Assessment of the nursing skill mix in Mozambique using a task analysis methodology
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RESEARCH
Open Access
Assessment of the nursing skill mix in Mozambique using a task analysis methodology Martinho Dgedge1†, Angel Mendoza2†, Edgar Necochea3†, Debora Bossemeyer3†, Maharifa Rajabo2† and Judith Fullerton4*†
Abstract Background: The density of the nursing and maternal child health nursing workforce in Mozambique (0.32/1000) is well below the WHO minimum standard of 1 nurse per 1000. Two levels of education were being offered for both nurses and maternal child health nurses, in programmes ranging from 18 to 30 months in length. The health care workforce in Mozambique also includes Medical Technicians and Medical Agents, who are also educated at either basic or mid-level. The Ministry of Health determined the need to document the tasks that each of the six cadres was performing within various health facilities to identify gaps, and duplications, in order to identify strategies for streamlining workforce production, while retaining highest educational and competency standards. The methodology of task analysis (TA) was used to achieve this objective. This article provides information about the TA methodology, and selected outcomes of the very broad study. Methods: A cross-sectional descriptive task analysis survey was conducted over a 15 month period (2008–2009). A stratified sample of 1295 individuals was recruited from every type of health facility in all of Mozambique’s 10 provinces and in Maputo City. Respondents indicated how frequently they performed any of 233 patient care tasks. Data analysis focused on identifying areas where identical tasks were performed by the various cadres. Analyses addressed frequency of performance, grouped by level of educational preparation, within various types of health facilities. Results: Task sharing ranged from 74% to 88% between basic and general nurse cadres and from 54% to 88% between maternal and child health nurse cadres, within various health facility types. Conversely, there was distinction between scope of practice for nursing and maternal/child health nursing cadres. Conclusion: The educational pathways to general nursing and maternal/child health nursing careers were consolidated into one 24 month programme for each career. The scopes of practice were affirmed based on task analysis survey data.
Background Mozambique, a country of approximately 21 million people, has undergone substantial developmental growth and change since achieving independence in 1975. The country has seen very strong economic growth in recent years [1], although the country is presently ranked 185 (of 187) on the Human Development Index [2]. The Government has made a commitment for health care reform and improvement in all health and human service sectors, in order to make an impact on the health * Correspondence: [email protected] † Equal contributors 4 Independent Consultant, 7717 Canyon Point Lane, San Diego, CA 92126, USA Full list of author information is available at the end of the article
and wellbeing of its citizens and to reach its goal of providing sufficient and
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