Medicine and Health Sciences Commons^™

The Horns Of Dilemma: Life Or Sovereignty, Farida Bibi Mughal, Bibi Hajira Irshad Ali

School of Nursing & Midwifery

Death and dying are the bitter truth that is faced by every person inevitably. Paying respect to the decision of a patient in a hospital setting is always a challenging task. In eastern countries, family plays an important role in decision making. But it always overrides the preferences and wishes of the patient and this leads to violation of ethical principles such as autonomy, informed consent and veracity. Looking a situation from different paradigms and deciding the best solution on the ground of ethical principles should be the utmost priority of the healthcare provider.

Building A New Generation Of Midwifery Faculty Members In Bangladesh, Malin Bogren, Sathyanarayanan Doraiswamy, Kerstin Erlandsson

Journal of Asian Midwives (JAM)

This paper presents an initiative to build a new generation of midwifery faculty in Bangladesh, with the ultimate objective of providing insight into how to build capacity in the midwifery faculty to best utilize the existing academic, health care and policy environment. The initiative focuses on a promising approach that starts with a new generation of midwifery faculty who can lead a chain of change when separating midwifery teaching from nursing. The initiative identified four different interdependent components of equal importance, namely the initiation of master’s and bachelor’s degrees, development of accreditation guidelines and tools, and a mentorship programme. Building …

Developments In Midwifery In Asia In 2017, Rafat Jan, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

No abstract provided.

Implementation Of A Bachelor’S In Midwifery Programme In Pakistan: Reflections Of Midwifery Faculty, Arusa Lakhani, Sadia Abbas Ali, Kiran Mubeen, Marina Baig, Shahnaz Shahid, Rafat Jan, Karyn Kaufman

Journal of Asian Midwives (JAM)

Introduction/Objective: There is an international consensus on the significant role of competent midwives in improving maternal and newborn health indicators. Midwives and midwifery education in the developing world including Pakistan have lagged behind in being part of higher education. To enhance the quality of maternal and newborn services through competency based higher education in midwifery, the first Bachelors of Science in Midwifery (BScM) programme was introduced in Pakistan. As part of a larger study about establishing this programme, this paper focuses on the reflective logs of midwifery faculty members who initiated this new programme in Pakistan.
Method: The team of …

Exploring The Fears Of Pakistani Primi Gravidas About Childbirth, Zohra Kurji, Amina Aijaz Khowaja, Zahra Shaheen, Yasmin Mithani, Naveeda Haq

Journal of Asian Midwives (JAM)

Background: Childbirth can be a very painful experience as it brings a lot of physiological and psychological changes in women’s lives. The literature demonstrates that anxiety and fear during the birthing process is related to a woman’s ability to give birth safely; fear can lead to complications such as emergency caesarean section and a reduced ability to tolerate pain. Therefore, health care professionals need to explore fears and educate expectant mothers, most especially primi gravidas, about the birthing process.
Method: A qualitative descriptive exploratory design was used to investigate fears about childbirth. Purposive sampling was used to recruit a …

Determinants Of Quality Of Care And Access To Basic Emergency Obstetric And Neonatal Care Facilities And Midwife-Led Facilities In Low And Middle-Income Countries: A Systematic Review, Preeti K. Mahato, Edwin Van Teijlingen, Padam P. Simkhada, Catherine Angell

Journal of Asian Midwives (JAM)

Background: Maternal mortality is a major challenge to health systems in Low and Middle-Income Countries (LMICs) where almost 99% of maternal deaths occurred in 2015. Primary-care facilities providing Basic Emergency Obstetric and Neonatal Care (BEmONC) facilities, and facilities that are midwife-led are appropriate for normal birth in LMICs and have been proposed as the best approach to reduce maternal deaths. However, the poor quality of maternal services that leads to decreased utilisation of these facilities is among the major causes of maternal deaths worldwide. This systematic review studied factors affecting the quality of care in BEmONC and midwife-led facilities in …

Why Women Suffer Domestic Violence In Silence: Web-Based Responses To A Blog, Salima Farooq, Tazeen Saeed Ali, Yasmin Parpio, Nasreen Lalani, Muecke Marjorie

School of Nursing & Midwifery

Background & Aim: Domestic violence (DV) is a global socio-cultural concern faced by a majority of women. DV has a negative impact on women’s social, physical, and psychological wellbeing. Objective was to explore perceptions regarding contributing factors to domestic violence among women.
Methods & Materials: A qualitative descriptive exploratory method was applied for the study. Purposive sampling was used to select participants through emails to respond to the web based blog created for the study. 41 worldwide participants shared their perceptions through the blogs in the study. The data were collected using a web-based discussion forum on the Urban Women …

Risk Factors Of Cardiovascular Disease And Its Recommendations In Pakistani Context., Rubina Barolia, Amber Hussain Sayani

School of Nursing & Midwifery

Cardiovascular diseases possess a major cause for fatality and disability the world over. Since last several decades, the rates of cardiovascular diseases-related deaths have decreased in a number of high-income countries but increased in low- and middle-income countries with around 80% of the burden. Despite the seriousness of cardiovascular diseases in low- and middle-income countries, minimal attention is given to the prevention of cardiovascular diseases risk factors in South Asia, particularly in Pakistan. In addition, economic and political instability is accelerating the rates of cardiovascular diseases in the country. Practical efforts are required to enhance the understanding of cardiovascular diseases …

Peer Violence Perpetration And Victimization: Prevalence, Associated Factors And Pathways Among 1752 Sixth Grade Boys And Girls In Schools In Pakistan, Rozina Karmaliani Professor, Judith Mcfarlane, Rozina Somani, Hussain Maqbool Ahmed Khuwaja, Shireen Shehzad Bhamani, Tazeen Saeed Ali, Saleema A. Gulzar, Yasmeen Hassan Somani, Esnat D. Chirwa, Rachel Jewkes

School of Nursing & Midwifery

Background: Child peer violence is a global problem and seriously impacts health and education. There are few research studies available in Pakistan, or South Asia. We describe the prevalence of peer violence, associations, and pathways between socio-economic status, school performance, gender attitudes and violence at home.
Methods: 1752 children were recruited into a cluster randomized controlled trial conducted on 40 fairly homogeneous public schools (20 for girls and 20 for boys), in Hyderabad, Pakistan. This was ranging from 20-65 children per school. All children were interviewed with questionnaires at baseline.
Results: Few children had no experience of peer violence in …

Women Experiences Of Using External Breast Prosthesis After Mastectomy., Zohra Asif Jetha, Raisa B. Gul, Sharifa Bashir Lalani

School of Nursing & Midwifery

Objective:

The aim of this study was to identify the experiences of breast cancer patients using external breast prostheses (EBP) in the context of the Pakistani society.

Methods:

A qualitative descriptive exploratory design was used in the study. In-depth individual interviews were conducted with 15 postmastectomy women using EBP. A semi-structured interview guide with open-ended questions was used for the interviews. The analysis of the data was organized into four categories according to the study questions including reasons for using EBP, feeling about EBP, challenges for using EBP, and coping with lost breast. Each category was further divided into subcategories. …

Who Teaches Science To Nurses?, Naghma Rizvi

School of Nursing & Midwifery

OBJECTIVE:

To explore the demographics of individuals teaching basic science courses in private nursing schools.

METHODS:

The study was conducted in Karachi, and comprised teachers teaching basic science courses in 16 registered private nursing schools. A demographic questionnaire was used to collect data. The study was conducted in the year 2013.

RESULTS:

Teachers holding academic/professional degrees in different science disciplines were involved in teaching science to nurses. In most of the schools, all the basic science courses were taught by one subject specialist science teacher. These subject specialist science teachers held degrees in different disciplines, which included Doctor of Philosophy, …

Knowledge, Attitude, And Practices Of Mid-Level Providers Regarding Post Abortion Care In Sindh, Pakistan, Marina Baig, Rafat Jan, Arusa Lakhani, Sadia Abbas Ali, Kiran Mubeen, Shahnaz Shahid Ali, Farzana Adnan

Journal of Asian Midwives (JAM)

Background: In Pakistan, half of all pregnancies are unintended (4.2 million per year); out of which 2.2 million end in induced abortions. Almost 700,000 women seek medical treatment for post abortion complications every year. This necessitates access to quality Post-Abortion Care (PAC) services from skilled providers in Pakistan.
Purpose: This study aimed to assess the knowledge, attitude and practices of Mid-Level Providers (MLPs) regarding PAC services in Sindh, Pakistan.
Method: The study utilized a cross-sectional design. Convenience sampling was used to recruit 116 MLPs, including Nurse Midwives (NM), Lady Health Visitors (LHVs), and Community Midwives (CMWs) from different parts …

News & Events

Journal of Asian Midwives (JAM)

No abstract provided.

Exciting Times In South-Asian Midwifery, Rafat Jan, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

No abstract provided.

Evaluating A Community Maternal Health Programme: Lessons Learnt, Sheetal Sharma, Padam Simkhada, Vanora Hundley, Edwin Van Teijlingen, Jane Stephens, Ram Chandra Silwal, Catherine Angell

Journal of Asian Midwives (JAM)

Using the example of a community-based health promotion intervention, this paper explores the important triangle between health promotion theory, intervention design, and evaluation research. This paper first outlines the intervention and then the mixed-method evaluation.

In 2007, a non-governmental organisation (NGO) designed and implemented an intervention to improve the uptake of maternal health provision in rural Nepal. A community-based needs assessment preceded this novel health-promotion intervention that empowered women with information on the benefits of seeking care. The intervention had a flexible design and, at several points, the intervention’s progress was assessed and, where necessary, changes were made. The intervention …

Birth Experiences Of Primiparous Turkish Women: Public And Private Hospitals, Filiz Okumus

Journal of Asian Midwives (JAM)

Introduction: We wished to better understand primiparous women’s childbirth experiences in private and public hospitals. Within the context of high caesarean section rates, in both private and public hospitals in Turkey, the experiences of women who delivered vaginally needs to be considered if we aim to decrease the number of caesarean births. We, therefore, conducted a descriptive study of women’s vaginal birth experiences in two hospitals in Istanbul.
Methods: Two hundred and forty primiparous women, from two hospitals (one public, one private), who had vaginal births, were included in this descriptive study. Information was obtained from medical records and through …

Development Of Mentorship Module And Its Feasibility For Community Midwives In Sindh, Pakistan: A Pilot Study, Amber Hussain Sayani, Rafat Jan, Susan Lennox, Yasmeen Jan Mohammad

Journal of Asian Midwives (JAM)

Numerous articles describe the concept of mentorship for providing professional support in midwifery settings in different countries; however, in Pakistan the concept is under developed. Before implementing the concept in the Pakistani context, it was important to first develop a mentorship module and pilot test the idea. Therefore, the aim of the present study was to develop and test a mentorship module to determine its feasibility for educating community midwives about providing mentoring, so that a formal mentorship program could be established in the future. The training aimed to provide skill focused mentorship training to experienced midwives, so that they …

The Historical Development Of The Midwifery Profession In Bangladesh, Malin Bogren, Farida Begum, Kerstin Erlandsson

Journal of Asian Midwives (JAM)

Sexual and reproductive health and rights have been identified as the core areas of practice, theory and research for the midwifery profession. The midwifery profession, as defined by the International Confederation of Midwives Global Standards, is new in Bangladesh. This paper aims to give an overview of the historical process that has taken place in the past decades to develop the midwifery profession in Bangladesh. The professional development of midwives is the result of many years of collaboration and relationship building among stakeholders such as the government, non-government organizations, academia, professional associations, United Nations agencies, and donors. All are working …

Quality Of Life And Its Determinants In Adult Cancer Patients Undergoing Chemotherapy Treatment In Pakistan., Parveen Chagani, Yasmin Parpio, Raisa B. Gul, Adnan Jabbar

School of Nursing & Midwifery

Objective:

Cancer is a leading cause of death worldwide. Likewise, in Pakistan, it is a major health problem, with an approximate increase each year. Cancer treatment, particularly chemotherapy, produces a detrimental effect on individuals' well-being. Since the past few years, quality of life (QOL) is considered as the primary goal of cancer treatment in patients' survival. This study aimed to assess the QOL and its determinants in adult cancer patients undergoing chemotherapy treatment.

Methods:

An analytical cross-sectional design was employed to achieve the study objectives, utilizing consecutive sampling technique. A total of 150 adult (>19 years) cancer patients were …

Practices Of Faculty Members Regarding Teaching And Learning Strategies In Nursing Education, Shams Ul Huda, Tazeen Saeed Ali, Kashmira Nanji, Shanaz Hussein Cassum

School of Nursing & Midwifery

Objective: To determine the different teaching learning strategies utilized, percentage of faculty members utilizing these teaching strategies and faculty perceptions regarding effectiveness of these in undergraduate nursing degree programs in Khyber Pakhtunkhwa (KPK), Pakistan.
Methodology: Cross sectional descriptive design was used to conduct this study. The sample size was 42. The faculty members were recruited from different nursing institutes offering degree programs in KPK, Pakistan. Statistical analysis was done using SPSS & STAT.
Results:Discussion, lecture, group discussion, and PPT were used by 78.6%, 73.8%, 73.8%, and 69% of the faculty members, respectively. However, other learning strategies like debate, PBL, …

Palliative Care: An Alien Concept In Pakistan, Nadia Pyarali Mulji, Sumaira Sachwani

School of Nursing & Midwifery

Every living being has to die. Respecting a dying individual’s personal values and preferences is a challenge. We live in a culture where family decisions are given priority over individual’s wish. To address this challenge, a concept of palliative or comfort care is newly introduced in Pakistan. Palliative care is a multidisciplinary specialty that emphases on prevention and relieving suffering as well as supporting the optimal quality of life of patients and their families (Bailey, Harman, Bruera, Arnold, & Savarese,2014). In Pakistan, the concept of palliative care is like a newborn baby who needs a lot of ethical attention in …

Nurse Teachers’ Conceptions And Practices Of Written Feedback In Karachi., Sobia Idrees, Raisa B. Gul, Ambreen Tharani, Syeda Kauser Ali

School of Nursing & Midwifery

Background:

Written Feedback (WFB) plays a significant role in student’s learning in terms of improvement of their academic writing skills. However, the quality of WFB may be affected by various personal and contextual factors. This study aimed to identify nurse teachers’ conceptions and practices of WFB on written assignments in nursing degree offering institutions in Karachi, Pakistan.

Methods:

A cross-sectional descriptive study design was used to answer the study questions. The study was conducted at 11 nursing schools in Karachi by recruiting those teachers who were teaching in nursing degree programs. The sample size of the study consists of 80 …

Creating Enabling Environment For Student Engagement: Faculty Practices Of Critical Thinking, Shanaz Hussein Cassum, Raisa B. Gul

School of Nursing & Midwifery

Critical thinking (CT) is considered an important attribute in practice disciplines and faculty members in nursing, medicine, and education are expected to facilitate the development of CT in their graduates so that these individuals can be critical, reflective, competent, and caring professionals and service providers (Distler, 2007; Shiau & Chen, 2008; Worell & Profetto-McGrath, 2007). When students are actively engaged in their learning, and classrooms have an enabling environment, critical thinking is promoted. Teachers must reflect upon their teaching pedagogy when students do not participate in stimulating discussions, or asks questions in class. Research suggests that lack of understanding of …

Infection Control In Labor And Delivery Room, Learning From The Small Hospital Based Project, Savera Aziz Ali, Sumera Aziz Ali

School of Nursing & Midwifery

Background: It has been estimated that around 36% of the neonatal deaths occur due to infection in the lower and middle income countries. Infection control is a more substantial area of concern, particularly in Labor and delivery room. Multiple factors can cause infection in the labor room, therefore it is important to assess various factors of maternal and neonatal infection. Hence we explored multiple factors through this project and developed the action plan to address those factors effectively.
Methods: During our Leadership and Management course, we conducted a project in Labor room pertaining to a prevalent issue. The whole process …

Exploring The Impact Of Gender Inequities On The Promotion Of Cardiovascular Health Of Women In Pakistan, Rubina Barolia, Alexander M. Clark, Gina M. Higginbottom

School of Nursing & Midwifery

Cardiovascular disease exerts an enormous burden on women's health. The intake of a healthy diet may reduce this burden. However, social norms and economic constraints are often factors that restrain women from paying attention to their diet. Underpinned by critical realism, this study explores how gender/sex influences decision-making regarding food consumption among women of low socioeconomic status (SES). The study was carried out at two cardiac facilities in Karachi, Pakistan, on 24 participants (male and female from different ethnic backgrounds), who had received health education. Using an interpretive descriptive approach, the study identified major barriers to a healthy diet: proscribed …

Cultural Practices Of Rearing Preterm Infants: A Qualitative Study In A Tertiary Care Hospital, Karachi, Pakistan, Salima Sulaiman Gulamani, Ambreen Tharani, Sharifa Bashir Lalani, Kiran Shaikh

School of Nursing & Midwifery

The research work explores the cultural practices of feeding and hygiene of preterm infants in the Pakistani context. A Qualitative descriptive-exploratory design has been used. Purposive sampling was utilized to recruit 17 mothers, who met inclusion criteria from a largest government tertiary care hospital in Karachi, Pakistan. The semi-structured interview was used to collect the data, which lasted for approximately 45-60 minutes. Thematic analysis was conducted to analyze the key findings of the study. Welcoming newborn with 'honey' and herbal remedies were reported as a common ritual among mothers. Findings revealed differences in the time period of initial bath given …

Attitude Towards Gender Roles And Violence Against Women And Girls (Vawg): Baseline Findings From An Rct Of 1752 Youths In Pakistan, Tazeen S. Ali, Rozina Karmaliani, Judith Mcfarlane, Hussain M. A. Khuwaja, Yasmeen Somani, Esnat D. Chirwa, Rachel Jewkes

School of Nursing & Midwifery

Background: Violence against women is driven by gender norms that normalize and justify gender inequality and violence. Gender norms are substantially shaped during adolescence. Programs offered through schools offer an opportunity to influence gender attitudes toward gender equity if we understand these to be partly shaped by peers and the school environment.
Objective: We present an analysis of the baseline research conducted for a randomized controlled trial with 1752 grade 6 boys and girls and their attitudes toward gender roles, VAWG, and associated factors.
Methods: We used baseline data from a cluster randomised control study. Interviews were …

Association Of Awareness About Hepatitis C Infection With Patterns Of Health Seeking Behavior Among Hepatitis C Patients In Karachi, Pakistan, Shahina S. Pirani, Saleema Allana, Tazeen S. Ali, Faisal Wasim Ismail

School of Nursing & Midwifery

Background: Hepatitis C infection is one of the significant causes of morbidity and mortality throughout the world. In Pakistan, hepatitis C infection rate is 4.8%, which is the second highest prevalence rate among all developing countries. This study aimed to identify the association between awareness about hepatitis C infection and pattern of health seeking behavior among patients living with hepatitis C in Karachi, Pakistan.
Methods: A descriptive, cross-sectional study was conducted among 250 hepatitis C patients who were recruited from the Aga Khan University Hospital and the Civil Hospital Karachi, Pakistan between March and May 2013. Data were …