Development of a capability maturity model for the establishment of children's nursing training programmes in southern and eastern Africa

Establishing sustainable training to strengthen human resources for health for children's nursing in Africa requires stakeholders to navigate complex pathways spanning multiple regulatory systems and sectors. Incomplete stakeholder insight threatens long-term sustainability of new training programmes. We drew on collective experiential knowledge of capacity building for children's nursing in southern and eastern Africa to articulate a Capability Maturity Model (CMM), using a six-stage process to: identify necessary supportive conditions; specify levels of process maturity; develop domains; characterise levels of capability; consult with stakeholders; and finalise the model. We articulated a comprehensive CMM describing five levels of process maturity in relation to education, clinical and regulatory systems, human resources for health systems, and requirements related to overall stakeholder collaboration. The model makes visible the range of regulatory and associated processes involved in developing a new educational programme for specialist nurses, including educational standards, quality assurance, scopes of practice, and systems for licensing and registering specialist children's nurses. Stakeholders can use the model as a map to identify where they are in the process, and establish the resources and actions needed to make further progress.