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Surgical informed consent practices and influencing factors in sub-Saharan Africa: a scoping review of the literature

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posted on 2024-03-06, 17:59 authored by Chiara PittalisChiara Pittalis, Cherie Sackey, Paul OkenyPaul Okeny, Bip Nandi, Jakub GajewskiJakub Gajewski

Introduction: Current international standards in consent to surgery practices are usually derived from health systems in Western countries, while little attention has been given to other contexts such as sub-Saharan Africa (SSA), despite this region facing the highest burdens of disease amenable to surgery globally. The aim of this study was to examine how the concept of informed consent for surgery is interpreted and applied in the context of SSA, and factors affecting current practices.

Methods: A systematic search of Medline, Embase and African Journal OnLine databases as well as grey sources was executed in May 2023 to retrieve relevant literature published since 2010 in English language against a set of given criteria. The socioecological framework for health was used for organising and summarising the identified evidence.

Results: A total of 27 papers were included in the review. Findings revealed that consent to surgery practices is generally substandard across SSA and the process is not adequate. Patients' understanding of informed consent is limited, likewise awareness of their rights to decision-making. A range of factors at the individual, interpersonal, institutional and system/societal levels affect the informed consent process.

Conclusion: There is a need to find more culturally acceptable and ethical ways to include the participation of patients in the decision-making process for surgical treatment in the SSA and define standards more closely aligned with the local context.

History

Data Availability Statement

All data relevant to the study are included in the article or uploaded as supplementary information

Comments

The original article is available at https://qualitysafety.bmj.com/

Published Citation

Pittalis C, Sackey C, Okeny P, Nandi B, Gajewski J. Surgical informed consent practices and influencing factors in sub-Saharan Africa: a scoping review of the literature. BMJ Qual Saf. 2023:bmjqs-2023-016823.

Publication Date

30 December 2023

PubMed ID

38160058

Department/Unit

  • Institute of Global Surgery
  • School of Population Health

Publisher

BMJ Publishing Group Ltd & Medtrust Innovations Ltd

Version

  • Published Version (Version of Record)

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