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This article is part of the supplement: An innovative approach to building capacity at an African university to improve health outcomes

Open Access Research

The impact on nurses and nurse managers of introducing PEPFAR clinical services in urban government clinics in Uganda

Joyce Nankumbi1*, Sara Groves2, Elli Leontsini3, Nambusi Kyegombe4, Alex Coutinho5 and Yuka Manabe6

Author Affiliations

1 Department of Nursing, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda

2 Johns Hopkins University School of Nursing, Baltimore, Maryland, 21205, USA

3 Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, 21205, USA

4 London School of Hygiene and Tropical Medicine, London, UK

5 Institute of Infectious Disease, Kampala, Uganda

6 Johns Hopkins School of Medicine, Baltimore, Maryland, 21205, USA

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BMC International Health and Human Rights 2011, 11(Suppl 1):S8  doi:10.1186/1472-698X-11-S1-S8

Published: 9 March 2011

Abstract

Background

Improving provider performance is central to strengthening health services in developing countries. Because of critical shortages of physicians, many clinics in sub-Saharan Africa are led by nurses. In addition to clinical skills, nurse managers need practical managerial skills and adequate resources to ensure procurement of essential supplies, quality assurance implementation, and productive work environment. Giving nurses more autonomy in their work empowers them in the workplace and has shown to create positive influence on work attitudes and behaviors. The Infectious Disease Institute, an affiliate of Makerere University College of Health Science, in an effort to expand the needed HIV services in the Ugandan capital, established a community-university partnership with the Ministry of Health to implement an innovative model to build capacity in HIV service delivery. This paper evaluates the impact on the nurses from this innovative program to provide more health care in six nurse managed Kampala City Council (KCC) Clinics.

Methods

A mixed method approach was used. The descriptive study collected key informant interviews from the six nurse managers, and administered a questionnaire to 20 staff nurses between September and December 2009. Key themes were manually identified from the interviews, and the questionnaire data were analyzed using SPSS.

Results

Introducing new HIV services into six KCC clinics was positive for the nurses. They identified the project as successful because of perceived improved environment, increase in useful in-service training, new competence to manage patients and staff, improved physical infrastructure, provision of more direct patient care, motivation to improve the clinic because the project acted on their suggestions, and involvement in role expansion. All of these helped empower the nurses, improving quality of care and increasing job satisfaction.

Conclusions

This community-university HIV innovative model was successful from the point of view of the nurses and nurse managers. This model shows promise in increasing effective, quality health service; HIV and other programs can build capacity and empower nurses and nurse managers to directly implement such services. It also demonstrates how MakCHS can be instrumental through partnerships in designing and testing effective strategies, building human health resources and improving Ugandan health outcomes.