The Road to an Evidence-Based African Nursing Practice

Monday, 22 July 2013: 1:50 PM

Julia Challinor, RN, MA, MSN, MSc, PhD
School of Nursing Dept. of Physiological Nursing, University of California, San Francisco, Amsterdam, Netherlands

Learning Objective 1: The learner will be able to distinguish between evidence-based practice (EBP) in a resource-rich country and EBP in a country with severely limited resources.

Learning Objective 2: The learner will be able to identify new strategies to achieve evidence-based practice in low- and middle-income countries.

Purpose: Although evidence-based practice (EBP) is widely accepted and applied in high-income countries, this is rarely the case in low-income countries. What is the evidence that a pediatric oncology nursing practice should be based on in a country like Ethiopia with 85 million people with the vast majority living in rural areas on less than US$2/day? Given STTI’s vision statement, how do we include nurses in Ethiopia in such a global community of nurse leaders when they have 10 or more patients/shift and lack internet, continuing education, basic material and human resources on the unit.

Methods: A pediatric oncology twinning project between Georgetown University Hospital, the International Network of Cancer Treatment and Research and Tikur Anbessa General Specialized Hospital (TAGSH) in Addis Ababa, Ethiopia began January 2011. The nursing collaboration includes a US/European visiting nursing team and nurses on two pediatric units at TAGSH. There are no local pediatric oncology nursing specialists or training; however, nurses are dedicated to pediatrics and do not rotate. Nurses prepare and administer all chemotherapy. There are no ancillary health professionals, cancer registry or data collection and “research” is explicitly prohibited.


Supported by the visiting nurses, the local nurses began a circuitous route to improve the care of the children with cancer. Based on our experience at TAGSH, we have learned look to the ingenuity, experience and perseverance of the local nurses who teach us how to find the evidence and apply it to practice in a cultural context we can never fully appreciate as “expert” outsiders. “In developing countries, particularly where resources are scarce and professional support limited, what defines evidence-based healthcare is different”1.


Theoretical consideration of EBP and implications for countries with severely limited resources as exemplified by the current challenges and successes on the “road” to “EBP” in an African setting will be presented.