Effects of changes in the pre-licensure education of health workers on health-worker supply

Pariyo, George; Kiwanuka, Suzanne N; Rutebemberwa, Elizeus; Okui, Olico; Ssengooba, Freddie

doi:10.1002/14651858.cd007018.pub2

Cited by 7 publications

(3 citation statements)

References 19 publications

(1 reference statement)

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“…Supportive workplace interventions in our review, including mentorship and professional support, demonstrated a generally positive effect on retention, with risk ratios up to 1.4. This is slightly higher than some studies in the literature, where risk ratios ranged from 1.1 to 1.3 [26,27]. The variation might reflect the differing methodologies and contexts of these studies, underscoring the importance of contextually adapted interventions.…”

Section: Resultscontrasting

confidence: 55%

Enhancing the Retention of Healthcare Workers in Rural Areas: A Systematic Review

Rawas,

Al-Matared,

Al-Hutailah

et al. 2023

IJSR

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Introduction: Rural areas globally face significant challenges in retaining healthcare workers, impacting the delivery of essential health services and exacerbating health disparities. This systematic review aimed to evaluate the effectiveness of various strategies implemented over the last 15 years to enhance healthcare worker retention in rural settings, with the goal of identifying evidence-based interventions that can inform policy and practice to improve rural healthcare delivery. Methods: The review focused exclusively on interventional studies and clinical trials published from 2007 to 2022. A comprehensive search of multiple databases, including PubMed, MEDLINE, Embase, CINAHL, and the Cochrane Library, was conducted using specific search terms related to healthcare worker retention in rural areas. Inclusion criteria targeted studies evaluating quantifiable outcomes of retention strategies, with exclusion criteria set to omit non-interventional studies, research focused on urban settings, and non-English publications. The study selection, data extraction, and quality assessment processes were rigorously conducted to ensure the reliability of the findings. Results: Twelve studies met the inclusion criteria, revealing a broad range of interventions from financial incentives and educational programs to supportive workplace interventions and community engagement strategies. Financial incentives demonstrated a notable positive impact on retention, with risk ratios ranging from 1.2 to 1.75, indicating a 20% to 75% increase in retention rates. Supportive workplace interventions also showed effectiveness, with a risk ratio of up to 1.4. However, the results for educational and community engagement strategies were more variable, suggesting the need for tailored approaches. Conclusions: The review highlights the effectiveness of targeted interventions in enhancing the retention of healthcare workers in rural areas, particularly financial incentives and supportive workplace interventions. These findings underscore the importance of implementing multifaceted, evidence-based strategies tailored to the unique challenges of rural healthcare settings to improve workforce stability and healthcare delivery.

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Section: Resultscontrasting

confidence: 55%

Enhancing the Retention of Healthcare Workers in Rural Areas: A Systematic Review

Rawas,

Al-Matared,

Al-Hutailah

et al. 2023

IJSR

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“…Targeted recruitment of qualified students from rural and low-resource settings was a particularly effective strategy for retaining students in vulnerable communities after graduation [ 7 , 8 ]. An applicant’s specific expression of interest in the profession was important to student retention [ 9 ]. Student support strategies (for example, financial support and mentoring) offered some advantage to student retention and expanded student diversity [ 10 - 12 ].…”

Section: Resultsmentioning

confidence: 99%

An integrative review and evidence-based conceptual model of the essential components of pre-service education

Johnson¹,

Fogarty²,

Fullerton³

et al. 2013

Hum Resour Health

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BackgroundWith decreasing global resources, a pervasive critical shortage of skilled health workers, and a growing disease burden in many countries, the need to maximize the effectiveness and efficiency of pre-service education in low-and middle-income countries has never been greater.MethodsWe performed an integrative review of the literature to analyse factors contributing to quality pre-service education and created a conceptual model that shows the links between essential elements of quality pre-service education and desired outcomes.ResultsThe literature contains a rich discussion of factors that contribute to quality pre-service education, including the following: (1) targeted recruitment of qualified students from rural and low-resource settings appears to be a particularly effective strategy for retaining students in vulnerable communities after graduation; (2) evidence supports a competency-based curriculum, but there is no clear evidence supporting specific curricular models such as problem-based learning; (3) the health workforce must be well prepared to address national health priorities; (4) the role of the preceptor and preceptors’ skills in clinical teaching, identifying student learning needs, assessing student learning, and prioritizing and time management are particularly important; (5) modern, Internet-enabled medical libraries, skills and simulation laboratories, and computer laboratories to support computer-aided instruction are elements of infrastructure meriting strong consideration; and (6) all students must receive sufficient clinical practice opportunities in high-quality clinical learning environments in order to graduate with the competencies required for effective practice. Few studies make a link between PSE and impact on the health system. Nevertheless, it is logical that the production of a trained and competent staff through high-quality pre-service education and continuing professional development activities is the foundation required to achieve the desired health outcomes. Professional regulation, deployment practices, workplace environment upon graduation and other service delivery contextual factors were analysed as influencing factors that affect educational outcomes and health impact.ConclusionsOur model for pre-service education reflects the investments that must be made by countries into programmes capable of leading to graduates who are competent for the health occupations and professions at the time of their entry into the workforce.

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“…However, discourses regarding nursing education reform in low- and middle-income countries are different. The emphasis is more on educational changes required to address the global shortage, maldistribution, retention, skills mix, scope of practice, and performance of nurses so as to strengthen health systems, scale up priority health interventions and achieve universal coverage ( 43 – 46 ). For example, the recent World Health Organization (WHO) report on global standards for the initial education of professional nurses and midwives makes reference to the global shift towards university-based nursing education but identifies this as a goal for the future ( 47 ).…”

Section: Discussionmentioning

confidence: 99%

Nursing education reform in South Africa – lessons from a policy analysis study

Blaauw¹,

Ditlopo²,

Rispel

2014

Global Health Action

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BackgroundNursing education reform is identified as an important strategy for enhancing health workforce performance, and thereby improving the functioning of health systems. Globally, a predominant trend in such reform is towards greater professionalisation and university-based education. Related nursing education reform in South Africa culminated in a new Framework for Nursing Qualifications in 2013.ObjectiveWe undertook a policy analysis study of the development of the new Nursing Qualifications Framework in South Africa.DesignWe used a policy analysis framework derived from Walt and Gilson that interrogated the context, content, actors, and processes of policy development and implementation. Following informed consent, in-depth interviews were conducted with 28 key informants from national and provincial government; the South African Nursing Council; the national nursing association; nursing academics, managers, and educators; and other nursing organisations. The interviews were complemented with a review of relevant legislation and policy documents. Documents and interview transcripts were coded thematically using Atlas-ti software.ResultsThe revision of nursing qualifications was part of the post-apartheid transformation of nursing, but was also influenced by changes in the education sector. The policy process took more than 10 years to complete and the final Regulations were promulgated in 2013. The two most important changes are the requirement for a baccalaureate degree to qualify as a professional nurse and abolishing the enrolled nurse with 2 years training in favour of a staff nurse with a 3-year college diploma. Respondents criticised slow progress, weak governance by the Nursing Council and the Department of Health, limited planning for implementation, and the inappropriateness of the proposals for South Africa.ConclusionsThe study found significant weaknesses in the policy capacity of the main institutions responsible for the leadership and governance of nursing in South Africa, which will need to be addressed if important nursing education reforms are to be realised.

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Effects of changes in the pre-licensure education of health workers on health-worker supply

Cited by 7 publications

References 19 publications

Enhancing the Retention of Healthcare Workers in Rural Areas: A Systematic Review

Enhancing the Retention of Healthcare Workers in Rural Areas: A Systematic Review

An integrative review and evidence-based conceptual model of the essential components of pre-service education

Nursing education reform in South Africa – lessons from a policy analysis study

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