Search

Richter M.S., Mill J., Muller C.E., Kahwa E., Etowa J., Dawkins P. & Hepburn C. (2013) Nurses' engagement in AIDS policy development. International Nursing Review 60, 52-58 Background: A multidisciplinary team of 20 researchers and research users from six countries - Canada, Jamaica, Barbados, Kenya, Uganda and South Africa - are collaborating on a 5-year (2007-12) program of research and capacity building project. This program of research situates nurses as leaders in building capacity and promotes collaborative action with other health professionals and decision-makers to improve health systems for human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) nursing care . One of the projects within this program of research focused on the influence of workplace policies on nursing care for individuals and families living with HIV. Nurses are at the forefront of HIV prevention and AIDS care in these countries but have limited involvement in related policy decisions and development. In this paper, we present findings related to the barriers and facilitators for nurses' engagement in policymaking. Methods: A participatory action research design guided the program of research. Purposive sampling was used to recruit 51 nurses (unit managers, clinic and healthcare managers, and senior nurse officers) for interviews. Findings: Participants expressed the urgent need to develop policies related to AIDS care. The need to raise awareness and to 'protect' not only the workers but also the patients were critical reason to develop policies. Nurses in all of the participating countries commented on their lack of involvement in policy development. Lack of communication from the top down and lack of information sharing were mentioned as barriers to participation in policy development. Resources were often not available to implement the policy requirement. Strong support from the management team is necessary to facilitate nurses involvement in policy development. Conclusions: The findings of this study clearly express the need for nurses and all other stakeholders to mobilize nurses' involvement in policy development. Long-term and sustained actions are needed to address gaps on the education, research and practice level. [ABSTRACT FROM AUTHOR]

Issues of local governance have dominated Caribbean policy agenda for the past two decades, prompting considerable thought and action on local government reform by scholars, local government practitioners and policy makers, alike. No reforms have been as ubiquitous as those of local government. Permitted by an international reformist agenda, local government reform policy is linked positively to efforts to redress incapacities of public management and administration. This article examines conceptual and empirical issues relating to implementation of local government reform in two Caribbean countries, Jamaica and Trinidad. It analyses how the vision for local governance is articulated through specific reform taxonomies and argues that, although local government reform is normatively a policy aimed at fundamental changes in intergovernmental relations, in Jamaica and Trinidad reform has led merely to adjustments in the internal administration of local government. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]