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Author Notes:

Correspondence: stephen.vindigni@gmail.com 1 University of Washington School of Medicine, 1959 NE Pacific Street, Box 356421, Seattle, WA 98195-6421, USA

See publication for full list of author contributions.

This evaluation would have not have been possible without the strong support of the Kenya Ministry of Health, the Centers for Disease Control and Prevention (U.S. Headquarters and Kenya Country Office), Emory University, and the Kenya Health Workforce Project Office.

Additional gratitude is accorded to Subroto Banerji and Tom Oluoch, who were both instrumental in facilitating the logistics of this evaluation.

The findings and conclusions in this report are those of the author(s) and do not necessarily reflect the views of the Centers for Disease Control and Prevention.

This evaluation protocol was approved by the Emory University Institutional Review Board and the Kenya Ministry of Health.

The authors declare that they have no competing interests.

Subjects:

Research Funding:

All authors declare: no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work.

Keywords:

  • Science & Technology
  • Social Sciences
  • Life Sciences & Biomedicine
  • Health Policy & Services
  • Industrial Relations & Labor
  • Health Care Sciences & Services
  • Business & Economics
  • HEALTH POLICY & SERVICES
  • INDUSTRIAL RELATIONS & LABOR
  • Emergency-hire programme
  • Human resources for health
  • Human resource information systems
  • Health management information systems
  • Kenya
  • Nursing
  • Primary care
  • HUMAN-RESOURCES
  • RURAL-AREAS
  • NURSES
  • SHORTAGE
  • SYSTEMS
  • AFRICA
  • CRISIS

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

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Journal Title:

Human Resources for Health

Volume:

Volume 12, Number 1

Publisher:

, Pages 16-16

Type of Work:

Article | Final Publisher PDF

Abstract:

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.

Copyright information:

© 2014 Vindigni et al.; licensee BioMed Central Ltd.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 2.0 Generic License (http://creativecommons.org/licenses/by/2.0/).

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