Exploring the unmet needs for creating an enabling environment for nurturing care to promote migrant child health in Bishkek, Kyrgyzstan: A theory-guided community-based participatory action research

Nursing core competencies and educational needs in the low- and middle-income country: A cross-sectional study

BACKGROUND

The government of the Kyrgyz Republic is committed to improving healthcare worker education, and as nurses comprise the majority of healthcare workers, improving nursing education and competency is a critical policy strategy. However, insufficient understanding of nurses' duties and competencies, low levels of professional education and motivation, and the poor reputation of the profession have negatively impacted the development of nursing in the Kyrgyz Republic.

AIM

This study aimed to identify the core competencies of nursing that are necessary for improving healthcare in the Kyrgyz Republic.

DESIGN

The research design was a cross-sectional study.

SETTING

The study was conducted from June to November 2022 across the Kyrgyz Republic.

PARTICIPANTS

A total of ten focus group interviews were conducted with 54 participants, and 289 individuals responded to the survey.

METHODS

A job analysis was conducted to identify nursing core competencies, followed by focus group interviews. Educational needs were assessed and analysed for importance and performance using the Competency Inventory for Registered Nurses and the Borich Needs Assessment Model.

RESULTS

Of the 289 participants, 97.9 % were female, the mean age was 43.22, and the mean nursing career length was 19 years. Eleven duties were identified as nursing core competencies. Educational needs were highest for teaching-coaching, followed by clinical care and critical thinking and research aptitude, with interpersonal relations being the lowest. Critical thinking and research aptitude, clinical care, and professional development were identified as topics with high importance and educational needs.

CONCLUSIONS

The nursing core competencies reflect the emphasis on primary health care in the Kyrgyz Republic, while the educational needs were related to international nursing standards and national nursing education characteristics. The findings can be used to develop a bachelor's-level nursing curriculum in the Kyrgyz Republic to improve nursing care and contribute to improving the health status of the population.

Normalising participatory health research approaches in the WHO European region for refugee and migrant health: a paradigm shift

While people's involvement in health research is increasingly the encouraged norm in many countries, the involvement of refugees and migrants in research about their health is rare. Here, we call for a paradigm shift in the field of refugee and migrant health to make participatory health research routine, i.e. normalised. To disrupt 'business as usual', we synthesise evidence about meaningful research partnerships and features of inclusive participatory spaces. We present examples of decolonial, culturally attuned methods that can be used to reimagine and reinvigorate research practice because they encourage critical reflexivity and power-sharing: arts-based research using music and singing, participatory learning and action research, Photovoice and co-design (ideas generation) workshops. We consider the consequences of not making this paradigm shift. We conclude with recommendations for specific structural and policy changes and empirical research questions that are needed to inform the normalisation of participatory health research in this field.

Understanding community health workers' activities in a community-based child health promotion project in Kyrgyzstan

BACKGROUND

Community health workers (CHWs) have strong potential for conducting health initiatives in vulnerable countries. Their continuing activities are essential for positive outcomes. The purpose of this study is to understand CHW activities in Kyrgyzstan migrant villages and their impact on individuals and communities.

METHODS

This study used a mixed-method design. All active CHWs were invited to participate in the survey and the first reflection note regarding their experience and satisfaction with CHW activities. Respondents who agreed to participate in the second reflection notes wrote additional reflection notes. Participatory observational CHW activity report meeting data was collected for additional qualitative analysis. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed thematically.

RESULTS

CHWs started their activities with altruistic and personal motives, such as social recognition and knowledge acquisition. Job-related satisfaction after the activity tended to be high. After performing home visits and resident participatory events, they experienced intrinsic motivation, resource mobilization efforts, increased autonomy, and social recognition. Although the material rewards were small as volunteers, they recognized their positive impact on individuals and communities and gained pride and happiness.

CONCLUSIONS

CHWs participating in health promotion projects had training and CHW-nurse network activities and were gradually empowered in the process. When considering the sustainability of CHW activities, it is important to increase self-confidence and strengthen social recognition through empowerment.

Exploring community engagement in place-based approaches in areas of poor health and disadvantage: A scoping review

A scoping review was conducted to explore the characteristics, barriers, and enablers of community engagement in place-based approaches to improving health outcomes in a designated area of poor health and disadvantage. The Joanna Briggs Institute methodology for scoping reviews was used. Forty articles met the inclusion criteria of which 31 were conducted in the United Kingdom, United States, Canada, or Australia, and 70% used qualitative methods. The health initiatives were delivered in multiple settings including neighbourhoods, towns, and regions and with a range of population groups including Indigenous and migrant communities. Trust, power, and cultural considerations were the most significant barriers and enablers to community participation in place-based approaches. Developing trust is key to success in community-led, place-based initiatives.

Migrants' involvement in health policy, service development and research in the WHO European Region: A narrative review of policy and practice

OBJECTIVES

The involvement of individuals and communities in health decision-making is enshrined in WHO policies. However, migrant groups are under-represented in health decision-making processes. Our aim was to explore migrants' involvement in health policy, service development and research in the WHO European Region to identify levers for inclusive and meaningful practice.

METHODS

We conducted a narrative review of grey literature and peer-reviewed research on migrants' involvement in health decision-making across the 53 countries in WHO Europe. We searched for articles published in English between 2010 and the present in two electronic databases (PubMed, Scopus), IOM MIPEX Health Strand country reports, the EU SOPHIE project and using a Google advanced search. Findings were analysed descriptively and using Normalisation Process Theory to investigate levers and barriers to implementation of policy into practice.

RESULTS

Of 1,444 articles retrieved, 79 met the inclusion criteria. We identified 20 policies promoting migrants' involvement, but national-level policies were present in only two countries. We identified 59 examples of migrants' involvement in practice from half of the WHO Europe countries (n = 27). Our Normalisation Process Theory (NPT) analysis of 14 peer-reviewed empirical papers found that participatory research approaches are a lever to putting policy into practice in a meaningful way.

CONCLUSIONS

Migrants' involvement in health decision-making requires explicit national policies that are implemented evenly across policymaking, service provider and research activities in all countries in the WHO European Region. Participatory approaches to involvement activities are encouraged because they are a lever to perceived barriers to migrants' involvement.