Erratum: Current state of preconception care in sub-Saharan Africa: A systematic scoping review.

No abstract available.

Views of adolescents living with perinatally acquired HIV on HIV status disclosure in Eswatini.

HIV is recognised as a multifaceted chronic disease, bearing psychosocial consequences that potentially impact on the personal and social well-being of those living with it. Adolescents and youth bear a significant proportion of the burden of the HIV epidemic but they have low rates of disclosure of their HIV status. This study aims to determine the views of adolescents living with perinatally acquired HIV on HIV status disclosure among 361 adolescents aged 15-19 in Eswatini. A cross-sectional study was conducted on adolescents who already knew their status, and data were collected using a structured questionnaire. A majority of the participants, 55% (n = 200), were females, and 44% (n = 160) were males. A low number of adolescents (22%) had disclosed their HIV status to anyone. Adolescents who found it difficult to understand disclosure themselves had low levels of onward disclosure (27%) compared to adolescents who better understood the disclosure event. Our results revealed that adolescents' prevalence of HIV status disclosure was low. This raises concerns as some of the adolescents were in relationships with partners who were not aware of their status. However, older adolescents displayed some level of disclosure self-efficacy in that a higher proportion of them disclosed better than younger adolescents.

"We will tell when we are ready": perinatally HIV-infected adolescents and self-disclosure of their status in Eswatini.

Access to antiretroviral therapy (ART) has promoted a significant decrease in mortality of vertically HIV-infected children. As a result, there has been an increasing growth of this population that reaches adolescence. These adolescents face problems such as self-disclosure and the stigma of the disease. This study aimed to determine the process followed by perinatally HIV-infected adolescents in self-disclosing their HIV status to significant others and the barriers and promoters of perinatally HIV-infected adolescents' disclosure of their HIV status to others. Data were collected from 15-19-year-old adolescents through 23 in-depth individual interviews and three focus groups. For adolescents, a clear barrier to disclosure was being told when they were younger by a parent to keep their status secret from other people. Lack of trust and fear of breaches of confidentiality which would lead to stigma and discrimination also hindered disclosure. For those adolescents who disclosed, they did so face to face and through short text messages. Adolescents expressed the need to be capacitated to self-disclose and also called for HIV and AIDS education to the general public as a way of fighting stigma and discrimination in their communities and in society. For adolescents to be able to disclose, they have to work through issues of acceptance of their own HIV status first. This study is the first-ever study to document difficulties faced by adolescents in the self-disclosure of their status in Eswatini.

Factors influencing the utilization of doctoral research findings at a university in KwaZulu-Natal, South Africa: Views of academic leaders.

BACKGROUND: Translation of health research findings into policy remains a challenge in sub-Saharan Africa. Factors influencing health research utilization are poorly described in literature. Therefore, identifying factors that influence the utilization of research findings for policy formulation is essential to facilitate implementation of evidence-based interventions. The purpose of this study was to explore the views of academic leaders as to why doctoral research is not adequately used in policymaking. METHODS: In-depth interviews were held with purposively selected key informants from the College of Health Sciences. An open-ended interview guide aimed at exploring college leadership views on factors influencing utilization of PhD generated knowledge into policy was used. Data was analysed thematically using NVivo 12 software. Thematic analysis was used to generate themes around the factors influencing utilization of doctoral research into policy. RESULTS: Factors such as inaccessibility of research results, lack of funding, poor quality of research, lack of continuity in translating research into policy, lack of timeliness of research results and lack of collaboration between researchers and policymakers hindered the utilization of PhD generated knowledge. Participants recommended engagement with the Department of Health/policymakers, collaboration with Department of Health/policymakers, increasing enrolment of South African citizens into PhD program, making final research products available to Department of Health/policymakers, and provision of funding for dissemination of research results. CONCLUSION: The study demonstrated that final doctoral research results are mainly disseminated through journal articles and theses. Participants cited inaccessibility of research findings, lack of funding and poor-quality research as the most common factors hindering utilization of doctoral research findings. The study also recommended availing adequate funding for dissemination of research results, collaboration between researchers and policymakers, facilitation of policymaker-researcher engagement to find best ways of using research findings to influence policy and making final research products accessible to policymakers. Further research to gain the perspective of policymakers as to why doctoral research is not adequately used in policy formulation is recommended.

Preconception Care Recommendations, Training, and Competency of Primary Healthcare Nurses in South Africa: A Quantitative Descriptive Study.

Introduction: There has been a growing interest in preconception care (PCC) as a primary means of tackling the high maternal and child mortality rates, as evidence has shown that the state of maternal health before conception can have a direct impact on the health of the mother and baby. Primary care nurses have been recognized as the highest providers of sexual and reproductive healthcare to the vulnerable population in resource-constrained settings. Objective: This study aimed to examine and describe the PCC recommendations, training, and competency of primary healthcare (PHC) nurses in South Africa. Methods: A cross-sectional descriptive study was conducted among 196 PHC nurses to examine the PCC recommendations, training, and competency. A self-administered survey tool was used for data collection. Results: The self-reported PCC recommendations, training, and competency of PHC nurses were 63.3%, 88.3%, and 94.9%, respectively, in each aspect. The PCC training among the respondents was mainly in-service training. The only training that was indicated to have been done primarily at a pre-service level was training about reproductive life plan screening and brief counseling. Over 20% of the respondents indicated that they did not receive any training on how to provide alcohol, drug, or tobacco cessation services and how to conduct preconception risk assessments. Conclusion: Although PHC nurses reported a high level of recommendation, training, and competency, their level of reported PCC practice is not equivalent to their provision, as they rendered PCC services to fewer women, and they also reported fewer women seeking PCC. A future longitudinal study is required to examine the reason for low PCC-seeking habits among those at high risk of adverse pregnancy outcomes and contextual factors influencing the provision of PCC services among healthcare workers.

Measuring perceived learning gains of undergraduate nursing students in ICT skills: One group pre-test and post-test design.

Purpose: This study aimed to measure learning gains during an ICT training intervention in first-year students completing a four-year undergraduate nursing degree.Methodology: This study adopted a quasi-experimental, one group pre-test and post-test design. The intervention effectiveness was measured using individual single-student normalised gains, g; class average normalised gain, 〈g〉; and average single-student normalised gain, g(ave).Results: In this study, the class average normalised gains, 〈g〉 ranged from 34.4% to 58.2%, and the average of single student normalised gains, g(ave) ranged from 32.4% to 50.7%. The overall class average normalised gain 〈g〉 was 44.8%, and the average of the single student normalised gain was 44.5%, with 68% of students having a normalised gain of 30% and above, indicating that the intervention was effective.Conclusion: Similar interventions and measurements are recommended to all health professional students during their first academic year to pave a foundation for ICT usage for academic purposes.

Integration of preconception care into the bachelor of nursing curriculum: An exploratory qualitative study.

Background: The significance of ensuring high quality of care has become apparent in nursing and midwifery education worldwide, especially in low- and middle-income countries. This has led to upgrades of the nursing curriculum to include several aspects of care that have been overlooked with recent evidence-based care. Objectives: To explore the integration of preconception care (PCC) into the Bachelor of nursing curriculum in South Africa. Design: An exploratory qualitative study. Setting and participants: This study was conducted in a higher education institution in South Africa that has recently revised its Bachelor of nursing curriculum. Data sources were Bachelor educators and program documents. Methods: Individual in-depth interviews were conducted among ten nurse educators. Interviews were complemented with an analysis of the curriculum documents for the Bachelor of nursing program using the BEKA (benchmarking, evidencing, knowing, and applying) model of curriculum analysis and evaluation. Findings: Benchmarking and evidencing of the Bachelor of nursing curriculum reveals a high level of compliance with the externally set standards. Both data sources pointed to some degree of incorporating the preconception care concept into the curriculum. The educators perceived that for full integration to occur, preconception care should be taught as a standalone topic. Lack of focus and poor perception was further reported as barriers to introducing the concept. Most preconception care components and services were taught to students throughout the four hundred levels of the nursing program, especially in the sexual and reproductive health module. Gaps were noted in female genital mutilation, mental health, environmental health, preconception vaccination, and other aspects where preconception care needs emphasis. Conclusions: There has been a high level of integration of preconception care competency in the Bachelor of nursing curriculum. Especially in the sexual and reproductive health module, most preconception care components are taught to students. However, there is a need to emphasise the preconception nursing management of women with certain conditions. To ensure nurses' role in providing health for all, safeguarding reproductive health, and maintaining the health continuum is enhanced.

Simulation-based education model for under-resourced nursing education institutions in Lesotho.

Background: The changing landscape of nursing education to competency-based education has strengthened the importance of simulation learning in the process of developing the required graduate competencies. Aim: This study aimed to develop a model that guides the implementation of simulation-based education (SBE) in under-resourced nursing education institutions in Lesotho. Setting: Four Nursing Education Institutions in Lesotho. Methods: An explanatory sequential mixed methods design was adopted. Sampling methods included stratified systematic random, purposive and systematic sampling. The total sample was 390 comprising students, nurse educators and principals. Data were collected through questionnaires, focus group discussions and in-depth unstructured individual interviews. Statistical analysis was employed for quantitative data while a grounded theory approach guided the qualitative data analysis and model development. Results: Implementation of simulation emerged as a multilevel, multi-actor and multistage process of adopting, introducing and implementing SBE. This education takes place in a simulated environment that serves as a connecting bridge between the learning of theory in the classroom and clinical learning in real-life settings. The model generated from this study has simulation implementation as the main concept that is supported by four major concepts: (1) simulation initiation at the strategic level, (2) simulation implementation at the tactical level, (3) simulation implementation at the operational level and (4) simulation outcomes. Conclusion: Successful implementation of simulation requires buy-in from key stakeholders. Simulation-based education policy, competent facilitators and a well-resourced clinical skills laboratory may facilitate the development of the required competencies. Contribution: The study provides guidance on how SBE can be implemented in resource-limited settings.

Preconception care practices among primary health care nurses working in public health facilities in KwaZulu-Natal.

BACKGROUND: Preconception care (PCC) is necessary to identify and deal with all the risk factors before conception. Some aspects of PCC, like folic acid supplementation, would be relevant to people desiring a pregnancy. Alternatively, PCC could provide contraceptive support to those with no pregnancy intention. In South Africa, primary healthcare nurses provide a comprehensive package of essential services in public health facilities to about 90% of the population at no cost. Therefore, they are the key providers of promotive, preventive, and curative services, including PCC. OBJECTIVE: This study aimed to determine the level of PCC practice among primary healthcare nurses and identify determinants of effective practice. METHODS: This cross-sectional descriptive survey was conducted among 196 nurses undertaking a specialisation Primary HealthCare program in a selected higher education institution. A pretested questionnaire was used to collect data that were analysed with SPSS version 27 software. RESULTS: The overall practice of PCC was 87.8%. Older participants were significantly less likely to exhibit good PCC practice than their younger counterparts. Female participants were also less likely to have good PCC practices than their male counterparts. Married participants were significantly more likely to practice PCC than their unmarried counterparts. Participants practicing in rural areas were also less likely to have good PCC practices than their urban counterparts. CONCLUSION: The PCC practice of most primary healthcare nurses in the study is relatively high. The study also identified the determinants of good PCC practice that can enhance its practice. There is a need to revisit the PCC training of healthcare workers, as most indicated the need for further training.

Nurse educators and student nurses' perspectives on ways to improve implementation of simulation-based education in Lesotho.

BACKGROUND:  In order to ensure an effective health system, there is a need to recruit, train and deploy a competent nursing workforce. A competent workforce can be made possible by integrating simulation into the curriculum. Implementation of simulation-based education in Lesotho is facing a number of challenges as the country has limited resources. OBJECTIVES:  This study aimed to describe nurse educators and students' perspectives on ways to improve implementation of simulation-based education in Lesotho. METHOD:  A qualitative study was conducted. A total of 24 students, 24 nurse educators and 4 principals who were purposely selected participated in the study. Focus group discussions as one of the data collection methods were used to collect data from the nurse educators and students whilst in-depth, unstructured individual interviews were used with the principals. Data were analysed following the Corbin and Strauss grounded theory approach where similar codes were categorised together as part of open coding, and axial coding was conducted by refining the codes and organising them into categories and subcategories. RESULTS:  Two categories emerged from the areas where improvement is required: resources to support simulation. Resources emerged as playing a major role in ensuring quality simulation. The teaching and learning process emerged as collaborative in nature with all key players ensuring that they meet their responsibilities in order to ensure effective simulation-based learning. CONCLUSION:  The study revealed that there are limited numbers of simulation facilitators and this hinders effective implementation of simulation. Students are concerned about the comments of educators during simulation, as some of the comments are belittling.

"We Are Having a Huge Problem with Compliance": Exploring Preconception Care Utilization in South Africa.

BACKGROUND: Preconception care (PCC), a policy directive from the World Health Organisation (WHO), comprises all the health interventions offered to women and couples before conception and is intended to improve their overall health status and the pregnancy outcomes. Although PCC should be an essential part of maternal and child health services in most African countries, its provision and utilization are not widely documented. Hence, this study aimed to explore the factors influencing preconception care utilization among high-risk women in South Africa. METHODS: A descriptive qualitative study of 29 purposively selected women and healthcare workers was conducted through individual in-depth interviews using a semi-structured interview guide. The interviews were transcribed verbatim, and the analyses were performed using Nvivo version 12. The Social-Ecological Model (SEM) guided the data analysis. Four levels of factors (the individual, the interpersonal, the community and social, and the policy and institutional) were used to assess what can influence PCC utilization. FINDINGS: The availability of PCC services, the intrahospital referral of women, the referral practices of other healthcare workers, the underutilization of the PCC facility, and resources emerged at the institutional levels, while compliance with PCC appointments, socioeconomic factors, pregnancy planning, assumptions, and knowledge was at the individual levels. CONCLUSION: The utilization of the preconception care services was inadequate. The primary influencer of preconception care utilization was at the individual, policy, and institutional levels. The availability of preconception care services and the intrahospital referral of women at high risk of adverse pregnancy outcomes positively influenced the women's PCC utilization, while poor pregnancy planning, and unavailability of PCC policies and guidelines negatively influenced preconception care utilization. Therefore, interventions to improve PCC utilization should focus on the four SEM levels for effectiveness. There is a need to raise PCC awareness and develop policy and guidelines to ensure consistent, standardized practice among healthcare workers.

Current state of preconception care in sub-Saharan Africa: A systematic scoping review.

BACKGROUND:  Preconception care (PCC) utilisation is essential to extend and complete the health continuum. However, these services are not yet incorporated into many low-income countries' existing maternal health services. AIM:  This study aims to review the current literature on the knowledge, utilisation and provision of PCC. SETTING:  This included women and healthcare workers (HCWs) in Sub-Saharan African (SSA) countries. METHODS:  Arksey and O'Malley's scoping review methodology framework is used in this study. The following databases, Google Scholar, Science Direct, PubMed, Scopus and Dissertation via ProQuest, were searched. Articles that met the eligibility criteria were included in this study. RESULTS:  Out of the 451 retrieved articles, 39 were relevant. In most studies, women's utilisation and HCW's provision of PCC were considered limited. Their knowledge, however, varies between studies, and there were a few studies conducted among women with chronic conditions. Several factors influenced women and HCWs' knowledge, utilisation and provision of PCC, including age, level of education, employment, practice area, resources and knowledge. Preconception care interventions most commonly identified, utilised and provided were HIV testing, counselling and family planning, while preconception folic acid supplementation was the least. CONCLUSION:  The estimates of knowledge and utilisation were suboptimal among women, while provision was the worst affected among HCWs. Gaps exist between the HCW knowledge and practice of PCC. There is a need to promote, prioritise, integrate and optimise the opportunistic provision of PCC in SSA. There is also a need for more studies on PCC provision and utilisation among women with chronic medical conditions.

A report of a South African university's management of undergraduate nursing students' teaching and learning following the COVID-19 interruptions.

The coronavirus disease 2019 (COVID-19) pandemic exposed an absence of blueprints to avert an education disaster. In South Africa, in line with Alert Level-5, adhering to lockdown restrictions, higher education institutions (HEIs) closed, necessitating the transition to online teaching and learning. The HEIs, inclusive of the nursing discipline, needed to develop comprehensive plans and a rigorous follow-up scheme in order to ensure that faculty and students made proper use of virtual platforms and simultaneously met regulatory body requirements, thus ensuring that 'no student and faculty were left behind'. The responses varied from one HEI to another. The objective of this study was to present how a South African nursing education faculty managed teaching and learning following COVID-19-related interruptions. This included an HEI in KwaZulu-Natal, South Africa. Donabedian's tripartite model, comprising structure, process and outcome, provides the organising structure to present the faculty and university's approach to meet the desired outcome of saving the 2020 academic year. The Structures' and Processes' components of Donabedian's tripartite model influenced both intended and unintended outcomes. In 3 months, what might have been argued as impossible, a 4-year undergraduate nursing programme was transitioned from a traditional approach to fully virtual remote teaching and learning. Thus, the 2020 academic year was saved. Contribution: This article offers guidance to HEIs on how to continue teaching and learning in contexts where education is interrupted.

Lessons Learnt during the Implementation of WISN for Comprehensive Primary Health Care in India, South Africa and Peru.

INTRODUCTION: The World Health Organization introduced the workload indicators of staffing needs (WISN) in 1998 to improve country-level health workforce planning. This study presents the primary care health workforce planning experiences of India, South Africa and Peru. METHODS: A case study approach was used to explore the lessons learnt in the implementation of WISN in India and South Africa. It also describes the methods developed and implemented to estimate health workforce in Peru. We identify the barriers and facilitators faced by countries during the implementation phase through the triangulation of literature, government reports and accounts of involved health planners in the three countries. RESULTS: India implemented WISN in a referral pathway of three district health facilities, including a primary health centre, community health centre and district hospital. Implementation was impeded by limited technical support, poor stakeholder consultation and information systems challenges. South Africa implemented WISN for health workforce planning in primary care and found the skills mix and staff determinations to be unaffordable. The Peruvian Ministry of Health considered using WISN but decided to develop a context-specific tool to estimate the health workforce needed using its available resources such as the National Register of Health Personnel. The main challenge in using WISN was the insufficient information on its inputs. CONCLUSION: While India and South Africa had unique experiences with the integration of WISN in their health system, none of the countries has yet benefited from the implementation of WISN due to financial, infrastructure and technical challenges. Since the methodology developed by the Peruvian Ministry of Health is context-specific, its implementation has been promising for health workforce planning. The learnings from these countries' experiences will prove useful in bringing future changes for the health workforce.

Perceptions and Practice of Preconception Care by Healthcare Workers and High-Risk Women in South Africa: A Qualitative Study.

Preconception care is biomedical, behavioural, and social health interventions provided to women and couples before conception. This service is sometimes prioritised for women at high risk for adverse pregnancy outcomes. Evidence revealed that only very few women in Africa with severe chronic conditions receive or seek preconception care advice and assessment for future pregnancy. Thus, this study aimed to explore the perceptions and practice of preconception care by healthcare workers and high-risk women in Kwa-Zulu-Natal, South Africa. This exploratory, descriptive qualitative study utilised individual in-depth interviews to collect data from 24 women at high risk of adverse pregnancy outcomes and five healthcare workers. Thematic analysis was conducted using Nvivo version 12. Five main themes that emerged from the study include participants' views, patients' access to information, practices, and perceived benefits of preconception care. The healthcare workers were well acquainted with the preconception care concept, but the women had inconsistent acquaintance. Both groups acknowledge the role preconception care can play in the reduction of maternal and child mortality. A recommendation is made for the healthcare workers to use the 'One key' reproductive life plan question as an entry point for the provision of preconception care.

Perceived predictors of quality of life in patients with end-stage renal disease on dialysis.

BACKGROUND: Reduced quality of life (QOL) is associated with shorter survival, and is more marked in patients with end-stage renal disease (ESRD). Predictors of health, which include policymaking, social factors, health services, individual behaviour, biology and genetics, have an impact on the QOL of patients with ESRD. Patients with ESRD in South Africa are cared for in public and private hospitals, with public health institutions characterised by several challenges. OBJECTIVE: To explore and analyse the perceived predictors of QOL in patients with ESRD in the three district hospitals that provide renal services in KwaZulu-Natal. METHODS: An exploratory, descriptive qualitative research approach based on grounded theory research design was used and three focus group discussions (FGDs) were conducted. The researcher recruited 18 participants, 6 in each focus group. Three phases of data analysis were followed: open coding, axial coding, and selective coding. RESULTS: Predictors of QOL that emerged were the geographic location of the patients, accessibility of haemodialysis centres, patients' adaptation and acceptance of the condition, self-management, support by family members and caregivers and availability of adequately trained nurses. CONCLUSION: Predictors of QOL in patients with ESRD are associated with an increased risk of morbidity and mortality resulting from dialysis. The broad range of dimensions of life is negatively affected and requires intervention by the renal team and policymakers to improve the QOL of patients.

Using Mobile Technologies Among Undergraduate Nursing Students for Academic Purposes in Tertiary Education: A Quantitative Survey.

Mobile devices are increasingly part of daily life, with the benefits of using the technology in nursing education widely recognized. This study explored the use of mobile devices among undergraduate nursing students for academic purposes in South Africa, using a quantitative survey. The majority of participants owned smartphones (87.6%), followed by laptops (76%) and tablets (47.1%). Mobile devices were used to perform academic tasks and communicate and collaborate with peers and teachers, as well as search and access electronic resources. Few of the first year nursing students owned laptops and tablets and used them less frequently than the students from other levels of the study. Equipping nursing students with mobile devices, such as laptops and tablets, particularly first year students, and ensuring that they have adequate skills to use them, is essential to training future nurses who are expected to work in a technology-mediated health environment.

Using Exploratory and Confirmatory Factor Analysis to understand the role of technology in nursing education.

AIM: The study aimed to establish the role played by technology in nursing education through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). METHODS: 150 student nurses participated, with data being collected using a structured questionnaire with 14 items on a 5-point Likert scale. Parallel Analysis (PA) and Exploratory Factor Analysis (EFA) were conducted to identify the factors for the role of technology in nursing education, Confirmatory Factor analysis (CFA) was used to ascertain the model fit. ANOVA, t-test and binary regression analysis were used to identify among the factors the differences within the level of the study, and perceived abilities to use the computer. RESULTS: The EFA identified five factors from 14 items, and through the CFA, the results indicated that the model was supported by the following indices: Comparative Fit Index (CFI) = 0.968 (>0.95); Incremental Fit Index (IFI) = 0.969 (>0.95); Tucker-Lewis Index (TLI) = 0.957 (>0.95); Root Mean Squared Error of Approximation (RMSEA) = 0.077 (<0.080); and SRMR = 0.0396 (<0.08). These results were within acceptable ranges, which indicated that the five factors obtained from EFA were validated. However, Chi-square goodness of fit statistics was not statistically significant (χ2 = 126.312, d.f = 67, p = .000). Overall, 89.3% (n = 134) nursing students had a positive perception of the role of technology in nursing education. Binary regression analysis indicated that 1st year nursing students positively perceived the role of technology 6.7 times more than other levels (OR = 6.710, 95% CI: 1.33-33.63, p = .021). Students with good ability to use the computers (92.9%) were 5.3 more likely to have a positive perception towards the role of technology in nursing than those with the poor ability (OR = 5.35, 95%CI = 1.76-16.26, p = .003). CONCLUSION: Using innovative teaching strategies and ensuring that nursing students are skilled is essential to the future of the nursing profession. The five-factor model would be a useful tool to assess the perception of students towards the role of technology in nursing education.

Challenges in postgraduate research supervision in nursing education: Integrative review.

AIM: The aim of this study was to investigate challenges associated with postgraduate research supervision in nursing education and possible implications for improvement efforts. BACKGROUND: Postgraduate research-based programs in nursing education are particularly new compared to other professions. Anecdotal notes from nursing education stakeholders indicate that postgraduate research supervision encounters numerous challenges, with negative consequences for the nursing profession and for society. METHOD: Integrative review that combines empirical and theoretical evidence was used to obtain a comprehensive picture of challenges in the supervision of postgraduate research. DATA SOURCES: EBSCOhost; Science Direct; Google Scholar. REVIEW METHODS: The quality of included studies was appraised using the Mixed Method Appraisal Tool for quantitative, qualitative and mixed-method studies. Two reviewers extracted data and did quality appraisal. ANALYSIS: Inductive content analysis was used to analyse extracted data from included studies. RESULTS: Seven studies were included. Three main categories of challenges associated with (a) institutional context, (b) research supervisors, and (c) postgraduate students. DISCUSSION: Institutional context challenges were lack of clear guidelines for nursing schools, limited pool of appropriate research supervisors, and recruitment of many postgraduate students leading to mismatch, confusion and limited support. Research supervisors are insufficiently prepared, predominantly use traditional face-to-face method, and provide inconsistent feedback. Postgraduate students are inadequately prepared and are mostly full-time employed. CONCLUSION: Many challenges continue to beset postgraduate research supervision in nursing discipline, with negative consequences for the quality of graduates and the quality of their research output. THE IMPLICATION FOR NURSING POLICY: To generate useful knowledge and increase the number of motivated nursing scholars, challenges associated with postgraduate research supervision need to be addressed, with emphasis on formal training for research supervisors and development of clear guidelines for postgraduate research supervision and for recruitment of postgraduate students.

Positioning public nursing colleges in South African higher education: Stakeholders' perspectives.

BACKGROUND:  Public nursing colleges (PNCs) are currently redeploying from provincial departments of health to higher education to become part of a unified higher education system in South Africa. As primary producers of nurses, this migration process needs to be managed carefully, with stakeholders having a common understanding of this process. OBJECTIVES:  This study aimed to explore the stakeholders' perspectives on the positioning of PNCs in higher education. METHOD:  The study followed a qualitative grounded theory design. Purposive and theoretical sampling were utilised to achieve a sample size of 40 participants, including representatives from the Department of Higher Education and Training; professional associates; nursing educators; student leaders; nursing leaders; and nurses from the healthcare setting. Data were collected through observations, interviews and document analysis. RESULTS:  It emerged from the study that the integration of PNCs into higher education is a result of the country's political and legal context. A number of policy and legal frameworks emerged as contextual conditions that provided a basis for the change. The integration of PNCs into higher education was conceptualised as a functional shift in the governance of colleges; a political tool to transform nursing education; a means to enhance the quality of college-based nursing programmes, and a vehicle for the greater professionalisation of nursing. Conflicting legislation and funding emerged as two issues of concern. CONCLUSION:  Integrating PNCs with higher education came about because of political changes and the resolution of the ruling party to improve the quality of graduates produced, who will in turn improve the quality of healthcare service delivery offered.