An assessment of management competencies of community health nurses of the Gambia

Abstract

Mixed method of a cross-sectional and qualitative study design was used to assess, compare, and determine the factors associated with the management competencies among Community Health Nurses (CHNs) of the Gambia. Sample size of 179 Primary Health Care (PHC) nurses censured, 87 from health facilities and 92 from PHC circuits. Total response rate was 83%. Quantitative data was collected using structured self-administered questionnaire. Qualitative data was collected using structured FGD guide and analyzed using thematic analyzes. Data collected between April and May 2020. Descriptive statistics used to calculate management competencies levels; independent t-test used to compare means. Chi-Square tests were used to identify association between independent variables and outcomes. Multiple logistic regression was used to explore the most significant predictors of management competencies. Results from quantitative analyzes showed CHNs were not competent in only financial inline with qualitative results. CHNs at health facilities rated themselves competent than those at PHC circuits. Sociodemographic characteristics revealed marital status was a significant predictor associated with, planning and priority-setting (AOR=2.63, 95% CI=1.19-5.84), problem-solving (AOR=2.43, 95% CI= 1.03-5.73), and professionalism (AOR=2.88, 95% CI= 1.10-7.55). Place of work was a significant predictor associated with financial (AOR=5.00, 95% CI=2.44-10.24), planning and priority-setting (AOR=5.28,95% CI=2.49-11.18) and problem-solving (AOR=2.28, 95% CI=1.07-4.87). Work-related factors revealed training received on management competencies was a significant predictor associated with leadership (AOR=2.70, CI=1.09-6.68), planning and priority-setting AOR=2.72, 95% CI=1.32-5.60 and professionalism (AOR=2.51,95% CI=1.10-5.72). Awareness of role expectation was a significant predictor associated with knowledge of healthcare environment (AOR=2.85, 95% CI=1.14-7.13). Under life stress events experience personal injury and feeling easily annoyed/irritated were predictors significantly associated with communication management competence (AOR=3.80, 95% CI= 1.05-13.72) and (AOR=3.53, 95% CI=1.17-10.63). Place of work was the only factor statistically significantly associated with overall management competence (AOR=2.95,CI =1.31-6.63). Qualitative data revealed CHNs at health facilities and PHC circuits were competent but need more trainings in management competencies. They mentioned inadequate supportive supervision and limited professional development trainings are major factors associated with management competencies. In conclusion, policy makers should give adequate attention to financial management competence of CHNs. They should develop management training modules in CHNs training curriculum.