How do Tanzanian hospital nurses perceive their professional role? A qualitative study

Aim To describe the experiences of Tanzanian nurses, how they perceive their role as a professional nurse and their experience with nursing care in a general hospital. Design This study is explorative, descriptive and qualitative. Methods The data were collected in 2015 by means of 10 semi‐structured interviews and was analysed using qualitative content analysis. Results The data analysis revealed two themes with corresponding sub‐themes related to Tanzanian nurses' perception with their professional role and experiences with nursing care: (1) Feeling professional pride; (2) Experiencing limitations and inadequacy. The findings indicate that the Tanzanian nurses possess a strong professional pride and commitment to serve and care for their patients. The nurses do their best to provide high quality nursing care but are faced with staffing shortages and limited materials that are beyond their control. Such limitations leave them feeling unable to fulfil their role and responsibilities.publishedVersio

Taking More Than a Fair Share? The Migration of Health Professionals from Poor to Rich Countries

The international migration of health workers, especially of physicians and nurses but also increasingly of other health workers, has become a major global health concern. Most of the migration of health professionals is occurring from countries with physician densities of about 17 per 100,000 population to countries with densities of 300 per 100,000 population. Because of this, developing countries may find it difficult to meet the Millennium Development Goals [PloS Medicine May 2005].health workers, professionals, migration, MDGs

Scaling up specialist training in developing countries: lessons learned from the first 12 years of regional postgraduate training in Fiji – a case study

Background: In 1997, regional specialist training was established in Fiji, consisting of one-year Postgraduate Diplomas followed by three-year master’s degree programs in anesthesia, internal medicine, obstetrics/gynecology, pediatrics and surgery. The evolution of these programs during the first 12 years is presented.\ud \ud Case description: A case study utilizing mixed methods was carried out, including a prospective collection of enrolment and employment data, supplemented by semi-structured interviews. Between 1997 and 2009, 207 doctors (113 from Fiji and 94 from 13 other countries or territories in the Pacific) trained to at least the Postgraduate Diploma level. For Fiji graduates, 29.2% migrated permanently to developed countries, compared to only 8.5% for regional graduates (P <0.001). Early years of the program were characterized by large intakes and enthusiasm, but also uncertainty. Many resignations took place following a coup d’etat in 2000. By 2005, interviews suggested a dynamic of political instability initially leading to resignations, leading to even heavier workloads, compounded by academic studies that seemed unlikely to lead to career benefit. This was associated with loss of hope and downward spirals of further resignations. After 2006, however, Master’s graduates generally returned from overseas placements, had variable success in career progression, and were able to engage in limited private practice. Enrolments and retention stabilized and increased.\ud \ud Discussion and evaluation: Over time, all specialties have had years when the viability and future of the programs were in question, but all have recovered to varying degrees, and the programs continue to evolve and strengthen. Prospective clarification of expected career outcomes for graduates, establishment of career pathways for diploma-only graduates, and balancing desires for academic excellence with workloads that trainees were able to bear may have lessened ongoing losses of trainees and graduates.\ud \ud Conclusions: Despite early losses of trainees, the establishment of regional postgraduate training in Fiji is having an increasingly positive impact on the specialist workforce in the Pacific. With forethought, many of the difficulties we encountered may have been avoidable. Our experiences may help others who are establishing or expanding postgraduate training in developing countries to optimize the benefit of postgraduate training on their national and regional workforces