Intercountry master's degree in nursing: policy implications for the Mozambican health system.

Abstract

Within an overarching evaluation framework, this study explored the experiences of course participants and administrators of an intercountry master's degree in nursing between South Africa and Mozambique. The lessons learnt were used to inform nursing and health policy for the Mozambican health system. Kirkpatrick's four levels of training evaluation and a results-oriented approach to capacity change were integrated to form a hybrid evaluation framework to capture information about course implementation and the context/environment within which it was delivered. The study used quantitative and qualitative methods including a self-administered survey of course participants, document review, in-depth, semi-structured interviews with course administrators and two focus group discussions with course participants. Participants enrolled in the course primarily to gain new knowledge and to improve health outcomes; course participants and administrators responded positively to the course design, course implementation and the quality of teaching. Knowledge and skills gained help to build graduates' confidence and boost their attitude towards nursing. Paradoxically, graduates felt powerless to transfer knowledge and effect change in practice. This collaborative, capacity development project produced postgraduate nurses in two areas of specialization, namely, critical care and trauma nursing and maternal and neonatal health. While course participants gained significant benefits in new skills and knowledge and a higher degree qualification, the rewards available to them in the public health system remain unclear. Lessons learnt may serve to influence policy decisions about the role of the Ministry of Health and other stakeholders in sustaining the output and quality of postgraduate nurses for the Mozambican health system. A strategic approach informed by multilevel policies at government, organizational and managerial levels should be adopted to systematically minimize and remove barriers to the transfer and utilization of knowledge and skills in the workplace.