Assessing the impact of a partnership‐based work/study nursing upgrade programme in a low and middle‐income setting

Aim: To evaluate the 15‐years impact of the work‐study nursing upgrading programme in East Africa. Background: Working nurses in Africa are often primary family income earners, with limited ability to leave jobs and upgrade qualifications. In 2001, the university established a work‐study upgrade programme for enrolled‐ and diploma‐level nurses, allowing them to upgrade their qualifications while continuing to work and support families. Donor partnerships provided scholarships to further increase programme access. Design: A mixed method design was used involving an online alumni survey and 24 interviews and 23 focus groups with 172 purposively selected representatives of nursing graduates, employers, regulatory bodies, professional associations, and senior nursing officials. Method: Quantitative data were analysed using frequencies and percentages. Inductive thematic analysis was used for qualitative data. Equator guidelines informed reporting of both qualitative and quantitative results. Results: Of the 549 graduates that completed the survey, 81.2% (n=446) were female, 93.1% were currently employed and 98% worked within East Africa. They reported improved professional competence (69.4%), nursing practice (25.9%) and patient outcomes (4.6%) on graduation. Extracted themes included: flexible/accessible programme; friendly learning environment; effective teaching and learning strategies; acquisition of nursing knowledge, skills, and competencies; stakeholders’ role in the programme; career/professional advancement; and strengthened health systems. Conclusion: The work‐study programme was an effective nursing workforce capacity development strategy. Programme access was strengthened via the supporting donor partnership. Positive outcomes were achieved in respect to the university\u27s values of quality, access, relevance, and impact. Relevance to clinical practice: Long‐term sustainable development of nurses and midwives is fundamental to achieving Sustainable Development Goals. Work‐study programmes and private‐public partnerships are effective mechanisms to strength the development of nursing and the overall healthcare workforce in low resource settings

Introduction of an Advanced Practice Nurse Program in Kenya: A New Era in Nursing Education

Purpose: The purpose of this presentation is to share the intra and interprofessional collaborative process of developing an Advanced Practice Nursing (APN) program to be offered in 2020 in Kenya, a low middle-income country. Methods: Engagement with stakeholders (students, clinicians, regulators and educators) affirmed the need for an APN program. Faculty from Schools of Nursing and Midwifery in three East African countries developed an APN curriculum with input from local and international agencies such as the Nursing Council of Kenya with linkages to the ICN, the Nursing Now Team and partner universities in the UK and USA. The curriculum was reviewed for relevance and cultural sensitivity. Christmals and Crous (2019) noted the importance of contextualizing the APN role to the specific country and healthcare systems. The development of collaborative frameworks between nursing and midwifery, and higher educational councils is important (Muraraneza, Mtshali, and Mukamana, 2017), therefore, feedback from the Council for Higher Education was sought and incorporated. The final document will be sent to external reviewers from partner universities prior to implementation in 2020. Limited resources and opposition from the medical profession have been reported as challenges to APN programs in Sub Saharan Africa (Christmals and Armstrong, 2019). To address these problems, the Liverpool John Moore University, UK, will host a six weeks’ capacity building program for East African faculty who will teach in this program. The program will be also offered in partnership with Family Medicine physicians and pharmacists and this will enhance interprofessional competencies (Monahan, Sparbel, Heinschel, Rugen, and Rosenberger, 2018). A workshop will be held in 2020 to share a common understanding of the program with all collaborative partners. The APN role is evolving globally and there is no consensus on the core competencies and its definition (Heale and Buckley, 2016). Kenya has no scope of practice for APN (East, Arudo, Loefler and Evans, 2014) and one will be developed. Results: An APN curriculum has been developed and is in the final stages of review prior to implementation in 2020. Anticipated challenges have been identified such as lack of resources among others, and strategies have been put in place to mitigate them. Conclusion: An APN program is pivotal to the realization of the Universal Health Coverage (UHC) as graduates of this program will be deployed in primary health care settings. The intra and interprofessional collaboration will strengthen both the program and partnerships (local and global) with mutual benefits for all involved

Scopes of practice for advanced practice nursing and advanced practice midwifery in Kenya:A gap analysis

BACKGROUND: There is increasing global evidence on the impact of advanced nursing and midwifery practitioners, and Kenya's healthcare system has an excellent opportunity to develop scopes of practice and other regulatory frameworks for the integration of these roles.OBJECTIVE: The primary purpose of this gap analysis was to explore the existing evidence on opportunities and threats toward the integration of the advanced practice nursing (APN) and advanced practice midwifery (APM) roles in Kenya's healthcare system.METHODS: The study team conducted a structured electronic database search of PubMed, CINAHL, Scopus, EBSCOhost Academic Search Complete, and PsycINFO to retrieve articles and credible websites for reports highlighting the opportunities and threats toward the integration of the APN and APM roles in Kenya's healthcare systems. The retrieved articles were screened for relevance and synthesized for reporting using the traditional literature review approach.RESULTS: The Kenya Health Policy Framework 2014-2030, growing population needs, and implementation of universal health coverage provide an opportunity to harness and leverage advanced practice roles in nursing and midwifery. There is also momentum to develop advanced practice because of strategic alliances and global evidence showing the contributions and quality of services offered by advanced practice nurses and advanced practice midwives. However, lack of financial support, structural challenges, and lack of national policies, regulations, and legislation continue to obstruct progress.CONCLUSION AND IMPLICATIONS FOR NURSING POLICY: Developing scopes of practice for APN and APM in Kenya will benefit the professions, the country's healthcare delivery system, and the population. Achieving universal health coverage depends on a health workforce trained and practicing at optimal levels in tandem with education and training to deliver quality care.</p

Scopes of practice for advanced practice nursing and advanced practice midwifery in Kenya: A gap analysis

Background: There is increasing global evidence on the impact of advanced nursing andmidwifery practitioners, and Kenya’s healthcare system has an excellent opportunity todevelop scopes of practice and other regulatory frameworks for the integration of theseroles. Objective: The primary purpose of this gap analysis was to explore the existing evidenceon opportunities and threats toward the integration of the advanced practice nursing(APN) and advanced practice midwifery (APM) roles in Kenya’s healthcare system. Methods: The study team conducted a structured electronic database search of PubMed,CINAHL, Scopus, EBSCOhost Academic Search Complete, and PsycINFO to retrievearticles and credible websites for reports highlighting the opportunities and threatstoward the integration of the APN and APM roles in Kenya’s healthcare systems. Theretrieved articles were screened for relevance and synthesized for reporting using thetraditional literature review approach. Results: The Kenya Health Policy Framework 2014–2030, growing population needs,and implementation of universal health coverage provide an opportunity to harness andleverage advanced practice roles in nursing and midwifery. There is also momentum todevelop advanced practice because of strategic alliances and global evidence showing thecontributions and quality of services offered by advanced practice nurses and advancedpractice midwives. However, lack of financial support, structural challenges, and lack ofnational policies, regulations, and legislation continue to obstruct progress. Conclusion and implications: for nursing policy:Developing scopes of practice forAPN and APM in Kenya will benefit the professions, the country’s healthcare deliverysystem, and the population. Achieving universal health coverage depends on a healthworkforce trained and practicing at optimal levels in tandem with education and trainingto deliver quality car

Supporting Healthy Futures for East Africa: Celebrating 15 years of partnership in nursing education. School of Nursing and Midwifery in East Africa, Aga Khan University, Nairobi, Kenya

This impact evaluation study was designed on the basis of quality and accountability. It focused on sourcing evidence regarding the impact and achievements of a 15-year investment in nursing education and workforce capacity building. The study was also designed to enhance alumni connection and establish sustainable models for monitoring and evaluation.https://ecommons.aku.edu/books/1062/thumbnail.jp

Stakeholders’ Expectations of Graduates of a Work-Study Nursing Upskilling Programme in East Africa

Sound alignment of stakeholders’ expectations and graduate ability forms the reputational hallmark of a university’s education programmes. However, little is currently known about stakeholders’ expectations of graduates of work-study nursing upskilling programmes in low- and middle-income settings. Information is needed to ensure the quality and adequacy of curricula in such settings. The main aim of the current study was to explore the nursing stakeholders’ expectations of graduates of work-study nursing upskilling programmes. An exploratory qualitative study was conducted between March and October 2016 in three low- and middle-income countries in East Africa. Forty-two representatives of nursing employers, regulators and professional associations (PAs) participated. The data was collected during 27 key informant interviews (KIIs) and three focus group discussions (FGDs) using a pretested interview guide. Content analysis of the data was completed. Consolidated criteria for reporting of qualitative research guidelines were used as the standard for collecting data and reporting results. Stakeholders reported their expectations of a clinically and professionally competent nurse (an “all-round” graduate) with nursing management and leadership skills that facilitated sound clinical judgement and decision making and a high level of professionalism. The study highlighted nursing stakeholders’ expectations of nursing graduates who had completed a work-study upskilling programme. These expectations should inform curriculum planning and development, and highlight the need for a strong focus on clinical competence, leadership, critical thinking and professionalism in nursing upskilling programmes

Duty versus distributive justice during the COVID-19 pandemic

The COVID-19 pandemic exposed vulnerabilities in inadequately prioritized healthcare systems in low- and middle-income countries such as Kenya. In this prolonged pandemic, nurses and midwives working at the frontline face multiple ethical problems, including their obligation to care for their patients and the risk for infection with severe acute respiratory syndrome coronavirus 2. Despite the frequency of emergencies in Africa, there is a paucity of literature on ethical issues during epidemics. Furthermore, nursing regulatory bodies in African countries such as Kenya have primarily adopted a Western code of ethics that may not reflect the realities of the healthcare systems and cultural context in which nurses and midwives care for patients. In this article, we discuss the tension between nurses’ and midwives’ duty of care and resource allocation in the context of the COVID-19 pandemic. There is an urgent need to clarify nurses’ and midwives’ rights and responsibilities, especially in the current political setting, limited resources, and ambiguous professional codes of ethics that guide their practice