scholarly journals Increasing Nursing Student Interest in Rural Healthcare: Lessons From a Rural Rotation Program in Democratic Republic of the Congo

2020 ◽  
Author(s):  
Susan Michaels-Strasser ◽  
Paul W. Thurman ◽  
Narcisse Mwinkeu Kasongo ◽  
Daniel Kapenda ◽  
John Ngulefac ◽  
...  
Keyword(s):  
Nursing Students ◽  
Rural Health ◽  
Rural Areas ◽  
Democratic Republic ◽  
Rural Practice ◽  
School Year ◽  
Rural And Urban ◽  
Key Stakeholders ◽  
Republic Of The Congo ◽  
Rural Sites

Abstract BackgroundMany challenges exist in providing equitable access to healthcare in the Democratic Republic of the Congo (DRC) including resource disparities between rural and urban areas coupled with a majority rural population. One of the most promising ways to close the gap between rural and urban healthcare access and quality is through the support of human resources for health (HRH), especially nurses, in rural health settings. Current barriers including lack of nursing students from rural communities, insufficient infrastructure, and absence of programs for rural practice exposure, have allowed disparities between rural and urban healthcare to persist. MethodsTo implement a rural rotation (RR) program for nursing students in DRC, whereby students are immersed in a rural clinical and community placement for an extended period of time, ICAP at Columbia University (ICAP), with funding and support from the United States Health Resources Service Administration (HRSA), consulted with stakeholders in DRC including students, the Ministry of Health (MoH), the Ministry of Education (MoE), and nursing schools and associations to improve health workforce education including understanding the disparities and realities of rural health care. Following this, schools of nursing in the Lubumbashi area agreed to add nursing students into rural workforce settings, including time in clinical as well as community health on a rotational basis. ICAP then worked with the MoH and MoE to select rural sites that could adequately support rotating nursing students and develop expectations for the RR program. Assessments of the selected rural sites were conducted, and the availability of nursing mentors, teaching materials, security, and accessibility, as well as patient volumes, were identified. Building on prior work to strengthen preceptors, a training of trainers approach was used. Out of a cohort of 85 trained preceptors from across 55 target schools and 30 rural health facilities, 30 were selected to be “master trainers” based on their experience in training others, their performance in initial preceptor training, and willingness to contribute more to overall success of the RR program. These master trainers educated the remaining 55 preceptors in rural practice. Concurrent with the training, ICAP, along with the MoH and MoE, worked with communities around the rural health facilities to secure accommodations for nursing students and to engage them with community leaders for purposes of future health promotion and clinic collaboration.ResultsAll five target schools from the Lubumbashi area that were selected for the project chose to participate. Kinshasa was not targeted for the project but did have two schools in rural areas outside the urban center interested and willing to accept students on rotations. Over the life of the project, 583 students successfully participated in the program and completed rural rotations as planned. Sixteen rural sites and 298 students participated in the rotational program during the 2018-2019 school year. For the 2019-2020 school year (through March), 285 students participated.Post-rotation feedback RECEIVED FROM 274 students, as well as from over 25 preceptors, and nursing school leaders, has been very positive and has resulted in more nursing students seeking rural assignments upon completion of their studies. Ninety-three percent of students surveyed, for example, indicated that they agreed or strongly agreed that they would recommend participation in RR programs to their classmates. Ninety-seven percent agreed or strongly agreed that their RR program had strengthened their education experience and increased their willingness to serve in rural areas in the future. The most significant challenges, however, were financial support (35%) and housing (30%).ConclusionsWith nearly 600 successful participants, this project showed that a RR program is both feasible and acceptable for nursing students, faculty, and rural clinic staff in resource-limited settings. Student exposure to rural practice is critical to increasing interest (and therefore downstream HRH staffing) in rural area healthcare. ICAP, HRSA, and DRC ministry leadership believe these early successes are indicative of both the opportunity available and value-added of such a RR program. Going forward, HRSA, ICAP and key stakeholders will continue to collaborate to sustain this project and advocate for employment and placement of student nurses who expressed interest, into rural employment following graduation. In addition, expanding such programs to other majority rural areas of sub-Saharan Africa seems both feasible and affordable with the right up-front collaborations and program design with key stakeholders.

scholarly journals Increasing nursing student interest in rural healthcare: lessons from a rural rotation program in Democratic Republic of the Congo

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Susan Michaels-Strasser ◽  
Paul W. Thurman ◽  
Narcisse Mwinkeu Kasongo ◽  
Daniel Kapenda ◽  
John Ngulefac ◽  
...  
Keyword(s):  
Nursing Students ◽  
Rural Health ◽  
Nursing Student ◽  
Democratic Republic ◽  
Nursing Schools ◽  
Student Interest ◽  
Columbia University ◽  
Rural Healthcare ◽  
Republic Of The Congo ◽  
Rural Sites

Abstract Background Many challenges exist in providing equitable access to rural healthcare in the Democratic Republic of the Congo (DRC). WHO recommends student exposure to rural clinical rotations to promote interest in rural healthcare. Challenges to rural engagement include lack of adequate infrastructure and staff to lead rural education. This case report highlights key steps in developing a rural rotation program for DRC nursing students. Case presentation To implement a rural rotation (RR) program, ICAP at Columbia University (ICAP) consulted with students, the Ministries of Health (MoH) and Education (MoE), and nursing schools to pilot and expand a rural rotation program. Nursing schools agreed to place students in rural clinics and communities. Key stakeholders collaborated to assess and select rural sites based on availability of nursing mentors, educational resources, security, accessibility, and patient volume. To support this, 85 preceptors from 55 target schools and 30 rural health facilities were trained of which 30 were selected to be “master trainers”. These master trainers led the remaining 55 preceptors implementing the rural rotation program. We worked with rural facilities to engage community leaders and secure accommodation for students. A total of 583 students from five Lubumbashi schools and two rural schools outside Kinshasa participated across 16 rural sites (298 students in 2018–2019 school year and 285 in 2019–2020). Feedback from 274 students and 25 preceptors and nursing school leaders was positive with many students actively seeking rural assignments upon graduation. For example, 97% agreed or strongly agreed that their RR programs had strengthened their educational experience. Key challenges, however, were long-term financial support (35%) for rural rotations, adequate student housing (30%) and advocacy for expanding the rural workforce. Conclusions With nearly 600 participants, this project showed that a RR program is feasible and acceptable in resource-limited settings yet availability of ample student accommodation and increasing availability of rural jobs remain health system challenges. Using a multipronged approach to rural health investment as outlined by WHO over two decades ago remains essential. Attracting future nurses to rural health is necessary but not sufficient to achieve equitable health workforce distribution.

scholarly journals Acceptability of the community-level provision of Sayana® Press by medical and nursing students in Kinshasa, Democratic Republic of the Congo

Contraception ◽  
2017 ◽  
Vol 96 (3) ◽  
pp. 211-215 ◽  
Author(s):  
Jane T. Bertrand ◽  
Paul Bukutuvwidi Makani ◽  
Julie Hernandez ◽  
Pierre Akilimali ◽  
Bitshi Mukengeshayi ◽  
...  
Keyword(s):  
Nursing Students ◽  
Democratic Republic ◽  
Community Level ◽  
Republic Of The Congo

scholarly journals Facility conditions, obstetric and neonatal care practices, and availability of emergency obstetric and neonatal care in 72 rural health facilities in the Democratic Republic of the Congo: A cross-sectional study

2019 ◽  
Vol 3 ◽  
pp. 13
Author(s):  
Rebecca Carter ◽  
Xu Xiong ◽  
Paul-Samson Lusamba-Dikassa ◽  
Elvis C. Kuburhanwa ◽  
Francine Kimanuka ◽  
...  
Keyword(s):  
Rural Health ◽  
Postnatal Care ◽  
Democratic Republic ◽  
Neonatal Care ◽  
Health Facilities ◽  
Facility Conditions ◽  
Facility Type ◽  
Republic Of The Congo ◽  
Care Practices ◽  
Delivery Rooms

Background: Current facility conditions, obstetric and neonatal care practices, and availability of emergency obstetric and neonatal care (EmONC) were assessed in the Kwango and Kwilu provinces of the Democratic Republic of the Congo (DRC). Methods: This is an analysis of the baseline survey data from an ongoing clinical mentoring program among 72 rural health facilities in the DRC. Data collectors visited each of the facilities and collected data through a pre-programmed smartphone. Frequencies of selected indicators were calculated by province and facility type—general referral hospital (GRH) and primary health centers (HC). Results: Facility conditions varied across province and facility type. Maternity wards and delivery rooms were available in the highest frequency of rooms assessed (>95% of all facilities). Drinking water was available in 25.0% of all facilities; electricity was available in 49.2% of labor rooms and 67.6% of delivery rooms in all facilities. Antenatal, delivery, and postnatal care services were available but varied across facilities. While the proportion of blood pressure measured during antenatal care was high (94.9%), the antenatal screening rate for proteinuria was low (14.7%). The use of uterotonics immediately after birth was observed in high numbers across both provinces (94.4% in Kwango and 75.6% in Kwilu) and facility type (91.3% in GRH and 81.4% in HC). The provision of immediate postnatal care to mothers every 15 minutes was provided in less than 50% of all facilities. GRH facilities generally had higher frequencies of available equipment and more services available than HC. GRH facilities provided an average of 6 EmONC signal functions (range: 2-9). Conclusions: Despite poor facility conditions and a lack of supplies, GRH and HC facilities were able to provide EmONC care in rural DRC. These findings could guide the provision of essential needs to the health facilities for better delivery of maternal and neonatal care.

Tantalus and the Tyranny of Territory: Pursuing the dream of parity in rural and metropolitan population health outcomes through primary health care programs

2004 ◽  
Vol 10 (3) ◽  
pp. 83 ◽  
Author(s):  
Peter Harvey
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Rural Communities ◽  
Health Outcomes ◽  
Rural Health ◽  
Rural Areas ◽  
Access To Health Care ◽  
Fundamental Problem ◽  
Primary Health ◽  
Rural And Urban

Many health professionals and rural health academics are motivated by the challenge of achieving equitable access to health care in rural communities with the implicit vision that fairer access to services might ultimately lead to more equitable health outcomes for people living in rural and remote settings. The purpose of this paper is to put the issue of rural and urban health outcome parity into perspective and assess recent progress towards achieving the ultimate goal of improving rural health status. I will also explore ways in which rural communities might increase their access to and use of primary health care revenue in the future to improve community health outcomes. While some improvements have been achieved across the rural health system in recent times, the fundamental problem of maintaining infrastructure to service community needs in rural areas remains as daunting as ever. Extensive evidence has now been assembled to show that rural people generally enjoy a much lower standard of health care, health outcomes and life expectancy than their urban cousins. The question underlying all of this evidence, however, is... must this always be so? Is it possible to redress the current inequities between rural and urban populations and could new primary health care initiatives, such as the Enhanced Primary Care (EPC) program, be vehicles for achieving more equitable health care arrangements and health outcomes for people living in rural communities?

Toward Identifying the Unique Characteristics of Social Work Practice in Rural Areas: From the Voices of Practitioners

2000 ◽  
Vol 6 (1) ◽  
pp. 19-35 ◽  
Author(s):  
Joanne Gumpert ◽  
Joan E. Saltman ◽  
Donna Sauer-Jones
Keyword(s):  
Social Work ◽  
Cultural Values ◽  
Rural Areas ◽  
Work Practice ◽  
Social Work Practice ◽  
Rural Practice ◽  
Small Communities ◽  
Rural And Urban ◽  
Self Help Groups ◽  
The Impact

Although literature has identified cultural values, environmental factors, and specific problems unique to social work practice in rural and small communities, research efforts focused on identification of the differences between rural and urban practice have found little variation. This article presents a new dimension. The findings from a survey of rural practitioners provide a closer look at practice within the rural context. Findings confirm several characteristics found in the literature: direct and indirect practice with multiple client systems, and extensive interface with community based systems of self help groups and natural helpers. The impact of two factors, the influence of rural cultural norms and values and lack of resources, appears to suggest avenues for further study in order to uncover the unique qualities of rural practice. Implications are drawn for social work education.

scholarly journals The Rural Nursing Workforce Hierarchy of Needs: Decision-Making concerning Future Rural Healthcare Employment

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1232
Author(s):  
Daniel Terry ◽  
Blake Peck ◽  
Ed Baker ◽  
David Schmitz
Keyword(s):  
Decision Making ◽  
Nursing Students ◽  
Rural Areas ◽  
Nursing Student ◽  
Rural Practice ◽  
Nursing Workforce ◽  
Hierarchy Of Needs ◽  
Related Factors ◽  
Rural Nursing ◽  
Rural Employment

Addressing nursing shortages in rural areas remains essential, and attracting nursing graduates is one solution. However, understanding what factors are most important or prioritized among nursing students contemplating rural employment remains essential. The study sought to understand nursing student decision-making and what aspects of a rural career need to be satisfied before other factors are then considered. A cross-sectional study over three years at an Australian university was conducted. All nursing students were invited to complete a Nursing Community Apgar Questionnaire to examine their rural practice intentions. Data were analyzed using principal component analysis, and mean scores for each component were calculated and ranked. Overall, six components encompassed a total of 35 items that students felt were important to undertake rural practice after graduating. Clinical related factors were ranked the highest, followed by managerial, practical, fiscal, familial, and geographical factors. Maslow’s Hierarchy of Needs provided a lens to examine nursing student decision-making and guided the development of the Rural Nursing Workforce Hierarchy of Needs model. Each element of the model grouped key factors that students considered to be important in order to undertake rural employment. In culmination, these factors provide a conceptual model of the hierarchy of needs that must be met in order to contemplate a rural career.

scholarly journals Putting the (R) Ural in Preceptorship

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Deirdre Jackman ◽  
Florence Myrick ◽  
Olive Yonge
Keyword(s):  
Nursing Students ◽  
Rural Areas ◽  
Nursing Student ◽  
Role Model ◽  
Rural Practice ◽  
Rural Setting ◽  
Rural Nursing ◽  
Important Approach ◽  
Research Gap ◽  
The One

Rural nursing is recognized as a unique health care domain. Within that context, the preceptorship experience is purported to be an important approach to preparing safe and competent rural practitioners. Preceptorship is the one-to-one pairing of a nursing student with a professional nurse who assumes the mandate of teacher and role model in a designated clinical/contextual setting, in this case the rural setting. A research gap exists in the literature in which rural preceptorship is specifically explored. The purpose of this paper is to review preceptorship in relation to preparing nursing students specifically for the rural setting. Understanding how preceptorship as an educational model can prepare nursing students to transition to rural practice is an important endeavor. An authentic rural preceptorship may serve to influence the recruitment and retention needs for registered nurses in rural areas. A greater understanding of rural preceptorship serves to illustrate the appropriate support, socialization and contextual competence required to prepare nursing students for rural nursing practice. This paper's review may serve to highlight the research that currently exists related to rural preceptorship and where additional research can contribute to further understanding and development for authentic rural nursing preparation.

scholarly journals Health Disparities between the Rural and Urban Elderly in China: A Cross-Sectional Study

2021 ◽  
Vol 18 (15) ◽  
pp. 8056
Author(s):  
Jian Zhang ◽  
Dan Li ◽  
Jianmin Gao
Keyword(s):  
Health Disparities ◽  
Rural Health ◽  
Rural Areas ◽  
Decomposition Analysis ◽  
The Elderly ◽  
Rural Elderly ◽  
Urban Elderly ◽  
Rural And Urban ◽  
Urban Rural ◽  
Urban And Rural Areas

Background: China is becoming an aging society, and the proportion of the population aged 60 years and above is increasing. There is a dualistic urban–rural economic structure between urban and rural areas in China, but there are few comparative health studies on the self-assessed health (SAH) status of the elderly between urban and rural areas. The aim of this study is to explore the SAH status of the elderly in China, and to identify the health disparity between the urban and rural elderly. Methods: The data from the fourth wave of the China Health and Retirement Longitudinal Study (CHARLS) in 2018 were adopted. A total of 9630 participants aged 60 and above were included in this study. SAH was used as the indicator, measuring the health status. Fairlie decomposition analysis was conducted to find the SAH disparity. Results: The proportion of good SAH of the rural elderly (24.01%) was significantly higher than the urban elderly (19.99%). The association of SAH was widely different between the rural and urban elderly. There was a stronger association between SAH and sleeping time in the urban elderly (Odds ratios (OR) = 3.347 of 4–8 hours; OR = 3.337 of above 8 hours) than the rural elderly (OR = 1.630 of 4–8 hours; OR = 2.293 of above 8 hours). Smoking and social activity were significant only in the urban elderly, while region and assets were significant only in the rural elderly. Drinking (11.45%), region (−33.92%), and assets (73.50%) were the main factors contributing to the urban–rural health disparities. Conclusions: This is the first comparative study examining SAH disparity, focusing on the elderly aged 60 and above in China. From the perspective of drinking, region, and assets, our study highlighted substantial urban–rural health disparities, and provided evidence for policy making on narrowing the health gap between urban and rural areas in China.

scholarly journals A systematic review of antimalarial medicinal plants in Democratic Republic of the Congo

2021 ◽  
Vol 347 ◽  
pp. 13-29
Author(s):  
Butoto Imani wa RUSAATI ◽  
Arusi Patience GENDUSA ◽  
Sung-Hyun JOO ◽  
Joo Won PARK ◽  
Cephas Ndabaga MASUMBUKO ◽  
...  
Keyword(s):  
Systematic Review ◽  
Medicinal Plants ◽  
Plant Species ◽  
Democratic Republic ◽  
Plasmodium Falciparum Malaria ◽  
Urban Environments ◽  
Bioactive Molecules ◽  
Plant Resources ◽  
Rural And Urban ◽  
Republic Of The Congo

In Democratic Republic of the Congo (DRC), malaria is caused by a parasite called Plasmodium falciparum. Malaria is one of the country's major public health issues and responsible for the death of tens of thousands of people every year in both rural and urban environments. Antimalarial drugs are commonly used but some recorded cases of drug resistance are a major obstacle to controlling the spread of malaria. It is therefore essential to identify new bioactive molecules as an alternative. Many medicinal plants with different properties have been used as treatments for a variety of diseases in the DRC, including malaria. This study provides a systematic review of antimalarial plant resources in the DRC. From 28 papers on ethnomedicine published between 2001 and 2019, a total of 232 plant species belonging to 67 different plant families and identified in 13 provinces was reported in the treatment of malaria. A large number of these plant species belong to the Fabaceae, Asteraceae, Euphorbiaceae, Rubiaceae, and Apocyanaceae families. Species cited in more than three provinces include Cymbopogon citratus, Vernonia amygdalina, Rauvolfia vomitoria and Catharanthus roseus. Most of the species identified as antimalarial plants were tree species, with phanerophytes predominating. In addition, leaves were identified as the main ingredients for preparing remedies, most commonly by decoction administered orally.    

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