title: Madagascar nursing needs assessment: education and development of the profession.
abstract: OBJECTIVE
  To address how Madagascar is improving nursing education and the profession to strengthen their nursing workforce.
  
  
  BACKGROUND
  The sub-Saharan Africa nursing workforce shortage is more than 600,000. Madagascar measures among affected countries. Nursing in Madagascar with reference to the Malagasy Lutheran Church Health Department (SALFA) is examined in this paper. The Malagasy Lutheran Nursing School (SEFAM) was established in 1956 to prepare nurses and midwives. The school recently relocated to better meet SALFA goals to increase nurses in the system and improve nursing education. A US nursing faculty and the SEFAM director proposed to conduct programme assessment to ensure that nursing and midwifery education meet health, social and community needs in Madagascar. DATA SOURCE/METHODS: An in-depth needs assessment of the school programme, facilities and resources occurred. Site visits and informal interviews were held. Field study visits to nursing schools and health-care facilities in Kenya and Tanzania assisted the authors in learning how nursing developed in those countries. Data analysis included comparison of the authors' comprehensive notes for congruity and accuracy.
  
  
  RESULTS
  Strategies are needed to support and maintain quality education, improve quality and quantity of nursing care services in hospitals and dispensaries, and improve conditions for nurses and other health-care workers. Compared with Madagascar, Kenya and Tanzania have more well-developed systems of nursing education and professional development.
  
  
  CONCLUSIONS
  There were limited written sources for some information but methods, such as verbal accounts, compensated for this limitation.
  
  
  CONCLUSIONS
  Implications include advantages, disadvantages, facilitators and barriers to nursing educational and professional development in Madagascar. Development of nursing education, regulation and the profession will continue with support from key stakeholders. Kenya and Tanzania can serve as role models for Madagascar nurses. Countries with similar nursing education and professional development issues can be informed by lessons learned in this project.
authors.affiliation: School of Nursing, Northern Arizona University, Flagstaff, AZ 86011, USA. karen.plager@nau.edu
authors.forename: K A
authors.initials: KA
authors.lastname: Plager
authors.forename: J O
authors.initials: JO
authors.lastname: Razaonandrianina
mesh_terms: D003479:Curriculum; D004508:Education, Nursing, Baccalaureate / Q000458:organization & administration*; D004511:Education, Nursing, Graduate / Q000458:organization & administration*; D006292:Health Priorities; D006801:Humans; D007393:International Educational Exchange; D008270:Madagascar; D009313:National Health Programs / Q000458:organization & administration; D020380:Needs Assessment / Q000458:organization & administration*; D024802:Nurse's Role; D015402:Nursing Education Research; D009740:Nursing Staff / Q000193:education / Q000458:organization & administration; D009937:Organizational Objectives; D010560:Personnel Selection; D017009:Professional Autonomy; D015397:Program Evaluation; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D012579:Schools, Nursing / Q000458:organization & administration; D017749:Total Quality Management / Q000458:organization & administration