Skip directly to search Skip directly to A to Z list Skip directly to navigation Skip directly to site content Skip directly to page options
CDC Home

Strengthening the African Health Workforce

To help achieve the vision of an AIDS-free generation, the U.S. President Emergency Plan for AIDS Relief (PEPFAR) is working to strengthen the African health workforce.

The CDC’s four-year initiative, the African Health Profession Regulatory Collaborative for Nurses and Midwives (ARC) builds the capacity of national nursing and midwifery leadership to update and strengthen professional nursing and midwifery regulation. Updated nursing and midwifery regulations can help in scaling-up HIV services by nurses and midwives. ARC uses a unique, collaborative approach that entails convening regional meetings or “Learning Sessions,” providing targeted technical assistance, and awarding short-term grants (see box).

ARC: Where we Work
ARC: Where we Work
Flash Player 9 is required.

ARC - Where we work: Download a PDF with ARC Map details as shown on the above interactive map. Click on country names above to see ARC activities.

A Model Approach for Collaboration

The collaborative approach used by ARC is adapted from the Institute for Healthcare Improvement (IHI) “Breakthrough Series” model for quality improvement collaboratives. (The Breakthrough Series: IHI’s Collaborative Model for Achieving Breakthrough Improvement. IHI Innovation Series white paper. Boston: Institute for Healthcare Improvement; 2003.)

The structure of the IHI model is a series of alternating Learning Sessions and Action Periods. During the Learning Sessions, teams from participating organizations come together to learn about and discuss the chosen topic and plan changes to implement in their home institutions. During the Action Periods, the teams return to their home institutions and work together on the planned actions for change.

At the conclusion of the collaborative cycle, participating organizations engage in a Summative Congress to share lessons learned and produce publications to disseminate their breakthrough improvements.

Building a “south-to-south” collaboration

The ARC initiative is funded by CDC through PEPFAR, and is implemented in partnership with the Lillian Carter Center for Global Health & Social Responsibility at Emory University, the Commonwealth Secretariat (based in the UK), the Commonwealth Nurses Federation, and the East, Central and Southern Africa Health Community—an intergovernmental regional coordinating body on health issues. Through this initiative, national nursing and midwifery leadership teams work together to identify and address regulatory bottlenecks to increasing and sustaining nurse and midwife-led models of HIV treatment and prevention services. The Learning Sessions provide a platform for sharing progress updates, tools, experiences, and challenges among country teams.

ARC is unique in that it supports regulation improvement projects which are developed, proposed, and implemented by the national nursing and midwifery leadership teams. By emphasizing south-to-south collaboration and sharing of resources, ARC not only advances rapid scale-up of regulatory reform in the region, but also builds long-term capacity among African professional institutions, resulting in stronger health systems for years to come.

ARC Year 3 activities

ARC kicked-off its third year of Learning Sessions, regulation strengthening grants, and targeted technical assistance with the annual Summative Congress, held July 30-August 2nd in Nairobi, Kenya. Nursing and midwifery leadership teams from 18 countries attended to discuss how regulations , such as continuing professional development, scopes of practice, and licensure exams, can be developed or updated to enhance HIV service delivery by nurses and midwives.

After each Summative Congress, country teams submit a one-year grant proposal on a ‘winnable battle’ in nursing and midwifery regulation. The proposals must describe how strengthening the regulation will result in expanded HIV services, such as such as voluntary medical male circumcision, the prevention of mother-to-child transmission and nurse initiated and managed treatment of HIV.

Fifteen country teams submitted proposals for ARC Year 3. After an interdisciplinary objective review process, ten were selected for funding on topics such as requiring continuing education on HIV content, establishing a licensure exam which would test knowledge and competence on HIV service delivery, and developing or updating nursing and midwifery scopes of practice to include critical HIV tasks (see map details).

These ten countries teams will convene for two regional Learning Sessions. In addition, countries will receive a technical assistance visit from an ARC faculty member to support successful project implementation. Countries not awarded grants received a technical review of their proposal to increase their chances of receiving funding next year.

ARC Support Group Photo

Group photo from a Learning Session in ARC Year 2 (Photo courtesy of Jill Illiffe)

ARC Year 1 and 2 activities

In the first two years of ARC, eleven grants were awarded on the following topics:

  • Developing or strengthening a continuing professional development system for nurses and midwives (Botswana, Lesotho, Malawi, Swaziland, Tanzania, and Zimbabwe)
  • Developing professional scopes of practice for nurses and midwives (Uganda)
  • Revising key elements of national Nursing Acts (Mauritius and Seychelles)
  • Decentralization of registration and licensure services to increase licensure renewal by nurses and midwives (Kenya)

ARC convened two regional Learning Sessions each year for the country teams awarded regulatory improvement grants. In addition, six countries not implementing grants received targeted technical assistance to support the further development and implementation of their regulatory priority.

For more information, please visit the ARC Initiative web site.


Contact Us:
  • Centers for Disease Control and Prevention
    1600 Clifton Rd
    Atlanta, GA 30333
  • 800-CDC-INFO
    TTY: (888) 232-6348
    24 Hours/Every Day
  • Page last reviewed: August 4, 2010
  • Page last updated: February 12, 2013 The U.S. Government's Official Web PortalDepartment of Health and Human Services
Centers for Disease Control and Prevention   1600 Clifton Rd. Atlanta, GA 30333, USA
800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 - Contact CDC-INFO