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The Power of Partnership—And Relentless Nursing Students

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J. Michael Moore
Dir. of Communications
How two students from the Emory-Addis Ababa PhD in Nursing Program are helping to forge a pathway for national healthcare reforms in Ethiopia.

Even before COVID-19, Ethiopia was in the midst of a historic health system transformation; and two students from the Emory-Addis Ababa University (AAU) PhD in Nursing Program have been helping to lead reforms. In March 2020, Lemlem Demisse, RN, MSc and Tefera Mulugeta, RN, MN—both AAU-Emory PhD in Nursing candidates and faculty at AAU College of Health Science School of Nursing and Midwifery—helped to execute a pivotal, trans-national meeting involving Kenyan and Ethiopian healthcare authorities. The group’s objective: leverage the collective knowledge of South-to-South partnership to develop successful healthcare provider regulations in Ethiopia.

With the assistance, knowledge, and experience of Agnes Waudo, former Chief Nursing Officer in Kenya and Country Director of the Emory University Kenya Health Information Systems Project (KHISP), and Edna Tallam, Registrar/CEO of the Nursing Council of Kenya, Ethiopian nurses are working to:

  • Develop a National Nursing Council that regulates practice and nursing scope
  • Advocate for a legal scope of practice for nurses and other healthcare professions
  • Institute nursing licensure and a national regulatory board
  • Create standards and processes for nursing licensure
  • Transition medical records systems from paper to electronic documentation (among other reforms) 

Lemlem Demisse, Mr. Tefera Mulugeta (AAU-Emory), and colleagues aim to draw upon the rich experience of Kenyan nurse leaders—who have already navigated the complexities of national professional reforms—to blaze a similar pathway forward for Ethiopia. As members of the inaugural cohort of the AAU-Emory PhD in Nursing Program, the first nursing PhD program in Ethiopia and the first hybrid in-person/remote program in Africa, Lemlem and Mr. Tefera seek to elevate the profession they soon will enter as academic nurse scientists. They envision a system in which nurses may practice safely, with the respect, collaboration, and teamwork of professional colleagues. In order for this vision to become a reality, professional regulations are essential at the national level.

“There is no such kind of nursing empowerment or independence here [in Ethiopia],” explains Ms. Lemlem. “This starts with there being no clear-cut scope of practice. I can practice anywhere without licensure, or people asking me whether I am qualified. We need structure; the Kenya partnership is a very nice opportunity for us—if we create this regulatory body, people will care about nurses, and nurses will be able to develop their careers.”

The March meeting was a particularly momentous benchmarking event: This meeting, which took place in Kenya, represented more than a year of planning and negotiation, convened many stakeholders, and established objectives for the myriad policy, legal, and healthcare changes to come. Among the parties in attendance were delegates from:

  • The Nursing Council of Kenya
  • Emory University-Kenya Health Information System Project
  • National Nurses’ Association of Kenya
  • Ethiopian Nurses’ Association
  • The Vice Chair of Ethiopian Professional Society
  • The Ethiopian and Kenyan Federal Ministries of Health
  • AAU-Emory PhD in Nursing Program 

As Ms. Lemlem and Mr. Tefera, along with Agnes Waudo and Edna Tallam, helped to liaise among these parties, they received mentorship and support from Martha Rogers, MD, Professor and Director of the Lillian Carter Center for Global Health and Social Responsibility. Dr. Rogers played a key role in this undertaking, having worked for years in Kenya to help develop the Kenyan Nursing Workforce database system.

Abebe Gebremariam, MD, In-Country Director of the Emory-Ethiopia Field Office, Linda McCauley, RN, PhD, Dean and Professor, Emory School of Nursing, and Rebecca Gary, RN, PhD, Director of the Emory-AAU PhD in Nursing Program were also instrumental in the execution of this meeting. Emory School of Nursing and the Emory Global Health Institute provided the funding and logistics for the Ethiopian delegates’ travel and supported the meetings in Nairobi.

The March meeting was held in person, as COVID-19 had not yet reached Kenya and Ethiopia at that point. The collaboration will involve a reverse consultation by Ms. Waudo and Ms. Tallam to Addis Ababa to finalize the group’s recommendations for a “road map” to establishing a nursing regulatory council; this meeting will occur when COVID-19 travel restrictions are lifted.

The Ethiopia team would like to acknowledge the warm welcome reception from the Ministry of Health’s Director General, Dr. Patrick Amoth, and Director of Nursing Services, Dr. Mary Nandili, and the acceptance of their collaboration with Kenya on the establishment of regulatory bodies for health professionals in Ethiopia. Special appreciation to the Registrar/CEO, Nursing Council of Kenya and National Nurses Association of Kenya for hosting the visiting team.

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