Mentorship and Retention: Evaluating a Structured Programme for Newly Graduated Nurses in Rural Eastern Cape Health Facilities

The retention of newly graduated nurses in rural health facilities is a critical challenge for health systems in South Africa. High turnover exacerbates staff shortages and compromises care quality. While mentorship is advocated as a retention strategy, evidence on structured programmes in resource-constrained rural settings is limited. This working paper evaluates the impact of a structured, one-year mentorship programme on the retention rates of newly graduated nurses in rural Eastern Cape health facilities. It aims to identify key programme mechanisms and contextual barriers influencing outcomes. A mixed-methods, longitudinal case study design was employed. Quantitative retention data were collected from facility records for two cohorts: programme participants and a non-participant comparison group. Qualitative data were gathered via semi-structured interviews and focus group discussions with new graduates, mentors, and facility managers. Preliminary analysis indicates a positive association between the programme and retention. The retention rate for the mentored cohort was higher at 12 months post-graduation compared to the comparison group. Qualitative themes highlight the value of psychosocial support and clinical guidance. Systemic challenges, including high workload and resource constraints, were identified as factors limiting the programme's effectiveness. The structured mentorship programme shows potential for improving nurse retention in a challenging rural context. Its success is contingent not only on the mentoring relationship but also on addressing broader systemic and workplace issues. Integrate structured mentorship as a core component of nurse induction in rural facilities. Programme design must include protected time for mentorship activities and formal training for mentors. Health management should concurrently address systemic barriers, such as excessive workloads and resource shortages, to maximise the programme's benefit. nurse retention, mentorship, rural health, human resources for health, South Africa, newly graduated nurses This paper provides evidence on the implementation and early outcomes of a structured mentorship intervention in a resource-constrained rural setting, contributing to the discourse on practical retention strategies for newly graduated health professionals.