The subject of international migration has become an important social issue and feature of globalized labour market in health care. International migration of nurses has increasingly become a concern and the volumes are reported to be increasing particularly from the developing world where, in some countries, is a leading cause of attrition and subsequent shortage of nurses as a human resource. This has implications on the capacity of health systems to respond to the challenge of health care delivery to populations considering that nurses form the largest health workforce in most countries. In Zambia, nurse migration has equally been a concern including the absence of relevant studies with evidence to inform policy direction, planning and management of nursing human resource. The purpose of this study was to determine the extent of nurse migration, the reasons why nurses resign their employment positions and leave the country, why other nurses do not migrate and to further determine the perceived nurse migration impact on the public health care system. The study was a non-experimental descriptive survey design that used both quantitative and qualitative approaches to data collection and data analysis. A triangulation approach was used in data collection involving various methods; multistage, stratified and systematic sampling; purposive and snowball with a range of data collection instruments; semi-structured for focused interviews of nurse migrants, nurses seeking verifications and policy makers; self-administered questionnaire that enlisted data from clinical nurses and nurse educators on the perceived impact of nurse migration on the public health care system and topic guides for focus group discussions. Computer software were used to code and analyze data; SPSS version 11.0 for quantitative data and NVivo7 for qualitative data. A total of 309 clinical nurses and 23 nurse educators responded to the self administered questionnaire. Thirty three key informants participated in focus group discussions conducted in four health facilities situated in four districts. There were five directors at provincial, district and national levels and 13 nurse migrants interviewed. Data on nurses with verification of qualifications sent to countries were collected from a total of 1,142 records; 931 for RNs and 211 for ENs. The study was guided by a conceptual framework developed from two migration theories namely the World Systems Theory and the Push and Pull Theory. The World Systems Theory structured the world into three zones of Periphery (poor countries), Semi-Periphery (Transitional economies) and the Core (industrialized wealthy countries). Push factors caused people to leave the Periphery to the Semi-periphery and to the Core where the Pull factors attracted those from the Periphery and Semi-periphery. Major findings of the study showed dissatisfaction with work conditions, poor living conditions, lack of professional recognition and autonomy and lack of access to professional development as being among the push factors while the pull factors included attractive work conditions, conducive work environment and access to professional development, among others. The perceived impact included nurse shortage, excessive workload, long working hours and poor quality of patient care. Findings on issues for policy on managing nurses leaving for greener pastures were in the form of interventions that would address the push factors and formed the basis for recommendations from the study. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2007.

Thesis (MBA)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: no abstract available / AFRIKAANSE OPSOMMING: geen opsomming

Submitted in compliance with the requirement for Degree of Doctor of Technology: Radiography, Durban University of Technology, 2013. / The shortage of radiologists in Zambia has persistently made the provision of equitable access to optimum radiological services unattainable in the current radiological service delivery system, while equity in distribution of cost-effective and quality healthcare service as closer to the community as possible is at the core of Zambia’s vision in the National Health Strategic Plan. This vision is maintained in Zambia’s Sixth National Development Plan, for the period 2011 to 2015. The number of radiologists as low as three radiologists, for a population of thirteen million people, makes the possibility of ever providing optimum radiological services equitably accessible to the community unattainable, without launching and upholding a precise remedial intervention. The purpose of the study was to develop a framework for sustainable radiographic human capital developmental guidelines embracing advanced radiographic practice and optimum radiological services, with special focus on hospitals without radiologists. The objectives were to: a) analyse the existing radiographic services and/or practices in rural Zambian hospitals without radiologists; b) examine the views of radiographers, physicians, and patients in hospitals without radiologists, regarding adequacy of radiological service delivery; (c) determine desirable competencies for frontline radiographers in comprehensive radiological service delivery, as well as the benefits of such competencies to the community and the health service facilities; d) analyse the healthcare managements’ expectations regarding frontline radiographers’ capabilities in rendering comprehensive radiological services in healthcare settings without the radiologists, e) formulate, implement, and evaluate a training programme for radiographers for comprehensive radiological services; with specific references to client (physician and patient) satisfaction and radiographic competencies; and (f) develop a framework for human capital development for frontline radiographers in providing comprehensive radiological services. The Accenture Human Capital Development Framework (AHCDF) was employed as the theoretical framework to link all key aspects of the inquiry (Thomas, Cheese and Benton, 2003). An Action Research design was used involving multidisciplinary participation, including patients, in the five cyclical phases of the Action Research design; diagnosing, planning, acting, evaluating, and specifying learning. The route of knowledge generation and application was guided by retroductive or abductive cyclical logical process. The interviews, document analysis, and questionnaires were applied to obtain data, whereas a designed training programme for frontline radiographers was piloted and evaluated within this study. The study’s data management and analysis were largely by qualitative methods, though quantitative aspects involving percentages as in descriptive statistics were also involved where appropriate. The discussion, integrates the research findings under appropriate themes of the theoretical framework. An investment perspective in AHCDF is linked to ways of investing in radiographers’ education and training towards extended roles is discussed. The radiographers’ extended roles are seen as a catalyst to desirable radiological technology, radiological service designs, and corresponding radiological service outcome. The benefit of this proposed investment is seen as promoting equitable access to radiological services, with averted or reduced costs ascribed to referrals of patients among hospitals. Consequently, incomes of households and healthcare institutions would be preserved for poverty reduction by reduced referral-related costs. The researcher-devised frontline radiographic human capital developmental (FRHCD) conceptual framework is developed and a way forward recommended. / African Doctoral Dissertation Research Fellowship International Development Research Center (IDRC) Ford Foundation

This qualitative study was done in Livingstone, Zambia, and used focus group discussions to investigate the reasons that youths aged 15 to 24 years see as justifying, or compelling, their non-use of recommended methods for prevention of sexual transmission of HIV. It focused on four methods, namely abstinence, condom use, voluntary counseling and testing, and mutual faithfulness. The study found that non-adherence to HIV preventative methods is linked to variables in the process of adolescent growth and development, to contextual variables in society, to characteristics of products and services associated with these HIV preventative methods, and to disease characteristics of HIV itself. A key conclusion of this study is that to improve the effectiveness of HIV prevention programs among the youths it is essential that factors that hinder adherence to preventative methods are recognized and addressed. / Social Work / M.A.(Social Work)

This qualitative study was done in Livingstone, Zambia, and used focus group discussions to investigate the reasons that youths aged 15 to 24 years see as justifying, or compelling, their non-use of recommended methods for prevention of sexual transmission of HIV. It focused on four methods, namely abstinence, condom use, voluntary counseling and testing, and mutual faithfulness. The study found that non-adherence to HIV preventative methods is linked to variables in the process of adolescent growth and development, to contextual variables in society, to characteristics of products and services associated with these HIV preventative methods, and to disease characteristics of HIV itself. A key conclusion of this study is that to improve the effectiveness of HIV prevention programs among the youths it is essential that factors that hinder adherence to preventative methods are recognized and addressed. / Social Work / M.A.(Social Work)