Margaret Kariuki is a maternity charge nurse in Hola hospital, Tana River county in north-east Kenya. She lives and works in a rural community, eight hours drive from the capital, serving mainly marginalised communities of pastoralists. Margaret participated in FNF’s first ever leadership programme in Kenya, in partnership with the Nursing Council of Kenya. Hear from Margaret about why she wanted to do the programme and the impact so far.
“I applied for this programme as I wanted to strengthen my leadership skills to drive impactful changes in healthcare, particularly in continuous medical education (CME). I qualified as nurse in 2014 and have worked in Hola hospital since 2017. There are around 50 nurses working in the hospital, most are joint nurse/midwives like myself.
I saw this programme as a way to enhance my ability to engage healthcare professionals, improve knowledge-sharing, and ultimately elevate patient care standards.
My QI project
My Quality Improvement project focused on increasing CME participation among healthcare professionals by implementing targeted engagement strategies and tracking progress through enrolment and satisfaction metrics.
I chose this topic because ongoing professional education is crucial for maintaining high standards of care, yet participation is often inconsistent due to various barriers. I wanted to address these challenges and create a sustainable model for continuous learning. Immense investments go into research and development of guidelines, policies and new drugs, but without continuous professional engagement the impact of new treatment modalities may not be felt.
Click here to read more detail on Margaret’s project.
One of the main barriers to CME participation is time. I therefore tried to engage more people with online training. However, the challenge with that is that many people don’t have the finances to buy the internet data needed to engage. In the end therefore most of the participation remained face to face. Another barrier is that if a course is not CPD accredited then it is harder to justify joining. We are working to change this – to get accredited. Again, this needs funding to take forward.
Impact so far
The programme has given me the skills to lead more effectively, communicate with diverse stakeholders, and implement structured approaches to CME participation. My colleagues have also become more engaged in professional development, leading to improved knowledge retention and better patient outcomes.
One significant impact on patient care was a case of a mother who developed bleeding before delivery and her hemoglobin level was 1.0 g/dl.This mother was brought in a day after we had CME on hemovigllance. It was impressive how the team cared for the mother administered the right blood products that we had just learnt and were able to save the life of the mother. Prior to this CME similar cases would be referred to another facility since there was low confidence in managing such cases. Not only did these interventions save the life of the mother but also saved the family the financial strain that would have been incurred if the mother had been referred to another facility.
The programme also gave me the opportunity to be in touch with other nurses from other parts of the country. Through this we could learn from each other, share information and guide each other.
What next
I hope to expand the impact of my CME initiative by refining engagement strategies, scaling up participation efforts, and possibly integrating technology to improve access. Additionally, I aim to mentor other nurses and healthcare professionals on the importance of leadership in driving educational programs.
Just this past week we have been looking at new ways of engaging the team – through case management in the maternity unit – with 30 of us together This is a more consultative way than many people are used to, with lots of opportunity for real discussion. As a result, we identified some of the root causes of issues related to perinatal deaths, and we are working to address this. I want to do more of this, engage managers more. My long term sustainability plan is to evaluate patient outcomes in relation to the ongoing education sessions.
This journey has reinforced my belief that leadership is about creating opportunities for growth, both for myself and those around me. Through this experience, I’ve learned that small, strategic changes can lead to significant improvements in professional education and patient care.
Hear Margaret talk about her QI project at the programme celebration day.
This project was funded through Global Health Partnership (formerly THET) Global Health Workforce Programme, which is funded by the UK Department of Health and Social Care (DHSC) for the benefit of the UK and partner country health sector.
FNF and the Nursing Council of Kenya (NCK) worked with Ministry of Health in Kenya, the UK-based Kenya Nurses and Midwives Association UK (KENMA-UK) and the Royal Berkshire NHS Foundation Trust to support the leadership development of mid-level nursing and midwifery managers in Kenya. The project aimed to to strengthen leadership performance, retention, and advocacy for better health outcomes across Kenya. Read more about it here.