The cost of registered nurse-midwifery education and enrolled nurse-midwifery education in Malawi, central Africa

Abstract

In the current socio-economic situation in the sub-Saharan Africa, educational institutions are challenged to produce more with less. In such an environment, it is critical that cost information pertaining to nursing education be available to assist nursing education programs in meeting the challenges of producing more nurse-midwives with less. This study determined the cost of registered nurse-midwifery (RNM) education and enrolled nurse-midwifery (ENM) education, and described factors which influenced the cost of nurse-midwifery education in Malawi, Central Africa. Full-costing approach was used. Data were collected using a standard data collection form. The university-based RNM program and the hospital-based ENM program under the auspices of the government Ministry of Health, comprised the study sample. Findings revealed that in both the RNM and the ENM programs, over 80% of the total cost of education was borne by the government. The remaining 20% was borne by the student in the form of financial contribution and opportunity cost. In both the RNM and ENM programs, a high percentage of the total annual cost of nursing education was in the form of indirect cost. For both programs, the cost per student contact hour and the subsequent total annual cost per student in each class year, was influenced by student enrollment and total student contact hours per class year. Student attrition and repetition influenced the total cost per graduating student in both programs. In the RNM university-based program, the professional component was 2.25 times more costly per student contact hour than the non-nursing (general education) component of the program. The findings discussed on the cost of RNM and ENM education have implications for policies related to the overall educational planning for the supply of RNMs and ENMs, the efficiency of nursing education programs, the organization of nursing education curricula and the sharing of cost of education among the government, the students and their families and other sources