Policy Awareness, Implementation Challenges, and Legislative Influence on Nursing Workforce Development in Nigeria: A Cross-Sectional Quantitative Study
Vera Usigbe1; Grace Odinkenma Onyeabor2
1National Assembly Clinic, Three Arms Zone, Garki Abuja. Nigeria
2Enugu State College of Nursing Science AWGU Campus, Enugu State, Nigeria
Abstract
Nursing workforce development is central to health-system performance, quality of care, and progress toward universal health coverage. In Nigeria, however, persistent shortages, migration pressures, poor working conditions, inequitable deployment, and weak implementation of workforce policies continue to affect workforce stability. Although policy frameworks exist, evidence on stakeholders’ awareness of these policies, perceived implementation barriers, and the role of the National Assembly in shaping workforce outcomes remains limited. This study assessed stakeholders’ awareness of existing nursing workforce policies in Nigeria, identified key challenges affecting implementation, and examined the perceived role of the National Assembly in shaping nursing workforce outcomes. This paper reports the quantitative strand of a mixed-methods cross-sectional study. Data were collected from 91 respondents using a structured questionnaire covering policy awareness, implementation challenges, and legislative role. Descriptive statistics were used to summarize demographic characteristics and key variables. Internal consistency reliability was assessed using Cronbach’s alpha. Pearson correlation and Welch’s t test were used to test the study hypotheses at a significance level of p < .05. The instrument demonstrated good to excellent reliability across scale domains, with an overall Cronbach’s alpha of .882. Respondents showed moderate awareness of nursing workforce policies, but weaker perceptions of policy communication and stakeholder sensitization. The most strongly endorsed implementation barriers were poor working conditions, poor remuneration, brain drain, inadequate workforce data, and inadequate funding. Respondents moderately acknowledged the National Assembly’s influence on workforce development, but confidence in budgetary adequacy was comparatively low. Policy awareness was significantly associated with perceived implementation effectiveness, r = .528, p < .001. Nurses and policymakers differed significantly in their perceptions of implementation challenges, t = 2.964, p = .005. Legislative engagement was also positively associated with workforce outcomes, r = .359, p < .001. Nursing workforce development in Nigeria is constrained not simply by the absence of policy, but by weaknesses in communication, implementation, financing, workforce conditions, and legislative follow-through. Strengthening dissemination, retention conditions, workforce data systems, and legislative support is essential to improving nursing workforce outcomes.
Keywords: nursing workforce development, policy awareness, implementation challenges, legislative role, National Assembly, Nigeria