Academic partnerships in transforming nursing and midwifery education in Africa: a systematic scoping review protocol

Abstract

Background

In recent decades, the literature on global partnerships in nursing and midwifery education, to enhance the quality of education and produce competent graduates in the labor market, is on the rise in Africa. However, there is a gap regarding the best practices and barriers in the African context. This systematic scoping review aims to map the evidence on academic partnerships in transforming nursing and midwifery education in Africa.

Methods

The review will be guided by Arksey and O’Malley’s methodology framework through five stages: (1) Identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, and (5) collecting, summarizing, and reporting the results. A search will be conducted with the use of the following electronic databases: Cumulative Index to Nursing and Applied Health Literature (CINAHL), PubMed, ScienceDirect, and Google Scholar. Additional gray literature will be searched via the World Health Organization’s website to locate relevant policies and guidelines. The search will be limited to work published in English from 2014 to 2023. All located resources will be exported to EndNote X8. All duplicates will be removed during when the abstracts are screened. Two independent reviewers will screen and extract the full text of the selected articles. Thematic analysis will be used to analyze data from this systematic scoping review.

Discussion

Mapping the evidence on global partnerships in transforming nursing and midwifery education in Africa will outline the best practices and preferences for sustainable collaboration. The review will also highlight knowledge gaps and limitations that could inform future research projects.

Systematic review registration

https://osf.io/h83cy

Background

Nurses and midwives are essential components of the health workforce since they constitute more than half of the global health workforce [1]. Nurses and midwives are increasingly expected to fulfill roles that require competencies beyond bedside services in complex and changing health systems [2] including leadership and management, education, and their participation in health research roles. Nurse and midwifery leaders and managers need to develop strategic directions within the organization toward its stated vision and mission, coordinate service delivery, manage resources, evaluate the quality of services, inspire best practices, and encourage teamwork [3,4,5]. Nurse and midwifery academics are expected to facilitate active learning, be autonomous, participate in university management, and actively participate in research activities [6]. However, global disparities in the quantity and quality of the health workforce remain a challenge for strengthening today’s healthcare systems [7].

Africa has a severe shortage of health workforce in the world [8]. By 2030, the World Health Organization [9] estimates a shortfall of 18 million health workers in low- and middle-income countries. Nurses and midwives constitute 66% of the health workforce in the African region [10]. Countries are required to ensure an adequate number of nurses and midwives to match or surpass national health system demand and who also have the required competencies to meet their health priorities [11]. To achieve these, faculty must be properly trained in innovative teaching strategies, be able to use technology, and demonstrate clinical expertise in their area of specialization [12].

However, the transition to innovative teaching strategies has been slow due to inadequate preparation of faculty members who lack confidence [13]. Nursing and midwifery African schools are struggling to provide quality education in the current vibrant working environment that imposes rapidly changing competency requirements. In addition, there are poor working conditions, a lack of professionalism, and few professional development opportunities in Africa [14]. Consequently, nursing and midwifery graduates are not ready to effectively respond to the needs of evolving healthcare systems. For example, Nzengya et al. [15] found that 90% of nurses and midwives in primary healthcare settings have low rates of research participation and use of evidence-based practices. Collaboration between nursing and midwifery institutions and academic partners is required to improve their education and working conditions [12, 13]. Partnerships are a strategy whereby academic institutions collaborate can meet their needs by sharing resources, capabilities, and skills [16]. Academic partnerships provide opportunities for continuous professional development for students and faculty members.

Partnerships have been established to raise the visibility of unmet needs and provide common platforms to work together by combining the relative strength of different stakeholders [17]. Successful nursing and midwifery schools are mostly likely to collaborate with other disciplines, clinical sites, professional organizations, and international partners [18]. This strategy is in line with the work of Muraraneza and Mtshali [19] who recommend that nursing and midwifery schools with limited resources need networks with other academic partners to harness global teaching resources and innovations.

Partnership programs are an opportunity to achieve mutual benefits to overcome challenges [20] such as brain drain through supporting skills transfer [21]. According to the same authors, mutual benefit is the cornerstone of a successful partnership and its sustainability. This reciprocity can be achieved through training and empowerment of human resources, developing and improving educational programs, sharing academic resources, and facilitating the production and implementation of knowledge into practice [20]. Further, the purpose, objectives, timeframe, structure, and functioning of partnerships should be regularly reviewed and modified [22] based on the arising needs or priorities of partners. Partners should have shared goals and address barriers to sustainable collaboration in a timely fashion to maintain mutual trust [23]. The notion of common positive outcomes and collaboration, planning, and implementation of practices is central to academic service partnerships [24]. According to the World Health Organization [25], institutions who engage in partnership with global partners experience mutual benefits, experience skills transfer, and have less international migration of health workers.

Little is known about partnerships among nursing and midwifery schools in Africa in the literature. The authors aim to address this gap by mapping the evidence about partnerships in transforming nursing and midwifery education in Africa.

Methods

A systematic scoping review of gray and peer-reviewed literature about global academic partnerships in nursing and midwifery education in Africa will be conducted. The review will be guided by the Arksey and O’Malley’s methodology framework [26]; its advanced methodology framework by Levac, Colquhoun, and O'Brien [27]; and Joanna Briggs Institute’s methodological guidance [28] through five stages: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, and (5) collecting, summarizing, and reporting the results.

Stage 1: Identifying the research questions

The following research questions will guide this review:

• 1.1 What evidence is available in the literature on academic partnerships in transforming nursing and midwifery education in Africa?

• 1.2 What are the main contributions of these partnerships in transforming nursing and midwifery education in Africa?

• 1.3 What are the research gaps in the literature on the global partnership in transforming nursing and midwifery education in Africa?

Stage 2: Identifying relevant studies

The population, concept, and context (PCC) will be used to determine eligible studies and guide the selection process [28] (see Table 1). In this systematic scoping review, the search strategy will be underpinned by the inclusion criteria. A comprehensive search will include peer-reviewed journal articles and gray literature on partnerships to enhance the quality of nursing and midwifery in Africa via the following databases such as Cumulative Index to Nursing and Applied Health Literature (CINAHL), PubMed, ScienceDirect, and Google Scholar. Search terms will be partnership OR collaboration OR academic partnership OR Academic service collaboration AND nursing education OR midwifery education. A search of the gray literature will be done through the World Health Organization website to locate relevant policies and guidelines. Additional articles will be located through an iterative process whereby cited articles of included studies will be explored for possible inclusion. According to the Joanna Briggs Institute [28], the search is iterative as the reviewer becomes more familiar with evidence, which in turn suggests additional keywords and sources that may incorporated into the search strategy (Table 2).

Table 1 PCC framework

Table 2 Key concepts and definitions

Only studies on academic partnerships in nursing and midwifery education within African countries published in English between 2014 and 2023 will be considered in this systematic scoping review to portray the picture of the academic partnerships in nursing and midwifery education in Africa. Related studies conducted outside of Africa and those published before 2014 and after 2023 will be excluded (see Table 3). The retrieved literature will be exported and managed by EndNote X8 to remove duplicates, and an Excel spreadsheet will be used as a tool for data extraction for the selected studies.

Table 3 Data charting template

Stage 3: Study selection

The selection of studies will eliminate those that do not help the authors answer the research questions of the systematic scoping review [29], or that do not meet the pre-determined inclusion criteria to minimize the risk of bias and thereby promote the credibility of findings [29] (see Table 3). The first author (C. M.) will pilot the initial search in one electronic database to refine the final keywords using the keywords via the title and abstract and then finally using the full text. A senior librarian at the University of Rwanda will assist in this search process. The full texts will be retrieved, and the last author (L. W.) will assist in finding difficult to access full-text versions of the articles. All resources deemed to be relevant will be exported to EndNote X8 whereby duplicates will be removed at the end of the data-entering process. The search process will be reported using the PRISMA chart extended for scoping reviews [30] as indicated in Fig. 1. Two independent reviewers (C. M. and D. M.) will decide on studies that meet inclusion criteria. Discrepancies will be solved by consensus with a member of the team (O. B.) for a final decision.

Fig. 1

PRISMA chart

Quality assessment

In this systematic scoping review, the quality of studies will not be assessed. The scoping review will be conducted to have a comprehensive summary of the literature on this particular phenomenon regardless of their quality [26].

Stage 4: Charting the data

Data charting consists of extracting a descriptive summary of the results in line with the systematic scoping review questions. In this systematic scoping review, the use of the data chart was developed by the first author (C. M.) in consultation with co-authors and includes authors and date, country, aim/purpose or research question(s), design, population and sample, key findings, and additional comments (see Table 3). The data charting tool can be piloted by extracting data from three resources. The findings will be discussed with the whole team to confirm the validity of the tool before the tool is used for final data collection. Three independent reviewers (C. M., K. G., and D. M.) will extract the data. This process should involve at least two reviewers to reduce errors and bias through the use of a standardized table [28]. The data charting table might be updated at the review stage with some refinements should it be needed so that the objectives and research questions of the scoping review may be met [28].

Stage 5: Collecting, summarizing, and reporting the results

Extracted data will be summarized and reported in ways that answer the research questions with a focus on what is known about partnerships in transforming nursing and midwifery education in Africa. Similarities of extracted findings will be summarized and analyzed together to generate coherent information on different themes that can inform best practices and barriers to academic partnerships in the transformation of nursing and midwifery education in Africa.

The results will be grouped based on research questions including the existing body of academic partnerships in nursing and midwifery in Africa, the main contributions, and gaps. Gaps in the literature will be highlighted and future studies will be recommended.

Drawing pieces of evidence and synthesizing data under a particular topic answer pressing questions for end users to inform policy, research, and practice [28]. This systematic scoping review will provide a summary for decision-makers about the phenomenon and how it has been studied over time which might inform future research agendas, other systematic reviews [28], and primary studies. This was asserted by Hetrick and Parker [31] who indicate that evidence mapping indicates the extent and distribution of evidence under the topic of study, highlights what is known, and gaps in the existing literature.

Thematic analysis will be used to analyze data from this systematic scoping review. This analysis approach consists of coding and theme development with the possibility of capturing the meaning of the data in inductive and/or deductive ways [32, 33]. Through thematic analysis, the researchers will familiarize themselves with data, generate initial codes, formulate themes and collate data to make them meaningful, review themes, define and name themes, and produce analytical narrative reports [34].

Discussion

Academic partnerships play a vital role in the transformation of nursing and midwifery education in Africa since there is a pressing need to enhance the quality of education through the production of competent nurses and midwives. The quality of nursing and midwifery education in Africa requires training institutions to draw upon resources from outside their countries [19] in a win–win situation to mobilize global knowledge and resources.

The reviewers of this systematic scoping review anticipate mapping the best practices and preferred ways of working in partnerships in nursing and midwifery education in Africa over the past 10 years. Possible gaps and future research projects will also be identified in the process. This review will be limited to studies conducted in African countries, and the findings might not be relevant outside of Africa. Some relevant studies published in other languages such as French in the same context might affect the credibility of information in this systematic scoping review. The findings will be disseminated in an international academic journal and presented at conferences on health professional education.