Advanced Nursing Practice and Advanced Practice Nursing roles within low and lower-middle-income countries

Area of Science:

• Global Health
• Nursing Workforce Development
• International Nursing Practice

Background:

• Population health initiatives depend on a skilled healthcare workforce.
• Advanced Nursing Practice (ANP) and Advanced Practice Nursing (APN) roles enhance healthcare services and access.
• Limited information exists on ANP/APN roles in Low and Lower-Middle-Income Countries (LLMICs).

Purpose of the Study:

• To describe the development and application of ANP/APN roles in LLMICs.
• To identify challenges and opportunities for ANP/APN roles in LLMICs.

Main Methods:

• A descriptive, cross-sectional, multilingual online survey was distributed to nursing experts in targeted LLMICs.
• Survey questions covered demographics, ANP/APN titles, role creation timelines, and alignment with International Council of Nurses (ICN) guidelines.
• Data from 24 participants across 24 countries were analyzed.

Main Results:

• Seventy-one ANP/APN roles were identified, predominantly developed in the last 20 years.
• Roles focus on underserved populations, with a balanced presence in primary and acute care settings.
• Significant variations in education, practice, and regulation were observed; master's-level education correlated with broader scope of practice, aligning with ICN guidelines.

Conclusions:

• ANP/APN roles in LLMICs are crucial for addressing service gaps but exhibit disparities compared to international benchmarks.
• International support from organizations and universities is vital for expanding educational programs and advancing these roles.
• Understanding operationalization of these roles informs policies for healthcare workforce development in similar settings.