Background

SolidarMed

SolidarMed is an international development organisation, registered as a non-profit in Switzerland.    Our health programmes are developed in close cooperation with local health authorities.  Our funds come largely from the Swiss government, namely the Liechtenstein Development Service and the Hilti Foundation, the two main funders of SolidarMed’s work in Zambia.

Policy

Zambia is committed to strengthening its health workforce by building the capacity of health professional training institutions and scaling up their outputs and quality.[1] The clinical training of nurse and midwifery students is an essential component of health workforce development which has traditionally been led from large academic health facilities, located close to large teaching hospitals. More recently, there has been a shift to support nurse and midwifery training in local, often in rural contexts. In Zambia, the training of nurses is regulated by the Nursing and Midwifery Council of Zambia (NMCZ). NMCZ recognizes clinical training as an important part of clinical governance and a means of maintaining and improving standards of patient care. As an international INGO with an MoU with the Ministry of Health, SolidarMed has a strong mandate to cooperate with the government on nurse education.

The Decentralised Model of Nurse Education

Based on the WHOs’ Global Policy Recommendations (2010) on improving access to health services and attracting health professionals to work in remote and rural locations, SolidarMed has had the support of the Hilti Foundation and the Liechtenstein Development Service to establish the Decentralised Model of nurse Training. Decentralised training in rural areas has a strong workforce imperative since it is based on evidence that training students from and in rural areas increases the likelihood of rural practice and thereby improves health services in those areas where they are most needed.[2]

SolidarMed initially partnered with St. Luke’s College from 2015 to 2018 to run a pilot of this approach. The pilot enabled more nurses and midwives to be trained using both a combined curriculum and a new approach to structured student placements.  Key components of the model are combined teaching for all nurse cadres in Year 1, decentralisation of clinical placements at multiple training sites, structured clinical mentoring of students, clinical rotation between the sites, and blended learning using both classroom and digital techniques. The model has been adopted by the Ministry of Health (MoH) and is currently being scaled[3].

The pilot Phase I also saw SolidarMed supporting infrastructure and equipment improvements through the provision of student hostels, staff houses for clinical instructors and large lecture theatres to improve the teaching facilities in the pilot college. The electrification of hostels using solar panels, library, digital and other learning equipment at St. Luke’s were significantly improved to enable improvements in the standard of teaching.[4] Phase II of the decentralisation initiative ran from 2019 to 2022 and was designed to build on the successes of the decentralised training model and extend it to two additional colleges – St. Pauls and Chilonga.

The New Phase of the Project

Phase III has commenced and runs from 2022-2026 and further extends the model’s reach to seven new colleges in each of the seven remaining provinces (resulting in a total of 10 colleges, one in each province).

Overall, the focus of this project phase is to increase the number and quality of Registered Nurse (RN), Registered Midwife (RM) as well and Public Health Nurse (PHN) graduates for the Zambian healthcare system, in a way that maintains the quality of the education provided but is efficient and sustainable for training institutions as well as maintaining a strong rural focus.

Previous phases did not focus in depth on how teaching and learning content are delivered.  Each college took its own approach.  The COVID-19 pandemic spurred both colleges and SolidarMed, to take a renewed look at how learning systems could be digitally transformed and modernised to be made more efficient.  Phase III has digital learning systems as one of its key interventions.

Consultancy Aims & Objectives

Purpose

A key component of a sustainable, up-to-date, and consistent learning environment is a strong digital teaching and learning ecosystem.  One key barrier from a traditional teaching approach towards digital transformation is the level of digital maturity in the program areas. The purpose of this TOR is to specify how digital learning systems may be strengthened in nursing and midwifery colleges and their key partners while working to increase the overall digital maturity of the learning environment.

With support from the consultant(s), SolidarMed aims to enhance digital transformation and access to quality eTeaching and eLearning platforms.  This intervention will support the sustainable development of the digital ecosystem in support of eLearning and digital content development and delivery.  We recognise that delivering our purpose may bring with it additional needs to upgrade digital maturity more generally.

Aim
To develop a strategy and operational plan to realise enhanced e-learning in nurse/midwife education in Zambia.

Objectives
Objective 1. To analyse and determine the facilitators and barriers to having a standardized and sustainable blended digital learning and teaching system.

• To review the Zambia Digital Health and Education Strategy and how it relates to Nurse/Midwifery education.
• To contribute to the development of a basic ICT needs assessment that assesses, attitudes, and barriers to ICT and digital learning in SolidarMed program areas.
• To deliver a critical understanding of the level of digital maturity in nurse education in Zambia.
• To outline the critical facilitators and barriers to digital transformation in the nurse education space and how SolidarMed can address them.
• To outline the lessons learned from other resource-limited settings in this space.

Objective 2. To co-design an e-learning strategy for preservice nurse education with key partners nationwide to be trialled in SolidarMed’s project partner colleges.

• To develop a stakeholder and mapping analysis in the digital health eLearning space in nurse education.
• To identify and coproduce concepts for a strategy with local and international partners who are closely working in the same space.
• To facilitate a workshop to outline and agree on a comprehensive e-teaching and learning strategy for undergraduate nurse education, along with key partners.
• Define and propose roles and responsibilities and funding streams for the various actors who add value, including a clearly defined contribution that SolidarMed will make with its budget.

Objective 3. To design a detailed operational work plan that specifies how SolidarMed will support eLearning development over the next five years in Nurse/Midwifery Colleges in collaboration with partners.

[The operational work plan should be guided by the strategy and may/or may not include the following:

• Proposals for a modus operandi for SolidarMed to deliver its input, which may include the procurement of hardware, software, cloud-based solutions, training, etc, but also staffing roles, instructional design functions, etc (if required) to ensure effective implementation of the new approach.
• Recommendations for staffing to support the delivery of the SolidarMed intervention.
• A capacity-building plan for colleges and NMCZ to maintain a learner management system and the necessary support infrastructure to provide sustainable IT support in support of digital learning.

Consultancy Process

Methodology

The consultant will propose a suitable approach to delivering the required objectives and outputs.  That approach may include a limited literature and policy review, as well as an analysis of our baseline survey data from the colleges that we have generated.  They may also carry out their focused data collection exercise with key stakeholders. They may then go on to propose strategic concepts to deliver effective eLearning and eTeaching with partners for development and clarification, resulting in an agreed, practical and fundable eLearning strategy.

The next stage will be an approach to taking the strategy into concrete actions for each party, especially SolidarMed, bearing in mind its budget.

Project documentation, including national strategy and reports, will be availed to the consultant.

Duration of the Assignment

The consultancy is from January 2024- March 2024 and the consultant(s) should be available for a briefing on December 4th. During the consultancy, strict adherence to the timeframe is required. The consultant(s) will coordinate with SolidarMed throughout the consultancy process until the deliverables are met.

1.     Scope of work

The consultant(s) will work closely with SolidarMed to complete a:

• Consultancy that covers pre-service Nurse/Midwifery Training across the Registered Nurse, Registered Midwife and Public Health Nurse disciplines and does not cover post-graduate degrees or in-service training.
• The strategy and operational plan need to be realistic and sustainable within the scope of SolidarMed and the context of pre-service Nurse/Midwifery Training in Zambia.
• While this consultancy can identify and reference other actors in this space and broader needs, that is not the primary focus of this assignment.

2.   Key Output(s)

Outputs and Expected Deliverables
Expected Timelines

Consultancy Execution Plan
12th of January 2024

Inception report and agreed methodology
19th of January 2024

Contextual Review and Analysis and report of key findings
31st of January 2024

Stakeholder Engagement Workshop with preparatory material shared in advance
16th February 2024

Nurse education eLearning Strategy drafted and shared
29th of February 2024

The round of consultation following the Digital Transformation and eLearning Strategy when finalised
7th March 2024

Operational plan for eLearning strategy implementation drafted, shared, and developed with SolidarMed
14th March 2024

Consultation on Operation Plan
15th of March

eLearning Operational Plan finalised and signed off
25th of March 2024

Final Submissions
29th of March 2024

Close-out
3rd of April 2024

3.    Work Location

During the period of engagement, the consultant will be required to travel to interview relevant stakeholders and collaborate with SolidarMed’s Program Manager and Systems Strengthening Manager, both based in Lusaka.

4.   Reporting Lines

The consultant(s) will report to the Program Manager, Nursing, SolidarMed.

Based on the deliverables and consultancy outputs and timeframes, SolidarMed will prepare a management letter responding to the deliverables agreeing on follow-up action to be taken to ensure best practices and the lessons are learned.

5.    Qualifications and experience

The consultancy will require the following qualifications, experience and competencies:

• PhD/Master’s degree in ICT/ Software development/ Digital education/transformation
• Demonstratable experience in digital transformation, design and implementation of digital learning systems
• Experience setting up ICT infrastructure, student management and learning systems.
• Proven record of having participated in digital transformation within training institutions
• Knowledge and experience working in digital transformation in Zambia.
• Experience working in consultation with stakeholders in the health sector

The consultant should possess the following attributes:

• Evidence of excellent business report writing in English
• Demonstrate innovative thinking
• Ability to provide strong and well-informed technical advice
• Work independently within strict timelines
• Adaptive management skills
• Possess interpersonal, teamwork and communication skills to support multi-level stakeholder engagement

Submission of application

Proposals, CV’s including evidence of delivery on similar projects should be delivered no later than 12:00hrs on the 30th of December by 17.00hours (CAT/Zambian time).

Eligible consultants/firms should submit their CVs with a cover letter detailing the methodology and a daily rate (inclusive of tax, per diems, travel and other incidental costs) electronically to zambia@solidarmed.ch.