Nursing education challenges and solutions in Sub Saharan Africa: an integrative review

BACKGROUND

The Lancet Commission and the Global Health Workforce Alliance reported that professional education has generally not kept up the pace of health care challenges. Sub Saharan Africa needs an effective and efficient nursing education system to build an adequate, competent and relevant nursing workforce necessary for the achievement of Sustainable Development Goals. The Plan of Action for Scaling up Quality Nursing and Midwifery Education and Practice for the African Region 2012 - 2022 provided a framework for scale up of nurses and midwives. This integrative review examined literature on nursing education challenges and solutions in Sub Saharan Africa to inform development of a model for improving the quality, quantity and relevance of nursing education at local level.

METHODS

A search of PubMed, Medline on EBCSOhost and Google Scholar was conducted using key words: nursing education, challenges, solutions and/ or Africa. Published works from 2012 to 2016 were reviewed to explore reports about challenges and solution in nursing education in Sub Saharan Africa. Full texts of relevant studies were retrieved after reading the tittles and abstracts. Critical appraisal was undertaken and the findings of the relevant studies were analysed using thematic analysis.

RESULTS

Twenty articles and five grey sources were included. Findings of the review generally supports World Health Organisation framework for transformative and scale up of health professions education. Six themes emerged; curriculum reforms, profession regulation, transformative teaching strategies, collaboration and partnership, capacity building and infrastructure and resources. Challenges and solutions in nursing education are common within countries. The review shows that massive investment by development partners is resulting in positive development of nursing education in Sub Saharan Africa. However, strategic leadership, networking and partnership to share expertise and best practices are critical.

CONCLUSION

Sub Saharan Africa needs more reforms to increase capacity of educators and mentors, responsiveness of curricula, strongly regulatory frameworks, and availability of infrastructure and resources. The review adds to the body of knowledge to enhance efforts of stakeholders in the improvement of the quality, quantity and relevance of nursing education in Sub Saharan Africa.

Challenges in postgraduate research supervision in nursing education: Integrative review

AIM

The aim of this study was to investigate challenges associated with postgraduate research supervision in nursing education and possible implications for improvement efforts.

BACKGROUND

Postgraduate research-based programs in nursing education are particularly new compared to other professions. Anecdotal notes from nursing education stakeholders indicate that postgraduate research supervision encounters numerous challenges, with negative consequences for the nursing profession and for society.

METHOD

Integrative review that combines empirical and theoretical evidence was used to obtain a comprehensive picture of challenges in the supervision of postgraduate research.

DATA SOURCES

EBSCOhost; Science Direct; Google Scholar.

REVIEW METHODS

The quality of included studies was appraised using the Mixed Method Appraisal Tool for quantitative, qualitative and mixed-method studies. Two reviewers extracted data and did quality appraisal.

ANALYSIS

Inductive content analysis was used to analyse extracted data from included studies.

RESULTS

Seven studies were included. Three main categories of challenges associated with (a) institutional context, (b) research supervisors, and (c) postgraduate students.

DISCUSSION

Institutional context challenges were lack of clear guidelines for nursing schools, limited pool of appropriate research supervisors, and recruitment of many postgraduate students leading to mismatch, confusion and limited support. Research supervisors are insufficiently prepared, predominantly use traditional face-to-face method, and provide inconsistent feedback. Postgraduate students are inadequately prepared and are mostly full-time employed.

CONCLUSION

Many challenges continue to beset postgraduate research supervision in nursing discipline, with negative consequences for the quality of graduates and the quality of their research output.

THE IMPLICATION FOR NURSING POLICY

To generate useful knowledge and increase the number of motivated nursing scholars, challenges associated with postgraduate research supervision need to be addressed, with emphasis on formal training for research supervisors and development of clear guidelines for postgraduate research supervision and for recruitment of postgraduate students.

Perceived predictors of quality of life in patients with end-stage renal disease on dialysis

BACKGROUND

Reduced quality of life (QOL) is associated with shorter survival, and is more marked in patients with end-stage renal disease (ESRD). Predictors of health, which include policymaking, social factors, health services, individual behaviour, biology and genetics, have an impact on the QOL of patients with ESRD. Patients with ESRD in South Africa are cared for in public and private hospitals, with public health institutions characterised by several challenges.

OBJECTIVE

To explore and analyse the perceived predictors of QOL in patients with ESRD in the three district hospitals that provide renal services in KwaZulu-Natal.

METHODS

An exploratory, descriptive qualitative research approach based on grounded theory research design was used and three focus group discussions (FGDs) were conducted. The researcher recruited 18 participants, 6 in each focus group. Three phases of data analysis were followed: open coding, axial coding, and selective coding.

RESULTS

Predictors of QOL that emerged were the geographic location of the patients, accessibility of haemodialysis centres, patients' adaptation and acceptance of the condition, self-management, support by family members and caregivers and availability of adequately trained nurses.

CONCLUSION

Predictors of QOL in patients with ESRD are associated with an increased risk of morbidity and mortality resulting from dialysis. The broad range of dimensions of life is negatively affected and requires intervention by the renal team and policymakers to improve the QOL of patients.

Obesity is South Africa's new HIV epidemic

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