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      Factors to Effective Clinical Experience, Willingness to pursue Career in Rural Health Facilities among Nursing Students on Clinical Placement in Southeast Nigeria and Rural Development Translated title: Factores para una experiencia clínica eficaz, voluntad de seguir una carrera en instalaciones de salud rurales entre estudiantes de enfermería en prácticas clínicas en el sudeste de Nigeria y desarrollo rural Translated title: Fatores para experiência clínica eficaz, vontade de seguir carreira em unidades de saúde rurais entre estudantes de enfermagem em estágios clínicos no sudeste da Nigéria e desenvolvimento rural

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          Abstract

          Objective.

          To describe the Factors to Effective Clinical Experience and Willingness to pursue Career in Rural Health Facilities among Nursing Students on Clinical Placement in southeast Nigeria.

          Methods.

          The study was conducted among 48 rural health centres and general hospitals with 528 respondents from different higher institutions of learning serving in these health facilities for their clinical experience. The study applied survey design and utilized questionnaire instrument for data collection.

          Results.

          Majority of the students (60%) agreed that their school lacked functional practical demonstration laboratory for students’ clinical practice, 66.7% agreed that their school lab lacked large space for all the students to observe what is being taught, 79.9% that their school lab lacked enough equipment that can enable many students to practice procedures; majority of the students (79.9%) answered that the hospitals where they are on clinical placement lacked enough equipment needed for the students on each shift of practice, 59.9% agreed that student/client ratio in each ward during clinical experience periods was not enough for students' practice under supervision, while 73.3% indicated that their school lacked library with current nursing texts for references. Personal, socioeconomic and institutional factors explain the 76% of the variance of effective clinical experience and the 52% of the variance of the willingness to work in rural health facilities in the future if offered employment.

          Conclusion.

          The factors surrounding effective clinical experience in rural healthcare facilities in southeastern Nigeria are unfavorable and could discourage future nurses from working there. It is necessary to implement strategies to improve the management of these centers in order to promote the perspective of improving sustainable rural health in this region.

          Resumen

          Objetivo.

          Describir la experiencia clínica efectiva entre los estudiantes de enfermería en prácticas clínicas en las instalaciones sanitarias rurales en el sudeste de Nigeria.

          Métodos.

          Este estudio descriptivo se llevó a cabo entre 48 centros de salud rurales y hospitales generales con 528 encuestados de diferentes instituciones de enseñanza superior que prestaban servicio en estas instalaciones sanitarias para su experiencia clínica.

          Resultados.

          60% de los estudiantes comentaron que su centro carecía de un laboratorio de simulación para las prácticas clínicas de los estudiantes, el 66.7% indicó que el laboratorio de su centro carecía de un espacio para que todos los estudiantes pudieran observar lo que se enseñaba. Un 79.9% indicó que el laboratorio de su centro no disponía de equipos suficientes para practicar los procedimientos, y otro porcentaje igual (79.9%) manifestaron que los hospitales carecían del equipo necesario para realizar adecuadamente las prácticas clínicas. El 59.9% indicaron que la razón de estudiantes por paciente en cada sala durante los periodos de experiencia clínica era insuficiente para que los estudiantes realizaran prácticas bajo supervisión, y el 73.3% indicaron que los recursos de la biblioteca en textos de enfermería eran insuficientes para sus necesidades. Los factores personales, socioeconómicos e institucionales explican el 76% de la varianza en la experiencia clínica efectiva y el 52% en la disposición a trabajar en centros sanitarios rurales en el futuro.

          Conclusión.

          Los factores que rodean la experiencia clínica efectiva en los centros sanitarios rurales del sudeste de Nigeria son desfavorables y podrían desanimar a los futuros enfermeros a trabajar en ellos. Es necesario implementar estrategias de mejoramiento de la gestión de estos centros con el fin de impulsar la perspectiva de mejorar la salud rural sostenible en esta región.

          Resumo

          Objetivo.

          Descrever a experiência clínica eficaz entre estudantes de enfermagem em estágios clínicos em unidades de saúde rurais no sudeste da Nigéria (África).

          Métodos.

          Este estudo descritivo foi realizado em 48 centros de saúde rurais e hospitais gerais com 528 entrevistados de diferentes instituições de ensino superior que atendem essas unidades de saúde pela sua experiência clínica.

          Resultados.

          60% dos alunos comentaram que seu centro não possuía laboratório de simulação para as práticas clínicas dos alunos, 66.7% indicaram que o laboratório de seu centro carecia de espaço para que todos os alunos pudessem observar o que estava sendo ensinado. 79.9% indicaram que o laboratório do seu centro não possuía equipamentos suficientes para a realização dos procedimentos e outro percentual igual (79.9%) afirmou que os hospitais não possuíam os equipamentos necessários para a realização adequada das práticas clínicas. 59.9% indicaram que a proporção de estudantes por pacientes em cada sala durante os períodos de experiência clínica era insuficiente para que os estudantes realizassem as práticas sob supervisão e 73.3% indicaram que os recursos da biblioteca em textos de enfermagem eram insuficientes para suas necessidades. Fatores pessoais, socioeconómicos e institucionais explicam 76% da variação na experiência clínica efetiva e 52% na vontade de trabalhar em centros de saúde rurais no futuro.

          Conclusão.

          Os fatores que rodeiam a experiência clínica eficaz em unidades de saúde rurais no sudeste da Nigéria são desfavoráveis ​​e podem desencorajar futuros enfermeiros de trabalhar lá. É necessário implementar estratégias para melhorar a gestão destes centros, a fim de promover a perspectiva de melhorar a saúde rural sustentável nesta região.

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          Identifying Key Challenges Facing Healthcare Systems In Africa And Potential Solutions

          Introduction Healthcare systems in Africa suffer from neglect and underfunding, leading to severe challenges across the six World Health Organization (WHO) pillars of healthcare delivery. We conducted this study to identify the principal challenges in the health sector in Africa and their solutions for evidence-based decisions, policy development and program prioritization. Methods The study was conducted as part of a recent African Epidemiological Association Meeting in Maputo, Mozambique with participants drawn from 11 African countries, Cuba, Portugal and the United Kingdom. Participants were divided into 10 groups, consisting of 7 to 10 persons each. Brainstorming approaches were used in a structured, modified nominal group process exercise to identify key challenges and strategies to mitigate healthcare service challenges in Africa. Identified challenges and solutions were prioritised by ranking 1–5, with 1 most important and 5 being least important. Results The first three challenges identified were inadequate human resources (34.29%), inadequate budgetary allocation to health (30%) and poor leadership and management (8.45%). The leading solutions suggested included training and capacity building for health workers (29.69%), increase budgetary allocation to health (20.31%) and advocacy for political support and commitment (12.31%). Conclusion The underdeveloped healthcare systems in Africa need radical solutions with innovative thought to break the current impasse in service delivery. For example, public-private initiatives should be sought, where multinational companies extracting resources from Africa might be encouraged to plough some of the profits back into healthcare for the communities providing the workforce for their commercial activities. Most problems and their solutions lie within human resources, budget allocation and management. These should be accorded the highest priority for better health outcomes.
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            Nursing education challenges and solutions in Sub Saharan Africa: an integrative review

            Background The Lancet Commission and the Global Health Workforce Alliance reported that professional education has generally not kept up the pace of health care challenges. Sub Saharan Africa needs an effective and efficient nursing education system to build an adequate, competent and relevant nursing workforce necessary for the achievement of Sustainable Development Goals. The Plan of Action for Scaling up Quality Nursing and Midwifery Education and Practice for the African Region 2012 - 2022 provided a framework for scale up of nurses and midwives. This integrative review examined literature on nursing education challenges and solutions in Sub Saharan Africa to inform development of a model for improving the quality, quantity and relevance of nursing education at local level. Methods A search of PubMed, Medline on EBCSOhost and Google Scholar was conducted using key words: nursing education, challenges, solutions and/ or Africa. Published works from 2012 to 2016 were reviewed to explore reports about challenges and solution in nursing education in Sub Saharan Africa. Full texts of relevant studies were retrieved after reading the tittles and abstracts. Critical appraisal was undertaken and the findings of the relevant studies were analysed using thematic analysis. Results Twenty articles and five grey sources were included. Findings of the review generally supports World Health Organisation framework for transformative and scale up of health professions education. Six themes emerged; curriculum reforms, profession regulation, transformative teaching strategies, collaboration and partnership, capacity building and infrastructure and resources. Challenges and solutions in nursing education are common within countries. The review shows that massive investment by development partners is resulting in positive development of nursing education in Sub Saharan Africa. However, strategic leadership, networking and partnership to share expertise and best practices are critical. Conclusion Sub Saharan Africa needs more reforms to increase capacity of educators and mentors, responsiveness of curricula, strongly regulatory frameworks, and availability of infrastructure and resources. The review adds to the body of knowledge to enhance efforts of stakeholders in the improvement of the quality, quantity and relevance of nursing education in Sub Saharan Africa.
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              Assessment of primary health care facilities’ service readiness in Nigeria

              Background Effective delivery of healthcare services requires availability of adequate infrastructure, diagnostic medical equipment, drugs and well-trained medical personnel. In Nigeria, poor funding and mismanagement often characterize healthcare service delivery thereby affecting coverage and quality of healthcare services. Therefore, the state of service delivery in Nigeria’s health sector has come under some persistent criticisms. This paper analyzed service readiness of Primary Health Care (PHC) facilities in Nigeria with focus on availability of some essential drugs and medical equipment. Methods Service Delivery Indicator (SDI) data for PHC in Nigeria were used. The data were collected from 2480 healthcare facilities from 12 states in the Nigeria’s 6 geopolitical zones between 2013 and 2014. Data were analyzed with descriptive statistics, Principal Component Analysis (PCA) and Ordinary Least Square regression. Results Medical disposables such as hand gloves and male condoms were reported to be available in 77.18 and 44.03% of all the healthcare facilities respectively, while immunization services were provided by 86.57%. Functional stethoscopes were reported by 77.22% of the healthcare facilities, while only 68.10% had sphygmomanometers. In the combined healthcare facilities, availability of some basic drugs such as Azithromycin, Nifedipine, Dexamethasone and Misoprostol was low with 10.48, 25.20, 21.94 and 17.06%, respectively, while paracetamol and folic acid both had high availability with 74.31%. Regression results showed that indices of drug and medical equipment availability increased significantly (p < 0.05) among states in southern Nigeria and with presence of some power sources (electricity, generators, batteries and solar), but decreased among dispensaries/health posts. Travel time to headquarters and rural facilities significantly reduced indices of equipment availability (p < 0.05). Conclusion It was concluded that for Nigeria to ensure better equity in access to healthcare facilities, which would facilitate achievement of some health-related sustainable development goals (SDGs), quality of services at its healthcare facilities should be improved. Given some differences between availability of basic medical equipment and their functionality, and lack of some basic drugs, proper inventory of medical services should be taken with effort put in place to increase funding and ensure proper management of healthcare resources.
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                Author and article information

                Journal
                Invest Educ Enferm
                Invest Educ Enferm
                iee
                Investigacion y Educacion en Enfermeria
                Imprenta Universidad de Antioquia
                0120-5307
                2216-0280
                06 July 2024
                May-Aug 2024
                : 42
                : 2
                : e09
                Affiliations
                [1 ] original Senior Lecturer. Philosophy Department, University of Nigeria, Nsukka. Email: george.aba@unn.edu.ng normalizedUniversity of Nigeria, Nsukka orgdiv1Philosophy Department orgnameUniversity of Nigeria Nsukka, Nigeria george.aba@ 123456unn.edu.ng
                [2 ] originalPh.D. student and research consultant. Department of Sociology/Anthropology, University of Nigeria, Nsukka. Email: samuelokey200@gmail.com. Corresponding author normalizedUniversity of Nigeria, Nsukka orgdiv1Department of Sociology/Anthropology orgnameUniversity of Nigeria Nsukka, Nigeria samuelokey200@ 123456gmail.com
                [3 ] original Lecturer. School of General Studies, University of Nigeria, Nsukka. Email: okuma.anyoko-shaba@unn.edu.ng normalizedUniversity of Nigeria, Nsukka orgdiv1School of General Studies orgnameUniversity of Nigeria Nsukka, Nigeria okuma.anyoko-shaba@ 123456unn.edu.ng
                [4 ] original Lecturer. Department of Psychology, University of Nigeria, Nsukka. Email onyedikachi.nnamchi@unn.edu.ng normalizedUniversity of Nigeria, Nsukka orgdiv1Department of Psychology orgnameUniversity of Nigeria Nsukka, Nigeria onyedikachi.nnamchi@ 123456unn.edu.ng
                [5] original5 Lecturer. Department of Adult Education and extra Moral Studies, University of Nigeria, Nsukka. Email: ekaette.okop@unn.edu.ng normalizedUniversity of Nigeria, Nsukka Nigeria
                [6] original6 Consultant. EI Paso Educational Leadership and Foundations, University of Texas, USA. Email: aogundele@miners.utep.edu normalizedUniversity of Texas USA
                Author notes
                [* ] Email: samuelokey200@ 123456gmail.com . Corresponding author
                Article
                00009
                10.17533/udea.iee.v42n2e09
                11297459
                39083836
                0f5fcbd8-b6cd-4ce9-9d21-44c7f5a239b0

                This is an open-access article distributed under the terms of the Creative Commons Attribution License

                History
                : 19 November 2023
                : 14 May 2024
                Page count
                Figures: 0, Tables: 4, Equations: 0, References: 64, Pages: 0
                Categories
                Original Article

                rural health services,clinical competence,public health,students, nursing,nigeria,servicios de salud rural,competencia clínica,salud pública,estudiantes de enfermería,serviços de saúde rural,competência clínica,saúde pública: estudantes de enfermagem

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