Transforming nursing policy, practice and management in South Africa

Rispel, Laetitia C.

doi:10.3402/gha.v8.28005

Cited by 27 publications

(31 citation statements)

References 14 publications

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“…A similar study in South Africa using the same MJS tool also found that a large number of respondents were between the ages of 41 and 50 years, highlighting an ageing nursing workforce that has been pointed out by others [51,55,56]. Our study found that the job satisfaction of clinic nursing managers decreased for every unit increase in years qualified as a nurse and as they got older.…”

Section: Discussionsupporting

confidence: 82%

Positive practice environments influence job satisfaction of primary health care clinic nursing managers in two South African provinces

2014

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BackgroundNurses constitute the majority of the health workforce in South Africa and they play a major role in providing primary health care (PHC) services. Job satisfaction influences nurse retention and successful implementation of health system reforms. This study was conducted in light of renewed government commitment to reforms at the PHC level, and to contribute to the development of solutions to the challenges faced by the South African nursing workforce. The objective of the study was to determine overall job satisfaction of PHC clinic nursing managers and the predictors of their job satisfaction in two South African provinces.MethodsDuring 2012, a cross-sectional study was conducted in two South African provinces. Stratified random sampling was used to survey a total of 111 nursing managers working in PHC clinics. These managers completed a pre-tested Measure of Job Satisfaction questionnaire with subscales on personal satisfaction, workload, professional support, training, pay, career prospects and standards of care. Mean scores were used to measure overall job satisfaction and various subscales. Predictors of job satisfaction were determined through multiple logistic regression analysis.ResultsA total of 108 nursing managers completed the survey representing a 97% response rate. The mean age of respondents was 49 years (SD = 7.9) and the majority of them (92%) were female. Seventy-six percent had a PHC clinical training qualification. Overall mean job satisfaction scores were 142.80 (SD = 24.3) and 143.41 (SD = 25.6) for Gauteng and Free State provinces respectively out of a maximum possible score of 215. Predictors of job satisfaction were: working in a clinic of choice (RRR = 3.10 (95% CI: 1.11 to 8.62, P = 0.030)), being tired at work (RRR = 0.19 (95% CI: 0.08 to 0.50, P = 0.001)) and experience of verbal abuse (RRR = 0.18 (95% CI: 0.06 to 0.55, P = 0.001).ConclusionAllowing nurses greater choice of clinic to work in, the prevention of violence and addressing workloads could improve the practice environment and job satisfaction of PHC clinic nursing managers.

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Section: Discussionsupporting

confidence: 82%

Positive practice environments influence job satisfaction of primary health care clinic nursing managers in two South African provinces

2014

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“…Managerial incompetence has negative consequences for service delivery, well-being, and retention of health workers and health system performance (13, 15, 16). …”

Section: Introductionmentioning

confidence: 99%

An evaluation of the competencies of primary health care clinic nursing managers in two South African provinces

Munyewende

Levin

Rispel

2016

Global Health Action

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BackgroundManagerial competencies to enhance individual and organisational performance have gained currency in global efforts to strengthen health systems. Competent managers are essential in the implementation of primary health care (PHC) reforms that aim to achieve universal health coverage.ObjectiveTo evaluate the competencies of PHC clinic nursing managers in two South African provinces.DesignA cross-sectional study was conducted in two South African provinces. Using stratified random sampling, 111 PHC clinic nursing managers were selected. All supervisors (n=104) and subordinate nurses (n=383) were invited to participate in the survey on the day of data collection. Following informed consent, the nursing managers, their supervisors, and subordinate nurses completed a 40-item, 360-degree competency assessment questionnaire, with six domains: communication, leadership and management, staff management, financial management, planning and priority setting, and problem-solving. Standard deviations, medians, and inter-quartile ranges (IQRs) were computed separately for PHC nursing managers, supervisors, and subordinate nurses for competencies in the six domains. The Tinsley and Weiss index was used to assess agreement between each of the three possible pairs of raters.ResultsA 95.4% response rate was obtained, with 105 nursing managers in Gauteng and Free State completing the questionnaires. There was a lack of agreement about nursing managers’ competencies among the three groups of raters. Overall, clinic nursing managers rated themselves high on the five domains of communication (8.6), leadership and management (8.67), staff management (8.75), planning and priority setting (8.6), and problem-solving (8.83). The exception was financial management with a median score of 7.94 (IQR 6.33–9.11). Compared to the PHC clinic managers, the supervisors and subordinate nurses gave PHC nursing managers lower ratings on all six competency domains, with the lowest rating for financial management (supervisor median rating 6.56; subordinate median rating 7.31).ConclusionThe financial management competencies of PHC clinic nursing managers need to be prioritised in continuing professional development programmes.

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“…Other studies have highlighted the working conditions of nurses and professional cultures in different contexts, as well as the contrast between ideals associated with nursing roles and the lived experiences of providing health services in resource-limited countries (Martin, 2009). Literature from South Africa shows that it is impossible to understand the positionality of nurses without understanding the politics of a health system (Ditlopo et al., 2014; Fassin, 2008; Harris et al., 2016; Lewin and Green, 2009; Rispel, 2015; Schneider et al., 2010; Walker and Gilson, 2004). In Senegal, female and male nurses are present at all levels of the health system; however, they are not present at the central level in national decision-making processes (Seck, 2010).…”

Section: Envisioned Diaries: Researching the Pyramidal Bureaucracies mentioning

confidence: 99%

Why didn’t you write this in your diary? Or how nurses (mis)used clinic diaries to (re)claim shared reflexive spaces in Senegal

Duclos

Ndoye²,

Faye³

et al. 2019

Critique of Anthropology

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Between 2015 and 2017, we implemented the clinic diaries project as part of the qualitative component of an evaluation of a supply chain intervention for family planning in Senegal. This project combined different tools including the diaries and participatory workshops with nurses. At the intersection between writings and silences, this paper explores the role played by the clinic diaries to mediate ethnographic encounters, and the iterative nature of ‘doing fieldwork’ to produce knowledge in hierarchical health systems. This paper also reflects on the processes through which the diaries created a space where accounts of lived experiences routinely unfolding in health facilities could be shared, in the context of a health system increasingly dominated by metrics, performances and vertical reporting mechanisms. The clinic diaries research process therefore sheds light on the limits of approaching bureaucratic norms and practices as coming from the top, an approach reinforced by data reporting and coordination mechanisms in the Senegalese pyramidal health system. In contrast, the diaries suggest a role for participative ethnography to identify collegial spaces to reflect on shared experiences in and of bureaucratic spaces.

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Transforming nursing policy, practice and management in South Africa

Cited by 27 publications

References 14 publications

Positive practice environments influence job satisfaction of primary health care clinic nursing managers in two South African provinces

Positive practice environments influence job satisfaction of primary health care clinic nursing managers in two South African provinces

An evaluation of the competencies of primary health care clinic nursing managers in two South African provinces

Why didn’t you write this in your diary? Or how nurses (mis)used clinic diaries to (re)claim shared reflexive spaces in Senegal

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