Strengthening of oncology nursing education and training in Africa in the year of the nurse and midwife: addressing the challenges to improve cancer control in Africa Naomi Oyoe Ohene Oti1,2,3a , Martjie de Villiers4,5b , Prisca Adejumo3,6c , Roselyne Okumu3,7d , Biemba Maliti3,8,9e , Nagwa Elkateb3,10f and Nazik Hammad3,11g 1National Radiotherapy, Oncology and Nuclear Medicine Centre, Guggisberg Avenue, Harley Street, PO Box KB369, Korle Bu–Accra, Ghana 2Accra Cancer Registry, Guggisberg Avenue, Harley Street, PO Box KB369, Korle Bu–Accra, Ghana 3African Organisation for Research and Training in Cancer, 1ST Floor, Birkdale 1 River Park, Gloucester Road, Mowbray, Cape Town, 7901, South Africa 4Adelaide Tambo School of Nursing Science, Building 5, Room 327, Staatsartillerie Road, Pretoria West, Private Bag x 680, South Africa 5Tshwane University of Technology, Building 5, Room 327, Staatsartillerie Road, Pretoria West, Private Bag x 680, South Africa 6University of Ibadan, Oduduwa Road, Ibadan, 900001, Nigeria 7Kenyatta National Hospital, PO Box 20723-00202, Nairobi, Kenya 8Cancer Disease Hospital PO Box 51337, Lusaka, 10101, Zambia 9Zambia Oncology Nurses Society, PO Box UTH73, Lusaka, 10101, Zambia 10National Cancer Institute, Kasr Eleini St. fom Elkhalig, Cairo, 1196, Egypt 11Queens University, 99 University Ave, Kingston, ON K7L 3N6, Canada ahttps://orcid.org/0000-0002-1433-0364 bhttps://orcid.org/0000-0002-88109144 chttps://orcid.org/0000-0003-3065-8308 dhttps://orcid.org/0000-0002-2459-8532 ehttps://orcid.org/0000-0002-2552-7031 fhttps://orcid.org/0000-0002-3961-1736 ghttps://orcid.org/0000-0003-3963-5815 Short Communication Short Abstract The Cancer burden in Africa is increasing. Nurses play a pivotal role in health care systems Correspondence to: Naomi Oyoe Ohene Oti Email: [email protected] and find themselves in a key position to engage with patients, communities and other health professionals to address disparities in cancer care and work towards achieving ecancer 2021, 15:1209 https://doi.org/10.3332/ecancer.2021.1209 cancer control in Africa. The rapidly evolving nature of cancer care requires a highly skilled and specialised oncology nurse to either provide clinical care and/or conduct research to Published: 23/03/2021 improve evidence-based practice. Although Africa has been slow to respond to the need Received: 16/06/2020 for trained oncology nurses, much has been done over the past few years. This article Publication costs for this article were supported by aims to provide an update of Oncology nursing education and training in Africa with spe- ecancer (UK Charity number 1176307). cific focus on South Africa, Ghana, Nigeria, Kenya, Zambia and Egypt. Mapping oncology Copyright: © the authors; licensee nursing education and training in Africa in 2020, the International Year of the Nurse and ecancermedicalscience. This is an Open Access the Midwife, provides an opportunity to leverage on the essential roles of the oncology article distributed under the terms of the Creative Commons Attribution License (http:// nurse and commit to an agenda that will drive and sustain progress to 2030 and beyond. creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and Keywords: oncology nursing, education, training, cancer care, Africa reproduction in any medium, provided the original work is properly cited. ecancer 2021, 15:1209; www.ecancer.org; DOI: https://doi.org/10.3332/ecancer.2021.1209 1 Background Traditionally, cancer was not Africa’s most concerning health care problem [1]. However, over recent years, with an increasingly ageing population and more westernised lifestyle changes, cancer has become a public health threat [2]. In 2018, the African continent has seen an estimated 752,000 people newly diagnosed with cancer; that is 4% of the total global cancer incidence rate; with cancer deaths totaling 506,000 for the same period [3, 4]. Moreover, it is projected that the cancer burden will increase by more than 60% by 2030 in low-and middle-income countries (LMIC) [2]. Of the people diagnosed with cancer in sub-Saharan Africa, approximately 80% present with advanced disease at the time of diagnosis [1]. LMIC’s ability to respond to the cancer burden is hampered by the limited resources, especially special- ised healthcare personnel [1, 5, 6]. In 2015, it was found that there were only 102 cancer treatment centres on the continent, of which 38 were found in South Africa [7]. There is pressing demand for specialised Oncology personnel, especially nurses. Nurses, who are seen as the backbone of the healthcare system [8], are often the first point of entry to the system and play a pivotal role in cancer control programmes [9]. An effective, skilled oncol- ogy nursing workforce can provide care throughout the cancer continuum – from prevention, early detection, various treatment modalities to survivorship care and ultimately end-of-life care [10] thus contributing to both a reduction of cancer burden and improvement in patients’ outcomes [6]. Research has shown that having a highly competent and skilled nurse who provides quality care leads to reducing patient mor- tality [5, 11]. Despite the key contribution nurses can offer to control cancer, LMICs devote few resources and pay limited attention towards the development of the cancer nursing workforce [10]. Out of 22 countries, six reported having no oncology trained nurses [9]. African countries such as South Africa and Egypt have been providing specialised oncology education and training for many years; however, in recent years, several other countries have since developed formal education and training programmes leading to certification in oncology nursing [12]. Significance of specialisation in oncology nursing Short Communication Short Although nurses are key providers of cancer care across the spectrum, the effectiveness of care is dependent on the nurse’s acquired knowl- edge and skills [13, 14]. In addition, nurses are capable of designing and delivering innovative culturally acceptable cost-effective cancer con- trol packages by identifying and closing the gaps on missed opportunities, thus providing for the holistic approach in caring for these patients [6, 15]. Therefore, the need for effective training of the African nurses to provide expert oncology nursing care for the continent is paramount by developing and implementing innovative interventions and strategies to enhance oncology nursing education and training in LMICs. Purpose This article aims to provide an update on oncology nursing education and training in Africa, challenges and the way forward with specific focus on South Africa, Ghana, Kenya, Zambia, Nigeria and Egypt. These countries have formal education and training programmes accredited by their respective regulatory bodies and are representative of the selected regions in Africa. Method This article was written by representatives from the different countries involved, who could provide accurate information from the educa- tional institutions providing oncology nursing education and training as well as the regulatory bodies and challenges experienced. Further- more, a literature search was conducted using Public/Publisher MEDLINE, Scopus, Web of Science and Cumulative Index to Nursing and Allied Health Literature as databases and ‘education and training’, ‘Oncology OR Cancer nursing’ and ‘Africa’ as search words. The authors also requested the members of African Organisation for Research and Training in Cancer (AORTIC) Nursing group and the African Cancer Nurses Network for input with regard to Oncology nursing education and training programmes for information pertaining to education and ecancer 2021, 15:1209; www.ecancer.org; DOI: https://doi.org/10.3332/ecancer.2021.1209 2 training available in their countries. Data were obtained electronically via use of Telegram (a social media app) to reach and obtain informa- tion from the African Cancer Nurse Network (171 nurses representing 10 countries) and a direct call to members of the AORTIC Nursing group. Participants were asked whether or not an oncology nursing programme was currently being offered in their countries and details of the programme; in terms of duration, type of certificate or degree offered, whether it is postgraduate and whether or not the programme/s were accredited by the appropriate regulatory body. This was supported by a telephonic interview of key personnel in the various countries represented on the AORTIC Nursing group. In the instance where a specific country was not represented on the group, the country was contacted vial telephone through its representative in the main AORTIC network as to obtain information by means of direct contact. A survey was posted on the Telegram social media group. The information obtained from both the survey and the direct phone contact were combined and captured on an Excel spreadsheet and plotted on a map of Africa. This paper highlights the evolution of Oncology Nursing in Africa, the role of oncology nursing, the selected country-specific experience, mode of education, available oncology nursing education and training, challenges and enabling actions. Results Role of the oncology nurse The European Oncology Nursing Society defined a cancer nurse as a registered nurse who has the mandate and full responsibility to provide crucial nursing care to people affected by cancer based on his/her evidence-based, specialised ethical and personal knowledge and skills [16]. These nurses have unique roles and responsibilities