title: Development of a framework to measure health profession regulation strengthening.
abstract: This paper describes the development of a framework to evaluate the progress and impact of a multi-year US government initiative to strengthen nursing and midwifery professional regulation in sub-Saharan Africa. The framework was designed as a capability maturity model, which is a stepwise series of performance levels that describe the sophistication of processes necessary to achieve an organization's objectives. A model from the field of software design was adapted to comprise the key functions of a nursing and midwifery regulatory body and describe five stages of advancing each function. The framework was used to measure the progress of five countries that received direct assistance to strengthen regulations and to benchmark the status of regulations in the 17 countries participating in the initiative. The framework captured meaningful advancements in regulatory strengthening in the five supported countries and the level of regulatory capacity in participating countries. The project uses the framework to assess yearly progress of supported countries, track the overall impact of the project on national and regional nursing regulation, and to identify national and regional priorities for regulatory strengthening. It is the first of its kind to document and measure progress toward sustainably strengthening nursing and midwifery regulation in Africa.
authors.affiliation: Division of Global HIV/AIDS, Center for Global Health, U.S. Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, Atlanta, GA 30333, USA. Electronic address: cmccarthy@cdc.gov.
authors.forename: Carey F
authors.initials: CF
authors.lastname: McCarthy
authors.affiliation: Nell Hodgson Woodruff School of Nursing, Lillian Carter Center for Global Health and Social Responsibility, Emory University, Atlanta, GA 303XX, USA.
authors.forename: Maureen A
authors.initials: MA
authors.lastname: Kelley
authors.affiliation: Division of Global HIV/AIDS, Center for Global Health, U.S. Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, Atlanta, GA 30333, USA.
authors.forename: Andre R
authors.initials: AR
authors.lastname: Verani
authors.affiliation: Division of Global HIV/AIDS, Center for Global Health, U.S. Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, Atlanta, GA 30333, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: St Louis
authors.affiliation: Division of Global HIV/AIDS, Center for Global Health, U.S. Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, Atlanta, GA 30333, USA.
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Riley
mesh_terms: D017954:Africa South of the Sahara; D019985:Benchmarking; D006801:Humans; D007884:Legislation, Nursing; D008880:Midwifery / Q000592:standards; D016294:Models, Nursing; D009729:Nursing / Q000592:standards; D012985:Software Design; D014481:United States
keywords: Africa; Capability maturity model; Midwifery; Nursing; Regulation; Task sharing; Task shifting