Bridging the Gap: Challenges and Opportunities for Advancing Cleft Nursing in Sub-Saharan Africa.

Abstract

Nurses are integral members of the multidisciplinary cleft team, providing care throughout a child's treatment course. However, in resource-limited regions, such as sub-Saharan Africa (SSA), unique challenges can hinder the delivery of high-quality nursing care, while also presenting opportunities to advance cleft nursing practice. This article highlights the challenges nurses face and explores opportunities to improve nursing care in SSA. A literature review, recorded feedback from Smile Train's Nursing Care Saves Lives program (a cleft-specific nursing training program), and the senior author's (R.J.B.) experience were used to depict the challenges encountered and the subsequent opportunities to enhance nursing care in SSA. Challenges preventing optimal delivery of cleft-specific nursing care include workforce shortages, nursing education and professional development, resource limitations, and health care hierarchy. However, improvements in interprofessional education and collaboration, nurse availability, medical equipment allocation, and professional empowerment can mitigate the obstacles nurses encounter, allowing for enhanced comprehensive cleft care within SSA. Overcoming the obstacles that nurses experience in providing care to patients with a cleft lip and/or palate requires discussions on expectations for nursing practice (eg, nurse to patient ratios, frequency of monitoring, and required skill sets) that must occur at the highest levels of hospital and national planning. While workforce shortages are a well-documented challenge in SSA and will require long-term, multisectoral solutions, it remains essential to prioritize safe care delivery. Targeted improvements in nurse staffing allocation, even within resource-constrained systems, can make a measurable difference in cleft surgical outcomes.