Western Pacific Region Nursing/Midwifery Databank COUNTRY: 1. Historical events in nursing and midwifery 1978 Medical Assistant programme started 1983 Initiation of new curriculum 1991 New hospital built by Japanese government with library 1991 The WHO programme in technology supplied nursing books 1999 Post Basic Training on Public Health and Midwifery [11 months + 3 months internship in obstetric ward and reproductive health unit] 1999 Clinical Nurse Specialist created to cater for all clinical training needs, in-service etc. for curative nurses. 2008 KIR EU Project - Upgrading of Outer-islands infrastructure (Health Centers and Clinics) from local to permanent buildings. Upgrading and Up-skilling of Outer-Island Nursing staffs (Capacity building) Revised Post Basic Midwifery Curriculum (32 wks) and offered a Post Grad Diploma in Midwifery. It is accredited to Fiji School of Medicine Revised Public Health Course Curriculum (5-6months) and offered a Post Grad Certificate in Public Health. It is also accredited to Fiji School of Medicine 2008 Opening of Southern Kiribati Hospital (SKH) and another 23 new nursing post established to man SKH. 2010 New maternity ward constructed in Christmas Is and more midwives needed. 2012 Discussion of expansion of Basic Nursing School (Kiribati School of Nursing) is underway to be funded by AusAID Discussion of expansion of Betio Hospital with building of New Maternity Ward. Date Printed: 29/10/2013
2. Regulations and Laws 2.1 Act or Law Regulation focus For registration of qualified nurses Nurse/Midwife categories Title of Act or Law Year Regulatory authority Qualified Nurses Medical Services Act 1996: Nursing Council 1996 Nursing Council 2.2 Regulatory authority contact Authority Address Phone Fax E-mail address Mamao Robate Nursing Council Chairperson Ministry of Health & Medical Services P.O.Box 268, Bikenibeu, Tarawa, Republic of Kiribati 686 28100 Ext. 207 686 28152 mbrobate@ gmail.com 3. Nursing, Midwifery Associations Name of Association Address Phone Fax E-mail address Kiribati Nurses Association Chairperson [see 4 for full address] 686 28100 686 28152 Last Update: March 2013 Page 2
4. Nurse, Midwife leaders and/or focal points Name and position title Organization and Address Phone Fax E-mail address Mamao Robate Director of Nursing Services Ministry of Health and Medical Services TCH, Naverevere, Tarawa, Kiribati 686 28100 Ext 207 686 28152 mbrobate@ gmail.com Akineti Bauro Ag Deputy Director Nursing Services As above 68628100 ext 208 As above bauroakineti @yahoo.co m 5. Category and functions of nurses, midwives Category Entry requirement Length of training Level/Credential Description Registered Nurses Form 6 & 7 (Science students) Test and interview 3 years Diploma Rotated to outer island clinics and the wards. Midwife Registered Nurse 7-8months (35wks) Postgraduate Certificate No official registration process in country. As above Medical Assistants Nurse 5 years experience in Public Health 1 year training 6month practical Certificate Managers of Health centres in an Island. Last Update: March 2013 Page 3
6. Nursing and Midwifery Education System of Nursing Education Medical Assistant (18 months) Nursing Officer 5 years and up Registered Nurse ( 3 yrs) Form 6 &up Postbasic training in Midwifery Public Health HHeahCritical available The rest overseas overseasreprovided The Kiribati has one school for basic nurse education. The training course is 3 years in length and leads to a Diploma in Nursing. Basic Nurse curriculum revised and upgraded to Diploma in Nursing (New Zealand) by the assistance from WHO TAs from Auckland University since 2010.The annual intake is around 25 30 due to the capacity of the school itself. A Post Basic Course on Public Health (PH) and Midwifery commences at the beginning of 1999 with an intake of 6 Nurses, 2 Medical Assistants (MA) and 4 Nursing Officers. This is now an ongoing course which should cater for all our Registered Nurses including MAs. Currently the duration of the PH training months is 5-6months, Midwifery Course is 7-8months and the Medical Assistant is 12months in the classroom and 6months additional of internship. Midwifery is another additional 3 months internship in obstetric ward and reproductive health unit. This course also focuses on development and management of community health services. The Medical Assistant training programme started in 1978 and extends the role of nurses in dispensaries in outer islands to patient assessment, treatment planning, simple patient care and management and referral is needed (mini doctors in the island). Other nursing post-basic qualifications (e.g. Bachelor Nursing, Masters, Critical care, emergency, ophthalmology, paediatrics, medical and surgical nursing etc) are currently now obtained in Fiji, New Zealand, Australia, Malaysia, Japan and Taiwan. Last Update: March 2013 Page 4
7. Resources available (e.g. standards, practice guidelines, policies, etc.) Subject/Title Year published Description Contact (Name, Address, Telephone No., Fax No., E-mail, etc.) Health Workers Manual for Kiribati Nursing Procedures Manual 1997; updated 2012 Reference and instructional teaching/learning modules suitable to clinical continuing education for nurses and medical assistants. Dr T. Kienene Chief, Preventive Medicine Ministry of Health and Family Planning Bikenibeu, Tarawa, Kiribati Nursing Standards & Competencies 2010 Assisted by AUT consultants Oct 2010 8. Main nursing and midwifery issues/priorities Nursing Issues/priorities Limited resources for teaching new technology and library need updating. High turnover of nursing staff. Limited research material i.e. textbooks reference books and e-library. Need ongoing upgrading of nursing workforce through in country trainings (more nurses are trained if we are assisted from abroad), exchange and attachments. Midwives Issues/priorities High turnover of nurses/midwives. Staff development (upgrading and up-skilling of midwives or refresher trainings for Midwives) - preferable in-country training on new midwifery skills so that more midwives have the skill and knowledge to perform midwifery care. More skilled birth attendants so to contribute to the reduction of Mortality rate (maternal & neonatal) more midwives. Last Update: March 2013 Page 5
9. Important policies or strategies needed Review of Medical Act (Nursing Regulation). Development of Midwifery competencies and registration similar to the Pacific Island RN competencies for Kiribati. Update current practice of midwives through continued professional development initiatives and /or provision of training external to Kiribati. Develop Recognition for Prior Learning (RPL) policy for students entering the Diploma of Nursing. 10. Does your country have a National Health Plan and or Human Resources for Health Strategy? How have Nursing and Midwifery workforce policies been integrated into this plan/s? The country's Human Resources for Health Development Plan is undergoing revision (2013). The plan addresses: o Increasing nurses capacity to help in the reduction of neonate, infant/child and maternal mortality. o Increasing the of trained midwives and nurses to be able to place them at very remote areas (as skilled birth attendants) so to reduce referrals, as well as life saving for a mother and baby for early management. o Ongoing training for midwives. Last Update: March 2013 Page 6