国際医療協力研究委託費 17(公)6
アフガニスタンの看護学部カリキュラム
協働開発
Collaborative Development of Baccalaureate
Program in Afghanistan
田代 順子
(Junko Tashiro, RN, PhD)
協働研究者:
Shamsurahim Rahim, Sherin Aqua Zarif
(Kabul Medical University)
松谷美和子、長松康子、山崎好美、梅田麻希、林亜希子
(WHO 看護開発協力センター聖路加看護大学)
武田優子、大西弘高
(東京大学国際医学教育研究センター)
水嶋春朔
(国立保健医療科学院)
第6回医学教育国際協力研究フォーラム
12月14日2007年
話題(Topics)
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アフガニスタンの看護学部カリキュラム
協働的開発の背景と経緯
(Background of this project)
カブール医科大学看護学部のカリキュラム
開発過程
(Progress of this project)
カブール医科大学看護学部プロジェクトの
今後の課題
(Future direction of this project)
アフガニスタンの看護学部カリキュラム
協働的開発の背景と経緯
(Background of Collaborative Nursing Education Project for
Afghanistan)
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July, 2002:
“Comprehensive Needs Assessment in Education (CAN)”
ODA (Japan International Cooperation Agency) started to plan.
January, 2005:
The first trainees from Kabul Medical University (KMU)
hosted by Japanese International Cooperation Agency (JICA), designated
by International Research for Medical Education (IRME), Tokyo
University.
March, 2005:
JICA started “Medical Education Project”
August, 2005:
Collaborative Inter-disciplinary Study Team consists of IRME and WHO
C.C. at SLCN for Nursing Education started
October, 2006
Started to work with faculty members of Faculty of Nursing of Kabul
Medial University
実践研究の枠組み
Conceptual Framework
Structure (構造)
People's Health Status
Life Expectancy
Major Causes of Death
Infant Mortality
Maternal Mortality
Health Care Providers
Human Resources
Health Care System
Health policy
Regulations
Financial condition
Human resource
development
Process(過程)
People’s
Self-care
Health Care Providers
Quality of health care
services
Workload
Health Care system
Accessible health care
facilities
Financial support and
Health professional and
workers education
Development of
Educational Program
for Human Resource
for Health
Outcome(成果)
People’s Health Status
People’s accessibility of care
People’s satisfaction
Financial burden
Health Care Providers
Satisfaction
Health Care System
Cost-effectiveness
目的と2005-2006年の目標
(Main goal and Studies in 2005&2006)
The main goal of educational development in
Afghanistan is strengthen nursing and
consequently promote the health of the people
by focusing on women and children
Goals of 2005
To determine Afghanistan’s critical health needs that
would guide the development of their baccalaureate
nursing program
Goals of 2006
To develop educational program of Faculty of Nursing,
Kabul Medical University
2005年度の研究成果
(既存データ分析)
Findings of Study in 2005
Health Indicators of the Afghanistan
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Life Expectancy at Birth: 42 years old (WHO, 2004)
Under age 5 yrs. mortality rate: 258/1000
Infant Mortality: 144/1000 lb (Ministry of Health Afghanistan,
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2002)
Maternal Mortality: 160/100,000birth
Population Growth: 2.67% (2006 est.)
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Sex ratio at birth: 1.05 male/female
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Human Resource in Health (WHO, 2001)
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Number of
Physician:
Nurses:
Dentist:
Pharmacist
4,104
4,752
630
525
( Density per 1000 people)
( 0.19/1000 )
( 0.22/1000)
( 0.03/1000)
( 0.02/1000)
政府保健行政官・指導者ニーズ調査結果:
A: ヘルスケアニーズ
Findings (A) :Health care needs
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(A-a) Destroyed health care system and
institutions
(A-b) High maternal mortality
(A-c) High infant mortality
(A-d) High blood pressure and other chronic
diseases
(A-e) Infectious disease: Measles, HIV/AIDS
(A-f) Psychiatric illness such as post traumatic
stress disorder (PTSD) and depression.
政府保健行政官・指導者ニーズ調査結果:
B: 保健人材育成ニーズ
Findings (B) : Human resource development needs
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(B-a) unbalanced distribution of health worker
or personnel between urban and rural areas;
(B-b) reduced numbers of female human
resource in health because of the cultural and
regional value;
(B-c) less management of human resource
development due to heavily relied on nongovernmental agencies.
2005年度の研究方針:
Future Directions of Collaborative Study Team for
Development of Nursing Education in 2005
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To form international inter-disciplinal study team between
Afghanistan and Japan
To develop a nursing program that prepares nurse leaders
who can manage and develop nursing and health activities
within the health system consisted of tertiary, secondary,
and primary
This collaborative work developing a nursing educational
program, it should be based on the cultural values such as
gender-role in Afghanistan, and community health.
Shamsurahim Rahim
Dean of Nursing faculty
October 14, 2006
学部案内内容
(Contents)
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I. History of Kabul Medical University
II. Organization and Administration
III. Health system in Afghanistan
IV. Philosophy of education
V. Goals of Nursing education
VI. Concept of Nursing
VII. Components of Baccalaureate
Curriculum of Year of Study
XIII. Subjects and Credit
カブール医科大学の歴史
I. History of Kabul Medical University
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In1933,The nucleus
of higher education
established as a
Medical Faculty by
the supervision of
Turkish professor
Refqi big with 8
lecturers.
In 1985, the mentioned Medical faculty
progressed to Medical institute and to
Medical University in 2003 .
アフガニスタン看護教育の歴史
History of Nursing Education
•the Ministry of Public Health.
In 1940, the Medical Faculty established
the Primary Nursing School
In 1962, the Secondary Nursing School
established, with the cooperation of
German government
• In 1976, the Primary Nursing School of
Medical Faculty joined to this Secondary
Nursing School, and after that has promoted
to Health and Science Institution.
• In May, 2006, Kabul Medical University
established the Faculty of Nursing which is
the first faculty of nursing in Afghanistan.
•II. 組織と管理体制:Organization and Administration
Chancellor
Executive Board
of
the University
Vice CH. in
scientific
affairs
EDC
Research
Center
Vice CH.in
education
affairs
Publication
Academic Council
Vice CH in
Administrative
affairs
University Hospitals
G.Director
Finance
Library
Audiovisual
Curriculum
committee
Evaluation
committee
Account
Human
resource
Postgraduate
committee
PBL
committee
Curative faculty
11 Dept.
Pediatric faculty
11 Dept
Dentistry Faculty
(Stomatology)
Nursing Faculty
Fundamental
Public Health
4
Dept
Clinical Nursing
10 Dept.
Research &
Education
プライマリーヘルスケア
Basic package of health services
(primary care system)
Components:
1-Maternal and newborn health .
2-Child health and immunization .
3-public nutrition .
4-Disability.
5-Communicable diseases.
6-Mental health(community
management).
保健サービス
(Basic Package of Health Services)
-Community health workers
-limited curative care
-out patient.
-Same services as a HP
-But more complex out patient
care
-Will be staffed by a nurse , mid
wife and vaccinators.
- Covers area of 30000
to60000people -Offering BHCs,
normal delivery, handling Some
complications, grave care of child
illness, complicated malaria,
physiotherapy.
- Covered 100,000-300,000
population
-30-75 beds, for surgery,
medicine, pediatrics, obst & gyn,
and out patient for mental health
& dental services.
医療サービス
(Essential Package of Hospital Services)
1-District hospital (DH): mentioned before.
2- provincial hospital(PH): 100-200 beds, services
offered by DH , infectious diseases,
rehabilitation, nutrition, physiotherapy services
as well .
3-Regional hospital(RH):200-400beds beside
offered PH, ENT, Urology, Neurosurgery,
Orthopedics, plastic, Cardiovascular and the
other specialties. has training program.
4-University hospital: serve as RH, in addition
practical field of medicine, Pediatrics, Nursing
and Dentistry students and research. is under
the authority of the medical university .
VI.看護教育の理念:
(Philosophy of Nursing Education)
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Education is characterized by training the mind to think,
gaining knowledge through engagement in intellectual
activities, pursuing research and disseminating knowledge
that is useful for all citizens and that also encourages their
continuous intellectual growth.
The education should help individuals to live usefully and
happily, able to solve problems.
Faculty of Nursing, Kabul Medical University will establish a
strong system of education in order to enable our students
to seek the goals including the highest quality of life of the
people and progress of health care in Afghanistan.
V. 看護の理念
(Concept of Nursing)
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A graduate nurse serve all individuals equally
A graduate nurse has sufficient knowledge on how to
practice in health system for both treatments and
prevention of diseases
A graduate nurse gains professional attitude and skills to
help both patients and clients in the community
A graduate nurse associates with health care professionals,
health workers, birth attendants, community volunteers
and leaders
A graduate nurse has sufficient capacity for taking
leadership in nursing practice and administration in health
care services.
看護理念図
(Concept of Nursing)
Community
Hospital
Essential Hospital
Service
Basic Package of
Health Service
Nursing
VI.看護教育の目標
(Objectives of Nursing Education)
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use a framework of assessment, planning,
implementation, and evaluation in
providing nursing care in the (BPHS) and in
the (EPHS)
analyze situations using multiple sources
of data in order to identify problems,
possible courses of sector of their
consequences.
make and defend decision on basis of
evidence and ethical considerations.
communicate about health matters with
members of the community.
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deliver basic preventive and curative care
services for communicable diseases.
use advanced knowledge to provide services
within specialized areas .
teach and work together with families and
community health other workers.
use basic nursing strategies and to promote
health comfort.
conceptualize, and analyze data for purposes
of quality assurance and research.
work collaboratively in the health care system.
VII.学部カリキュラムの概要
(Components of Baccalaureate Curriculum of Year of Study)
Fourth Year
Anesthesia Nursing (18 ); Operating Theater Nursing (18); Critical Care Nursing (18);
Psychiatric Nursing (18)Community Midwifery (18); Public Health Nursing (18)
Nursing Education(3); Nursing Administration(3); Nursing Research(10); Biostatistics (2)
Third Year
Adult Nursing III (4) ; Pediatric NursingⅠ(4); Maternal NursingⅠ(3); Psychiatric Nursing &
Mental HealthⅠ(3); Community Nursing Ⅰ( 4); Adult Nursing Ⅳ (4); Pediatric NursingⅡ
(4);
Maternal Nursing Ⅱ(4); Psychiatric Nursing and Mental Health Ⅱ(3); Community Nursing Ⅱ
(3)
Second Year
Adult Nursing I (3); Adult Nursing II (5); Anatomy and Physiology I (3); Pathology (2);
Pharmacology I (3); Health system (2); Nutrition (2); Anatomy and Physiology II (4);
Physiopathology (3); Pharmacology II (3); Medical ethics (1); Foreign Language III (2)
Law (optional) (1); Foreign Language IV (2)
First Year
Fundamental Nursing I (3); Fundamental Nursing II (5); Chemistry I (3); Biology I, (3)
Chemistry II (Biochemistry) (3); Biology II, (3); Information Technology (Computer) (2)
(optional);
Physical Education (1); Art (3); Islamic Study I (1); Foreign Language I (2); Information
Technology (Computer skill) (2); Psychology (2); Sociology (2); Islamic Study II ( 1);
Foreign Language II (2)
Reference
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WHO The World Health Report 2006
WHO The World Health Report 2005
http://www.cia.gov/cia/pubications/factbook/af.html
WHO (2006) The World Health Report. WHO.
JICA (2005). Report on Preliminary Evaluation of Medical
Education in Afghanistan. JICA.
International Research Center for Medical Education (2005).
Proceedings: The 4th Forum of International Cooperative
Research for Medical Education. IRCME, Tokyo U.
Afghan Ministry of Health (2003). Guidelines for Development of
a Health Worker Certification System. Ministry of Health,
Afghanistan.
Afghan Ministry of Public Health, CDC & UNICEF (2002)
Maternal Mortality in Afghanistan: Magnitude, causes, Risk
Factors and Preventability. Ministry of Health, Afghanistan.
今後の課題
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カリキュラムの概要試案の評価と洗練
科目シラバスの作成のためのファカル
ティ力量開発
更なる教育支援のための協働計画
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