Why well-trained health professionals are needed to make universal health coverage happen

D. Lecocq, P. Nziribusa, M. Nimpagaritse, P. Niyongabo, D. Nicayenzi, C. Horugavye, Y. Coppieters, A. Labat.

11th European congress on tropical medicine and international health, 16-20 september 2019, Liverpool, UK


Universal health coverage (UHC) has become the Number One priority in global health. UHC implementation and success critically depends on the quality of health services. A lot of evidence is accumulating to point the fact that highly graduated health professionals contribute to better health outcomes. A solid basic training of health professionals is needed to succeed at this respect.


This study aims to discuss how the only national higher training institution of healthcare professionals located in Burundi (INSP) works to improve the quality of health professionals’ teaching, with a focus on nurses’ clinical training.


A simultaneous qualitative-quantitative mixed method with data triangulation, using focus groups with students of INSP and clinical supervisors combined with field observations to quantify the phenomenon, enabled to describe and understand the process of clinical supervision of nursing students during internships.


We observed: a weak clinical supervisor/nurse student ratio; shortened internships within teaching programmes; complexity of coaching and evaluation tools, not properly used by the different stakeholders; lack of training and lower educational level of clinical supervisors; low motivation of clinical supervisors; competition between training institutions to access internship fields.


There are numerous challenges to take on regarding the clinical supervision of graduated nurses of INSP. The liberalisation of the education sector without appropriate regulation has complicated the situation by multiplying the number of healthcare training institutions. Public health policies should consider the number of trained healthcare professionals but also require and offer adequate conditions for a high quality training level. Otherwise, this could have a potentially negative impact on the quality of delivered care, compromising the UHC as defined by WHO that includes “a sufficient capacity of well-trained, motivated health workers to provide the services to meet patients’ needs (…)”.1 Like in other countries, the reinforcement of national training regulations and legal framework of nursing practice could help improve the quality of healthcare, considering that nurses are often the only accessible first-line healthcare practitioners.


  1. World Health Organization. What is universal health coverage? [Internet]. World Health Organization. Online Q&A. 2014 [cited 2019 Jan 29]. Available from: https://www.who.int/features/qa/universal_health_coverage/en/