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The impact of HIV education on nurses and nurse-midwives in Uganda Open Access


Other title
sub-Saharan Africa
critical qualitative methodology
Type of item
Degree grantor
University of Alberta
Author or creator
Harrowing, Jean Norma
Supervisor and department
Mill, Judith (Nursing)
Examining committee member and department
Uys, Leana (University of KwaZulu-Natal)
Spiers, Judith (Nursing)
Kulig, Judith (University of Lethbridge)
Kaler, Amy (Sociology)
Kipp, Walter (Public Health)
Faculty of Nursing

Date accepted
Graduation date
Doctor of Philosophy
Degree level
Over the past three decades, the HIV epidemic has gained a stranglehold in sub-Saharan Africa, where 10% of the world’s population comprises more than 60% of all people living with the disease. Recent initiatives to boost prevention and treatment interventions are beginning to yield modest but promising results, as infection rates slowly start to stabilize. However, continued improvement will require aggressive and unrelenting efforts to prepare and equip a workforce for the tremendous challenges that remain. The purpose of this critical ethnography was to explore the impact of an intensive 6-month HIV/AIDS education program on the lives of 24 Ugandan registered nurses and nurse-midwives who worked at a large referral hospital. The study began following completion of the course and involved participant observation and semi-structured interviews for 18 weeks over a 2-year period. The findings are presented in this dissertation, which consists of four published or publishable manuscripts along with introductory and concluding chapters. The first paper describes the impact of education on the personal, professional, and social lives of the participants, and provides an account of their new ways of viewing themselves as nurses, leaders, and advocates. The second paper addresses ethical issues concerning the conduct of research in international settings. The third paper identifies the phenomenon of moral distress as it manifested in the participants, and the effects of education on their ability to transform practice and attitudes. The final paper examines the congruence between the critical qualitative methodology used in the study and the concept of cultural safety in the context of international nursing research. The dissertation concludes with a discussion of the crucial role of continuing professional education for the development of a strong and responsive nursing workforce that is prepared to contribute leadership and vision to addressing the obstacles presented by HIV and AIDS. Dealing effectively with the epidemic requires numerous interventions at various levels; the potential synergies offered by a small investment in education may have far-reaching effects. Finally, implications for nursing practice are presented along with suggestions for further research.
License granted by Jean Harrowing ( on 2009-09-24T15:28:51Z (GMT): Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of the above terms. The author reserves all other publication and other rights in association with the copyright in the thesis, and except as herein provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
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