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The development of critical care nursing education in Zambia

14 May 2020
Volume 29 · Issue 9



Critical care services reflect the healthcare services they support. In many low-to-middle-income countries (LMICs), balancing a sparse workforce, resources and competing demands to fund services, is a significant challenge when providing critical care. In Zambia, critical care has evolved significantly over the past 10 years. This article explores the provision of critical care services and the review and validation of a critical care nursing course.


To review the literature relating to critical care nursing in sub-Saharan Africa to support a review and validation of the current critical care nursing course and to prepare a framework for a Bachelor of Science (BSc) in critical care nursing programme in Zambia.


A search of the published literature identified key themes, including a paucity of evidence, limited educational opportunities, a lack of national and international opportunities, protocols and standards, and the challenges of providing technical services. The subsequent review and validation took account of these themes.


This project has had an impact on improving critical care nurses' knowledge and skills and provided the foundations for the BSc in critical care nursing.

Critical care services are key components of modern healthcare delivery, with qualified and specialist nurses described as the core of service provision (Marshall et al, 2017). Globally, there is known to be a shortage of qualified nurses, and Zambia is recognised as having what the World Health Organization (WHO) classifies as a severe shortage (WHO, 2020). In addition, in Zambia, specialist fields of nursing practice such as critical care are relatively new (WHO, 2020), and across the country there are fewer than 200 trained critical care nurses (Ministry of Health (MoH), 2017). Zambia continues to face a high burden of disease, despite making progress in many of the internationally recognised indicators for HIV, malaria, under-five child mortality and maternal mortality ratio (MoH, 2017). In consequence, the achievement of targets set by the United Nations (UN) Sustainable Development Goals (SDGs) (2015) and the MoH, as well as the move to universal access to healthcare, will be delayed. As critical care is one of the few specialties that bridges both communicable and non-communicable diseases, it is essential that critical care services be prioritised when considering the allocation of resources.

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