A framework for implementing and sustaining a curricular innovation in a midwifery programme in Lesotho

[摘要] Background: In 2010, the government of Lesotho promulgated the adoption of competency-based education for all nursing and midwifery programmes. A competency-based curriculum underpinned by a constructivist philosophy was developed for the one-year post-basic midwifery programme, and implemented for the first time in 2014. Disparities in the enactment of the curriculum, including challengesassociated with the implementation of the new curriculum, were observed after two years of continuous implementation. Such disparities and challenges threatened the sustainability of the entire midwifery programme in Lesotho. Purpose: This study sought to develop a framework to implement and sustain thecurricular innovation in the midwifery programme in Lesotho. Methods: Multiple methods research informed by the theory-of-change logic model guided the development of the framework through a multi-phased approach. The initial phase synthesised literature on strategies to sustain curricular innovations in higher education through an integrative review. The second phase of the research described the implementation of the new curriculum through engaging with primary stakeholders from all nursing education institutions in Lesotho. In the final phase, findings of the preceding phases were used to develop the framework, which was validated by primary implementers of the new curriculum. Results: The outcome of this research provided a framework for implementing and sustaining a curricular innovation in a midwifery programme in Lesotho. Conclusion: Lesotho battles with perennially high maternal and neonatal mortality indicators, partly associated with the training of midwives. Competency-basededucation promises to improve the quality of midwives graduating from nursing education institutions. The promise of competency-based education may not be realised in Lesotho, as challenges during the implementation of the new curriculum are evident and threaten the sustainability of the entire programme. We propose a framework, based on the contextual realities in Lesotho that could support the implementation and sustainability of the new curriculum in midwifery, further sustaining the entire programme.

[发布机构] University of the Free State