Funding for this Strategic Plan was provided by the US Agency for international Development under the grant assistance agreement between the United

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2 Funding for this Strategic Plan was provided by the US Agency for international Development under the grant assistance agreement between the United States of America and the East, Central and Southern Africa Health Community (ECSA-HC), award number ii

3 Table of Contents ABBREVIATIONS... iv THE EXECUTIVE SUMMARY... v CHAPTER ONE: BACKGROUND Introduction Teaching and Learning Resources... 2 CHAPTER TWO: SITUATION ANALYSIS Introduction Assessment of Strengths and Weaknesses Assessment of Opportunities and Threats Force-Field Analysis Assessment of Political, Economic, Socio-Cultural, Technological and Legal Situation (PESTLE Analysis) Key Strategic Issues CHAPTER THREE: VISION, MISSION, VALUES, KEY RESULT AREAS, STRATEGIC OBJECTIVES AND STRATEGIES CHAPTER FOUR: STRATEGIC PLAN IMPLEMENTATION MATRIX iii

4 ABBREVIATIONS AMREF CHE HSS Jhpiego LNC NEPI NMDS PAYE SADC SWOT African Medical & Research Foundation Council on Higher Education Health Service Support The John Hopkins Program for International Education in Gynecology and Obstetrics Lesotho Nursing Council Nursing Education Partnership Initiative National Manpower Development Service Pay as You Earn Southern Africa Development Community Strengths Weaknesses Opportunities Threats iv

5 THE EXECUTIVE SUMMARY This strategic plan intends to guide the Scott Hospital School of Nursing in achieving its goals and respective objectives. Scott Hospital School of Nursing was established in 1961 as part of Scott Hospital of the evangelical Church of Lesotho. It is located at Morija in Maseru district, 45 Km from town. The Board of Management of Scott Hospital governs the school. The school started by training Enrolled Nurses which phased out in Since then the school stood the test of time as it still exists and continues to flourish despite the hardships that are experienced in everyday life. Scott Hospital School of Nursing vision is to provide high quality, comprehensive and sustainable nursing education based on research and Christian foundation. Its mission is to develop polyvalent, competent nurses who are lifelong students and are able to provide holistic, quality and essential nursing services at all levels and settings in Lesotho and internationally. Scott Hospital School of Nursing works with a number of stakeholders; its staff, Board of Directors, developing partners, donors, suppliers, students, and interested members of public. This plan is also grounded in an institutional analysis conducted as part of the transition and planning process. The analysis revealed a number of strengths, weaknesses, opportunities and threats (SWOT). The key strengths are skillful human resources base and availability of teaching and learning resources. Weaknesses include insufficient funding and inadequate transport facilities. Scott Hospital School of Nursing offers the following opportunities; government subvention and NEPI- supported human resources base. The threats include, inadequate funding by donors and government and competitions for candidates and students. The Scott Hospital School of Nursing operates in a dynamic external environment challenged by modern technologies, political climate, globe events, and HIV/AIDS. In recognition of that, this plan focuses on performance and resource mobilization. Furthermore, the plan focuses in building internal capacities and distinctive capabilities of producing highly qualified human resource that can operate in resource constrained environment without compromising quality and standards. v

6 CHAPTER ONE: BACKGROUND 1.0 Introduction Scott Hospital School of Nursing was established in 1961 as part of Scott Hospital of the Lesotho Evangelical Church. The school started by training Enrolled Nurses from 1961 and the programme phased out in Since then Scott Hospital School of Nursing has stood the test of time as it still exists and continues to flourish despite the hardships that are experienced in everyday life. Currently, the school is offering three programmes, namely; Certificate in Nursing Assistant, Diploma in General Nursing and Diploma in Midwifery in an attempt to produce future health professionals who will be able to enhance the health system by responding to the prevailing health needs within Lesotho and internationally. The school started by training enrolled Nurses in Certificate in Nursing Assistant programme was introduced when the above programme phased out, and it has been sustained to date. Given the high demand of nurses in the health system, the school introduced Diploma in General nursing that proved the school to be progressing. The programme has been sustained to date. Recently (In 2012), the school introduced Diploma in Midwifery programme with the support of the Nursing Education Partnership Initiative (NEPI). The table below summarizes the students enrolment for the 2012/13 academic year. Diploma in General Nursing Enrolled Dropouts Active Students (including Repeats) 1 st Year nd Year rd Year Certificate in Nursing Assistant 2 nd Year Diploma in Midwifery

7 Scott Hospital School of Nursing has twenty two (22) employees that comprise the following: Designation No. Of staff Nurse Educators 13 Clinical Supervisor 1 Assistant Administrator 1 Accountant 1 Assistant Librarian 1 Office Assistant 1 Driver 1 House Mother 1 House Father 1 Cleaner Teaching and Learning Resources Nurse Educators Scott Hospital School of Nursing is built up of fourteen (14) Nurse Educators (including the Clinical Supervisor) whose main duties are education, training and supervision of the students in various areas required in different nursing programmes. This includes teaching in class-rooms, guiding and supervising the students in the clinical areas such as in clinics and hospitals, assisting students with research, administering examinations and the like Hospitals and Clinics Scott School of Nursing also has access to utilize the hospitals for students training and experience purposes. For instance, they are often placed at Scott Hospital, Queen Mamohato Memorial Hospital, Rural Clinics, Mohlomi Hospital and other hospitals and health centers. This helps to improve their skills and acquire more knowledge as they are being exposed to various areas that may not be fully covered in the topics taught in class Skills Laboratory The school has the Skills Laboratory that has been donated by NEPI in The skills laboratory allows the students to practice critical nursing skills and improve their abilities to perform nursing procedures. Moreover, the Clinical Supervisor is the overseer of the activities performed in the skills laboratory. The Clinical Supervisor is charged with 2

8 providing hands-on practice for nursing students who are being equipped with the skills and competencies to provide quality care in all settings of health delivery School Library Scott Hospital School of Nursing has its own library that is managed by the Assistant Librarian under the Human Resources support of NEPI. The Library is equipped with books, articles and computers (some of which have been donated by NEPI and Jhpiego) which give students access to modern technical facilities that enhance their learning process, providing them with current information, clinical best practices, new research and scholarly journals. 3

9 CHAPTER TWO: SITUATION ANALYSIS 2.0 Introduction This chapter examines the internal and external environment for the Scott Hospital. At the end of the Chapter, key strategic issues that emerge from the analysis are outlined. 2.1 Assessment of Strengths and Weaknesses Strengths Skillful Human Resources base. There are fifteen professional staff; consisting of qualified Nurse Educators, Clinical Supervisor, Assistant Administrator, Accountant and Assistant Librarian. Each of the individual staff is qualified, skilled and experienced in their respective field. Availability of teaching and learning resources The school has the Skills Laboratory that helps the students to practice critical nursing skills and improve their abilities to perform nursing procedures at various areas. The school is based within the hospital (Scott Hospital) that allows the students for clinical practices; hence, what is taught in classes is easily practiced or demonstrated in real life situation. This helps to improve the students knowledge and skills from time to time, thus, helps to expose the students to various challenges that may be expected in their field of work, that is; after their course of study. Moreover, the school has access to various clinics or health centers where the students are being placed for rural clinical experience. The Library is available for the students to access and utilize reading materials to enhance their learning capabilities and research skills. Computer Laboratory is available in the campus that allows students in research processes through Internet, typing assignments and keeping them informed of current information. Students Dormitories There is accommodation (residences) for both male and female students that make learning easier, hence the students are able to get to classes on time and utilize after school hours. It is also less expensive for the students as their meals and accommodation fees are catered for. 4

10 Academic Freedom By liaising with the hospital management, key stakeholders and other nursing schools, the management of the school has autonomy to make administrative decisions in running the institution. The school has the power to decide among other things, a number of students to enroll per program based on the available resources.. Furthermore, the school develops its own operating policies Weaknesses Inadequate Human Resources base There is inadequate number of staff making it difficult to share duties. In administration and teaching and learning departments, additional personnel are needed.. Insufficient learning and teaching resources Ideally, the institution, to maximize its functionality, should have five (5) classrooms accommodating approximately forty students but there are only three (3) classrooms, with a capacity of thirty (30) students. The Library base is too small; hence, there is no space for students to read, therefore forcing them to study in their rooms or classrooms after school. Additional manikins for timely demonstrations of procedure and practice.. The capacity of the computer laboratory is limited, allowing fewer students at a time. Inadequate transport facilities The school has only two vehicles, one accommodating a maximum of twenty-two (22) people and the other accommodating only four (4) people. Insufficient funding There is insufficient funding to cater for operations of the institution indicated in the strategic plan, thus making it difficult to accomplish goals and objectives of the institution. Inadequate students dormitories Some of the students are forced to stay off-campus due to inadequate accommodation;. Inadequate staff housing There are only six (6) staff houses as per twenty-one (21) employees. Most of the employees are commuting to work on daily basis that is both costly and time-consuming. Moreover, most of the suitable candidates for various positions have been lost because there is no accommodation for them. 5

11 2.2 Assessment of Opportunities and Threats Opportunities Government of Lesotho The government of Lesotho plays a vital financial role in terms of salary payment for staff and scholarships for students through the National Manpower Development Secretariat. NEPI- support NEPI has supported the school with the following; Clinical Supervisor s salary from October 2012 to March 2014 Assistant Librarian s salary from September 2012 to March 2014 Fifteen (15) students sponsorship in General Nursing Diploma Thirty (30) students sponsorship in Diploma in Midwifery Teaching and learning resources (ten computers, four lap tops, three LCD projectors, one projector screen) Skills laboratory with equipment Midwifery accommodation Demand for Registered Nurses and Midwives in Lesotho The nation s call for reduction in maternal and child morbidity and mortality rates have led the school into training more Nurses and Midwives in order to answer to the increasing needs in the national health system.. Moreover, the high prevalence of HIV/AIDS in Lesotho calls for more nurses in the country in order to respond to the challenges post by the pandemic. Support from stakeholders The school has support (financial, human and material) from the stakeholders such as NEPI, Jhpiego, CHE, HSS, HRAA, AMREF, 6

12 2.2.2 Threats Inadequate funding by donors and government There are limited funds from donors and the government, hence the school has limited budget to operate on. Competition for candidates and students The school has to compete for both staff and students with other institutions offering similar programs. There are no retention strategies for staff. Inadequate government scholarships The government only sponsors 40 new students in a year while there are three programs, hence the school is forced to enroll a limited number of students to some extent. 2.3 Force-Field Analysis INTERNAL IMPELLING FORCES 1. Qualified, skillful personnel. 2. Availability of resources. 3. Need for the institution to become more efficient in order to have a competitive edge within the nursing education system. INTERNAL IMPEDING FORCES 1. Limited Human Resources base. 2. Lack of financial and material resources. 3. Inadequate staff houses. 4. Inadequate offices. 5. Inadequate students dormitories. EXTERNAL IMPELLING FORCES 1. Pressure from the stakeholders.. 2. Requirements/ terms and conditions of donors. 3. Financial support from the government and other stakeholders. 4. Competitive operating environment (which compels the institution to be equipped with appropriate skills). 5. Government laws and regulations. EXTERNAL IMPEDING FORCES 1. Competitive labour market. 2. Insufficient of government s funding. 3. Government laws and regulations (quota by NMDS). 4. Stakeholders. 6. Inadequate classrooms 7

13 2.4 Assessment of Political, Economic, Socio-Cultural, Technological and Legal Situation (PESTLE Analysis) Political setting The Kingdom of Lesotho is a democratic country ruled by King Letsie III, referred to as the Head of State, and the Prime Minister who is referred to as the Head of the Government. The Kingdom of Lesotho forms part of the Southern African Development Community (SADC) which is characterized by among other things, rule of law, monarchy, political stability, freedom and respect of fundamental human rights. In May 2012, general elections were held which gave birth to a coalition government consisting of three political parties. The political state of the Kingdom of Lesotho provides a favorable environment for Scott Hospital School of Nursing to carry out education and training of nurses. This is made easy by political elements such as Institutional Autonomy, which means that the institution has an administrative independence and self-regulatory powers that enable the school to operate within its policies, rules and regulations. However, such policies and rules are established in line with the government ministries. The second key political element that is an advantage to Scott Hospital School of Nursing is the Academic Freedom. This implies that there is no political influence that works to obstruct the pursuit and practice of students at Scott Hospital School of Nursing. All citizens have education as a fundamental human right based on zero discrimination in terms of age, sex, disabilities, political association, culture or religious affiliation. Moreover, the form of rule in the government of Lesotho portrays Democratic Participation as one of the key aspects of democracy. In this sense, the government of Lesotho plays an integral role in the education and training system across the country. The government of Lesotho plays a financial role by paying a portion (70%) of operating expenses, students sponsorship through NMDS and the legal role in terms of policies through the Ministry of Health and other regulatory bodies such as Council on Higher Education (CHE) Lesotho Nursing Council (LNC) and many more. Equally important, the Kingdom of Lesotho is one of few politically stable countries in the world. For instance, there are limited records of civil wars, war on terror and strikes associated with political divergence. This allows the school to operate freely and efficiently without having to close down due to the political instabilities. 8

14 2.4.2 Economic Environment The Kingdom of Lesotho is classified as a developing country with an estimated GDP of$1400 Per Capita. Lesotho has limited resources to generate income, hence its main sources of income are but not limited to agriculture, natural resources such as water and diamonds, remittances from Southern African Mines, Textile industries, taxes such as Pay as You earn (PAYE). The economy is therefore low, forcing the country to be more dependent on foreign aid. This economic condition implies that the standards of living in Lesotho are low, with most families having low incomes, most of which do not afford the education of their children especially at a higher level (Tertiary). For this reason, the higher population is dependent on sponsorship by the NMDS, hence, the reason why the school is forced to enroll only a limited number of students per year. This implies that the students intake is mostly determined by the availability of the government s sponsorship; hence, the school is unable to produce as many nurses as possible Socio-Cultural Environment The population density of the Kingdom of Lesotho is 2 Million. The country is divided into two classes; rural and urban communities. The two classes have diverse norms, beliefs, traditions and practices. For instance, the rural communities are strongly attached to the cultural practices such as initiation schools, while on the contrary the urban communities prefer formal education. The advantage is that Scott Hospital School of Nursing is located in Morija that is in the district of Maseru that is the capital city of Lesotho. Even though the school is not based in town, it is nearer to the towns such as Maseru and Mafeteng. It is easily reachable and the place has basic infrastructure such as roads, water and electricity that are key demands in the modern life Technological Facility The government of Lesotho has played a vital role in modern technical facilities that enhance teaching and learning process.. This has been achieved through the Ministry of Health that has provided free Internet services Moreover; partners such as NEPI and Jhpiego have donated the school with desktops and laptops to be utilized by both the students and the Nurse Educators. This has led to the school to re-opening the computer laboratory to be used by the students. 9

15 2.4.5 Legal Framework Scott Hospital School of Nursing is a registered institution of higher education that views nursing education as an essential pillar of development in the health system of Lesotho. Section 28 of the Constitution of Lesotho stipulates that the state shall endeavor to make education at all levels, including higher education equally accessible to all Basotho on the basis of capacity. In terms of the aspirations articulated in the Lesotho Vision 2020 Scott, Hospital School of Nursing therefore aims at ensuring that the nations Higher Education system contributes to the overall goal of creating and sustaining a stable, successful, healthy and well-informed human resources base within the health system Environmental Nature Scott Hospital School of Nursing is located at Morija, in Maseru district. Morija is a developing community characterized by among other things, improved roads, water supply and electricity coverage, formal schools and recreation resorts. The community is surrounded by the main city, Maseru, which makes the school easily reachable. The area is more weather- friendly than in many of the remotest areas in the country. This makes it the conducive environment for both students and staff. Having observed the financial constraints we have to meet our endless needs, we decide to draw the strategic plan so as to prioritize according to the degree of need. It is also easier to acquire sources from the None Governmental Organisations (NGOs) with the strategic plan, as they will realize our goals of priority and ease their work during the M & E processes. It also assist in keeping track of our work and it becomes easier to carry out the M & E. everyone in the organization have the sense of ownership as all employees are working together towards achieving the set goals of the institution. 2.5 Key Strategic Issues Key strategic issue 1: Improving Quality of Education There is a need to improve quality of education rendered to students. To achieve this, there is need to achieve accreditation status for the school, increase the human resource base for both technical and non-technical staff and improve the working culture within the school and provide students books. 10

16 Key strategic issue 2: Address school infrastructure challenges There is need to seek additional funds to finance the construction of the needed infrastructure like offices, dormitories and classrooms. In addition, increasing the funding base will help address other constraints related to students accommodation, transport facilities, construction of staff houses and offices, purchasing extra vehicles, improvement of the ICT Labs, library, skills lab and furnishing classrooms used for teaching. Key strategic issue 3: Improve the financial position for the school Although there are several stakeholders supporting the school and despite the Government supporting the school, funding is still limited to meet the many demands for the school. There is need to diversify the sources of funds and improve the revenue collection streams in the school. Additional development partners have to be sought while at the same time enhancing internal control mechanisms and processes for managing costs and improving the cost effectiveness of ongoing interventions. 11

17 CHAPTER THREE: VISION, MISSION, VALUES, KEY RESULT AREAS, STRATEGIC OBJECTIVES AND STRATEGIES Vision To provide high quality, comprehensive and sustainable nursing education based on research and Christian foundation. Mission The mission statement of Scott Hospital School of Nursing is to develop polyvalent, competent nurses who are lifelong students and are able to provide holistic, quality and essential nursing services at all levels and settings in Lesotho and internationally. Values The following values are given effect to within the school: Excellence: The hospital will offer best in class services. We deliver what we promise and add value that goes beyond what is expected. We achieve Excellence through Innovation, Learning and Agility while at the same time promoting academic freedom. Respect: We value diversity and unique contributions, foster a trusting, open and inclusive environment and treat each person with human dignity. Fundamental thinking: We apply our best thinking in every situation and endeavor to bring fundamental change to individuals and organizations alike. This entails the perpetuation of the disposition that benefits the school as an institution of learning, recognition of responsibilities. Key Result Areas Key strategic area 1: Quality of Education Improved Strategic Objectives Obtain accreditation status for the school Increase the human resource base for both technical and non-technical staff 12

18 Improve the working culture within the school Provide students with textbooks. Key strategic area 2: School infrastructure improved Strategic Objectives To construct offices, dormitories, staff houses and class rooms. Furnish classrooms. Rehabilitate and increase students accommodation Improve transport facilities, purchasing extra vehicles Improve the ICT Labs, library, skills lab. Key strategic area 3: Improved financial position for the school Strategic Objectives Diversify the sources of funds Increase the students enrolled in the school by 2018 Improve the revenue collection streams in the school. Acquire additional development partners Enhancing internal control mechanisms and processes for managing costs Improving the cost effectiveness of ongoing interventions. 13

19 CHAPTER FOUR: STRATEGIC PLAN IMPLEMENTATION MATRIX KRA Strategic Objective Strategies Service Delivery Target Quality of Obtain Increase Education accreditation learning Improved status for the opportunities school for the staff Increase the Monitoring human resource and base for both Evaluation of technical and teaching and non-technical learning staff activities Improve the Placement of working culture all students at within the school strategically Provide students clinical areas with textbooks. every academic year. Develop a school calendar that guides students activities. Mobilize support of all the clinical as well as Responsibility Centre 14

20 support staff in the health centers. School To construct Develop infrastructure offices, maintenance improved dormitories, staff plan/policy houses and class rooms. Furnish classrooms. Improve transport facilities, purchasing extra vehicles Improve the ICT Labs, library, skills lab Improved Diversify the Carry out Enroll 150 financial sources of funds continuous students by position for Increase the career 2018 the school students enrolled guidance in Source in the school by High Schools additional 2018 across the funds from Improve the country to NGO s, revenue attract them stakeholder collection into nursing s etc. streams in the profession. Mobilize school. To establish funds from Acquire and sustain partners, additional counseling NGOs, and development services for key 15

21 partners students. stakeholder Enhancing s. internal control mechanisms and processes for managing costs Improving the cost effectiveness of ongoing interventions. Improved the Enhance Improve Recruit and institutional teamwork in the employer- retain 2 culture school. employee and Nurse Institutionalize a employees Educators, performance relationships. 1 Assistant oriented culture (Employees Accountant Align the human interpersonal and 1 resources to the relationship) secretary strategic Offer by priorities of the competitive September school salaries Position the Reward school to become outstanding more competitive performance. in the global Ensure staff market place. welfare Recruit additional staff 16

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