Evidence map›Paper›PMID 40375060›Full record

SynthesisJournal of evidence-based medicine2025

Limited Evidence to Fully Determine the Implementation of Evidence-Based Practice by Healthcare Providers in Africa: A Systematic Review and Meta-Analysis.

Feleke H Astawesegn, Kedir Y Ahmed, Subash Thapa, Shakeel Mahmood, Anayochukwu Anyasodor, M Mamun Huda, Setognal B Aychilihum, Utpal K Modal, Allen G Ross

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of evidence-based medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Feleke H AstawesegnRural Health Research Institute (RHRI), Charles Sturt University, Orange, New South Wales, Australia.ORCID https://orcid.org/0000-0001-6435-8405
Kedir Y AhmedRural Health Research Institute (RHRI), Charles Sturt University, Orange, New South Wales, Australia.
Subash ThapaRural Health Research Institute (RHRI), Charles Sturt University, Orange, New South Wales, Australia.
Shakeel MahmoodRural Health Research Institute (RHRI), Charles Sturt University, Orange, New South Wales, Australia.
Anayochukwu AnyasodorRural Health Research Institute (RHRI), Charles Sturt University, Orange, New South Wales, Australia.
M Mamun HudaRural Health Research Institute (RHRI), Charles Sturt University, Orange, New South Wales, Australia.
Setognal B AychilihumRural Health Research Institute (RHRI), Charles Sturt University, Orange, New South Wales, Australia.
Utpal K ModalRural Health Research Institute (RHRI), Charles Sturt University, Orange, New South Wales, Australia.
Allen G RossRural Health Research Institute (RHRI), Charles Sturt University, Orange, New South Wales, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimImplementing evidence-based practice (EBP) is a complex process requiring healthcare providers to integrate evidence-based medicine (EBM) into clinical practice, ultimately improving clinical outcomes. This systematic review examined the sources of information for EBP, analyzed the extent of EBP implementation by healthcare providers, and explored the factors influencing EBP in Africa.

methodsWe identified articles published between January 1992 and March 2024 by searching Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMbase, PubMed, and Scopus databases. The pooled effect sizes for the prevalence of EBP and odds ratios (ORs) were estimated using random- and fixed-effects models as appropriate. For the qualitative component of the study, we performed a thematic analysis and subsequently integrated and interpreted findings from both the quantitative and qualitative analyses.

resultsThirty-three studies were included in this review, involving 9722 healthcare providers: 60.3% nurses, 15.9% physicians, and 15.4% midwives. Our findings revealed a lack of detailed information on how healthcare providers utilized different forms of EBM to inform EBP and clinical outcomes in Africa. Self-reported EBP was 57.3% among nurses and 37.3% among physicians. Nigeria had the highest self-reported EBP (75.2%), whereas Egypt had the lowest (18.9%). Common sources of information reported for EBP were PubMed, UpToDate, the Cochrane Library, clinical guidelines, and training programs. Factors associated with EBP included knowledge of EBP (OR = 2.13, 95% confidence interval [CI]: 1.83-2.47), positive attitude toward EBP (OR = 1.95, 95% CI: 1.76-2.15), and having EBM training (OR = 3.08, 95% CI: 2.08-4.57), and a managerial role (OR = 2.16, 95% CI: 1.37-3.41). The availability of guidelines (OR = 1.88, 95% CI: 1.5-2.37) and internet access (OR = 1.90, 95% CI: 1.54-2.34) were also found to increase EBP. Our qualitative analysis identified common barriers to EBP, including a lack of support, resistance to change, poor communication, and failure to integrate EBP courses into the continuing education curricula.

conclusionThis systematic review found limited information on the sources of EBM, how it was delivered, and its frequency of use in clinical practice. Thus, the correlation between EBM, EBP, and clinical outcomes was not fully transparent. Further studies are required to examine the medical conditions addressed within providers' scopes of practice, the types of evidence utilized, the frequency and consistency of EBP implementation, and its effect on enhancing patient outcomes.

Indexed as

Evidence-Based PracticeHealth PersonnelAfricaHumansAfricaclinical outcomesevidence‐based medicineevidence‐based practicehealthcare providers

Identifiers

PMID40375060
PMCPMC12081785

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.