Building Regional Sustainable Nursing and Midwifery Research Networks to Improve Health Outcomes

Purpose:

With the global demand for nurses and midwives with expanded scopes of practice to provide primary  care as the key to achieving Universal Health Coverage, there is increased need for evidence-based practice.  Nurses and midwives have made advances in expanding their practices at the educational and clinical levels.  This is exemplified by their major contributions to tackling the HIV pandemic in Sub Saharan African countries through nurse-initiated and managed antiretroviral treatment (NIMART) – a model that enables nurses and midwives at the frontline clinical levels to have the knowledge and skills to be first providers.   Parallel to this has been the implementation of competency-based nursing and midwifery education to increase the quantity, quality and relevance of new graduates.  This project focuses on the gap in nursing and midwifery clinical research outcomes regionally, a critical area to validate outcomes of care provided, and ways to develop research expertise to collect and critically analyze data and identify priorities for improved clinical practice. 

Methods:

In the first year, in collaboration with Columbia Global Centers|Africa, the Forum of University Nursing Deans of South Africa (FUNDISA), the University of Malawi, Kamuzu College of Nursing, and the University of Nairobi School of Nursing Sciences, the Columbia University School of Nursing conducted an environmental scan (including a scoping review of all indexed published research in African countries by nurses and midwives regarding clinical practice and a grey literature search of un-indexed journals, sources identified by clinical nurse research experts from southeastern African countries, and information found through universities within the region), a Delphi survey to establish clinical nursing and midwifery research priorities, and a network analysis of participants (to determine what networks exist formally and informally amongst nurses/midwives involved in clinical research).  This culminated in a Summit meeting of over 30 regional experts to achieve consensus on a regional research agenda and a mentorship plan to connect academicians with clinician to expand and deepen clinical research outcomes.

In the second year, as the mentorship plan is implemented, the same model has been adapted for Middle Eastern countries, in collaboration with Columbia Global Centers|Middle East. Methods include establishment of a core collaborator group of nursing and midwifery research experts from Jordan, Lebanon, Egypt, and Saudi Arabia that is currently conducting an environmental scan of over twenty Mediterranean East and Northern African countries to identify current research areas and gaps.  A Delphi survey will then be conducted to prioritize critical areas, with a Summit in July 2016 to achieve consensus and plan mentorship. 

Results:

Clinical research priorities for nurses and midwives have been identified in Southern and Eastern African countries, with a thriving network led by regional core collaborators in place that is implementing a mentorship component.  This model is being adapted by the core collaborator group based in Jordan, currently conducting the network analysis with the objective of strengthening and expanding current clinical research. 

Conclusion:

Robust networks of nursing and midwifery clinical researchers in two regions open the door to improved clinical practice and outcomes in areas that bear inequitable burden of disease.