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Supervisors’ Perceptions of Initial Graduates of a New HIV Nurse Practitioner Program in Zambia: Implications for Health Policy and Integration of Graduates into the Zambian Health System


There is a critical shortage of health care workers in the world, particularly in low resource countries.  This shortage has been compounded by the epidemic of HIV and AIDS, particularly in sub-Saharan Africa.  In 2009, under the leadership of the General Nursing Council of Zambia, and with involvement of multiple governmental and non-governmental organization partners, a 1-year diploma program was launched to prepare enrolled and registered nurses as HIV nurse practitioners.  To date, a total of 92 nurses have completed the program which is housed in the Lusaka School of Nursing, and there are plans to expand the program to 4 other nursing schools and prepare 150 more nurse practitioners in the next 4 years. 

Purpose and Methods:

At the end of the 1-year program, 44 supervisors completed surveys about their perceptions of the program, the extent to which the graduates would be able to implement 14 expanded role activities for which they had been prepared, and potential problems or challenges in integrating the HIV Nurse Practitioners into the Zambian health system


There was general agreement that graduates could implement 11 of the 14 expanded role activities identified on the survey and that the graduates made significant contributions in providing care for HIV patients although several expressed concerns that the new program might lead to shortages of nurses in other areas of care.  Supervisors identified challenges related to the lack of clear job descriptions and policies to provide salary increments for the graduates, and the need to ensure ongoing continuing education and supervision of the graduates.


The findings of this study have implications for health policy in Zambia and suggest a need for ongoing collaboration with the Ministry of Health to ensure that there are clear job descriptions, salary scale adjustments for nurses who assume the new and expanded roles, and policies to ensure that the graduates receive adequate supervision and support, and that they have access to continuing education opportunities. 


This project was supported by many partners including the General Nursing Council of Zambia , the UAB Sparkman Center for Global Health and School of Nursing;  the United States Centers for Disease Control and Prevention (CDC), Zambia Office;  Johnson & Johnson Corporate Contributions, AIDSRelief;  the Centre for Infectious Diseases Research in Zambia  (CIDRZ);  Zambia Prevention Care and Treatment (ZPCT);  the Lusaka Schools of Nursing & Midwifery, and the Zambia Ministry of Health. Preliminary results from the Year 1 graduates have been published in: Msidi, E., Sinkala, M., Bositis, A., Guberski, T., Menke, J., Montesanti, A., Morris, M., Katayamoyo, M., Mwanahamuntu, F., Mwale, A., Mweemba, P., Ngoma, R. W., Phiri, D., Wilson, C., &  Wilson, L. (2011).  The Zambian HIV Nurse Practitioner Diploma Programme:  Preliminary Outcomes.  International Journal of Nursing Education Scholarship, 8(1). 



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