Investigating the empirical relationship among health facility MAnagement and GovernancE, Nursing practice Environment, health workforce outcomes and quality of care

IMAGENE is an acronym derived from the aim of the study, namely Investigating the empirical relationship among health facility MAnagement and GovernancE , Nursing practice Environment, health workforce outcomes and quality of care. IMAGENE focuses on primary health care (PHC) facilities and aims to investigate the three-way relationship among (1) health facility management and governance; (2) health workforce outcomes, specifically nurses’ job satisfaction and intention to leave; and (3) quality of care, specifically patient perceptions of the responsiveness of the health system, and quality of care provided to individuals with diabetes and hypertension. We will conduct a range of statistical analyses, such as structural equation modelling (SEM), and regression analyses to investigate these relationships.

This study involves facility managers and frontline nurses working in clinics in Gauteng, Limpopo, Mpumalanga and North West provinces. We hope that the study will generate evidence that will contribute to solutions to address nursing challenges and to improve quality of patient care at PHC facilities. To date, the study has made satisfactory progress. A number of research instruments has been developed for the different components of the study and these include: (1) a PHC facility manager questionnaire; (2) a frontline nurses’ questionnaire; (3) a questionnaire measuring patient’s experiences of the health system responsiveness; and (4) a record audit tool to measure the health care provided to people with diabetes and hypertension. The complexity of the study necessitated a number of consultative meetings: firstly, with biostatisticians to ensure that the structural equation modelling would be done correctly; secondly with health systems researchers to examine the assumptions and relationships among the various components; thirdly with the health facility managers to ensure that the instrument measures relevant and appropriate aspects.

The study is funded through the NRF Thuthuka Grant (Post-PhD track) and the University Research Council (URC). The research leader is Dr Prudence Ditlopo. Tel: +27 11 717 3433; Email: prudence.ditlopo1@wits.ac.za