Policy Initiatives and Effectiveness: Maldivian Nurses' Career Advancement and Remuneration

Career ladders and pay are crucial factors for policymakers aspiring to maintain an efficient workforce in the Maldives. This study aimed to analyze the perceived effectiveness of the nursing workforce policy "Job Family Standards for Nursing 2018" in enhancing movement on the local nurses' career ladder and the development of contemporary pay structures. A qualitative descriptive approach was implemented using a semi-structured expert-validated interview guide. Through purposive and snowball sampling methods, 26 participants who were decision-makers, implementors, or stakeholders in policy formulation and implementation were interviewed. The data were analyzed using thematic analysis. Two superordinate themes emerged: positive impacts and negative outcomes of the policy. The positive impacts were perceptions of greater recognition of the nursing profession, more opportunities for professional development, and evidence of salary increments. Conversely, negative outcomes were reflected in views on the policy as incomplete, flaws in professional advancement pathways, and incongruent pay structures. This study highlights the necessity to both strengthen positive impacts of policy initiatives and address negative outcomes to make the policy on the career ladder and pay structure more effective.