Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Dec 17:5:100116.
doi: 10.1016/j.ijnsa.2022.100116. eCollection 2023 Dec.

Experiences of nurses and midwives in policy development in low- and middle-income countries: Qualitative systematic review

Josephine Etowa  1 , Adele Vukic  2 , Megan Aston  2 , Damilola Iduye  2 , Shelley Mckibbon  3 , Awoala George  4 , Chioma Nkwocha  4 , Binita Thapa  1 , Getachew Abrha  1 , Justine Dol  5
Affiliations
Review

Experiences of nurses and midwives in policy development in low- and middle-income countries: Qualitative systematic review

Josephine Etowa et al. Int J Nurs Stud Adv. .

Abstract

Background: Nurses provide 90% of health care worldwide, yet little is known of the experiences of nurses and midwives in policy development in low- and middle-income countries (LMICs).

Objective: To identify, appraise and synthesize the qualitative evidence on the experiences of nurses' and midwives' involvement in policy development LMICs.

Design: A qualitative systematic review using modified Joanna Briggs Institute (JBI) methodology.

Setting: Low and middle-income countries.

Participants: Nurses' and midwives' involved in policy development, implementation, and/or evaluation.

Methods: A systematic search was undertaken across nine databases to retrieve published studies in English between inception and April of 2021. Screening, critical appraisal, and data extraction was undertaken by two independent reviewers.

Results: Ten articles met inclusion criteria. All studies were published between 2000 to 2021 from a variety of LMICs. The studies were medium to high quality (70-100% critical appraisal scores). Four major themes were identified related to policy development: 1) Marginal representation of nurses; 2) Determinants of nurses' involvement (including at the individual, organization, and systematic level); 3) Leadership as a pathway to involvement; 4) Promoting nurses' involvement.

Conclusion: All studies demonstrated that nurses and nurse midwives continue to be minimally involved in policy development. Findings reveal reasons for nurses' limited involvement and strategies to foster sustained engagement of nurses in policy development in LMICs. To enhance their involvement in policy development in LMICs, change is needed at multiple levels. Systemic power relations need to be reconstructed to facilitate more collaborative interdisciplinary practices with nurses co-leading and co-developing health care policies.

Keywords: Healthcare; Involvement; Low- and middle-income countries; Midwives; Nurses; Policy development.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. No conflict of interest has been declared by the author(s).

Figures

Fig 1
Fig. 1
Prisma diagram of identifying the literature, From: Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. doi: 10.1136/bmj.n71, For more information, visit: http://www.prisma-statement.org/.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. AbuAlRub R.F., Foudeh F.N. Jordanian Nurses’ involvement in health policy: perceived benefits and barriers. Int. Nurs. Rev. 2017;64:13–21. doi: 10.1111/inr.12249. - DOI - PubMed
    1. Acheampong A.K., Ohene L.A., Asante I.N.A., Kyei J., Dzansi G., Adjei C.A., Adjorlolo S., Boateng F., Woolley P., Nyante F., Aziato L. Nurses’ and midwives’ perspectives on participation in national policy development, review and reforms in Ghana: a qualitative study. BMC Nurs. 2021;20:1–10. doi: 10.1186/s12912-021-00545-y. - DOI - PMC - PubMed
    1. Anders R.L. Engaging nurses in health policy in the era of COVID-19. Nurs. Forum. 2021;56:89–94. doi: 10.1111/nuf.12514. - DOI - PMC - PubMed
    1. Arabi A., Rafii F., Cheraghi M.A., Ghiyasvandian S. Nurses’ policy influence: a concept analysis. Iran. J. Nurs. Midwifery Res. 2014;19:315–322. - PMC - PubMed
    1. Arries E. Practice standards for quality clinical decision-making in nursing. Curationis. 2006;29:62–72. doi: 10.4102/curationis.v29i1.1052. - DOI - PubMed

LinkOut - more resources