National Curriculum on Reproductive Health
for Nurses and Midwives
The concept of Reproductive Heath (RH) is a relatively new one. Although the term ‘reproductive health’ has been used by scientists and health practitioners for several years, the concept as it is presently known gained worldwide acceptance following the 1994 International Conference on Population and Development (ICPD) held in Cairo, Egypt. The Programme of Action (PoA) of the ICPD adopted by 178 countries, including Nigeria, has become a globally accepted framework for national actions in the areas of population, development, health and human rights. The paradigm shift that emerged at the ICPD, from the traditional maternal and child health/family planning (MCH/FP) and population control to reproductive health and rights is a highly significant one. The shift represents one of the greatest developments in the health sector in recent times, with the entire life cycle of the human being and coverage of both sexes as the focus in reproductive health. The concept of reproductive health puts people at the center of human development, and aims at meeting the needs of the individual rather than simply focusing on demographic targets.
The Nigerian government is determined to operationalise the reproductive health concept for the betterment of the health and quality of life of its citizenry. In this respect, one area of major concerns is that of making quality reproductive health services accessible to all Nigerians. Thus the development of appropriately knowledgeable and skilled health workers holds a central position. The training activity for which the present curriculum has been designed represents one of the efforts aimed at developing human resources for the provision of quality reproductive health service delivery.
This curriculum has been designed specifically for the in-service training of the nurse/midwife, a professional category that is critical to the delivery of sustainable quality health services particularly at the primary level. It is designed to ensure that practicing nurses/midwives acquire appropriate knowledge and skills in the area of reproductive health at the community and facility levels. The curriculum can also be suitably adapted for pre-service training of nursing personnel and other categories of health workers. The ultimate goal is to ensure that pre-service training curriculum incorporates the content of this curriculum. When backed by the provision of relevant medical equipment and materials, improved service management, appropriate policies and guidelines and improved community participation, the result of the use of this curriculum for training should contribute significantly to the achievement of the goals of ICPD PoA and the national aspiration for improved quality of life.
Overview of Reproductive Health and Reproductive Rights
Provides background information on reproductive health and reproductive rights, their definition, relevance, and components.
Information, Education, and Communication
Focuses on adoption process of RH behaviors, interpersonal communication, counseling techniques, advocacy, community mobilization, health education and appropriate use of IEC support materials.
Quality of Care
Provides facts of what constitute quality of care, strategies for achieving, sustaining, and implementing quality of care
Integrated Management Information System for Reproductive Health
Explains the rational and concept of management information system (MIS), principles of record keeping, analysis of data for decision making, collation of data from VHWs and TBAs and the process of submission of reports to appropriate authorities.
Focuses on prenatal care, normal delivery and postnatal care, care of the newborn and emergency obstetric care
Explains the role of family planning (FP) in achieving the goals of the National Population Policy which includes reduction of maternal mortality and improved quality of life, techniques for advocating for adoption of FP, provision of safe and effective FP services, organization and management of FP clinics and on setting up and conducting outreach activities.
Sexually Transmitted Infection/HIV/AIDS
Covers major types of STI’s, the use of syndromic approach to examine and treat STI’s clients, clinical features of HIV/AIDS, the prevention and management of HIV/AIDS and management of the relatives of affected persons.
Adolescent Reproductive Health
Provides information on the importance of adolescent sexuality, reproductive health, principles of provision of youth-friendly services, equipping young people with life skills, and the provision of counseling and clinical care for young people.
Abortion and Post Abortion Care
Addresses the issues of abortion, and post abortion care
Gender and Male Involvement in RH
Discusses the issue of male involvement in reproductive health and the relevance of gender considerations in the promotion and provision of reproductive health
Harmful Practices against Woman and Children
Provides information on harmful practices in Nigeria, their consequences, management of complications as well as strategies for eliminating the practice
Discusses infertility and sub-fertility, their causes, management and prevention of infertility
Provides information about breast, cervical and prostate cancers including associated factors, screening procedures and management
Menopause and Andropause
Covers the changes associated with menopause and andropause, signs, symptoms and management
The reproductive health challenge in Nigeria is indeed great as shown by indicators such as maternal mortality ratio of about 1,000/100,000 live births (FMOH, 1998), total fertility rate of 5.15 (NDHS, 1999), HIV prevalence rate of 4.5% among ante-natal clinic clients(FMOH, 1998), and a national prevalence rate of female genital mutilation (FGM) of 40.5% among adult woman(UNDS, 1998). Among young people, a high rate of unprotected sexual activity, teenage pregnancy, unsafe abortion and sexually transmitted infections has been recorded. The situation depicted above clearly indicates a need for the provision of quality reproductive health information services, which are comprehensive in scope, and delivered in a user-friendly and integrated manner. To meet these needs, the development of appropriate human resources is critical. Recognizing that reproductive health is a relatively new area, following the recent shift from the MCH/FP concept, existing health workers need to be oriented in its concept and equipment with necessary skills. This situation calls for the development of appropriate curricula on reproductive health for different categories of health workers. Such curricula at the national level are particularly important as they provide countrywide training guides to all stakeholders in the area of human rights development and indirectly set standards of practice in service delivery.
Nurses and midwives hold a special place in provision of reproductive health services in Nigeria, as they constitute a great proportion of skilled health workers available at the primary health care level. Globally, midwives with appropriate service delivery skills have been recognized as the lynchpin of the effort to reduce maternal mortality. In many communities in Nigeria, members of the nursing cadre serve as care givers, counselors, health educators and advocates as well as opinion leaders. The present curriculum, for the training of nurse/midwives, has been developed with these multi-dimensional roles in mind. It aims to equip trainees with knowledge and skills in clinical areas, result-based management (through management information system) as well as inter-personal communication and counseling.