In West Africa, the training of nurses and midwives faces numerous challenges. The lack of educational materials is one of the most pressing. Students, often confronted with insufficient clinical demonstration equipment, struggle to acquire essential practical skills before they must work with real patients.

"Before the arrival of the new equipment, our students severely lacked resources to train effectively,” says Ousseini Moussa Abderhamane, Director General of the School for Health Agents (EFAS) in Dosso, Niger. “This absence of equipment limited their preparation and made learning difficult. They often felt anxious about entering practical internships without having had the opportunity to practice in realistic conditions. This was reflected in their performance during internships, where they lacked confidence and competence. With the old equipment, it was impossible to cover all the necessary skills, which left a gap between the theory taught and the practice in the field."

Statistics highlight the urgent need for improved training and infrastructure for nurses and midwives. In Mali, maternal and infant mortality rates remain among the highest in the region, with a neonatal mortality rate of 334 per 10,000 live births, partly due to inadequate training and a shortage of health professionals in rural areas. Similarly, in Niger, the neonatal mortality rate is 250 per 10,000 live births, and in Senegal, it is 290 per 10,000. 

Statistics highlight the urgent need for improved training and infrastructure for nurses and midwives. 

The C2C project aims to provide health training institutions with the necessary resources to ensure high-quality practical training, focused on the Competency-Based Approach. An essential component is the creation of skills labs, the provision of modern educational materials, and the adaptation of curricula to local needs. These efforts have been supported by a substantial investment of 120 million CFA francs (~ $202,700) for each of the three countries, enabling the acquisition of various essential equipment, including simulation mannequins for childbirth, obstetric examination tables, neonatal resuscitation equipment, as well as computers and projectors. The direct beneficiaries include 12 private schools and 9 public health schools.

Awa Fall Diagne, the former Director of Human Resources at the Ministry of Health and Social Action of Senegal, emphasizes the importance of this donation of educational materials. "The Ministry of Health greatly appreciates this donation, which will positively impact the provision of maternal and neonatal health care,” she says. “This donation truly helps to elevate the quality of training, so that the graduates from these schools can serve optimally in health facilities."

The skills labs are central to the project, providing a practical environment for students to develop clinical skills in a controlled setting before working with real patients. These labs help ensure that future professionals are ready for the challenges of maternal and infant health. Participating institutions also receive ongoing support through clinical supervisor training and curriculum updates, ensuring that teaching methods stay aligned with the latest health care advancements. 

"In nine years, this is the first time we have received this type of state-of-the-art equipment," says Ousseini. "It allows us to better explain, monitor, and teach our students how to provide quality care. As the saying goes, never on a real patient the first time, so we teach them to practice first on mannequins."

The schools encourage students to practice regularly in the newly equipped skills labs, where they have access to simulators that recreate realistic clinical scenarios in an immersive and secure learning environment. This training method allows them to become familiar with the technical skills necessary for their future profession, bridging the gap between theory and practice.

We can practice several types of nursing techniques here.

Minty Keita, a state nurse and permanent instructor at Vicenta Maria, cannot contain her excitement about how the new equipment will help improve the training of nurses, and health care for all Malians. "Finally, we have our skills lab,” she says. “Here we have a bisexed mannequin named Suzie Simone. It has the ability to be either male or female. It will allow us to [learn how to] perform clinical exams and care for a hospitalized or bedridden patient. We can practice several types of nursing techniques here, such as suprapubic puncture, urinary catheterization, or even dressing wounds."

In addition to the physical equipment, C2C is also investing in the development of eLearning platforms, which will offer students flexible access to online educational resources and promote distance learning and self-training. Trainers will be able to use these platforms to track students' progress and adapt educational content to specific needs.

C2C is also investing in eLearning and emphasizes equity, diversity, and inclusion.

Moreover, C2C emphasizes equity, diversity, and inclusion (EDI) in the implementation of its initiatives, and conducted a thorough EDI situational analysis to identify the specific challenges faced by the most vulnerable populations, such as disabled women, students from disadvantaged backgrounds or living in remote areas, as well as pregnant and nursing women. Dissemination workshops are underway with partner institutions to ensure that these considerations are integrated into governance policies, training programs, and infrastructure. For instance, baby-mother spaces will be provided to allow pregnant or nursing students to continue their education under favorable conditions, thus promoting their inclusion and academic success.

Through its innovative approaches and substantial investments, the Classroom to Care project is helping to lay the foundation for more resilient health systems in West Africa, better equipped to meet the challenges of maternal and infant health.