Skip to main content
×
Home
    • Aa
    • Aa

Preparing the sexual health workforce to deliver integrated services: is education the answer? A qualitative study exploring the impact of sexual health education on developing integrated policy and practice

  • Judy Brook (a1), Debra Salmon (a2) and Rachael-Anne Knight (a3)
Abstract
Aim

This study aimed to explore the ability of sexual health nurses working in the South West of England, to implement new learning within existing sexual health service delivery models. Drawing on Lipsky’s account of street-level bureaucracy to conceptualise policy implementation, the impact of workforce learning on the development of integrated services across this region of the United Kingdom was assessed.

Background

In order to achieve the United Nations’ goal of universal access to sexual health, it is essential for reproductive and sexual health, including HIV provision, to integrate into a single service. This integration requires a commitment to collaboration by service commissioners and an alignment of principles and values across sexual health and contraceptive services. UK health policy has embraced this holistic agenda but moves towards integrating historically separate clinical services, has presented significant workforce development challenges and influenced policy success.

Methods

Employing a qualitative approach, the study included data from semi-structured telephone interviews and focus groups, and longitudinal data from pre- and post-intervention surveys, collected between September 2013 and September 2015. Data were collected from 88 nurses undertaking a workforce development programme and six of their service managers. Data were analysed using thematic analysis to identify consistent themes.

Findings

Nurses confirmed the role of new learning in enabling them to negotiate the political landscape but expressed frustration at their lack of agency in the integration agenda, exposing a clear dichotomy between the intentions of policy and the reality of practice. Nevertheless, using high levels of professional judgement and discretion practitioners managed the incongruence between policy and practice in order to deliver integrated services in the interests of patients. Workforce education, while essential for the transition to the delivery of integrated services, was insufficient to fulfil the sexual health agenda without a strengthening of public health.

Copyright
Corresponding author
Correspondence to: Judy Brook, Lecturer in Health Visiting, School of Health Sciences, Division of Health Services Research and Management, City University London, Northampton Square, London EC1V 0HB, UK. Email: Judy.brook@city.ac.uk
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

P. Allotey , S. Diniz , J. DeJong , T. Delvaux , S. Gruskin and S. Fonnf 2011: Sexual and reproductive health and rights in public health education. Reproductive Health Matters 19, 5668.

V. Braun and V. Clarke 2006: Using thematic analysis in psychology. Qualitative Research in Psychology 3, 77101.

F. Bunn and S. Kendall 2011: Does nursing research impact on policy? A case study of health visiting research and UK health policy. Journal of Research in Nursing 16, 169191.

J. Clark 2012: Using diamond ranking as visual cues to engage young people in the research process. Qualitative Research Journal 12, 222237.

C. Dickinson , K. Attawell and N. Druce 2009: Progress on scaling up integrated services for sexual and reproductive health and HIV. Bull World Health Organ 87, 846851.

K. Etherington 2007: Ethical Research in Reflexive Relationships. Qualitative Inquiry 13, 599616.

B. Evans , H. Snooks , H. Howson and M. Davies 2013: How hard can it be to include research evidence and evaluation in local health policy implementation? Results from a mixed methods study. Implementation Science 8, 17.

K. Gerrish , P. Ashworth , A. Lacey , J. Bailey , J. Cooke , S. Kendall and E. McNeilly 2007: Factors influencing the development of evidence-based practice: a research tool. Journal of Advanced Nursing 57, 328338.

M.B. Ivankovich , K.A. Fenton and J.M. Douglas 2013: Considerations for National Public Health Leadership in Advancing Sexual Health. Public Health Reports 128 (Suppl), 102110.

R. Kane and K. Wellings 2003: Staff training in integrated sexual health services. Sexually Transmitted Infections Journal 79, 354356.

A. O’Cathain and K. Thomas 2004: ‘Any other comments?’ Open questions on questionnaires – a bane or a bonus to research? BMC Medical Research Methodology 4, 25.

J.B. Rotter 1966: Generalized expectancies of internal versus external control of reinforcements. Psychological Monographs 80, 609.

G. Rutaremwa and A. Kabagenyi 2016: Utilization of integrated HIV and sexual and reproductive health services among women in Uganda. BMC Health Services Research 16, 494.

A. Rütten , U. Röger , K. Abu-Omar and A. Frahsa 2009: Assessment of organizational readiness for health promotion policy implementation: test of a theoretical model. Health Promotion International 24, 243251.

J.A. Smit , K. Church , C. Milford , A.D. Harrison and M.E. Beksinska 2012: Key informant perspectives on policy and service-level challenges and opportunities for delivering integrated sexual and reproductive health and HIV care in South Africa. BMC Health Services Research 12, 48.

A. Summers and M. Semrud-Clikeman 2000: Implementation of the IDEA by School Psychologists: an exploratory study using the theory of street-level bureaucracy. School Psychology Quarterly 15, 255278.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Primary Health Care Research & Development
  • ISSN: 1463-4236
  • EISSN: 1477-1128
  • URL: /core/journals/primary-health-care-research-and-development
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Full text views

Total number of HTML views: 5
Total number of PDF views: 26 *
Loading metrics...

Abstract views

Total abstract views: 158 *
Loading metrics...

* Views captured on Cambridge Core between 14th March 2017 - 25th September 2017. This data will be updated every 24 hours.