Assessing the impact of a partnership-based work/study nursing upgrade programme in a low- and middle-income setting

Aims and objectives: To evaluate the 15-year impact of the work/study nursing upgrading programme in East Africa. Background: Working nurses in Africa are often primary family income earners, with limited ability to leave jobs and upgrade qualifications. In 2001, the university established a work/study upgrade programme for enrolled- and diploma-level nurses, allowing them to upgrade their qualifications while continuing to work and support families. Donor partnerships provided scholarships to further increase programme access. Design: A mixed-method design was used involving an online alumni survey and 24 interviews and 23 focus groups with 172 purposively selected representatives of nursing graduates, employers, regulatory bodies, professional associations and senior nursing officials. Method: Quantitative data were analysed using frequencies and percentages. Inductive thematic analysis was used for qualitative data. Equator guidelines informed reporting of both qualitative and quantitative results. Results: Of the 549 graduates who completed the survey, 81.2% (n = 446) were female, 93.1% were currently employed and 98% worked within East Africa. They reported improved professional competence (69.4%), nursing practice (25.9%) and patient outcomes (4.6%) on graduation. Extracted themes included the following: flexible/accessible programme; friendly learning environment; effective teaching and learning strategies; acquisition of nursing knowledge, skills and competencies; stakeholders’ role in the programme; career/professional advancement; and strengthened health systems. Conclusion: The work/study programme was an effective nursing workforce capacity development strategy. Programme access was strengthened via the supporting donor partnership. Positive outcomes were achieved with respect to the university's values of quality, access, relevance and impact. Relevance to clinical practice: Long-term sustainable development of nurses and midwives is fundamental to achieving sustainable development goals. Work/study programmes and private–public partnerships are effective mechanisms to strengthen the development of nursing and the overall healthcare workforce in low-resource settings.