Kenya’s emergency-hire nursing programme: a pilot evaluation of health service delivery in two districts

Details

• Alternative Title:
  Hum Resour Health
• Personal Author:
  Vindigni, Stephen M ; Riley, Patricia L ; Kimani, Francis ; Willy, Rankesh ; Warutere, Patrick ; Sabatier, Jennifer F ; Kiriinya, Rose ; Friedman, Michael ; Osumba, Martin ; Waudo, Agnes N ; Rakuom, Chris ; Rogers, Martha
• Description:
  Objective
  
  To assess the feasibility of utilizing a small-scale, low-cost, pilot evaluation in assessing the short-term impact of Kenya’s emergency-hire nursing programme (EHP) on the delivery of health services (outpatient visits and maternal-child health indicators) in two underserved health districts with high HIV/AIDS prevalence.
  
  Methods
  
  Six primary outcomes were assessed through the collection of data from facility-level health management forms—total general outpatient visits, vaginal deliveries, caesarean sections, antenatal care (ANC) attendance, ANC clients tested for HIV, and deliveries to HIV-positive women. Data on outcome measures were assessed both pre-and post-emergency-hire nurse placement. Informal discussions were also conducted to obtain supporting qualitative data.
  
  Findings
  
  The majority of EHP nurses were placed in Suba (15.5%) and Siaya (13%) districts. At the time of the intervention, we describe an increase in total general outpatient visits, vaginal deliveries and caesarean sections within both districts. Similar significant increases were seen with ANC attendance and deliveries to HIV-positive women. Despite increases in the quantity of health services immediately following nurse placement, these levels were often not sustained. We identify several factors that challenge the long-term sustainability of these staffing enhancements.
  
  Conclusions
  
  There are multiple factors beyond increasing the supply of nurses that affect the delivery of health services. We believe this pilot evaluation sets the foundation for future, larger and more comprehensive studies further elaborating on the interface between interventions to alleviate nursing shortages and promote enhanced health service delivery. We also stress the importance of strong national and local relationships in conducting future studies.
  
  
• Subjects:
  Adult Child Delivery, Obstetric Delivery Of Health Care Emergency Nursing Female HIV Infections Humans Nurses Personnel Selection Pregnancy Pregnancy Complications, Infectious Prenatal Care Program Evaluation Research

  More +
• Source:
  Hum Resour Health. 2014; 12:16.
• Pubmed ID:
  24636052
• Pubmed Central ID:
  PMC4003900
• Document Type:
  Journal Article
• Place as Subject:
  Kenya
• Volume:
  12
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:f3d5f854435d9563e0a4738922702c1c67728337795fb8cec32460ec5a41c724
• Download URL:
  https://stacks.cdc.gov/view/cdc/27655/cdc_27655_DS1.pdf
• File Type:
  [PDF - 1.35 MB ]