Medicine and Health Sciences Commons^™

Treatment Of Seizures In The Neonate: Guidelines And Consensus-Based Recommendations—Special Report From The Ilae Task Force On Neonatal Seizures, Ronit Pressler, Nicholas Abend, Stéphan Auvin, Geraldine Boylan, Francesco Brigo, Maria Roberta Cilio, Linda De Vries, Maurizio Elia, Pauline Samia

Paediatrics and Child Health, East Africa

Seizures are common in neonates, but there is substantial management variability. The Neonatal Task Force of the International League Against Epilepsy (ILAE) developed evidence-based recommendations about antiseizure medication (ASM) management in neonates in accordance with ILAE standards. Six priority questions were formulated, a systematic literature review and meta-analysis were performed, and results were reported following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 standards. Bias was evaluated using the Cochrane tool and risk of Bias in non-randomised studies - of interventions (ROBINS-I), and quality of evidence was evaluated using grading of recommendations, assessment, development and evaluation (GRADE). …

Interventions Co-Designed By Healthcare Providers And Clients For Improving Therapeutic Relationships In Maternal And Child Healthcare: A Pilot Study Using Human Centered Design In Rural Tanzania, Kahabi Isangula, Eunice Pallangyo, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Background

Research shows that poor provider–client interactions in maternity and child health (MCH) continue to affect health outcomes, service uptake, continuity of care, and trust in formal healthcare systems.

Objective The study’s objective was to jointly create a prototype intervention package for enhancing nurse-client relationships using human centered design (HCD) approach.

Methods A five-step HCD methodology was used: (1) Community-driven discovery through qualitative descriptive research methods using 9 focus groups with nurses and clients and 12 key informant interviews with MCH administrators; (2) consultative ideation and co-creation meetings with 10 nurses, 10 clients, and 10 administrators to co-design a rough …

Exploring The Experiences Of Mothers Who Attended The Kangaroo Mother Care Facility In A Tertiary Care Hospital In Swat, Pakistan: A Descriptive Qualitative Study, Muhammad Nasir

Theses & Dissertations

Background: Globally, four million neonates die yearly, and the substantial reasons for the deaths are low birth weight and being preterm. The neonate mortality rate was 18 per thousand live births in the year 2021, which means that approximately 7000 deaths occur worldwide daily. Pakistan is among the top ten countries with many preterm births.
Purpose: To explore the mother’s experiences with KMC, and the motive is that it will reduce the neonate's mortality rate by preventing preterm babies from hypothermia.
Method: A qualitative descriptive study design was used to explore the mothers’ experiences who attended the KMC facility. The …

The Incidence And Modifiable Risk Factors For Necrotizing Enterocolitis In Preterm Infants: A Retrospective Cohort Study, Kelvin Gitau, R. Ochieng, Mary Limbe, Caroline Kathomi, James Orwa

Paediatrics and Child Health, East Africa

Objectives: To evaluate the incidence and modifiable risk factors for Necrotizing enterocolitis (NEC) in preterm infants born at ≤32 weeks of gestation weighing <1500 >grams, at a private tertiary care hospital in Kenya.

Materials and methods: This retrospective cohort study was conducted at the Aga Khan University Hospital Neonatal Intensive Care Unit (NICU). Preterm infants born at ≤ 32 weeks’ gestation and weighing2019, were recruited into the study. The primary outcome was NEC Bell Stage IIa-IIIb based on Modified Bell’s criteria. Maternal and neonatal characteristics were evaluated. The association between variables of interest and NEC was determined using logistic regression analysis …

Exploring The Influence Of Postnatal Depression On Neonatal Care Practices Among Mothers In Western Kenya: A Qualitative Study, Florence Achieng, Alloys K’Oloo, Hellen Barsosio, Simon Kariuki, Helen Nabwera

Obstetrics and Gynaecology, East Africa

Background: Postnatal depression (PND) is associated with adverse infant neurodevelopmental outcomes. Evidence is limited on how PND influences neonatal (<28 days old) outcomes in low- and middle-income countries, such as Kenya, which bear the global burden of neonatal morbidity and mortality.

Objectives: To explore how PND influences neonatal feeding and care practices among women in the early postnatal period in rural Western Kenya.

Design: A cross-sectional study.

Methods: Semi-structured interviews were conducted at 2-weeks postpartum among mothers of newborn infants identified <72 h old from the postnatal wards and clinics across five health facilities in Kisumu County of Western Kenya. They were all screened for features suggestive of postnatal depression using the Edinburgh Postnatal Depression Scale.

Results: Twenty-four mothers were interviewed, 13 of whom had features suggestive of PND. All mothers experienced health or socio-economic adversities in the perinatal period, including traumatic deliveries, financial constraints, and challenging relationships with partners/other family members. Feeding difficulties due to …

Fostering Patient Safety: Importance Of Nursing Documentation, Shamsa Samani, Salma Amin Rattani

School of Nursing & Midwifery

Background: Nurses are professionally accountable for assessing and documenting patients’ vital signs. Nurses failing to fulfill this responsibility position their patients at risk. This paper presents two real-life cases pertaining to patients’ safety resulting in fatal outcomes, leading to the professional, legal, and ethical liability of nurses as the providers of patient care.
Objective: This paper focuses on the role of organizational culture in fostering patient safety specifically in monitoring and documentation of patients’ vital signs and early recognition of warning signs.
Methodology: A comprehensive literature search was conducted using various databases, examining the significance of vital signs monitoring and …

An Unaddressed Role Of Nurses: Barriers In Promoting Reproductive Health In Pakistan: A Commentary Paper, Rabab Vadivala, Arisha Amin, Sahar Jessani, Sara Hudani

Journal of Asian Midwives (JAM)

Reproductive health has a significant impact on a person’s overall wellbeing. Despite this, it is not given major attention. Many people are still unaware of the importance of reproductive health, and one reason for this is the often-overlooked role of nurses in sexual and reproductive health. Nurses, midwives and lady health visitors are the healthcare professionals that play a pivotal role in promoting reproductive health. However, due to several factors, such as burnout among nurses and a lack of educational preparedness, this role of nurses remains unaddressed. This article discusses the general determinants that contribute to the underutilization of nurses …

Father’S Role In Family Planning: A Case Study, Inara Muhammad Karim

Journal of Asian Midwives (JAM)

When a married couple decides the optimum time to start a family, how many children they want, how long they want to wait between kids, and the type of contraception they want to use it is called family planning. In Asian countries like Pakistan, men are decision makers inside the families and dominantly take decisions about contraception, prevention of sexually transmitted diseases (STI), finance distribution for antenatal care, childbirth, and nutrition requirements during pregnancy. Financial status, misconception, myths, and lack of knowledge about the use of contraception are a few factors apart from religion and culture which influence the father’s …

Design And Implementation Of A Community-Based Mother-To-Mother Peer Support Programme For The Follow-Up Of Low Birthweight Infants In Rural Western Kenya, Jemma Wright, Florence Achieng, Linda Tindi, Manasi Patil, Mwanamvua Boga, Mary Kimani, Hellen Barsosio, Dan Juma, Helen Nabwera, Laura Kiige

Obstetrics and Gynaecology, East Africa

Background: Globally, low birthweight (LBW) infants (

Methods: Key informant interviews were conducted with 10 mothers of neonates (infants days) from two rural communities in western Kenya. These data informed the identification of key characteristics required for mother-to-mother peer supporters (peer mothers) following up LBW infants post discharge. Forty potential peer mothers were invited to attend a 5-day training programme that focused on three main themes: supportive care using appropriate communication, identification of severe illness, and recommended care strategies for LBW infants. Sixteen peer mothers were mentored to conduct seven community follow-up visits to each mother-LBW infant pair with fifteen …

Editorial - Summer 2023, Edwin Van Teijlingen, Rafat Jan, Kiran Mubeen, Abeer Musaddique

Journal of Asian Midwives (JAM)

No abstract provided.

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 …

Labor Companionship: A Concept Of Doula Care: A Commentary Paper, Arisha Amin, Rabab Vadivala

Journal of Asian Midwives (JAM)

A labor companion is a person who offers consistent individualized support to laboring women. Doula care is defined as the care which an individual provides of physical, social, and emotional support during pregnancy, labor, birth, and the postnatal period (1). Doulas help women ease their anxiety, and pain and address their concerns with comfort, care, and respect. Doulas help in cherishing a mother and child bonding helps in initiate breastfeeding and provide an emotional bond throughout the birthing time. It helps in reducing cesarean sections, and high-risk pregnancies and minimizes infant and maternal mortalities. The purpose of the study is …

Bangladesh To Take Over The Training Of Midwifery Educators: A Commentary Paper, Kerstin Erlandsson, Ulrika Byrskog, Catrin Borneskog Sinclair, Christina Pedersen

Journal of Asian Midwives (JAM)

While Bangladesh has made gains in maternal health provisions, there are still gaps and unmet need for services. Bangladesh has trained over 7 000 midwives, and many more midwifery educators are needed to serve the country’s population of 140 million with midwifery services. In April 2016 the first nursing faculty teaching midwifery students at nursing institutes across Bangladesh were enrolled in a blended online and onsite master’s programme with the Dalarna University, Sweden. The programme content focused the subject sexual, reproductive and perinatal health and was the first of its kind in Asia. The graduating faculty members were expected to …

Is It Safe To Have Sexual Intercourse During Pregnancy? A Commentary Paper, Misbah Zafar, Mehreen Aslam

Journal of Asian Midwives (JAM)

Sexuality is an expression of love, care, and intimacy between couples but pregnancy, and the early postnatal period can have a significant impact on sexual health. Numerous physiological and psychological changes take place during pregnancy^[1]. These changes may have a deep influence on the sexual lives of married couples in a variety of ways. ^[2]

The degree of sexual health awareness, myths, rituals, and beliefs about sexual activity during pregnancy are some of the contributing factors which promote or hinders the sexual relationships during pregnancy ^[3]. The most common fear related …

A Peculiar Case Of Dengue Hemorrhagic Fever: A Case Report Of Radical Outcomes: A Case Study, Neelam Ubaid-Ur-Raheem

Journal of Asian Midwives (JAM)

Dengue is the arthropod-borne flavivirus infection, its severity increases during pregnancy, and results in worst maternofetal outcomes, which is an alarming issue. Dengue fever (DF) is the most common cause for preterm delivery and abortion. Dengue-related thrombocytopenia increases the risk of bleeding during pregnancy and delivery and can also leads to high maternal mortality rates. Globally 3.9 billion people are at risk of dengue fever, especially in Asia.
This case study focuses on a 22-years old pregnant woman from Pakistan without known co-morbidities. She presented in an emergency department with high fever, nausea, vomiting, and bleeding gum. She was positive …

Strengthening Midwifery Response: Implementing Updated Who Guidelines In Birthing Centers In Northern Pakistan, Rafat Jan, Marina Baig, Sadia Karimi, Farzana Yameen, Kiran Mubeen, Arusa Lakhani

Journal of Asian Midwives (JAM)

No abstract provided.

A Step To Improve Maternal Health In Mountain Region Of Pakistan, Rafat Jan, Farzana Yameen, Marina Baig, Sadia Karimi, Kiran Mubeen, Arusa Lakhani

Journal of Asian Midwives (JAM)

No abstract provided.

International Day Of Midwives: Honoring Midwives' Dedication And Zeal In Gilgit Baltistan, Pakistan, Arusa Lakhani, Rafat Jan, Sadia Karimi, Mehreen Aslam

Journal of Asian Midwives (JAM)

No abstract provided.

Harvesting Health: Indigenous Mothers’ Resilience In The Face Of Climate Change And Maternal Nutrition Challenges In Rural Bajaur, Pakistan: A Study Protocol, Ihsan Ullah, Rafat Jan, Dilshad Begum, Kiran Mubeen, Laila Amir Ali Lalji

Journal of Asian Midwives (JAM)

No abstract provided.

In The Name Of Riwaj: An Ethnographic Study To Explore The Notion Of Women Empowerment Among Bisp Recipients In Rural Sakhro-Sindh, Pakistan, Qurratulain Nasiruddin, Rozina Karmaliani, Nasim Zahid Shah, Tazeen Saeed Ali

School of Nursing & Midwifery

Women empowerment is a national agenda for Pakistan and, one of its manifestations is the nationwide cash transfer program namely Benazir Income Support Programme (BISP). With the help of Bourdieu methodological paradigm of “habitus” this paper analyses empowerment among BISP recipients in their social settings where various social actors such as her husband and wadera of the village dominate her agency but, at the same time, women herself submits her agency to these social actors under the veil of riwaj (social customs). This ethnographic study reveals that the performance of submission among women follows an inner drive for conformation to …

The Factors Associated With Caesarean Section At A Rural Hospital In Southwestern Uganda: A Cross-Sectional Study, Lilian Nuwabaine, Mathius Amperiize, Patience Annet Nakalega

School of Nursing & Midwifery, East Africa

Background

Globally, the overall prevalence of caesarean section (CS) is estimated at 18.6%, with 27% in high-income countries and 6% in low- and middle-income countries. There is an increase in trends of CS in Uganda from 8.5% in 2012 to 11% in 2016. No studies have been carried out to account for the high rates of CS at Kisiizi Hospital in Uganda. This study determined the proportion and factors associated with CS delivery at a rural hospital in southwestern Uganda.

Methods

This was a cross-sectional study of 321 immediate postnatal women in a rural hospital in southwestern Uganda. A structured …

Enhancing The Education Of Paediatric Nurses: A Positive Step Towards Achieving Sustainable Development Goals, Aimable Nkurunziza, Godfrey Katende, Philomene Uwimana, Patricia J. Moreland

School of Nursing & Midwifery, East Africa

Aim: The aim of this discursive paper was to describe and expound on how paediatric nurses will be able to address the needs of children and adolescents through the lens of selected Sustainable Development Goals (SDGs) in Rwanda.

Design: A discursive analysis of SDGs relating to the roles of paediatric nurses in the context of Rwanda.

Methods: A discursive method using SDGs as a guiding framework is used in this paper. We drew on our own experiences and supported them with the available literature.

Results: A collection of contextually relevant examples of how paediatric nurses will …

School-Based Study To Assess The Nutritional Status (Bmi Based) Of Adolescents Of Gojra City Of District Toba Tek Singh, Punjab, Pakistan, Shagufta Perveen, Rozina Karmaliani, Rubina Barolia, Rozina Mistry

School of Nursing & Midwifery

Adolescence is the make-or-break stage of life. Major physical, mental, and psychological growth takes place at this age. Adequate and balanced nutrition is a vital requirement to support this phase. Adolescents living in developing and low-income countries are more likely to face nutritional challenges. Poor nutritional status during adolescence is an important determinant of health outcomes.
Objective: To analyze the nutritional status (BMI based) of school-going adolescents in Gojra city, Punjab, Pakistan.
Methods: A school-based cross-sectional survey was carried out covering 635 (6-8 grade) school-going adolescents (boys and girls) from public schools in Gojra city. Data were collected through anthropometric …

Barriers And Facilitators To Anti-Retroviral Therapy Adherence Among Adolescents Aged 10 To 19 Years Living With Hiv In Sub-Saharan Africa: A Mixed-Methods Systematic Review And Meta-Analysis, Londiwe D. Hlophe, Jacques L. Tamuzi, Constance Shumba, Peter S. Nyasulu

School of Nursing & Midwifery, East Africa

Background: Human Immunodeficiency Virus (HIV) significantly affects adolescents globally, with the sub-Saharan Africa (SSA) reporting a high burden of the disease. HIV testing, treatment, and retention to care are low among adolescents. We conducted a mixed-method systematic review to assess anti-retroviral therapy (ART) adherence; barriers and facilitators to ART adherence and ART outcomes among adolescents living with HIV and on ART in sub-Saharan Africa.

Methods: We conducted searches in four scientific databases for studies conducted between 2010 and March 2022 to identify relevant primary studies. Studies were screened against inclusion criteria and assessed for quality, and data was …

Psychometric Evaluation Of Phq–9 And Gad–7 Among Community Health Volunteers And Nurses/Midwives In Kenya Following A Nation-Wide Telephonic Survey, Sabina Odero, Paul Mwangi, Rachel Odhiambo, Brenda Nzioka, Constance Shumba, Eunice Ndirangu, Amina Abubakar

Institute for Human Development

Background: Nurses/midwives and Community Health Volunteers (CHVs) are exposed to chronic stressors putting them at risk of developing mental health problems. This has been exacerbated by the COVID-19 pandemic. There is limited empirical evidence of the burden of mental health problems among health care workers partly due to the lack of adequately standardized and validated measures for use among health care workers in Sub-Saharan Africa. This study aimed to perform the psychometric evaluation of the PHQ-9 and GAD-7 administered to nurses/midwives and CHVs across 47 counties in Kenya.

Methods: Between June and November 2021, a national survey on mental well-being …

Nurses' Preparedness For Disaster Response In Rural And Urban Primary Healthcare Settings In Tanzania, Kahabi Isangula, Mary Lyimo, Yudas Ndungile, Elisha Robert

School of Nursing & Midwifery, East Africa

Introduction: Nurses are often on the frontline of disaster management, providing care to patients with emerging physical, mental, and emotional turbulence, and acting as educators for health promotion and disaster prevention in both rural and urban contexts. However, the literature suggests that nurses are inadequately prepared for disaster response. This study examined preparedness for disaster response among nurses in rural and urban primary healthcare settings in Tanzania.

Methods: This qualitative descriptive study involved purposefully selected qualified nurses and nurse administrators working in rural (n=20) and urban (n=11) primary healthcare facilities in Tanzania. Telephone-based interviews were conducted to gather …

Implementation Of Evidence-Based Multiple Focus Integrated Intensified Tb Screening To End Tb (Exit-Tb) Package In East Africa: A Qualitative Study, Kahabi Isangula, Doreen Philbert, Florence Ngari, Tigest Ajeme, Godfather Kimaro, Getnet Yimer, Nicholaus P. Mnyambwa, Winters Muttamba, Irene Najjingo, Aman Wilfred

School of Nursing & Midwifery, East Africa

Introduction Tuberculosis (TB) remains a major cause of morbidity and mortality, especially in sub-Saharan Africa. We qualitatively evaluated the implementation of an Evidence-Based Multiple Focus Integrated Intensified TB Screening package (EXIT-TB) in the East African region, aimed at increasing TB case detection and number of patients receiving care.

Objective We present the accounts of participants from Tanzania, Kenya, Uganda, and Ethiopia regarding the implementation of EXIT-TB, and suggestions for scaling up.

Methods A qualitative descriptive design was used to gather insights from purposefully selected healthcare workers, community health workers, and other stakeholders. A total of 27, 13, 14, and 19 …

The Clinical And Genetic Spectrum Of Autosomal-Recessive Tor1a-Related Disorders, Afshin Saffari, Tracy Lau, Homa Tajsharghi, Ehsan Ghayoor Karimiani, Ariana Kariminejad, Stephanie Efthymiou, Giovanni Zifarelli, Tipu Sultan, Mehran Beiraghi Toosi, Shahnaz Ibrahim

Department of Paediatrics and Child Health

In the field of rare diseases, progress in molecular diagnostics led to the recognition that variants linked to autosomal-dominant neurodegenerative diseases of later onset can, in the context of biallelic inheritance, cause devastating neurodevelopmental disorders and infantile or childhood-onset neurodegeneration. TOR1A-associated arthrogryposis multiplex congenita 5 (AMC5) is a rare neurodevelopmental disorder arising from biallelic variants in TOR1A, a gene that in the heterozygous state is associated to torsion dystonia-1 (DYT1 or DYT-TOR1A), an early-onset dystonia with reduced penetrance. While 15 individuals with TOR1A-AMC5 have been reported (less than 10 in detail), a systematic investigation of the full disease-associated spectrum has …

Preparedness, Resilience And Unmet Needs Of Informal Caregivers Of Advanced Cancer Patients In A Regional Mission Hospital In Kenya: Qualitative Study, Too Wesley, Faith Lelei, Mary Adam, Pete Halestrap

School of Nursing & Midwifery, East Africa

Background: Cancer is the third highest cause of death in Kenya. Eighty percent of cancer cases arrive at advanced stages, when there is nothing that can be done to cure them, and palliative care is the best alternative. Although the majority of end-of-life care in Kenya is provided at home, little is known about the caregivers’ preparedness, resilience and continued unmet needs. The goal of this qualitative study was to explore caregivers’ perceived preparedness, resilience and continued unmet needs in their caregiving role to patients with advanced stages of cancer.

Methods: A purposive sampling method was used to identify and …

Caesarean Section For Placenta Previa: A Retrospective Cohort Study Of Anaesthesia Techniques, Samina Ismail, Saima Rashid

Department of Anaesthesia

Objective: Placenta previa is associated with maternal and neonatal morbidity and mortality. This study aims to add to the limited literature from the developing world on the association of different anaesthetic techniques with blood loss, the need for blood transfusion, and maternal/ neonatal outcomes among women undergoing caesarean section with placenta previa.
Methods: This retrospective study was conducted at Aga University Hospital, Karachi, Pakistan. The patient population included parturients undergoing caesarean section for placenta previa from January 1, 2006, through December 31, 2019.
Results: Out of 276 consecutive cases of placenta previa progressing to caesarean section during the study period, …