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As healthcare systems confront rising demands and workforce shortages, advanced practice nursing (APN) has emerged globally as a vital strategy to improve care delivery and address systemic gaps, particularly in primary care facilities in low- and middle-income countries like the Philippines.
Qualitative case study.
This study was conducted in a rural setting in the Philippines and draws on a preceding mixed-methods case study that explored task shifting and advanced nursing practice in primary care facilities. Using purposeful sampling, 41 nurses, physicians, academics, policymakers, and recipients of care participated in interviews and focus group discussions. Qualitative data were thematically analyzed in ATLAS.ti, and quantitative data were descriptively analyzed in JASP. Findings were integrated into the APN framework tailored to primary care in low- and middle-income countries (LMICs).
Although the Philippines lacks a formal APN policy, nurses informally fulfill many advanced practice roles aligned with Hamric's model, particularly in direct patient care, leadership, collaboration, and evidence-based practice. Key enabling competencies include health promotion, systems thinking, and policy implementation—environmental barriers such as a lack of regulatory frameworks, educational pathways, and financing limit APN institutionalization.
This study proposes a contextualized advanced practice nursing (APN) model, which is relevant for LMICs, particularly in primary care facilities facing workforce shortages and rising NCD burdens. To institutionalize APN roles, key reforms should include investments in education, certification, financing, and regulation. Settings implementing initiatives to attain universal health coverage can serve as entry points for recognizing APN functions through competency-based systems.
The study proposes a contextualized APN framework for low-resource settings, showing that formalizing expanded nursing roles through education and certification can enhance access to quality care and advance UHC in underserved areas.
Today in academia and health care, creating a vision and crafting a career path that progresses toward that vision is essential. Career cartography is the comprehensive and iterative process of applying the science of cartography within the context of policy toward achieving a career with impact.
The purpose of this article is to advance the knowledge and application of the original publication as described by Feetham and Doering in 2015. Career cartography supports scientific thinking, communicates science, and addresses the uncertainty of a career.
We conducted a critical analysis of differences between the original publication and our current practical experience of career cartography. Workshops conducted the past 10 years have advanced our understanding of the career cartography components and their utility to one's career. This analysis is informed by a review of the 25 publications citing the 2015 publication to evaluate how scholars report applying the process across health professions and organizations.
All components of career cartography are expanded beyond the 2015 publication to include application of the process with exemplars.
Career cartography is an effective guide across disciplines and at all stages of a career for determining, directing, evaluating, and communicating one's career and its impact.
The intentional and ongoing use of career cartography maximizes the impact one's chosen career can have on improvements to health and health policy.
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