Nurses and midwives demographic shift in Ghana—the policy implications of a looming crisis
Tóm tắt
As part of measures to address severe shortage of nurses and midwives, Ghana embarked on massive scale-up of the production of nurses and midwives which has yielded remarkable improvements in nurse staffing levels. It has, however, also resulted in a dramatic demographic shift in the nursing and midwifery workforce in which 71 to 93% of nurses and midwives by 2018 were 35 years or younger, as compared with 2.8 to 44% in 2008. In this commentary, we examine how the drastic generational transition could adversely impact on the quality of nursing care and how the educational advancement needs of the young generation of the nursing and midwifery workforce are not being met. We propose the institution of a national nursing and midwifery mentorship programme and a review of the study leave policy to make it flexible and be based on a comprehensive training needs assessment of the nursing and midwifery workforce. We further advocate that policymakers should also consider upgrading all professional nursing and midwifery programmes to bachelor degrees as this would not only potentially enhance the quality of training but also address the phenomenon of large numbers of nurses and midwives seeking bachelor degree training soon after employment—sometimes putting them at the offending side of organisational policy.
Tài liệu tham khảo
Boniol M, McIsaac M, Xu L, Wuliji T, Diallo K, Campbell J. Gender equity in the health workforce: analysis of 104 countries. Geneva: World Health Organ; 2019. p. 8.
George A. Human resources for health: a gender analysis. 2007. p. 57. https://www.who.int/social_determinants/resources/human_resources_for_health_wgkn_2007.pdf?ua=1
WHO. The world health report: 2006: working together for health. 2006; Available from: http://apps.who.int/iris/handle/10665/43432. [Cited 10 Oct 2016]
MOH. Human resource policies and strategies for the health sector, 2007–2011 [Internet]. Ghana: Ministry of Health; 2007. Available from: www.moh.gov.gh
Sagoe K. Human resources for health - challenges and strategies to address them in sub-Saharan Africa. 2013. Available from: http://www.fatoafrique.org/congres2013/IMG/pdf/sagoe_kenneth_ppt_fr.pdf. [cited 24 Mar 2019]
GHS. Human resource directorate annual report for 2017. Accra: Ghana Health Service, Human Resource Directorate; 2018.
Campbell J, Buchan J, Cometto G, David B, Dussault G, Fogstad H, et al. Human resources for health and universal health coverage: fostering equity and effective coverage. Bull World Health Org. 2013;91(11):853–63 Available from: http://www.scielosp.org/scielo.php?pid=S0042-96862013001100853&script=sci_arttext. [cited 29 Jan 2017].
WHO. Equitable access to functional health workforce and community health workers in the africa region [Internet], WHO Regional Forum on Strengthening Health Systems for the SDGs and UHC. Windhoek; 2016.
GHS. Human resource annual report - 2018. Accra: Ghana Health Service; 2019.
Asamani JA, Chebere MM, Barton PM, D’Almeida SA, Odame EA, Oppong R. Forecast of healthcare facilities and health workforce requirements for the public sector in Ghana, 2016–2026. Int J Health Policy Manag. 2018;0(0) Available from: http://www.ijhpm.com/article_3525.html. [Cited 7 Aug 2018].
Scheffler RM, Mahoney CB, Fulton BD, Dal Poz MR, Preker AS. Estimates of health care professional shortages in sub-Saharan Africa by 2015. Health Aff (Millwood). 2009;28(5):w849–62 Available from: http://content.healthaffairs.org/cgi/doi/10.1377/hlthaff.28.5.w849. [Cited 3 Jun 2016].
Amadu H. The rising trend in nurses unemployment: the need to include entrepreneurship in our nursing colleges curriculum [Internet]: Modern Ghana; 2018. Available from: https://www.modernghana.com/news/886516/the-rising-trend-in-nurses-unemployment-the-need-to-include.html. [cited 24 Mar 2019]
Elorm. Bonded nurses and midwives demand postings to health facilities [Internet]: Ghana Business News; 2018. Available from: https://www.ghanabusinessnews.com/2018/09/07/bonded-nurses-and-midwives-demand-postings-to-health-facilities/. [Cited 24 Mar 2019]
Appiah-Denkyira E, Herbst CH. Toward evidence-based interventions for HRH. 2013 . Available from: http://elibrary.worldbank.org/doi/abs/10.1596/9780821396674_CH01. [Cited 29 Jan 2017].
Dzomeku MV. Maternal satisfaction with care during labour: a case study of the Mampong-Ashanti district hospital maternity unit in Ghana. Int J Nurs Midwifery. 2011;3(3):30–4 Available from: http://www.academicjournals.org/journal/IJNM/article-full-text-pdf/154DAFD809. [cited 17 Nov 2016].
Moyer CA, Rominski S, Nakua EK, Dzomeku VM, Agyei-Baffour P, Lori JR. Exposure to disrespectful patient care during training: data from midwifery students at 15 midwifery schools in Ghana. Midwifery. 2016;41:39–44 Available from: http://www.sciencedirect.com/science/article/pii/S026661381630119X. [Cited 18 Dec 2016].
Asamani JA, Kwafo EO, Ansah-Ofei AM. Planning among nurse managers in district hospitals in Ghana. Nurs Manag (Harrow). 2013;20(8):26–31 Available from: http://journals.rcni.com/doi/full/10.7748/nm2013.12.20.8.26.e1151. [Cited 18 Apr 2016].
Ofei AM, Sakyi EK, Buabeng T, Mwini-Nyaledzigbor P, Atindanbila S. Perceived and preferred leadership behavior of nurse managers at the unit level in the Greater Accra Region: a mixed method approach. Int Rev Soc Sci. 2014;2(2):42–61.
Peter Adatara JA. Challenges of being a hospital nurse manager in the Volta region of Ghana: a qualitative study. Nusing Manag Harrows. 2019;25(5):35–42 Available from: https://journals.rcni.com/nursing-management/evidence-and-practice/challenges-of-being-a-hospital-nurse-manager-in-the-volta-region-of-ghana-a-qualitative-study-nm.2018.e1773/print/abs. [Cited 24 Mar 2019].
Azaare J, Gross J. The nature of leadership style in nursing management. Br J Nurs. 2011;20(11):672–80 Available from: https://www.magonlinelibrary.com/doi/abs/10.12968/bjon.2011.20.11.672. [Cited 27 Sep 2013].
Asamani JA, Naab F, Ofei AMA. Leadership styles in nursing management: implications for staff outcomes. J Health Sci. 2016;6(1):1–14 Available from: https://www.jhsci.ba/ojs/index.php/jhsci/article/view/533. [Cited 18 Apr 2016].
Cummings GG, MacGregor T, Davey M, Lee H, Wong CA, Lo E, et al. Leadership styles and outcome patterns for the nursing workforce and work environment: a systematic review. Int J Nurs Stud. 2010;47(3):363–85 Available from: http://www.sciencedirect.com/science/article/pii/S0020748909002831. [Cited 27 Sep 2013].
Cummings GG, Midodzi WK, Wong CA, Estabrooks CA. The contribution of hospital nursing leadership styles to 30-day patient mortality. Nurs Res [Internet]. 2010;59(5):331–9 Available from: https://www.ncbi.nlm.nih.gov/pubmed/20686431. [Cited 25 May 2016].
Wong CA, Cummings GG. The relationship between nursing leadership and patient outcomes: a systematic review. J Nurs Manag. 2007;15(5):508–21 Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2834.2007.00723.x/full. [Cited 27 Sep 2013].
Kane RL, Shamliyan TA, Mueller C, Duval S, Wilt TJ. The association of registered nurse staffing levels and patient outcomes: systematic review and meta-analysis. Med Care. 2007;45(12):1195 Available from: https://journals.lww.com/lww-medicalcare/Abstract/2007/12000/The_Association_of_Registered_Nurse_Staffing.11.aspx. [Cited 6 May 2019].
Aiken LH, Sloane DM, Bruyneel L, den HKV, Griffiths P, Busse R, et al. Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. Lancet. 2014;383(9931):1824–30 Available from: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62631-8/abstract. [Cited 6 May 2019].