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Poor menstrual health and unmet menstrual needs influence several aspects of adolescent girls’ lives, including their educational outcomes. However, evidence on menstrual health needs and educational outcomes among these vulnerable girls living in countries across sub-Saharan Africa (SSA) is fragmented and inconclusive. The systematic review aims to explore the association between menstrual health needs and educational outcomes among adolescent girls (10–19 years) living in SSA.
Studies (published and unpublished) will be identified from relevant electronic databases including PubMed, CINAHL, ScienceDirect, Google Scholar and LILACS without language restriction from January 2012 to December 2024. A comprehensive set of search terms and their alternate terms, together with the names of countries in sub-Saharan Africa, will be used for running the searches. We will also search Scopus, Web of Science, African Index Medicus, HINARI, African Journals Online, Academic Search Premier, MedRXIV, ProQuest, EBSCO Open Dissertations and reference lists of relevant studies. We will contact experts, identified through authorship of key publications in menstrual health research and recommendations from established research networks, for potentially relevant unpublished studies. All retrieved articles from the electronic databases and grey literature will be collated and deduplicated using Endnote and exported to Rayyan QCRI. The pre-defined eligibility criteria will be followed to screen papers for inclusion in the review. The flow of studies will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram. Given the anticipated volume of literature to be reviewed, at least two reviewers will independently select studies, extract data and assess the quality of the included studies for risk of bias using the Robbins-E risk of bias assessment tool. Any disagreements will be resolved through discussion between the reviewers. The Joanna Briggs Institute’s Sumari Software will be used for citation management. Binary outcomes will be estimated using pooled proportions (for non-comparative studies) and odds ratio (OR) or risk ratio (RR) (for comparative studies), reported with their 95% CIs. The mean difference (MD) will be used for reporting continuous outcomes with their 95% CIs. In the case where different instruments have been used to report means, we will employ standardised mean difference (SMD). Heterogeneity will be assessed graphically for overlapping CIs and statistically using the I2 statistic, and if heterogeneity is detected to be high (>50%), subgroup analysis will be performed to assess the impact of such variation.
While ethical approval is not required for the systematic review methodology itself, appropriate data sharing agreements and confidentiality protocols will be followed when collecting unpublished data from experts. The findings from this review will be published in a peer-reviewed journal and presented at relevant conferences. Also, the findings will be communicated to local stakeholders (eg, adolescent girls, parents/guardians, school authorities) in appropriate formats and languages to support translation into policy and practice to improve menstrual health and hygiene and education for adolescent girls in sub-Saharan Africa.
CRD42024565296.
Over the past three decades, research studies on nurses' engagement in evidence-based practice (EBP) have been widely reported, particularly in high-income countries, with studies from these countries dominating literature reviews. As low- and middle-income countries (LMICs) continue to join the EBP movement, primary research has emerged over the past decade about nurses' engagement with EBP.
The aim of this scoping review was to identify the types and extent of published research regarding nurses' knowledge, skills, attitudes, beliefs, and implementation of EBP in LMICs.
The JBI scoping review methodology was used. Eight databases were searched up to November 2023. The review included primary studies (quantitative, qualitative, and mixed methods) that reported the knowledge, skills, attitudes, beliefs, or implementation of EBP among nurses in LMICs. Included studies focused on registered nurses in all healthcare settings within LMICs. Studies published in English were included with no limit on publication date. Two independent reviewers screened titles, abstracts, and full-text articles of published studies. Data were analyzed quantitatively using frequencies and counts. Textual data from qualitative studies were analyzed using descriptive content analysis.
Fifty-three publications were included, involving 20 LMICs. Studies were published between 2007 and 2023, with over 60% published in the past 7 years. Studies that evaluated familiarity/awareness of EBP showed that in general, nurses had low familiarity with or awareness of EBP. Most studies (60%) described nurses' attitudes toward EBP as positive, favorable, or high, and 31% as moderate. However, over 60% of studies described nurses' EBP knowledge/skills as moderate, low, or insufficient. Approximately 84% of studies described EBP implementation in healthcare settings as moderate, low, poor, or suboptimal.
Studies on nursing EBP have been increasing in LMICs for the past two decades, with findings highlighting opportunities for advancing EBP in nursing within LMICs. Health systems and healthcare organization leaders in LMICs should equip nurses with EBP knowledge and skills while providing the needed resources and support to ensure consistent implementation of EBP to improve health outcomes.
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