Barriers to the Provision and Utilization of Palliative Care in Africa: A Rapid Scoping Review

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Abstract

Palliative care (PC) has continued to be less available, underutilized, and unintegrated in many of the healthcare systems, especially in Africa. This scoping review synthesized existing published papers on adult PC in Africa, to report the barriers to PC and to assess the methodologies used in these studies. Eight electronic databases and Google Scholar were searched to identify relevant studies published between 2005 and 2018. Overall, 42 publications (34 empirical studies and 9 reviews) that reported issues related to barriers to adult PC were selected. Three themes identified were individual-level, system-level, and relational barriers. The studies reviewed predominantly utilized cross-sectional and retrospective study design, underscoring the need for more studies employing qualitative design. Findings highlight the need for health education, training opportunities, more funding, communication, and timely referral. Future works could focus on underlying factors to these barriers and ethno-religious perspectives to PC in Africa.

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Scoping studies: towards a methodological framework

Lisa O'Malley, Hilary Arksey (2005)

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Scoping studies: advancing the methodology

Danielle Levac, Heather Colquhoun, Kelly K. O’Brien (2010)

Background Scoping studies are an increasingly popular approach to reviewing health research evidence. In 2005, Arksey and O'Malley published the first methodological framework for conducting scoping studies. While this framework provides an excellent foundation for scoping study methodology, further clarifying and enhancing this framework will help support the consistency with which authors undertake and report scoping studies and may encourage researchers and clinicians to engage in this process. Discussion We build upon our experiences conducting three scoping studies using the Arksey and O'Malley methodology to propose recommendations that clarify and enhance each stage of the framework. Recommendations include: clarifying and linking the purpose and research question (stage one); balancing feasibility with breadth and comprehensiveness of the scoping process (stage two); using an iterative team approach to selecting studies (stage three) and extracting data (stage four); incorporating a numerical summary and qualitative thematic analysis, reporting results, and considering the implications of study findings to policy, practice, or research (stage five); and incorporating consultation with stakeholders as a required knowledge translation component of scoping study methodology (stage six). Lastly, we propose additional considerations for scoping study methodology in order to support the advancement, application and relevance of scoping studies in health research. Summary Specific recommendations to clarify and enhance this methodology are outlined for each stage of the Arksey and O'Malley framework. Continued debate and development about scoping study methodology will help to maximize the usefulness and rigor of scoping study findings within healthcare research and practice.

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A scoping review of scoping reviews: advancing the approach and enhancing the consistency

Phuong-Mai T Pham, Andrijana Rajić, Judy Greig … (2014)

Background The scoping review has become an increasingly popular approach for synthesizing research evidence. It is a relatively new approach for which a universal study definition or definitive procedure has not been established. The purpose of this scoping review was to provide an overview of scoping reviews in the literature. Methods A scoping review was conducted using the Arksey and O'Malley framework. A search was conducted in four bibliographic databases and the gray literature to identify scoping review studies. Review selection and characterization were performed by two independent reviewers using pretested forms. Results The search identified 344 scoping reviews published from 1999 to October 2012. The reviews varied in terms of purpose, methodology, and detail of reporting. Nearly three-quarter of reviews (74.1%) addressed a health topic. Study completion times varied from 2 weeks to 20 months, and 51% utilized a published methodological framework. Quality assessment of included studies was infrequently performed (22.38%). Conclusions Scoping reviews are a relatively new but increasingly common approach for mapping broad topics. Because of variability in their conduct, there is a need for their methodological standardization to ensure the utility and strength of evidence. © 2014 The Authors. Research Synthesis Methods published by John Wiley & Sons, Ltd.

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Author and article information

Journal

Journal ID (nlm-ta): Indian J Palliat Care

Journal ID (iso-abbrev): Indian J Palliat Care

Journal ID (publisher-id): IJPC

Title: Indian Journal of Palliative Care

Publisher: Wolters Kluwer - Medknow (India )

ISSN (Print): 0973-1075

ISSN (Electronic): 1998-3735

Publication date (Print): Jan-Mar 2021

Publication date (Electronic): 17 February 2021

Volume: 27

Issue: 1

Pages: 3-17

Affiliations

[1 ]Department of Nursing, Faculty of Health and Society, University of Northampton, Northampton, United Kingdom

[2 ]Department of Nursing, Faculty of Health Science and Technology, Ebonyi State University, Abakaliki, Nigeria

[3 ]Department of Anaesthesia/Pain and Palliative Care Unit, Multidisciplinary Oncology Centre, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria

[4 ]Department of Nursing Sciences, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria

Author notes

Address for correspondence: Dr. David A Agom, Faculty of Health and Society, University of Northampton, Waterside Campus, University Drive, Northampton, NN1 5PH England, United Kingdom. E-mail: davidagom56@ 123456gmail.com

Article

Publisher ID: IJPC-27-3

DOI: 10.4103/IJPC.IJPC_355_20

PMC ID: 8121217

PubMed ID: 34035611

SO-VID: 18e312a2-9590-46d6-86be-8a3aaba43c90

License:

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

History

Date received : 11 April 2020

Date accepted : 18 October 2020

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