HIV Task Shifting from Physicians to Nurses in Nigeria: Examining the Correlates of Nurse Self-Efficacy and Job Satisfaction
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With 3% global health workforce, the African region accounts for 25% of global disease burden and the largest proportion of people living with HIV. Although task sharing between physicians and nurses improved access to ART, the process also led to nurses being assigned roles beyond their scope of practice. In a sample of 399 nurses in “task-shifted” roles, this study examined the correlates of self-efficacy and job satisfaction in Nigeria. We surveyed of 508 nurses from 8 of 36 states in Nigeria. There were 399 usable responses (a response rate of 79%). The mean age and years in nursing practice were 42 (SD = 9.1) and 17 (SD = 9.2); 86% worked in Government hospitals, 26% in Tertiary hospitals, 76% were female and 70% Registered Nurse/Midwives. Over 95% received training and mentoring and 82% had previous HIV experience. Demographic and setting variables were correlated with self-efficacy and job satisfaction. Years in nursing practice negatively correlated with Self-Efficacy for HIV task sharing. The correlates of Job Satisfaction were: years in nursing practice; dual licensure as Nurse/Midwife; working in tertiary hospital; older age; male gender; duration of training and mentoring. Working in secondary and primary health centers as well as faith based hospitals were correlated with increased job dissatisfaction. The nurses reported system related challenges which negatively affected their job satisfaction. These findings have critical implications for burnout, retention and quality service delivery. System-specific strategies such as: complementary staffing; continuing education; certification; updated policies, curricula and scope of practice are needed to support nurses working in task-shifted roles.