title: Empowerment model for nurse leaders' participation in health policy development: an east African perspective.
abstract: BACKGROUND
  Nurses comprise the largest portion of the health care workforce in most countries; they interact closely with patients and communities, they work throughout the day and within all sectors of health care. Their breath of practice gives them a broad understanding of requirements of the health care system, of how factors in the environment affect the health outcomes of clients and communities. Nurses' involvement in health policy development ensures that health services are: safe, effective, available and inexpensive.
  
  
  METHODS
  A Delphi survey was utilized and included the following criteria: expert panelists, three iterative rounds, qualitative and quantitative analysis, and building consensus. The overall aim of the study was to develop "An Empowerment Model for Nurse Leaders' participation in Health Policy Development". The study included purposively selected sample of national nurse leaders from the three East African countries of Kenya, Tanzania and Uganda. The study was conducted in three iterative rounds. Data collection tools were questionnaires. Data analysis was done by examining the data for the most commonly occurring concepts in the first round and descriptive statistics in the second and third rounds.
  
  
  RESULTS
  The findings of the study support the development of the "Empowerment Model for Nurse Leaders' Participation in Health Policy Development". Further the study identified that there was a significant gap in and barriers to participation in health policy activity and that an opportunity seems to exist to enable and develop nurse leaders' role and involvement in this respect. There was consensus on factors considered to be facilitators and barriers to nurse leaders' involvement in health policy development. Furthermore, consensus was achieved on essential leadership attributes that enhance nurse leaders' participation in health policy development. The model was validated a small sample of the nurse leaders' who participated in the study.
  
  
  CONCLUSIONS
  The model provides a framework with an aim of facilitating involvement in health policy activity. Nurses need to be strategic in ensuring that they place themselves and others on the forefront of the policy development arena. The empowerment model suggests proactive and strategic involvement of nurses and nurse leaders in health policy development activities.
authors.affiliation: School of Nursing and Midwifery, Aga Khan University, Kenya, Box 39340-00623, Nairobi, Kenya.
authors.forename: Nilufa Jivraj
authors.initials: NJ
authors.lastname: Shariff
keywords: Empowerment; Leadership; Model; Nurse leaders; Participation