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J Nurs Regul. 2017 Oct;8(3):41-52. doi: 10.1016/S2155-8256(17)30159.

Promoting Regulatory Reform: The African Health Profession Regulatory Collaborative (ARC) for Nursing and Midwifery Year 4 Evaluation.

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Former Principal Investigator for the African Health Profession Regulatory Collaborative (ARC) and Clinical Professor Emeritus at Emory University's Nell Hodgson Woodruff School of Nursing, Atlanta, GA.
Co-Principal Investigator for ARC and Assistant Clinical Professor at Emory University's Nell Hodgson Woodruff School of Nursing.
Public Health Analyst in the HIV Care and Treatment Branch at the U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA.
Nurse Consultant in the HIV Care and Treatment Branch at the CDC.
Health Scientist in the Maternal and Child Health Branch at the CDC.
Executive Secretary for the Commonwealth Nurses and Midwives Federation, London, England.
Principal Investigator for ARC and a Professor at Emory University's Nell Hodgson Woodruff School of Nursing.
Senior Nursing Advisor in the Division of Global HIV and TB at the CDC.


As countries across sub-Saharan Africa work towards universal health coverage and HIV epidemic control, investments seek to bolster the quality and relevance of the health workforce. The African Health Profession Regulatory Collaborative (ARC) partnered with 17 countries across East, Central, and Southern Africa to ensure nurses and midwives were authorized and equipped to provide essential HIV services to pregnant women and children with HIV. Through ARC, nursing leadership teams representing each country identify a priority regulatory function and develop a proposal to strengthen that regulation over a 1-year period. Each year culminates with a summative congress meeting, involving all ARC countries, where teams present their projects and share lessons learned with their colleagues. During a recent ARC Summative Congress, a group survey was administered to 11 country teams that received ARC Year 4 grants to measure advancements in regulatory function using the five-stage Regulatory Function Framework, and a group questionnaire was administered to 16 country teams to measure improvements in national nursing capacity (February 2011-2016). In ARC Year 4, eight countries implemented continuing professional development projects, Botswana revised their scope of practice, Mozambique piloted a licensing examination to assess HIV-related competencies, and South Africa developed accreditation standards for HIV/tuberculosis specialty nurses. Countries reported improvements in national nursing leaders' teamwork, collaborations with national organizations, regional networking with nursing leaders, and the ability to garner additional resources. ARC provides an effective, collaborative model to rapidly strengthen national regulatory frameworks, which other health professional cadres or regions may consider using to ensure a relevant health workforce, authorized and equipped to meet the emerging demand for health services.


African Health Profession Regulatory Collaborative; Regulatory Function Framework; global nursing regulation

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