Barriers and opportunities for involvement in health policy development of Somaliland nurses: Qualitative study

The nursing profession is the backbone of the healthcare system and the largest profession of healthcare workers globally. Nurses play a crucial role in providing healthcare services in the community. In recent years, nurses have improved their knowledge and skills but remained undervalued and unappreciated, with a poor public image. This study was to investigate the degree of involvement of Somaliland nurses in health policy development. A qualitative study design was adopted using in-depth interviews. A total of 13 interviews were conducted using open-ended questions. The data were analysed using an inductive reflective thematic analysis. One main theme and two sub-themes were identified. The sub-themes are (1) navigating the barriers to nursing education and equity , which emphasises the challenges in the proliferation of non-accredited private schools and policy engagement and the ambiguity and under-compensation in the nursing profession, and (2) building a strong nursing ecosystem: education, leadership and advocacy , which highlights the strengths of Somaliland nurses and the participants’ recommendations. The findings highlight the barriers to Somaliland nurses’ involvement in health policy development, including unregulated nursing education, others filling the nursing role and low nursing salary, consistent with other studies. The study also reveals that the existence of academically qualified nurses, national nursing associations and public institutions led by nurses demonstrates competency and dedication to develop the nursing profession. Therefore, it is important to intentionally develop nursing leaders through mentorship and succession plans, which can help to remove current nursing challenges