It takes a (children's nursing) workforce
Creators: name: Ruthe, Jennifer
Publisher: name: Zenodo
Year: 2020
Subjects: Nursing, Children's nursing, South Africa, Human Resources for Health

description: <strong>ABSTRACT</strong> <strong>Context:</strong> There is no health without a workforce. Rooted in the original concept of comprehensive primary healthcare, the World Health Organization sets Human Resources for Health (HRH) as one of six buildings blocks needed to direct health system strengthening towards universal health coverage (2007). Yet despite this ambition, a disconnect between theory and action exists - with forecasts predicting a global shortage of 14.53 million health workers in 2030 (WHO 2016a, p.18). Whilst this represents a marginal improvement on the current situation, Africa’s shortfall is set to grow from 4.19 million in 2013 to 6.09 million (WHO 2016a, p.18). Nurses make up 50% of this (WHO 2016a, p.18). Yet their role is often overlooked and undervalued, with literature showing a growing international focus on broader HRH and low-level, generalist care putting the role, education and training of professional and specialist cadres (including children’s nurses) at risk. <br> <strong>Methodology: </strong>Based at the Department of Paediatrics and Child Health at the University of Cape Town, South Africa, the Child Nurse Practice Development Initiative (CNPDI) is committed to building a children’s nursing workforce “for Africa, in Africa”, with this study using a mixed methodological approach to examine their direct contribution to the delivery of an educated children’s nursing workforce. To deliver on this, the CNPDI shared anonymised raw programme data. This included information on all student enrolments over the last 11 years - their age, gender, nationality, year of registration, course, funding source and graduation date. Where available, it also recorded information against baseline/current circumstance, practice environment and role. This data was then triangulated with desk-based research from on-line public sources (including government websites, national data sets, institutional websites and academic placement finders) in order to contextualise programme throughput and gain new understanding as to the origin, organisation, movement and long-term retention of CNPDI enrolments and alumni. Results were ‘member-checked’ for improved accuracy (Birt et al. 2016). <br> <strong>Findings:</strong> Research shows the CNPDI welcoming 348 enrolments in 11 years, 75% of which are South African, 25% of which travelled from 10 other sub-Saharan countries. With a graduation rate of 94%, this has seen the CNPDI qualify 170 individual children’s nurses, 131 critical care children’s nurses and 11 advanced practitioners from nine African countries. Available data also shows the team making a sustained contribution to workforce development, with 99% of known alumni continuing to work in Africa. Of those where direct follow-up data is available, 91% are based at their original centre of employment. Almost all enrolments and alumni are linked to top-tier, public hospital facilities - although a small percentage have moved into education. In total, 9% of all known CNDPI alumni work in educational facilities, with 63% working in centres that offer (or will offer) children’s nursing. <br> <strong>Conclusion: </strong>The CNPDI is an important contributor to the development of a children’s nursing workforce in South Africa and across the continent. But in-country enrolments are slowing, with discussion showing the extent to which such programmes are connected to broader issues in health, education and labour market development. As such, five recommendations for future development are made: improved data capture; new research; landscape analysis; recruitment planning; marketing and advocacy. To support this process the researcher asks the South African government to renew its commitment to children’s nursing, and for the international community to recognise and reinforce this need by advocating a mandate of comprehensive care and supporting national governments in their plans to deliver this.
description: A dissertation submitted to the University of Manchester for the degree of MSc in Global Health in the Humanitarian and Conflict Response Institute.