysis Checklist Request to Offer a New Degree Program. Board of Governors, State University System of Florida

Staff Analysis Checklist Request to Offer a New Degree Program. Board of Governors, State University System of Florida Staff Analysis Checklist Request to Offer a New Degree Program Board of Governors, State University System of Florida University Submitting Proposal Initial Review Date Proposed Implementation Term Last

More information

The Supply and Demand for Registered Nurses and Licensed Practical Nurses in Nebraska

The Supply and Demand for Registered Nurses and Licensed Practical Nurses in Nebraska The Supply and Demand for Registered Nurses and Licensed Practical Nurses in Nebraska February 6, 2006 David I. Rosenbaum, Ph.D. 4103 South Gate Blvd Lincoln NE 68506 402-489-1218 Executive Summary Recent

More information

How To Work For A College Of Technology

How To Work For A College Of Technology Internship Employer Guidelines Pennsylvania College of Technology One College Avenue Williamsport, PA 17701 570-327 4517 An affiliate of The Pennsylvania State University Penn College operates on a nondiscriminatory

More information

MEDICAL BOARD STAFF REPORT

MEDICAL BOARD STAFF REPORT Agenda Item 5 MEDICAL BOARD STAFF REPORT DATE REPORT ISSUED: April 16, 2014 ATTENTION: Medical Board of California SUBJECT: Recognition of International Medical School Medical University of the Americas

More information

Southern University College of Business Strategic Plan

Southern University College of Business Strategic Plan Southern University College of Business Strategic Plan 2012-2017 Baton Rouge, Louisiana February 24, 2012 This document is the draft Strategic Plan of the College of Business for the period 2012 2017.

More information

GUIDANCE FOR COMPLETION OF THE ENHANCED FINANCIAL REPORTING TEMPLATE

GUIDANCE FOR COMPLETION OF THE ENHANCED FINANCIAL REPORTING TEMPLATE GUIDANCE FOR COMPLETION OF THE ENHANCED FINANCIAL REPORTING TEMPLATE Version: November 2007 TABLE OF CONTENTS INTRODUCTION...3 REPORTING ON THE GRANT AS A WHOLE...4 REPORTING PERIODS AND TIMELINES...7

More information

The Ethiopian national ehealth strategy and its alignment with the health informatics curriculum

The Ethiopian national ehealth strategy and its alignment with the health informatics curriculum 9 th Health Informatics in Africa Conference (HELINA 2014) Peer-reviewed and selected under the responsibility of the Scientific Programme Committee The Ethiopian national ehealth strategy and its alignment

More information

The Midwives Council of Hong Kong. Handbook for Accreditation of Midwives Education Programs/ Training Institutes for Midwives Registration

The Midwives Council of Hong Kong. Handbook for Accreditation of Midwives Education Programs/ Training Institutes for Midwives Registration The Midwives Council of Hong Kong Handbook for Accreditation of Midwives Education Programs/ Training Institutes for Midwives Registration January 2012 Revised in November 2013 Contents Page I Preamble

More information

LCME ACCREDITATION GUIDELINES FOR NEW AND DEVELOPING MEDICAL SCHOOLS

LCME ACCREDITATION GUIDELINES FOR NEW AND DEVELOPING MEDICAL SCHOOLS LCME ACCREDITATION GUIDELINES FOR NEW AND DEVELOPING MEDICAL SCHOOLS LIAISON COMMITTEE ON MEDICAL EDUCATION Chicago, Illinois 60611 312-464-4933 Association of American Medical Colleges 655 K Street NW,

More information

CHAPTER 6 STANDARDS FOR NURSING EDUCATION PROGRAMS

CHAPTER 6 STANDARDS FOR NURSING EDUCATION PROGRAMS Section 1. Statement of Purpose. CHAPTER 6 STANDARDS FOR NURSING EDUCATION PROGRAMS (a) To foster the safe and effective practice of nursing by graduates of nursing education programs by setting standards

More information

Appendix K. Nutrition and Dietetics Department Dietetics Student Handbook. Bluffton University Bluffton, Ohio

Appendix K. Nutrition and Dietetics Department Dietetics Student Handbook. Bluffton University Bluffton, Ohio Appendix K Nutrition and Dietetics Department Dietetics Student Handbook Bluffton University Bluffton, Ohio Revised June, 2014 Table of Contents Page Welcome... 3 Program Information Mission Statement...

More information

NURSING COLLEGE OF NURSING AND HEALTH SCIENCES LEADING TO THE DEGREE OF MASTER OF SCIENCE IN NURSING (M.S.N

NURSING COLLEGE OF NURSING AND HEALTH SCIENCES LEADING TO THE DEGREE OF MASTER OF SCIENCE IN NURSING (M.S.N NURSING COLLEGE OF NURSING AND HEALTH SCIENCES LEADING TO THE DEGREE OF MASTER OF SCIENCE IN NURSING (M.S.N.) INTERCOLLEGIATE CONSORTIUM FOR A MASTER OF SCIENCE IN NURSING DESCRIPTION OF THE PROGRAM The

More information

MPH Program Policies and Procedures Manual

MPH Program Policies and Procedures Manual MPH Program Policies and Procedures Manual Curriculum and Advising Academic Advising Academic advisors are appointed by the chairs, in consultation with the MPH Director Curriculum Decisions All changes

More information

CHARTER of ADA University

CHARTER of ADA University CHARTER of ADA University 1. General provisions 1.1. ADA University (hereinafter referred to as University) was established under the decree dated January 13th, 2014 by the President of the Republic of

More information

Requirements for Graduate Students in the Vanderbilt Psychological Sciences Program. April 2015

Requirements for Graduate Students in the Vanderbilt Psychological Sciences Program. April 2015 Requirements for Graduate Students in the Vanderbilt Psychological Sciences Program April 2015 Table of Contents I. Overview... 3 II. Areas of Specialization... 3 III. Accreditation... 3 IV. Training Objectives

More information

GENERAL. Information

GENERAL. Information GENERAL Information MISSION Samuel Merritt University educates students to become highly skilled and compassionate healthcare professionals who positively transform the experience of care in diverse communities.

More information

STATE OF NEVADA Department of Administration Division of Human Resource Management CLASS SPECIFICATION

STATE OF NEVADA Department of Administration Division of Human Resource Management CLASS SPECIFICATION STATE OF NEVADA Department of Administration Division of Human Resource Management CLASS SPECIFICATION TITLE GRADE EEO-4 CODE CHIEF OF NURSING SERVICES 47* A 10.310 DIRECTOR OF NURSING SERVICES II 45*

More information

SCHOOL OF EDUCATION PROPOSAL FOR DIFFERENTIAL TUITION DEPARTMENT OF COUNSELING AND EDUCATIONAL DEVELOPMENT FOR THE MS, EdS AND PHD PROGRAMS

SCHOOL OF EDUCATION PROPOSAL FOR DIFFERENTIAL TUITION DEPARTMENT OF COUNSELING AND EDUCATIONAL DEVELOPMENT FOR THE MS, EdS AND PHD PROGRAMS SCHOOL OF EDUCATION PROPOSAL FOR DIFFERENTIAL TUITION DEPARTMENT OF COUNSELING AND EDUCATIONAL DEVELOPMENT FOR THE MS, EdS AND PHD PROGRAMS The Department of Counseling and Educational Development (CED)

More information

This program is offered entirely ONLINE throughout the United States and in approved international locations.

This program is offered entirely ONLINE throughout the United States and in approved international locations. West Virginia University 1 Special Education Degrees Offered Master of Arts in Special Education Doctor of Education with a major in Special Education MASTER OF ARTS IN SPECIAL EDUCATION OVERVIEW The graduate

More information

RECOMMEND APPROVAL OF BACHELOR OF APPLIED SCIENCE IN DENTAL HYGIENE AT COMMUNITY COLLEGE OF DENVER AND PUEBLO COMMUNITY COLLEGE

RECOMMEND APPROVAL OF BACHELOR OF APPLIED SCIENCE IN DENTAL HYGIENE AT COMMUNITY COLLEGE OF DENVER AND PUEBLO COMMUNITY COLLEGE Page 1 of 15 TOPIC: PREPARED BY: RECOMMEND APPROVAL OF BACHELOR OF APPLIED SCIENCE IN DENTAL HYGIENE AT COMMUNITY COLLEGE OF DENVER AND PUEBLO COMMUNITY COLLEGE DR. IAN MACGILLIVRAY, DIRECTOR OF ACADEMIC

More information

HR 2272 Conference Report STEM Education Provisions Summary

HR 2272 Conference Report STEM Education Provisions Summary HR 2272 Conference Report STEM Education Provisions Summary Title I Office of Science and Technology Policy (OSTP) Directs the President to convene a National Science and Technology Summit not more than

More information

December 2005 Report No. 05-58

December 2005 Report No. 05-58 December 2005 Report No. 05-58 Individuals with Baccalaureate Degrees Have Positive Outcomes; Increasing Production in Critical Areas Poses Challenges at a glance Individuals who received baccalaureate

More information

SCIENCE AND MATHEMATICS SECONDARY EDUCATION IN ETHIOPIA

SCIENCE AND MATHEMATICS SECONDARY EDUCATION IN ETHIOPIA SCIENCE AND MATHEMATICS SECONDARY EDUCATION IN ETHIOPIA An Option paper presented at the Technical Workshop on Science and Mathematics Secondary Education in Africa (SEIA) Follow-up Program. Eshetu Asfaw

More information

Graduate Nurse Education Demonstration Solicitation

Graduate Nurse Education Demonstration Solicitation Graduate Nurse Education Demonstration Solicitation I. Introduction A. Authority The Graduate Nurse Education (GNE) Demonstration is mandated under Section 5509 of the Affordable Care Act (Pub. L. 111-148)

More information

M.S.N. Graduate Program

M.S.N. Graduate Program M.S.N. Graduate Program Graduate Program Mission The Saint Luke s College of Health Sciences is an educational leader serving exceptional students pursuing a graduate nursing degree. An institution of

More information

Rules governing masters studies at the Reykjavík University School of Law

Rules governing masters studies at the Reykjavík University School of Law Rules governing masters studies at the Reykjavík University School of Law Article 1 Masters Degree in Law The Reykjavík University School of Law confers the academic title of Master of Legal Studies (

More information

Cost Guidelines for State Virtual Schools

Cost Guidelines for State Virtual Schools Educational Technology Cooperative Cost Guidelines for State Virtual Schools Development, Implementation and Sustainability August 2006 Southern Regional Education Board 592 10th St. N.W. Atlanta, GA 30318

More information

A. Grade Point Average (GPA): Admission is normally limited to students with undergraduate GPA of 3.2 or above.

A. Grade Point Average (GPA): Admission is normally limited to students with undergraduate GPA of 3.2 or above. GRADUATE PROGRAM IN VETERINARY MEDICAL SCIENCES GRADUATE PROGRAM I. Minimum Requirements for Admission Application for admission to the Graduate School must be made to the Director of Admissions as described

More information

Highlights From the 2012 National Sample Survey of Nurse Practitioners

Highlights From the 2012 National Sample Survey of Nurse Practitioners Highlights From the 2012 National Sample Survey of Nurse Practitioners Health Resources and Services Administration Bureau of Health Professions National Center for Health Workforce Analysis The Health

More information

To help transform our health care system and improve

To help transform our health care system and improve INVITED COMMENTARY The RIBN Initiative: A New Effort to Increase the Number of Baccalaureate Nurses in North Carolina Polly Johnson To meet the increasing demand for a more educated nursing workforce,

More information

MASTER OF SCIENCE IN EDUCATION AND CERTIFICATION OPTIONS

MASTER OF SCIENCE IN EDUCATION AND CERTIFICATION OPTIONS Overview MASTER OF SCIENCE IN EDUCATION (INSTRUCTIONAL LEADERSHIP) AND CERTIFICATION OPTIONS Neumann University s graduate program leading to the Master of Science in Education: Instructional Leadership

More information

Pittsburg State University Distance Education Plan, 2013-15

Pittsburg State University Distance Education Plan, 2013-15 Pittsburg State University Distance Education Plan, 2013-15 Pittsburg State University (PSU) continues to be successful in offering distance-delivered educational programs. Out of the various modes that

More information

Exposing the hidden cost of Payroll and HR Administration A total cost of ownership study

Exposing the hidden cost of Payroll and HR Administration A total cost of ownership study www.pwc.com/ca Exposing the hidden cost of Payroll and HR Administration A total cost of ownership study A PwC/ADP study March 2012 Executive overview Do you know how much your organization is really

More information

I. Introduction and Purpose

I. Introduction and Purpose Kentucky Council on Postsecondary Education and Kentucky Department of Education Dual Credit Policy for Kentucky Public and Participating Postsecondary Institutions and Secondary Schools I. Introduction

More information

Funds that have been obligated by a funding agency for a particular project either as a grant, contract, or cooperative agreement.

Funds that have been obligated by a funding agency for a particular project either as a grant, contract, or cooperative agreement. Academic Year Salary Academic year salaries are based on the individual faculty member's regular compensation for the continuous period which, under CCU's policies, constitutes the basis of his/her salary.

More information