The retention of ACCESS nursing assistant graduates in rural Uganda

Abstract

Background: In 2004, the African Community Center for Social Sustainability (ACCESS) established a Nursing Assistant School in Nakaseke, a rural district in Uganda, to address the region’s severe shortage of healthcare resources. A survey conducted in July 2014 assessed the retention of its graduates in rural healthcare work.

Methods: A survey aimed at evaluating the retention of ACCESS graduates in rural areas was created with the help of local stakeholders, focusing on demographics, the training program, employment, career development goals, and community impact. A short-form telephone survey was administered to graduates living outside Nakaseke, and a long-form in-person survey to graduates residing close to the school. Quantitative data was analyzed using standard statistical software, and qualitative data via identification of common themes.

Results: Thirty-seven participants were contacted using telephone numbers stored in a database containing information for 109 graduates. The mean participant age was 24 years, and 86.5% were female. Nearly all worked in healthcare (91.1%), primarily in health clinics (37.14%) and pharmacies (33.33%) in communities they described as rural (80%), low-resource (60%), and underserved (25.7%). Most graduates planned to continue working in healthcare (85.3%) in rural areas (61.3%). All felt that their work positively impacts their community.

Conclusions: The ACCESS nursing assistant training program provided a stepping stone for trainees while contributing to increased health service provision to the community. Rural-focused location and school curriculum, along with confidence building, may help retain nursing assistant trainees in underserved areas.