An adverse consequence of the fundamental nursing shortage in Africa came clear in detail with a recent publication in the International Journal of Nursing Studies (logo pictured) entitled “Clinical nursing and midwifery research in African countries: A scoping study.” The Columbia University–based team searched for studies involving nurse researchers on clinical topics. They found and reviewed 1,091 papers in the 2004-2014 window of time. Of these, just 73 the met their inclusion criteria.
The lead topics “were associated with major funding sources.” A top concern was HIV. Others were midwifery/pregnancy/child health and “patient experience.” “Major and common health care problems” like hypertension, diabetes, malnutrition, and diarrheal disease received very little attention across this decade. The team concluded that there exists a “clear gap between health care needs and problems and the focus of the majority of clinical nursing research.” They share that they did find 90 studies “about the role of nurses in African countries that were carried out by researchers other than nurses.” Yet, while honoring the value in such studies, they note that ”nurses spend more time with patients than other healthcare professionals positioning them to make important discoveries that otherwise may go unnoticed.” The authors note that the dearth of studies may be due in part to capacity issues associated with both the endemic brain drain that washes qualified nurses out of Africa into the industrial world and the lack professionals with nursing doctorates who are educated and skilled in research.
Comment: One cannot read this report without encountering the cascading crimes of global resource inequities. These favor investment in the acute over chronic; products over people; medical doctors over nurses; and industrial over less economically developed nations.
Funder-bias shapes research—and practice itself—everywhere. A small hint of a course correction from a major player might be imagined on reading the Nicholas Kristof interview with Bill and Melinda Gates (pictured) on the recent occasion of their foundation’s 15th birthday. Kristof writes: “So what mistakes did they make in their philanthropy? They say they started out too tech-focused. Now some of the measures they promote are distinctly low-tech—like breast-feeding, which could save the lives of more than 800,000 children worldwide each year.”
Nice to see these new foci coming around to possibly bolster investment in research by and about the care of nurses and midwives in Africa. Kristof’s column offers tactical guidance for prospective grantees. Melinda is clearly the access point. While Bill is said to favor meetings with policy makers, Melinda’s the one of the two most likely to go out into the field to encounter human-to-human conditions, and thus to witness the shortages and potential additional contributions of a more empowered nursing workforce.