title: Clinical nursing and midwifery research in African countries: a scoping review.
abstract: BACKGROUND
  Globally, the nursing shortage has been deemed a crisis, but African countries have been hit hardest. Therefore, it is of utmost importance nurses use the best available evidence and that nursing research is targeted to address gaps in the evidence. To achieve this, an understanding of what is currently available and identification of gaps in clinical nursing research is critical.
  
  
  OBJECTIVE
  We performed a scoping review of existing literature to assess clinical nursing research conducted in all African countries over the past decade, identify gaps in clinical nursing and midwifery research, determine whether they match with health priorities for countries, and define priorities for regional clinical nursing research agendas to improve health outcomes.
  
  
  METHODS
  This is a scoping review of published clinical nursing research conducted in African countries.
  
  
  METHODS
  Systematic searches of literature published between January 01, 2004 and September 15, 2014 were performed in PubMed, Medline, CINHAL, and Embase.
  
  
  METHODS
  Research was included if it was conducted by nurses, included data obtained in African countries or regions within the African continent, published in a peer-reviewed journal with an abstract, and included patient outcomes. Abstracts were independently reviewed for inclusion by two authors. The following data were extracted: countries of publication and study, study type and design, journal, language, and topics of research. Gaps in the literature were identified.
  
  
  RESULTS
  Initially, 1091 papers were identified with a final sample of 73 articles meeting inclusion criteria. Studies used 12 designs, were published in 35 journals published in five countries (including two African countries); 29% of the research was published in a single journal (Curatonis). Research was mostly qualitative (57%) and included twenty countries in Africa (38%). There were 12 major topics of study, most often midwifery/maternal/child health (43%), patient experiences (38%), and human immunodeficiency virus (HIV)/sexually transmitted infections (STIs) (36%).
  
  
  CONCLUSIONS
  Areas most often studied were associated with funding sources (e.g., a large influx of funds for HIV-related research). Major and common health care problems in African countries (e.g. infectious disease other than HIV, and noncommunicable diseases such as malnutrition, diarrheal disease, hypertension and diabetes) were not subjects of the published literature, indicating a clear gap between health care needs and problems and the focus of the majority of clinical nursing research. Additionally, the shortage of doctorally prepared nurses may contribute to the lack of clinical nursing and midwifery research in African countries.
authors.affiliation: Columbia University School of Nursing, 617 West 168th Street, New York, NY, United States. Electronic address: cjs2200@columbia.edu.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Sun
authors.affiliation: Columbia University School of Nursing, 617 West 168th Street, New York, NY, United States; Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, United States. Electronic address: ell23@cumc.columbia.edu.
authors.forename: Elaine
authors.initials: E
authors.lastname: Larson
mesh_terms: D000349:Africa; D008880:Midwifery; D009729:Nursing; D015399:Nursing Research
keywords: Africa; Clinical research; Midwifery; Nursing; Scoping review