Factors enabling and hindering an eLearning programme for nurses and midwives in Afghanistan

Afghanistan faces an acute shortage of trained healthcare providers. To build capacity of nurses and midwives, in 2014 a private hospital in Afghanistan initiated an eLearning programme to enhance their knowledge and skills. The study was conducted to identify facilitating and hindering factors for the successful implementation of eLearning. Data collection took place between June and September 2016, when seven Maternal and Child Health (MNCH) related eLearning sessions were conducted. The participants were nurses and midwives working in MNCH wards at the research sites in Bamyan, Faizabad and Kandahar, along with the programme planners and facilitators. Data was collected through pre/post and delayed post-tests, observations and questionnaires, semi-structured interviews and documents analysis. The results highlight four major factors as important for the successful implementation of eLearning, namely: curriculum, context, technology and individual. The needs assessment ensured relevance of the sessions to the needs of the participants. However, pedagogy was lecture-based with limited focus on skills development. Poor connectivity and language of instruction posed challenges. eLearning has shown the potential for developing knowledge and skills of nurses and midwives. Clear communication between teams involved in planning and implementation of the programme, technology infrastructure, design of online pedagogy and facilitator readiness are critical for the success of eLearning in low and middle income countries.