Developing a specialist children's nursing workforce in sub-Saharan Africa: a descriptive programme evaluation

Area of Science:

• Public Health
• Nursing Workforce Development
• Global Health Equity

Background:

• Low and lower-middle income countries face a significant shortage of nurses, estimated at 5.25 million, hindering Universal Health Coverage.
• The specialist children's nursing workforce in most African nations is critically underdeveloped, falling below recommended densities.
• The Child Nursing Practice Development Initiative (CNPDI) was established to bolster the children's nursing workforce in Southern/Eastern Africa and Ghana.

Purpose of the Study:

• To evaluate the activities of the CNPDI from 2008 to 2018.
• To inform program review and identify lessons for specialist nursing workforce strengthening initiatives.
• To assess the impact of the CNPDI on the children's nursing workforce in the target regions.

Main Methods:

• A descriptive program evaluation methodology was employed.
• Analysis included quantitative program data and qualitative contextual information from documentary sources.
• Anonymized student enrollment data from 2008-2018 were analyzed, with findings member-checked for accuracy.

Main Results:

• The CNPDI recorded 348 enrollments over 11 years, with 75% from South Africa and 25% from other sub-Saharan African countries.
• A high course completion rate of 94% was achieved, with 99% of known alumni remaining in Africa by 2018.
• Most graduates work in specialist public hospitals, with 9% in education and 54% at institutions offering children's nursing education.

Conclusions:

• The CNPDI made a significant, positive contribution to the specialist children's nursing workforce in nine African countries.
• High completion and retention rates suggest promising program design and delivery approaches.
• Outputs are modest relative to the need; clearer vision, role definition, and costed plans are essential for scaling impact towards Universal Health Coverage.