Training the first generation of specialist child health nurses in the Solomon Islands

In a country where one third of the population is 14 years or younger, quality health care for children and adolescents is crucial. This is the case in the Solomon Islands, which this year celebrated the graduation of its first ever cohort of graduate paediatric nurses.

The new Bachelor of Nursing: Child Health (BNCH) is based at the School of Nursing of the Solomon Islands National University (SINU). Now, nurses in the Solomon Islands have access to a course tailored to the child health needs of the country, delivered by local nursing, medical, and paramedical staff.

Mikael Burhin, paediatric nurse and public health researcher, developed the course with the support of Professor Trevor Duke and the RE Ross Trust Regional Child Health Fellowship. Mikael spoke to us about why the course is needed, and what it hopes to achieve.

"Nurses provide more than 90% of the care and management of sick children in the Solomon Islands," he explained, "but up until last year, nurses could only train through a three-year Diploma of Nursing.

"Nurses wanting to specialise in child health had to either relocate to Papua New Guinea for a year or study online using pre-recorded lectures". Expensive travel, accommodation, and university costs meant that only one nurse could be sent for training each year."

"This meant that the island nation suffered from a shortage of properly trained and supported nurses to care for a population of over 200,000 children. In fact, at the time the course was developed there were only 12 graduate trained child health nurses in the country."

"As a country made up of over 900 islands, many nurses work in health centres in remote, rural parts of the country. Because of their isolation, these nurses must make important decisions about whether to treat or refer patients to hospital independently, with limited or no medical support.

Graduates require a high level of diagnostic, clinical problem solving and leadership abilities that the course aims to develop.

"The course seeks to improve the number of skilled nurses through peer-to-peer learning. Graduates learn clinical teaching skills and can support the professional development of other nurses and nurse-aids in their provincial health centres."

"The course teaches nurses a holistic approach to child and adolescent health, integrating many previously stand-alone WHO short-courses, including newborn care, the care of critically ill children, vaccines and nutrition, the care of children with chronic illnesses, adolescent health problems, and teaches the social and environmental aspects of good health", says Prof Trevor Duke. 

To make sure that the course has adequately prepared graduates for the challenges that they face on the ground, Mikael will spend 2018 tracking graduates as they take up their remote child health posts across the country's many islands. He will evaluate how the course has positively influenced their work, their health facilities, and the health of their communities.  

One of the graduates, Angela, believes that the course will not only help her community but the Solomon Islands as a country; "Nurses with a specialisation in Child Health are rare, I think I am the only one in Central Island Province. Think about it, Central Island Province is a big place, but there is only one Child Health nurse! It will be helpful to train many other nurses in Child Health".

Mikael's findings will go on to further improve the course for the next cohort of Solomon Islands' child health nurses.

The development of the Bachelor of Nursing: Child Health was supported by the RE Ross Trust Regional Child Health Fellowship, through the Centre for International Child Health, at the University of Melbourne Department of Paediatrics and the Murdoch Children's Research Institute. Mikael's work was also made possible through the support of Australian Volunteers Program.