Using Trends in Nurse Workforce Supply to Inform the Scale-Up of Nurse Training in Kenya 公开
Appiagyei, Ashley (2011)
Abstract
Background & Problem Statement: Recent initiatives aim to scale-up nurse training and education to address the health workforce shortage in sub-Saharan Africa. In order for the government of Kenya and donor agencies to support the scale-up, data on nurse supply must be analyzed to develop evidence-based strategies to ensure the retention and licensure of all potential nurses who enroll in pre-service training.
Significance: Information generated from this project will enable Kenya's policymakers and donors to more effectively develop interventions for the scale-up of nurse training and education.
Aims: This study uses data from a Human Resources Information System in conjunction with qualitative methods to describe trends in the progression of Kenyan nursing students through the nurse supply pipeline and to identify barriers to the scale-up.
Methods: Data from the Kenya Health Workforce Informatics System were analyzed to describe students trained in Kenyan nursing schools from 1999 to 2004 and to determine how many of these potential nurses were lost from the nurse supply pipeline at the point of registration with the Nursing Council of Kenya (NCK). Key informant interviews were conducted with nurse training institution administrators and/or tutors to investigate barriers to the scale-up and perceptions related to nurse training capacity in their institutions.
Results: 8,645 students began training in Kenyan nursing schools from 1999 to 2004. Of these students, 8,110 (94%) are currently registered with the NCK. Failure to register was more common among BScN nurses (12%) compared with registered nurses (5%) and enrolled nurses (7%). Student attrition was not found to be a significant problem among institution key informants interviewed. Tutor recruitment and retention, as well as mentorship of students by qualified nurses were identified as key intervention areas for the scale-up.
Conclusion: Nearly all students in the study cohort successfully completed training and registered with the NCK. However, a greater proportion of students trained as BScN nurses have failed to register. Further research is needed to investigate reasons for failure of BScN nurses to register. Challenges regarding tutor recruitment and retention as well as the clinical environment should be addressed for scale-up initiatives to succeed.
Table of Contents
Chapter 1:
Introduction...............................................................................................1
--Introduction and
Rationale........................................................................................1
--Problem
Statement..................................................................................................3
--Purpose
Statement..................................................................................................3
--Figure 1. Supply and Deployment Framework for Nursing in
Kenya.....................................4
--Research
Questions.................................................................................................5
Chapter 2: Review of the
Literature...............................................................................7
--The Importance of Physical Infrastructure in the Scale-Up of
Nurse Education...................10
--Tutor Recruitment and
Retention...............................................................................12
--The Clinical Experience as a Component of Training
Capacity..........................................13
--The Burden of Training Disruptions and Attrition on Nurse
Training...................................15
--Nurse Licensure/Registration Subsequent to
Training.....................................................20
Chapter 3:
Manuscript................................................................................................22
--Background...........................................................................................................24
--Results.................................................................................................................32
--Discussion.............................................................................................................39
--Conclusions...........................................................................................................42
--References............................................................................................................44
--Tables..................................................................................................................46
Chapter 4: Discussion, Conclusion and
Recommendations...................................................49
--Overview...............................................................................................................49
--Strengths and
Limitations..........................................................................................52
--Conclusion &
Recommendations..................................................................................53
References................................................................................................................55
Appendices...............................................................................................................58
--Appendix A - Quantitative Data Analysis
Plan................................................................58
--Appendix B - Key Informant Interview
Guides................................................................60
--Appendix C - Internal Review Board Exemption
Form.......................................................63
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