CHAPTER 5 PHASE TWO INTERVENTION: CAPACITY-BUILDING WORKSHOP
5.6 CONCLUSION
The variety and richness of discussion at the workshop enabled the researcher to draw together in the final discussion all the insights, observations and proposals for action that had emerged during the course of the day. The collective conclusions and recommendations from the workshop set out a formidable agenda for action but say little about ways and means. The expectation is that individuals and organisations would have been motivated by these discussions to take up the themes most appropriate to their sphere, and create more developed plans of action. Some themes may be taken forward through joint action in partnership with contacts made at the workshop. The findings of the workshop have wide-ranging implications for policy. The researcher and the validation team developed a final policy brief based on the contribution by the workshop participants as illustrated in Figure 5.9. This action formed part of recommendations to policy-makers.
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PARTICIPATION OF NURSE LEADERS IN HEALTH POLICY:
IMPROVING HEALTH OUTCOMES
EXCUTIVE SUMMARY
Health care services in South Africa are under increasing demands placing higher pressure on nurses who are in the forefront and the largest group in the health care sector. Nurses are closest to the patients and their families with the main responsibility of providing quality care. Nursing is therefore uniquely positioned to influence the health care priorities nationally yet they are underrepresented at all levels of health policy development. They are mainly implementers of policies. It is important that nurses understand and influence the health policy process in order to improve health outcomes.
INTRODUCTION
Nurses are the majority of health care professionals but they have been undervalued in the decision making circles that inform the nation’s health policy. Given the complexity of S.A health care system reform they must be equipped to perform their leadership role so as to facilitate quality health care service delivery.
Proactive participation in the policy arena is a key to excellence in clinical practice and education for nursing.
Literature ((Khunou and Davhana- Maselesele 2016; Ditlopo et al.
2014; Juma et al., 2014; Ditlopo et al., 2014; Shariff and Potgieter 2012; Richter, Mill et al. 2012,) shows that nurses’ role in health policy development is limited.
Health policy is often formulated with little input from nurses, at the implementation level. Studies also maintain that policy making is
“Top Down” in nature. Nurse leaders are implementers of policies, much as the researcher would like to see them involved at all the stages of the health policy development process. There are also challenges with the implementation of policies.
Policies are interpreted and implemented differently by various institutions e.g. OSD (Ditlopo et al., 2014). This could result from the absence of policy implementation guidelines. The policies are also not explained. The findings also suggest that the implementation difficulties stem partly from absence of the key actors (nurse leaders) at the policy development stage that would provide input on the operational mechanisms required for implementation. There was also no formal system of communicating gaps identified in the policy that affect implementation. The absence of feedback from grassroots policy implementers might lead to further suppression of the voices of nurses at the lower level (Juma, Edwards et al. (2014).
Factors contributing to lack of participation of nurses in health policy development include political factors, gender issues, financial issues, limited resources;
lack of skills training in policy development; image and status of nursing; leadership competency;
and the inability to use research to influence policy making. (McAskill 2009), Kunaviktikul, Nantsupawat et al. (2010), (Chase 2013, Robinson 2013).
Nurse leaders are a vital resource for shaping health policy.
It is important to strengthen the capacity and participation of nurse leaders in health policy development to create effective policies as they are the main implementers. This would contribute to improved health outcomes and effective health service delivery. Since currently nurse leaders are prominent in implementation, the following policy options should be considered.
Policy Options
1. Enhancing participation of nurse leaders in the policy development process by increasing representation of nurses in the policy structures.
2. Deploying nurse leaders per province to participate in the policy development process so that they could facilitate implementation.
Identify them from organised structures e.g. forums. Development of communication strategies for representatives. This option is costly which might be a barrier to its implementation.
3. Development of policy implementation guidelines for each policy. This would enhance
HEALTH POLICY BRIEF
DATE: JULY 2016
‘Nurse Leaders could define the direction of the health policy’
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Figure 5.9: Final Health Policy Brief policy implementation. This
option is cost effective as it will eliminate the risk of failed execution of a policy which could result to a lack of success
REFERENCES
Chase, Lynne M. (2013). A qualitative study to explore the role of nurses in health policy development in the Middle East. Paper presented at the Sigma Theta Tau International's 24th International Nursing Research Congress.
Ditlopo, P. (2014). "Contestations and complexities of nurses' participation in policy- making in South Africa." Global Health Action 7: 25327.
AUTHORS
Zanele F Dlamini (UKZN PhD Student Professor Busi Bhengu (Supervisor
KZN Nurse Leaders (Nurse Manager’s, Assistant Nurse Managers, Nurse Educators)
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(Juma, Edwards et al. 2014)
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