Kenya’s emergency-hire nursing programme: a pilot evaluation of health service delivery in two districts

Human Resources for Health

Martha Rogers⁴  Chris Rakuom²  Agnes N Waudo¹  Martin Osumba⁶  Michael Friedman⁵  Rose Kiriinya¹  Jennifer F Sabatier⁵  Patrick Warutere⁶  Rankesh Willy²  Francis Kimani³  Patricia L Riley⁵  Stephen M Vindigni⁵ 

[1] Kenya Health Workforce Project, Lower Hill Duplex, P.O. Box 7808–00200, Nairobi, Kenya;Office of the Chief Nursing Officer, Kenya Ministry of Medical Services, Afya House, Cathedral Road, P.O. Box 30016, Nairobi, Kenya;Office of the Director of Medical Services, Kenya Ministry of Medical Services, Afya House, Cathedral Road, P.O. Box 30016, Nairobi, Kenya;Lillian Carter Center for International Nursing, Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA 30322-4201, USA;Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, USA;Office of Health Management Information Systems, Ministry of Medical Services, Afya House, Cathedral Road, P.O. Box 30016, Nairobi, Kenya

关键词: Primary care;    Nursing;    Kenya;    Health management information systems;    Human resource information systems;    Human resources for health;    Emergency-hire programme;   

Others  :  821842
DOI  :  10.1186/1478-4491-12-16

 received in 2013-08-25, accepted in 2014-03-04,  发布年份 2014

【 摘 要 】

Objective

To assess the feasibility of utilizing a small-scale, low-cost, pilot evaluation in assessing the short-term impact of Kenya’s emergency-hire nursing programme (EHP) on the delivery of health services (outpatient visits and maternal-child health indicators) in two underserved health districts with high HIV/AIDS prevalence.

Methods

Six primary outcomes were assessed through the collection of data from facility-level health management forms—total general outpatient visits, vaginal deliveries, caesarean sections, antenatal care (ANC) attendance, ANC clients tested for HIV, and deliveries to HIV-positive women. Data on outcome measures were assessed both pre-and post-emergency-hire nurse placement. Informal discussions were also conducted to obtain supporting qualitative data.

Findings

The majority of EHP nurses were placed in Suba (15.5%) and Siaya (13%) districts. At the time of the intervention, we describe an increase in total general outpatient visits, vaginal deliveries and caesarean sections within both districts. Similar significant increases were seen with ANC attendance and deliveries to HIV-positive women. Despite increases in the quantity of health services immediately following nurse placement, these levels were often not sustained. We identify several factors that challenge the long-term sustainability of these staffing enhancements.

Conclusions

There are multiple factors beyond increasing the supply of nurses that affect the delivery of health services. We believe this pilot evaluation sets the foundation for future, larger and more comprehensive studies further elaborating on the interface between interventions to alleviate nursing shortages and promote enhanced health service delivery. We also stress the importance of strong national and local relationships in conducting future studies.

【 授权许可】

   
2014 Vindigni et al.; licensee BioMed Central Ltd.

【 图 表 】

Fig 16.

Figure 2.

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