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Exploring Midwives’ Challenges And Strategies To Provide Care In Maternity Settings During The Harsh Winter Weather In The Northern Areas Of Pakistan: A Qualitative Study, Sana Sultan

Theses & Dissertations

Background: Midwives play a vital role in enhancing the quality of care and achieving substantial reductions in maternal and newborn mortality rates. However, in Gilgit Baltistan, the harsh winter weather and frequent heavy snowfall present distinct challenges for midwives providing essential maternal care. These challenges can lead to an increased risk of maternal infections and newborn hypothermia. Consequently, the limited accessibility to healthcare facilities due to frequent harsh winter weather and the resulting scarcity of resources like heating, electricity, and water exacerbate the situation.
Objective: The study aims to explore the challenges and barriers midwives face in maternity settings and …

Work-Related Stress Among Midwives In Central Uganda. A Key Comparison Between Rural-Urban And Private-Public Midwives: A Cross-Sectional Study, Diana Mbatudde, Ahmed Sarki, Ofra Halperin, Ekaete Asuquo, Grace Edward

Journal of Asian Midwives (JAM)

Background: Midwives in Uganda face challenges that predispose them to vulnerability and traumatic work-related stress which may impact the provision of quality midwifery care and the well-being of midwives. This study aimed at exploring the prevalence and sources of work-related stress and comparing the differences in the experiences of stress among rural or urban midwives and private or public midwives in health facilities in central Uganda.
Methods: A descriptive cross-sectional study design was utilized. The 57-item Expanded Nursing Stress Scale (ENSS) was used to collect data from 208 midwives working in urban and rural (both public and private) health facilities …

Disrespect And Abuse In Maternity Care In A Low-Resource Setting In Tanzania: Provider’S Perspectives Of Practice, Loveluck Mwasha, Lucy Kisaka, Eunice Pallangyo

School of Nursing & Midwifery, East Africa

Background

Globally, women experience disrespectful and abusive care from maternity healthcare providers at health facilities, committed intentionally or unintentionally, particularly during labor and delivery. Disrespectful care affects women’s childbirth experience and birth outcomes.

Methods

This study used a descriptive qualitative design to obtain thick and rich data on disrespect and abuse in maternity care in a low-resource setting in Tanzania. Three days workshop was conducted at the Aga Khan University comprising maternity healthcare providers from diverse settings. The workshop was designed based on the existing evidence and anecdotal data and inspired by the authors’ experiences of disrespectful and abusive care …

The Psychological Toll Of Covid-19 Pandemic On Private Practice Midwives In Indonesia And Its Relation With Perceived Knowledge And Individual Adaptability, Amelia Citra Kirana, Gracia Ivonika, Dewa Ayu Mirah Ardrini, Maria Stephani Dwitya, Ratih Ibrahim, Ray Wagiu Basrowi

Journal of Asian Midwives (JAM)

COVID-19 had serious impacts on the lives and health of people across the globe. Due to the high-risk nature of their work midwives frequently report personal/professional adverse psychological impacts. However, there is a lack of studies examining the psychological impacts of the COVID-19 pandemic on private practice midwives in Indonesia and beyond. This study examines the psychological impacts of the pandemic on private practice midwives in Indonesia, as well as its association with individual adaptability and perceived knowledge about COVID-19. A total of 423 private practice midwives, who were active practitioners during the pandemic, completed an online survey, comprising five …

Knowledge, Attitudes, And Preparedness For Managing Pregnant And Postpartum Women With Covid-19 Among Nurse-Midwives In Kenya, Rose Maina, Rachel Kimani, James Orwa, Bernard Mutwiri, Carolyne K. Nyariki, Sheila Shaibu, Valerie Fleming

School of Nursing & Midwifery, East Africa

Introduction: Globally, maternal morbidity and mortality have increased during the COVID-19 pandemic. Given the high burden of maternal and neonatal mortality in Kenya prior to COVID-19, front line health workers, including nurse-midwives, must be competent to ensure continued quality maternal services. Knowledge and awareness of COVID-19 transmission influence nurse-midwives risk perception and ability to implement prevention strategies.

Objective: We examined nurse-midwives’ knowledge, attitudes, and preparedness in managing pregnant and postpartum women with COVID-19 in Kenya.

Methods: A cross-sectional online survey was conducted among 118 nurse-midwives between July 2020 and November 2020. A 31-item survey comprising 15 knowledge, …

Maternal Health Care Professionals’ Experiences And Views On The Use Of Obstetric Ultrasound In Rwanda: A Cross-Sectional Study, Ingrid Mogren, Joseph Ntaganira, Jean Paul Semasaka Sengoma, Sophia Holmlund, Rhonda Small, Lan Pham Thi, Hussein Lesio Kidanto, Matilda Ngarina, Cecilia Bergström, Kristina Edvardsson

Faculty of Health Sciences, East Africa

Background This study, undertaken in Rwanda, aimed to investigate health professionals’ experiences and views on the following topics: current clinical guidelines for ultrasound from second trimester at the clinic, regional and national levels, and adherence to clinical guidelines; medically indicated ultrasound examinations; non-medical use of ultrasound including ultrasounds on maternal request; commercialisation of ultrasound; the value of ultrasound in relation to other clinical examinations in pregnancy; and ultrasound and medicalisation of pregnancy.

Methods A cross-sectional design was adopted. Health professionals providing antenatal care and delivery services to pregnant women in 108 health facilities were invited to complete a survey, which …

Midwives’ And Women’S Perception On Moyo Fetal Heart Rate Monitor For Intrapartum Fetal Heart Rate Monitoring; A Cross-Sectional Study, Paschal Mdoe, Anita Yeconia, Fanuel Buu, Simeon Kusulla, Ladislaus Blacy, Estomih Mduma, Godfrey Guga, Hussein Kidanto

Obstetrics and Gynaecology, East Africa

Background: The annual global neonatal mortality stands at 2.5 million deaths, 1 million of them dying within the first day of life. An additional 2.6 million are stillborn globally, the majority of them due to intrapartum events. Optimal fetal heart rate (FHR) monitoring has the potential to timely detect fetuses at risk and, if coupled with timely obstetric responses may save more newborns. Moyo is a new Doppler with nine crystals capable of monitoring FHR both intermittently and continuously.

Aim: To assess women’s and midwives’ opinions on the use of Moyo for intrapartum FHR monitoring.

Methods: We conducted a cross-sectional …

Sociodemographic Factors Associated With Mothers’ Experiences Of Psychosocial Care And Communication By Midwives During Childbirth In Nairobi, Kenya, Jane Kabo, Eleanor Holroyd, Grace Edwards, Ahmed Sarki

School of Nursing & Midwifery, East Africa

Purpose: To clarify sociodemographic and socioeconomic factors associated with mothers’ experiences of psychosocial care and communication by midwives during childbirth in Nairobi, Kenya.

Design: A descriptive cross-sectional study conducted in a government national referral hospital. Respondents were 109 systematically sampled mothers who delivered in the study hospital. Mothers’ experiences of intrapartum care were assessed using three subscales from the Experience of Psychosocial Care and Communication during Childbirth Questionnaire (effective communication; emotional support; and respect, care and dignity). Simple and multivariable logistic regression analyses were used to assess associations between sociodemographic factors, socioeconomic factors and mothers’ experiences of intrapartum care.

Findings: …

Cultural Assessment: A Study Of Midwives’ Knowledge, Attitude And Self-Reported Practice In Uganda, Mercy Muwema, Karen Drake, Pamela Friesen, Grace Edwards

Journal of Asian Midwives (JAM)

Background: Cultural assessment is critical due to the increased movement and resettlement of people across the globe, and diverse cultural groups in Uganda. This is putting the health care delivery systems serving the communities under pressure to recognize the different attitudes of people towards health and to develop care systems that are effective in meeting diverse needs. However, despite the importance of cultural assessment in nursing literature, little is known about the cultural assessment competence of Ugandan midwives. This study assessed the knowledge, attitude, and practice of midwives in this assessment process.

Methods: A descriptive correlational design was used to …

Perceptions And Experiences Of Skilled Birth Attendants On Using A Newly Developed Strap-On Electronic Fetal Heart Rate Monitor In Tanzania, Sara Rivenes Lafontan, Hussein Kidanto, Hege L. Ersdal, Columba Mbekenga, Johanne Sundby

School of Nursing & Midwifery, East Africa

Background: Regular fetal heart rate monitoring during labor can drastically reduce fresh stillbirths and neonatal mortality through early detection and management of fetal distress. Fetal monitoring in low-resource settings is often inadequate. An electronic strap-on fetal heart rate monitor called Moyo was introduced in Tanzania to improve intrapartum fetal heart rate monitoring. There is limited knowledge about how skilled birth attendants in low-resource settings perceive using new technology in routine labor care. This study aimed to explore the attitude and perceptions of skilled birth attendants using Moyo in Dar es Salaam, Tanzania.

Methods: A qualitative design was used to collect …

Midwives’ Perceptions On Using A Fetoscope And Doppler For Fetal Heart Rate Assessments During Labor: A Qualitative Study In Rural Tanzania, Paschal Francis Mdoe, Hege Langli Ersdal, Estomih Mduma, Robert Moshiro, Hussein Kidanto, Columba Mbekenga

School of Nursing & Midwifery, East Africa

Background: The Doppler is thought to be more comfortable and effective compared to the fetoscope for assessing the fetal heart rate (FHR) during labor. However, in a rural Tanzanian hospital, midwives who had easy access to both devices mostly used fetoscope. This study explored midwives’ perception of factors influencing their preference for using either a Pinard fetoscope or a FreePlay wind-up Doppler for intermittent FHR monitoring.

Methods: Midwives who had worked for at least 6 months in the labor ward were recruited. Focus group discussion (FGD) was used to collect data. Five FGDs were conducted between December 2015 and February …

Determinants Of Knowledge Of Critical Danger Signs, Safe Childbirth And Immediate Newborn Care Practices Among Auxiliary Midwives: A Cross Sectional Survey In Myanmar, Kyu Kyu Than, Alison Morgan, Minh Duc Pham, James G. Beeson, Stanley Luchters

Population Health, East Africa

Objectives The re-emergence of community-based health workers such as the auxiliary midwives (AMWs) in Myanmar, who are local female volunteers, has been an important strategy to address global health workforce shortages. The Myanmar government recommends one AMW for every village. The aim of this study is to investigate the current knowledge of critical danger signs and practices for safe childbirth and immediate newborn care of AMWs to inform potential task shifting of additional healthcare responsibilities.

Methods A cross-sectional survey was conducted from July 2015 to June 2016 in three hard-to-reach areas in Myanmar. Face-to-face interviews were conducted using a pretested …

Training Midwives To Perform Basic Obstetric Point-Of-Care Ultrasound In Rural Areas Using A Tablet Platform And Mobile Phone Transmission Technology—A Wfumb Coe Project, Sudhir Vinayak, Joyce Sande, Harvey Nisenbaum, Christian Pállson Nolsøe

Imaging & Diagnostic Radiology, East Africa

Point-of-care ultrasound (POCUS) has become a topical subject and can be applied in a variety of ways with differing outcomes. The cost of all diagnostic procedures including obstetric ultrasound examinations is a major factor in the developing world and POCUS is only useful if it can be equated to good outcomes at a lower cost than a routine obstetric examination. The aim of this study was to assess a number of processes including accuracy of images and reports generated by midwives, performance of a tablet-sized ultrasound scanner, training of midwives to complete ultrasounds, teleradiology solution transmissions of images via internet, …

Needs And Expectations: A Membership Survey Of The Midwifery Association In Afghanistan, Sabera Turkmani, Cristina De Nicolás, Fatima Gohar, Pashtoon Azfar Zyaee

Journal of Asian Midwives (JAM)

A survey of the Afghan Midwives Association (AMA) members was conducted in April 2013 to determine the profile of the midwifery workforce, and to provide guidance on the professional needs and expectations of midwives in the future. Of the estimated 3,000 members across the country, around 500 participated in the Annual Congress, 400 questionnaires were distributed randomly among participants, and 357 were returned (89% response rate representing 12% of the overall membership).

The results showed that most members are pleased with the Association, and value its work, particularly its ability to advocate on their behalf with the Ministry of Public …

Birthing Centres In Nepal: Recent Developments, Obstacles And Opportunities, Preeti K. Mahato, Edwin Van Teijlingen, Padam Simkhada, Catherine Angell

Journal of Asian Midwives (JAM)

Background: Establishing and promoting birthing centers (BCs) can be one strategy to increase access to emergency obstetric care and skilled attendants at birth, to avert many maternal deaths. BCs are a component of local health service delivery, whereby midwives (or health care professionals with midwifery competencies) provide maternity services to generally healthy women with uncomplicated pregnancies, mostly in the community setting.
Methods: A literature review was carried out involving searches and appraisals of relevant literature on birthing centers in Nepal, South Asia, and other similar settings.
Findings//Conclusion: In Nepal, midwife-led care in BCs was found to be …

Supporting Healthy Futures For East Africa: Celebrating 15 Years Of Partnership In Nursing Education. School Of Nursing And Midwifery In East Africa, Aga Khan University, Nairobi, Kenya, Sharon Brownie, Walter Robb, Lyndal Hunter, Cliff Aliga, Isabel Kambo, Atem Machar, Joseph Mwizerwa, Judith Mutyabule, M. Namuguzi, Carolyne Namukwaya, Esther Nderitu, Leah Sande, Victor Skrzypczynski, Muneerah Vastani, Mariana Xavier

Books

This impact evaluation study was designed on the basis of quality and accountability. It focused on sourcing evidence regarding the impact and achievements of a 15-year investment in nursing education and workforce capacity building. The study was also designed to enhance alumni connection and establish sustainable models for monitoring and evaluation.

Empowering Midwives In The United Arab Emirates, Grace Edwards, Philidah Seda

School of Nursing & Midwifery, East Africa

Considerable efforts have been made to increase women’s access to quality midwifery care around the world. The World Health Organization (WHO) identifies midwives as ‘the most appropriate and cost effective healthcare professional to provide care in normal pregnancy and childbirth’ (WHO 2009). A growing body of evidence demonstrates that midwifery care is associated with more efficient use of resources and improved outcomes when provided by midwives who are educated, trained, licensed, and regulated. A recent Cochrane review revealed many benefits of midwifery care, including reduction in the use of regional analgesia, fewer episiotomies, fewer instrumental births, and women feeling more …

Which Role Do Midwives And Gynecologists Have In Smoking Cessation In Pregnant Women?–A Study In Flanders, Belgium, Katrien De Wilde, Inge Tency, Sarah Steckel, Marleen Temmerman, Hedwig Boudrez, Lea Maes

Obstetrics and Gynaecology, East Africa

Objectives: The objectives of our study were (1) to explore knowledge, beliefs and practice among mid-wives and gynecologists concerning a smoking cessation policy for pregnant women and their partners and (2) to examine if midwives and gynecologists do have a role in smoking cessation in pregnant women.

Method: We performed a qualitative study using semi-structured interviews with nine midwives and eight gynecologists. Data were analyzed using deductive content analysis, based on the 5 A’s frame-work (Ask–Advise–Assess–Assist–Arrange).

Results: The national smoking cessation policy seemed to be insufficiently known. “Ask” and “Advise" were part of a standard prenatal consultation, the next three …

Community Based Skilled Birth Attendants Programme In Bangladesh; Intervention Towards Improving Maternal Health, Sabera Turkmani, Fatima Gohar

Journal of Asian Midwives (JAM)

Aim: To review the strength and weakness of a community based skilled birth attendant (CSBA) program in Bangladesh.
Specific Objective: To explore perceptions of the providers, decision makers and community regarding newly trained community based skilled birth attendants.
To understand challenges, gaps and obstacles and recommend potential solutions for programme improvement.
Design: A descriptive study, using a qualitative approach was chosen to elicit the views and experiences of different stakeholders and the beneficiaries of the program was undertaken. The study intended to enhance understanding on gaps and challenges during program implementation by getting insight into different views. The data were …

News & Events

Journal of Asian Midwives (JAM)

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