A Formative Assessment of Nurses' Leadership Role in Zambia's Community Health System
| Autor: | Gail Tomblin Murphy, Marjorie Kabinga-Makukula, Laura Hollod, Charity Kapenda, Stembile Mugore, Carolyn Moore, Claire I. Viadro, Judith Shamian, Nellisiwe Chizuni, Allison Annette Foster, Fastone Goma |
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| Rok vydání: | 2018 |
| Předmět: |
National Health Programs
Population Zambia Nurse's Role Formative assessment Interviews as Topic 03 medical and health sciences 0302 clinical medicine Nursing Political science Humans 030212 general & internal medicine Community Health Services Health Workforce education Education Nursing Community Health Workers education.field_of_study 030219 obstetrics & reproductive medicine Primary Health Care Rural health Stakeholder Community Participation Focus group Digital health Quality Improvement Leadership Community health Respondent Clinical Competence Rural Health Services |
| Zdroj: | World healthpopulation. 17(3) |
| ISSN: | 1718-3340 |
| Popis: | Background Despite its achievements in decreasing HIV prevalence and under-five mortality, Zambia still faces high maternal and neonatal mortality, particularly in the rural and remote areas where almost 60% of the population resides. After significant investments in developing its community health system, the Zambian Ministry of Health was interested to understand how to leverage the role of nurses to sustain achievements made and further improve the quality of care in rural communities. The Ministry joined research partners in an assessment into the role and leadership capacity of nurses heading rural health facilities. Methods A seven-member research team conducted 30 in-depth interviews and 10 focus group discussions in four provinces with four categories of respondents: national decision-makers, provincial and district managers, rural facility staff and community respondents (neighborhood health committee members and volunteers). An initial scoping visit and literature review informed the development of specific interview guides for each category of respondent. After audio-recording and transcription, research team members identified and reached consensus on key themes, and presented and validated the findings at a national stakeholder workshop. Results Zambia's front-line health teams are a complex mixture of professional facility staff, community providers, community-based volunteers and neighborhood health committees. Nurses and nurse-midwives head over half the rural facilities in Zambia, where they are expected to lead the delivery of safe, high-quality care with staff and volunteers who often operate beyond their level of training. Nurses and midwives who are assigned to head rural facilities are not adequately prepared or recognized for the leadership responsibilities they are expected to fulfill. Conclusions This paper highlights opportunities to support rural facility heads in effectively leading front-line health teams to deliver primary healthcare to rural communities. Front-line teams require a leader to coordinate and motivate seamless and sustainable quality services that are accessible to all. Zambia has the potential to support integrated, responsive quality care and advance toward universal health coverage if nurses are adequately prepared and recognized with job descriptions that reflect their responsibilities and opportunities for career advancement. |
| Databáze: | OpenAIRE |
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