Systematic review and meta-synthesis protocol for examining policies mitigating the determinants of African nurses' and midwives' migration

BACKGROUND

There has been a notable rise in the number of African nurses and midwives migrating to high-income countries despite varying policies and restrictions to promote retention. The need to comprehensively evaluate existing policies addressing the exodus is crucial to future policy formulation and steps in addressing drivers of nurses and midwives brain drain in Africa.

AIM

To explore the existence of migration policies that address the drivers of nurse and midwives' migration outside Africa and determine the characteristics and implementation of these policies.

METHODS

The review would be guided by the JBI methodology for systematic reviews of text and non-research evidence. Databases including CINAHL, PubMed, Academic Search Complete via Ebscohost and ISI Web of Science will be searched using a PICOS selection criteria framework. Grey literature would be gathered from Google Scholar, government and organisational websites. Two independent reviewers would be involved in searching, study selection, data extraction and data analysis. A third reviewer would provide an arbitrary judgement during conflicts when disagreements persist after discussion. A meta-synthesis would be used to identify and report emerging themes in the literature.

ETHICS AND DISSEMINATION

The study does not require ethical approval. The findings would be published in peer-review journals and presented at research conferences.

PROSPERO REGISTRATION NUMBER

CRD42023395013.

Nurse-led telerehabilitation intervention to improve stroke efficacy: Protocol for a pilot randomized feasibility trial

BACKGROUND

The prevalence of stroke continues to rise in low-middle income countries. The continual rise in stroke cases and increasing prevalence on post-acute needs represent a crucial call for increased accessibility and utilization of rehabilitation services.

AIM

The primary objective of the study is to test the feasibility of a nurse-led telerehabilitation intervention in improving self-efficacy among stroke survivors. The findings of the trial are intended for use in a future larger study.

METHODS

Participants would be recruited at the University of Ghana Hospital and randomized into an intervention group and a control group. Participants aged ≥ 18 years, diagnosed of stroke at most 12months prior the recruitment and requiring moderate level of assistance would be considered for eligibility. Participants in the intervention group will receive individualized and comprehensive nurse-led rehabilitation therapies in physical, emotional, cognitive and nursing education domains for 6 months, in addition to treatment as usual (TAU). The control group will only receive treatment as usual. Follow-up evaluations will occur immediately, 30 days and 90 days after the intervention.

DISCUSSION

Providing stroke rehabilitation services in low-resource settings presents a significant challenge due to limited infrastructure and a lack of trained healthcare professionals. The current study has the potential of contributing to the growing body of evidence on the impact of telerehabilitation services in mitigating these challenges in low-resource settings.

TRIAL REGISTRATION

PACTR202210685104862, Pan African Clinical Trial Registry.