Barriers to effective patient care as experienced by nurses in primary healthcare clinics in African countries : a systematic review of qualitative studies

Abstract

BACKGROUND : The essence of adopting the Alma-Ata Declaration (1978) was to ensure that essential and acceptable healthcare services are accessible to individuals and families in the community. However, existing literature points that various factors pose as barriers towards effective caring for patients by nurses in primary healthcare clinics. Identifying factors that pose as barriers in effective caring for patients can assist in using strategies that can help in improving the provision of healthcare services. METHODS : A qualitative systematic review was conducted in accordance with the Joanna Briggs Institute’s approach, including the search and selection, critical appraisal, data extraction and synthesis. An extensive literature search was undertaken to identify relevant qualitative research studies research with substantive findings that reflected nurses’ challenges in PHC clinics, conducted in African countries from 2010 to 2024, in the following databases: CINAHL and Medline (through EBSCOhost), BioMed Central, ScienceDirect and Scopus (Elsevier), followed by a manual search in Google Scholar, and a citation search. RESULTS : Following the data extraction and analysis of nine articles, three themes were identified: (1) Shortage of nurses; (2) High workloads for nurses; and (3) Shortage of medicines. A majority of articles were from South Africa (n = 7). CONCLUSIONS : The identified barriers may be addressed at different healthcare system levels in various African countries to improve the provision of healthcare services.