Browsing by Author "North, Natasha"
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- ItemOpen AccessDistinctive nursing practices in working with mothers to care for hospitalised children at a district hospital in KwaZulu-Natal, South Africa: a descriptive observational study(2020-04-19) North, Natasha; Leonard, Angela; Bonaconsa, Candice; Duma, Thobeka; Coetzee, MinetteBackground The presence of family members and their active involvement in caring for hospitalised children is an established practice in many African paediatric settings, with family members often regarded as a resource. This aspect of African paediatric nursing practice lacks formal expression or a clear conceptual basis, and difficulties arise when applying concepts of family involvement originating from the culturally distinct practice environments of higher resourced settings including Europe and America. The aim of this study was to articulate a nurse-led practice innovation intended to facilitate family involvement in the care of hospitalised children, observed in a paediatric inpatient ward in a district hospital in rural KwaZulu-Natal, South Africa. Methods A qualitative case study design was used. Data collection included visual research methods (graphic facilitation, sociograms and photo-elicitation) as well as a focus group, interviews and practice observation. Activities associated with 20 nurses and 22 mother-child dyads were observed. Data were subjected to content analysis, with Standards for Reporting Qualitative Research (SRQR) applied. Results Findings relate to six aspects of practice, categorised thematically as: preserving the mother-child pair; enabling continuous presence; psychological support and empathy; sharing knowledge; mothers as a resource; and belief and trust. Conclusion The nursing practices and organisational policies observed in this setting relating to the facilitation of continuous maternal presence represent a distinctive nursing practice innovation. This deliberate practice contrasts with models of care provision which originate in higher resourced settings including Europe and America, such as Family Centred Care, and contrasts with informal practices in local African settings which tolerate the presence of mothers in other settings, as well as local institutional policies which limit mothers’ presence to varying extents.
- ItemOpen AccessThe children’s nursing workforce in Kenya, Malawi, Uganda, South Africa and Zambia: generating an initial indication of the extent of the workforce and training activity(2019-05-07) North, Natasha; Shung-King, Maylene; Coetzee, MinetteBackground This study sought to identify, as far as possible, the extent of the specialist children’s nursing workforce in five selected African countries. Strengthening children’s nursing training has been recommended as a primary strategy to reduce the under-five mortality rate in African nations. However, information about the extent of the specialist children’s nursing workforce in this region is not routinely available. Developing an accurate depiction of the specialist children’s nursing workforce is a necessary step towards optimising children’s health service delivery. Methods This study used a convergent parallel mixed methods design, incorporating quantitative (surveys) and qualitative (questionnaire and interview) components, to generate data addressing three related questions: how many children’s nurses are believed to be in practice nationally, how many such nurses are recorded on the national nursing register and how many children’s nurses are being produced through training annually. Results Data provide insights into reported children’s nursing workforce capacity, training activity and national training output in the five countries. Findings suggest there are approximately 3728 children’s nurses across the five countries in this study, with the majority in South Africa. A total of 16 educational programmes leading to a qualification in paediatric nursing or child health nursing are offered by 10 institutions across the countries in this study, with Kenya, Malawi and Zambia having one institution each and South Africa hosting seven. Data suggest that existing human resources for health information systems do not currently produce adequate information regarding the children’s nursing workforce. Analysis of qualitative data elicited two themes: the role of children’s nurses and their position within health systems, and the capacity of HRH information systems to accurately reflect the specialist children’s nursing workforce. Conclusion The data generated provide an initial indication of the size of the children’s nursing workforce in these five countries, as well as an overview of associated training activity. We hope that they can start to inform discussion about what would represent a viable and sustainable regional children’s nursing workforce for the future.
- ItemOpen AccessWhat is the capacity of the children's nursing workforce in seven selected Sub-Saharan African countries? Gathering insights from Botswana, Kenya, Namibia, Malawi, South Africa, Uganda and Zambia(2018) North, Natasha; Coetzee, Minette; King, Shung MayleneBackground This study attempted to identify as far as possible the extent of the children’s nursing workforce in five selected countries in the sub-Saharan African region. Strengthening children’s nursing training has been recommended as a primary strategy to reduce the underfive mortality rate in African nations, including South Africa and Malawi. The current level of data monitoring capacity worldwide means that it is not possible to disaggregate the children’s nursing workforce in countries in the World Health Organisation African Region from the data provided by the WHO Global Atlas of the Health Workforce database. Yet developing an accurate depiction of the specialist children’s nursing workforce is a necessary step towards optimizing children’s health service delivery. Methods In attempting to respond to this need, this study adheres to a collaborative research philosophy, using a convergent parallel mixed methods design, incorporating a scoping documentary review, together with quantitative (surveys and case study compilation) and qualitative (interview) components collected independently and then integrated during analysis and interpretation, to generate data addressing three related questions: how many children’s nurses are believed to be in practice nationally; how many such nurses are recorded on the nursing register nationally; and how many children’s nurses are being produced through training. Results Findings suggest there are approximately 3 728 children’s nurses across the five countries in this study. A combined total of 260 children’s nurses are produced through training each year across the five countries on average. Survey responses, interview data and content analysis of items identified through the scoping review suggest that adequate information regarding the children’s nursing workforce is not currently available to inform decision-making. Conclusion In conclusion, it is hoped that the data generated might contribute towards identifying the size of the children’s nursing workforce, as a first step towards identifying what would represent a viable and sustainable regional children’s nursing workforce for the future.