Medicine and Health Sciences Commons^™

Training Needs Assessment Of Health Care Professionals In Reproductive, Maternal And Newborn Health In A Low-Income Setting In Tanzania, Columba Mbekenga, Eunice Pallangyo, Tumbwene Mwansisya, Kahabi Isangula, Loveluck Mwasha, James Orwa, Micheal Mugerwa, Michaela Mantel, Leonard Subi, Secilia Mrema, David Siso, Edna Selestine, Marleen Temmerman, Grace Edwards

School of Nursing & Midwifery, East Africa

Background: Healthcare delivery globally and particularly in low-income setting is challenged by multiple, complex and dynamic problems. The reproductive, maternal and newborn health (RMNH) care is among the most affected areas resulting into high maternal and neonatal mortality and morbidity across the Sub Saharan region and Tanzania in particular. However, under-investment in adequate education and training of health care providers (HCPs) is reported worldwide and contributes to the critical shortages, and lack of adequate knowledge and skills among HCPs. The aim of this study was to assess the training needs among HCPs of RMNH care in selected health facilities …

Maternal And Newborn Care During The Covid-19 Pandemic In Kenya: Re-Contextualising The Community Midwifery Model, Rachel Kimani, Rose Maina, Constance Shumba, Sheila Shaibu

School of Nursing & Midwifery, East Africa

Peripartum deaths remain significantly high in low- and middle-income countries, including Kenya. The COVID-19 pandemic has disrupted essential services, which could lead to an increase in maternal and neonatal mortality and morbidity. Furthermore, the lockdowns, curfews, and increased risk for contracting COVID-19 may affect how women access health facilities. SARS-CoV-2 is a novel coronavirus that requires a community-centred response, not just hospital-based interventions. In this prolonged health crisis, pregnant women deserve a safe and humanised birth that prioritises the physical and emotional safety of the mother and the baby. There is an urgent need for innovative strategies to prevent the …

Trends In And Predictors Of Pregnancy Termination Among 15–24 Year-Old Women In Nigeria: A Multi-Level Analysis Of Demographic And Health Surveys 2003–2018, Franklin I. Onukwugha, Monica A. Magadi, Ahmed Sarki, Lesley Smith

School of Nursing & Midwifery, East Africa

Background: Three-quarters of pregnancy terminations in Africa are carried out in unsafe conditions. Unsafe abortion is the leading cause of maternal mortality among 15–24 year-old women in Sub-Saharan Africa. Greater understanding of the wider determinants of pregnancy termination in 15–24 year-olds could inform the design and development of interventions to mitigate the harm. Previous research has described the trends in and factors associated with termination of pregnancy for women of reproductive age in Nigeria. However, the wider determinants of pregnancy termination have not been ascertained, and data for all women have been aggregated which may obscure differences by age groups. …

Stakeholders’ Expectations Of Graduates Of A Work-Study Nursing Upskilling Programme In East Africa, Sharon Brownie, Samwel Gatimu, Isabel Kambo, Joseph Mwizerwa, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Sound alignment of stakeholders’ expectations and graduate ability forms the reputational hallmark of a university’s education programmes. However, little is currently known about stakeholders’ expectations of graduates of work-study nursing upskilling programmes in low- and middle-income settings. Information is needed to ensure the quality and adequacy of curricula in such settings. The main aim of the current study was to explore the nursing stakeholders’ expectations of graduates of work-study nursing upskilling programmes. An exploratory qualitative study was conducted between March and October 2016 in three low- and middle-income countries in East Africa. Forty-two representatives of nursing employers, regulators and professional …

Evaluating A Work/Study Programme For Nurses And Midwives At Aga Khan University, Uganda, Hellen Kyakuwaire, Agnes Kirikumwino, Juliet Nabossa, Grace Edwards

School of Nursing & Midwifery, East Africa

The work/study programme for nurses and midwives at Aga Khan University School of Nursing and Midwifery (AKU-SONAM) is a unique concept in East Africa. This study explored whether nursing and midwifery students undergoing a work-study programme at AKU-SONAM felt their education was underpinned by an adult education philosophy. A semi-structured questionnaire designed specifically for this study based on the Knowles’ (1980) ‘Principles of Adult Education’ was administered to 96 students who completed their programmes in 2017 and 2018 respectively. Our paper reports on both the positive aspects of students’ experiences in this work-study programme, including the improvement of critical thinking …

Challenges For Cancer Care During Covid-19 Pandemic In Kenya: Policy Implications, Diana Kassaman, Rachel Kimani, Adelaide Lusambili

School of Nursing & Midwifery, East Africa

Cancer accounts for roughly 7 percent of Kenyan mortality, making it the country's third leading cause of death [1]. Available statistics indicate that 70–80 percent of cancer cases in Kenya are first diagnosed only in later stages [2]. Despite its high prevalence and the care needed to treat late-stage cancer, Kenya has few facilities and qualified healthcare workers (HCWs) that are dedicated to cancer treatment. In periods of a pandemic like COVID-19, both patients and HCWs may be at an additional risk of contracting the disease if tailored measures and strategies are not implemented for continuity of services.

What Factors Shape Doctors’ Trustworthiness? Patients’ Perspectives In The Context Of Hypertension Care In Rural Tanzania, Kahabi Isangula, Holly Seale, Rohan Jayasuriya, Tumaini M. Nyamhanga, Niamh Stephenson

School of Nursing & Midwifery, East Africa

Introduction: There is increasing evidence that improving patient trust in doctors can improve patients’ use of healthcare services, compliance and continuing engagement with care –particularly for chronic diseases. Consequently, much of the current literature on trust in therapeutic relationships focuses on factors shaping doctors’ trustworthiness. However, few studies on this issue have been conducted among rural populations in low-income Africa, where health service delivery, cultural norms and patient expectations differ from those in high-income countries. This study examined patients’ perspectives of factors that shape doctors’ trustworthiness in rural Tanzania in the context of hypertension care.

Methods: A qualitative inquiry using …

Introduction Of An Advanced Practice Nurse Program In Kenya: A New Era In Nursing Education, Sheila Shaibu, Eunice Ndirangu, Eunice Pallangyo, Gladys Mbuthia, Rachel Kimani, Isabel Kambo

School of Nursing & Midwifery, East Africa

Purpose: The purpose of this presentation is to share the intra and interprofessional collaborative process of developing an Advanced Practice Nursing (APN) program to be offered in 2020 in Kenya, a low middle-income country.

Methods: Engagement with stakeholders (students, clinicians, regulators and educators) affirmed the need for an APN program. Faculty from Schools of Nursing and Midwifery in three East African countries developed an APN curriculum with input from local and international agencies such as the Nursing Council of Kenya with linkages to the ICN, the Nursing Now Team and partner universities in the UK and USA. The …

Trends In Hospitalisation For Human Immunodeficiency Virus In A Tertiary Hospital In Dar Es Salaam, Tanzania: A Case Study, Grace Shayo, Tumaini Nagu, Lilian Msele, Patricia Munseri, Columba Mbekenga, Stephen Kibusi, Kisali Pallangyo, Ferdinand Mugusia

School of Nursing & Midwifery, East Africa

Background: Reports on a systematic evaluation of the impact of antiretroviral therapy(ART) on patients’ hospitalisation in Sub Saharan Africa (SSA) and Tanzania, in particular, are scarce. We aimed at documenting the trends of hospital admissions at Muhimbili National Hospital (MNH) following scale-up of free access to ART in Tanzania.

Methods: Records for all admissions at MNH from June 2005 to June 2015 were reviewed. We extracted data from the Hospital Information Management System as well as from patients’ charts. Data extracted included diagnosis at discharge, the reason for admission and thereafter assessed admission trends over the decade. We summarised …

Religious Beliefs, Social Pressure, And Stigma: Rural Women’S Perceptions And Beliefs About Vasectomy In Pwani, Tanzania, Eunice Pallangyo, Agnes Msoka, Sharon Brownie, Eleanor Holroyd

School of Nursing & Midwifery, East Africa

Despite being a reliable and cost effective family planning method, vasectomy remains underutilized in many low resource settings such as East Africa. We explored rural women’s perceptions and beliefs regarding barriers to vasectomy use in the low resource setting of Pwani, Tanzania. The qualitative study used in-depth semi-structured interviews to obtain data. Purposive sampling was used to recruit 20 married/cohabiting women with two or more children. Thematic analysis guided the data analysis, with qualitative data reporting informed by COREQ guidelines. Most participants were Muslim and had between two and six children. Most had completed primary-level education and were engaged in …

Adherence To Universal Precautions And Associated Factors Among Nurses Caring For Critically Ill Patients In Dar Es Salaam Tanzania, Salma A. Wibonela, Columba Mbekenga, Fatina B. Ramadhani, Ally Mwanga, Pedro Palangyo

School of Nursing & Midwifery, East Africa

Background: Globally, it is known that heath care workers particularly in critical care settings are at higher risk of occupational exposure to infections. Surveillance systems to monitor body fluid exposure have been established in developed world. However, such systems are not available and consequently, exposure to body fluids is rarely reported, documented and monitored in many African countries.

Objectives: To assess knowledge, practice and factors influencing adherence of Universal Precautions of infection prevention among nurses at Muhimbili national hospital and Muhimbili orthopaedic institute Dar es salaam Tanzania.

Design: Quantitative cross-sectional and observational study. SPSS was used for data …

Factors Associated With First Antenatal Care Booking Among Pregnant Women At A Reproductive Health Clinic In Tanzania: A Cross Sectional Study, Lucy Kisaka, Sebalda Leshabari

School of Nursing & Midwifery, East Africa

Background: Antenatal care (ANC) is a key basic intervention targeting maternal and perinatal morbidity and mortality. The World Health Organization (WHO) recommends the first ANC booking before 12 weeks of gestation. This enhances positive maternal and fetal outcomes through early detection of complications, prompt treatment, referral, and management of expected physiological changes. Despite high ANC coverage (98%), free contacts, and easy accessibility, little is known why few (24%) pregnant women in Tanzania book their first ANC-visit early. This study aimed to identify factors associated with first ANC booking among pregnant women in a Tanzanian reproductive health clinic.

Methods: Systematic …