Empowerment Of Nurse Managers To Facilitate Change Management During Namibian Health Sector Reforms

ABSTRACT

During the previous dispensation, health services were fragmented along ethnic lines and were curatively biased. To redress the above situation, the Ministry of Health and Social Services embarked on a health sector reform. Out of the previous four health directorates thirteen health regions were established to bring decision making and development to the people. The eight original directorates at the central level merged into five key functional units.

The reform process in the health services in Namibia caused negative reactions among the nurse managers, who had previously worked in a stable environment. This research argued that, while the conceptual frameworks on change tend to focus on its management, the meaning and magnitude of change seems to be given little attention. Consequently, the nurse managers in Namibia seem not to be able to deal with change in order to facilitate an environment conducive to change in the health sector for fundamental change to take root.

The overall aim of this study was to describe a model that could be used by the nurse managers to facilitate change during the Namibian health sector reforms.

To achieve this aim the explorative, descriptive, qualitative, theory generative and contextual designs were used. Data was collected from thirty-nine top, middle and first-line nurse managers. In-depth individual interviews and focus vi

group discussions, as well as field notes, were used for data collection. The identification and conceptual meaning in respect of facilitating a conducive environment were achieved through the results of the empirical data that explored the experiences of the nurse managers and their needs for empowerment, and the results of concept analysis.

This research has shown that the facilitator is responsible for empowering the nurse managers to establish an enabling environment to manage change in the health sector. It was argued that to achieve this objective the nurse managers must possess the leadership skills necessary for facilitating the empowerment process. To this end, interactive facilitation was recognised as the dynamic through which an environment conducive to change had to be created. In this connection the procedure to facilitate an enabling environment in clinical practice was said to be built around two components, namely, adequately support and interpersonal relations reducing fear of the unknown, and active participation and involvement enhancing confidence and continuous interaction facilitating knowledge and skills development.

The researcher believes that the guidelines that are suggested in the model will bring valuable insights to dealing with the change process in the country.