This chapter reports on a project in Kenya that explored the feasibility of using interactive simulations delivered by portable DVD players as a technology-based learning solution for providing continuing education to nurses by taking the instruction directly to the workplace of the nurses rather than by removing them from their villages and clinics to transport them to the capital city for training. Technology-based learning using simulations holds great promise as an alternative or supplement to traditional classroom-based training in low-resource settings. This study demonstrates that technology has the potential to deliver learner-centered interactive video simulations that provide consistent content and uniform learning experiences that produced significant learning gains in complex content and had high acceptance from participants.
TopSetting The Stage
The health care status of people in Africa continues to lag behind the health care status of people living in other areas. Undoubtedly there are many factors that contribute to this including child nutrition problems, poverty, the low quality of many health care facilities and services, an inadequate number of health care workers, and several diseases that take a substantial toll including HIV/AIDS, acute respiratory infections, diarrhea, and malaria. In this regard, Kenya suffers as other nations in the region. While Kenya had been successful in achieving health gains during the 1980s and 1990s, this trend has reversed because of these problems and the rapid population growth Kenya experienced. Kenya has been losing skilled health care workers to other countries in recent years that offer better financial packages and to the private sector. The public sector doctor to population ratio in 2004 was 3:100,000; the nurse to population ration was 49:100,000 (Chankova, et al., 2006). These numbers fall short of what is desirable for providing adequate health care.
Like many countries, both developing and developed, Kenya has an imbalance in geographic location of health care workers. This is typical in sub-Saharan Africa where skilled health care workers are predominately located in urban areas. Within Kenya, 42 percent of the doctors and 30 percent of the nurses are located in Nairobi and the Rift Valley provinces alone while more rural areas have considerably fewer doctors and nurses (Chankova, et al., 2006). Throughout the country, over half of all health personnel are urban based with four-fifths of the doctors being in urban areas. This imbalance in health care workers serves to exacerbate the shortage in health care workers that Kenya and many other nations face.