Medicine and Health Sciences Commons^™

Conflict Between Paternalism And Autonomy., Amber Hussain Sayani

School of Nursing & Midwifery

In the past, paternalism played an important role in making decisions at the end of life. However, in the modern era its significance has become unpopular as it require physicians to decide what is good or bad for the patient without considering patients wish and interest. This commentary article is based on a case study of a woman whose life was lost due to complications of pregnancy. The paper critically reviews this case study, and attempts to provide a reasonable and systematic framework to make sound decisions in similar cases.

The Effect Of Bereavement Counseling On Women With Psychological Problems Associated With Late Pregnancy Loss, Christy Simpson, Pramila Lee, Jessie Lionel

Journal of Asian Midwives (JAM)

Pregnancy is most often a joyful experience and a woman’s plans and dreams are shattered when the death of an unborn or newborn infant occurs. Studies have reported that these women experience psychological problems such as grief, depression, and anxiety which can be minimized by counselling. Hence, this study was undertaken to assess the effect of bereavement counseling on women with psychological problems associated with pregnancy, focusing on Roy’s adaptation theory. An experimental design, with pre-test and post-test, was used with randomly allocated experimental and control groups. Women were randomly allocated to the experimental and control groups with 45 women …

The Nursing Documentation Dilemma In Uganda: Neglected But Necessary. A Case Study At Mulago National Referral Hospital, Grace Nakate, Diane Dahl, Pammla Petrucka, Karen B. Drake, Ruby Dunlap

School of Nursing & Midwifery, East Africa

In Uganda, nursing documentation still remains a challenge, in most of the government hospitals and some private hospitals, it remains at a manual (non-technology driven) level and omissions have been observed. Nurses continue to capture standard elements in their documentation. A mixed methods intervention study was conducted to determine knowledge and attitudes of nurses towards documentation, including an evaluation of nurses’ response to a designed nursing documentation form. Forty participants were selected through convenience sampling from six wards of a Ugandan health institution. The study intervention involved teaching nurses the importance of documentation and using of the trial documentation tool. …

Another Year Over …., Rafat Jan, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

No abstract provided.

News & Events

Journal of Asian Midwives (JAM)

No abstract provided.

Knowledge And Perceptions Regarding Sexual And Reproductive Health Among High School Students In Kathmandu, Nepal, Magdalena Mattebo, Rebecka Elfstrand, Ulrika Karlsson, Kerstin Erlandsson

Journal of Asian Midwives (JAM)

Background: Nepal recently began teaching sexual education in the school system and has established youth friendly services in order to meet the need of increased sexual and reproductive knowledge among the youth.
Objective: To examine the sexual and reproductive knowledge and perceptions among young people attending schools in Kathmandu.
Method: A written questionnaire was distributed to 160 students, in a classroom environment, in four schools in Kathmandu.
Results: Two thirds of the females and nearly 60% of the males knew that it was possible to get sexually transmitted infection (STI) during one sexual encounter and more than half of the …

Enhancement Of Knowledge And Skills Of Community Midwives In Sindh, Pakistan, Sadia Abbas Ali, Arusa Lakhani, Rafat Jan, Shahnaz Shahid, Marina Baig, Farzana Adnan

Journal of Asian Midwives (JAM)

With a maternal mortality rate of 276 deaths per 100,000 live births, Pakistan is one of the countries with a large share in the percentage of world’s maternal mortality. As an intervention for the Millennium Development Goals (MDG) 4 and 5, the World Health Organization (WHO) strongly suggests that skilled care before, during, and after childbirth can save the lives of women and newborn babies. One of the interventions to ensure care to mothers and babies by skilled care providers is the capacity building training of Community Midwives (CMWs) aiming to improve their midwifery competency.

One such training intervention was …

International Cooperation: Strengthening Midwifery In Central Asia, Meike Kolfenbach, Karen Birdsall

Journal of Asian Midwives (JAM)

Even 25 years after their independence, the Central Asian States (Kyrgyzstan / Tajikistan / Uzbekistan) are facing enormous challenges in the health system. Several years ago it became obvious that the MDG 4 and 5 would not be fully achieved. This led to an increased support of the health systems of the concerned countries by Germany’s International Cooperation. The GIZ Regional Health Programme in Central Asia placed great emphasis upon increasing the number of births attended by health professionals, including midwives. The strengthening of midwifery as a model of a sustainable maternal and child health relies on a broad based …

Community Based Midwives Practice In Patriarchal Social System, Yasmeen Jan Mohammad, Rafat Jan

Journal of Asian Midwives (JAM)

It is well accepted globally, that midwives can save the lives of mothers and their new-born successfully, if the community stakeholders provide support and freedom for full scope of practice. Recognising this many countries deploy midwives in the community as an intervention to achieve the MDGs (Millennium Development Goals) 4 and 5 targets set for decreasing maternal and neonatal mortality, respectively.

However, high-income countries’ reports show very good results, in achieving MDGs 4 and 5 while the low-income countries lag behind in this regard. The situation in high-income and low-income countries is different because midwives practising in the community in …

Prevalence Of Hypertension In Low- And Middle-Income Countries: A Systematic Review And Meta-Analysis., Ahmed Sarki, Chidozie U. Nduka, Saverio Stranges, Ngianga-Bakwin Kandala, Olalekan A. Uthman

School of Nursing & Midwifery, East Africa

We aimed to obtain overall and regional estimates of hypertension prevalence, and to examine the pattern of this disease condition across different socio-demographic characteristics in low-and middle-income countries. We searched electronic databases from inception to August 2015. We included population-based studies that reported hypertension prevalence using the current definition of blood pressure ≥140/90 mm Hg or self-reported use of antihypertensive medication. We used random-effects meta-analyses to pool prevalence estimates of hypertension, overall, by World Bank region and country income group. Meta-regression analyses were performed to explore sources of heterogeneity across the included studies. A total of 242 studies, comprising data …

Association Of Depression And Life Satisfaction With Low Resilience Among Married Women Of Karachi, Pakistan, Shireen Shehzad, Nida Zahid, Iqbal Azam Syed, Nargis Asad, Rozina Karmaliani Professor, Omrana Pasha

School of Nursing & Midwifery

Background:

The concept of resilience is very crucial in promoting positive psychological well-being. However, this construct was never looked among married women of Karachi, Pakistan. Therefore, this study aimed to assess the prevalence and the associated risk factors of resilience in Pakistan.

Methods:

It was a cross-sectional survey, using the Wagnild Resilience Scale (RS) to assess resilience, Beck Depression Inventory II (BDI-II) for measuring depression and Trait Wellbeing Inventory for determining Life Satisfaction. Systematic sampling was employed to enroll 636 participants of aged 20 to 40 years living in two urban squatter settlements of Karachi, Pakistan. Prevalence ratio was computed …

What Can Pakistan Do To Address Maternal And Child Health Over The Next Decade?, Zulfiqar Ahmed Bhutta, Assad Hafeez

Department of Paediatrics and Child Health

Pakistan faces huge challenges in meeting its international obligations and agreed Millennium Development Goal targets for reducing maternal and child mortality. While there have been reductions in maternal and under-5 child mortality, overall rates are barely above secular trends and neonatal mortality has not reduced much. Progress in addressing basic determinants, such as poverty, undernutrition, safe water, and sound sanitary conditions as well as female education, is unsatisfactory and, not surprisingly, population growth hampers economic growth and development across the country. The devolution of health to the provinces has created challenges as well as opportunities for action. This paper presents …

Promoting Resilience For Hiv Prevention In Female Sex Workers In Hong Kong: A Randomised Controlled Trial, Winnie W-Y Yuen, William C-W Wong, Catherine S-K Tang, Eleanor Holroyd, Agnes F-Y Tiwari, Daniel Y-T Fong, Weng Y. Chin

School of Nursing & Midwifery, East Africa

Background: Female sex workers are considered a reservoir of HIV and their psychological health has a role to play in HIV infections. In China, commercial sex workers were reported to account for nearly 50% of heterosexual transmission of HIV. Therefore, HIV prevention targeted at mental health could be an innovative strategy in controlling the infection. We aimed to provide an evidence-based resilience-promoting intervention targeting mental health and ultimately safe sexual practices of female sex workers.

Methods: This randomised controlled trial was done at three Hong Kong non-governmental organisations, namely Action for REACH OUT, JJJ Association, and the Society of …

Women’S Perceptions Of Antenatal, Delivery, And Postpartum Services In Rural Tanzania, Gladys Reuben Mahit, Dickson Ally Mkoka, Angwara Dennis Kiwara, Columba Mbekenga, Anna-Karin Hurtig, Isabel Goicolea

School of Nursing & Midwifery, East Africa

Background: Maternal health care provision remains a major challenge in developing countries. There is agreement that the provision of quality clinical services is essential if high rates of maternal death are to be reduced. However, despite efforts to improve access to these services, a high number of women in Tanzania do not access them. The aim of this study is to explore women’s views about the maternal health services (pregnancy, delivery, and postpartum period) that they received at health facilities in order to identify gaps in service provision that may lead to low-quality maternal care and increased risks associated with …

Global Collaboration Between Tanzania And Japan To Advance Midwifery Profession: A Case Report Of A Partnership Model, Yoko Shimpuku, Shigeko Horiuchi, Sebalda C. Leshabari, Dickson Mkoka, Yasuko Nagamatsu, Miwako Matsutani, Hiromi Eto, Michiko Oguro, Yukari Yaju, Mariko Iida, Columba Mbekenga, Lilian Mselle, Agnes Mtawa

School of Nursing & Midwifery, East Africa

The global health agenda to reduce maternal mortality is delayed in Sub-Saharan Africa. The shortage of skilled birth attendants in Tanzania hinders the improvement of midwifery care to prevent maternal mortality and morbidity. It is urgently neccesary to develop midwifery leaders capable of working as educators, researchers, administrators, and advanced practitioners, contributing to the improvement of midwifery care and maternal child health in their own country. This report describes the process of establishing the first midwifery master’s program in Tanzania through the efforts of two academic institutions, one in Tanzania and one in Japan. The collaboration developed a sustainable partnership …

Content Validity Of A Tool Measuring Medication Errors., Nishat Tabassum, Saleema Allana, Tanveer Saeed, Jacqueline Maria Dias

School of Nursing & Midwifery

The objective of this study was to determine content and face validity of a tool measuring medication errors among nursing students in baccalaureate nursing education. Data was collected from the Aga Khan University School of Nursing and Midwifery (AKUSoNaM), Karachi, from March to August 2014. The tool was developed utilizing literature and the expertise of the team members, expert in different areas. The developed tool was then sent to five experts from all over Karachi for ensuring the content validity of the tool, which was measured on relevance and clarity of the questions. The Scale Content Validity Index (S-CVI) for …

Review And Analysis Of Quality Healthcare System Enhancement In Developing Countries., Zohra Kurji, Zahra Zahra Shaheen Premani Shaheen, Yasmin Mithani

School of Nursing & Midwifery

Quality has multidimensional perspectives. It is a continuous and dynamic process. A systematic search of national and international literature was conducted from peer-reviewed databases MEDLINE, CINAHL and PubMed during January to July 2012. There are many frameworks to assess and measure quality. All frameworks give some levels in which quality could be assessed. Therefore, multiple frameworks should be used for measuring quality based on the situation and environment. Measuring quality is very important for primary healthcare programme, especially for developing countries because if we will not do quality assessment, our resources will not be utilised effectively and people may divert …

Strengthening Midwifery Education, Regulation And Association; A Case Study From Afghanistan, Sabera Turkmani, Fatima Gohar, Farida Shah, Saleha Hamnawazada, Pashtoon A. Zyaee

Journal of Asian Midwives (JAM)

Immediately after the fall of the Taliban in 2002, the midwifery system in Afghanistan underwent a massive reform, and Afghanistan has since developed a strong midwifery pre service educational (PSE) system to achieve the relevant MDG goals. Establishment and involvement of professional associations, and partnerships with the government and other key stakeholders have contributed in shared knowledge, resources, and coordinated activities to speed up achieving these goals.

The International Confederation of Midwives (ICM) and its partners believe that the midwifery profession needs to be a strong voice in reducing maternal and child mortality. The three pillars of the midwifery profession, …

A Survey Of Women’S Views Of Epidural Analgesia In The Middle East, Grace Edwards, Tarek Ansari

Journal of Asian Midwives (JAM)

Background: There is little information on the factors that influence epidural uptake in the Middle East. Anecdotal evidence suggests that the uptake is low, overall, but rising due to socio-economic change and increased awareness of analgesia options in labour. The low prevalence of epidural in labour is influenced by many factors; however, there is a general lack of information about epidurals, both risks and benefits.
Methods: This study was a questionnaire -based study eliciting women’s knowledge of epidural analgesia immediately post-delivery. It was based on a survey using a questionnaire with, largely, closed questions, with one final section inviting open-ended …

Jam: Sharing The Voices Of Regional Practicing Midwives, Rafat Jan, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

No abstract provided.

News & Events

Journal of Asian Midwives (JAM)

No abstract provided.

First Private Sector Midwifery Education Initiative In Bangladesh: Experience From The Brac University, Ismat Bhuiya, Asiful Haidar Chowdhury, Km Zahiduzzaman

Journal of Asian Midwives (JAM)

In an attempt to further improve maternal and newborn health in Bangladesh, the BRAC University has started a three-year diploma in midwifery education programme, with the goal of ensuring availability of at least one midwife in all the 4,500 unions of the country by 2030, starting from the hard-to-reach under-served areas. The programme used a ‘hub and spoke’ model, where the BRAC University is the hub and six NGOs working in the rural under-served areas are the spokes, termed as academic sites. In addition, a new academic site was established in 2014 by the BRAC University in urban, Dhaka through …

Twinning In Nepal: The Royal College Of Midwives Uk And The Midwifery Society Of Nepal Working In Partnership, Jillian Ireland, Edwin Van Teijlingen, Joy Kemp

Journal of Asian Midwives (JAM)

The midwifery association of the United Kingdom, the Royal College of Midwives (RCM), has twinned with the Midwifery Society of Nepal (MIDSON) to help strengthen the latter association, through its Global Midwifery Twinning Project (GMTP). The GMTP aims to strengthen midwifery and develop leadership, advocacy, and campaigning skills both at the level of the association and at the individual midwife level. Reciprocity is an important aspect of twinning as the RCM also hopes to strengthen midwifery in the UK through greater engagement of its members and a raised profile of global maternal and new-born health. This paper describes the importance …

Midwifery In Gilgit Baltistan By Aga Khan Health Service, Pakistan, Nawroz Zeenat, Rafat Jan

Journal of Asian Midwives (JAM)

Midwives are practicing in diverse capacities in public and private health settings of Pakistan, including Non-Governmental Organizations (NGOs) such as the Aga Khan Health Service, Pakistan (AKHS, P), which is a leading non-profit, non-governmental and non-denominational community-based organization that provides quality maternal and child health services all over Pakistan. Maternal and child health centers led by registered Midwives and Lady Health visitors (LHV), were specifically established in Gilgit Baltistan in 1974 by this NGO as a strategy to combat the alarming rates of maternal and child mortalities.

Woman, Mother And Baby: A Relishing Experience, Shahnaz Shahid, Ayesha Anwar

Journal of Asian Midwives (JAM)

No abstract provided.

Empowerment Model For Nurse Leaders' Participation In Health Policy Development: An East African Perspective, Nilufa Jivraj Shariff

School of Nursing & Midwifery, East Africa

Background: Nurses comprise the largest portion of the health care workforce in most countries; they interact closely with patients and communities, they work throughout the day and within all sectors of health care. Their breath of practice gives them a broad understanding of requirements of the health care system, of how factors in the environment affect the health outcomes of clients and communities. Nurses’ involvement in health policy development ensures that health services are: safe, effective, available and inexpensive.

Methods: A Delphi survey was utilized and included the following criteria: expert panelists, three iterative rounds, qualitative and quantitative analysis, and …

Utilizing The Delphi Survey Approach: A Review, Nilufar Shariff

School of Nursing & Midwifery, East Africa

No abstract provided.

Are We Empowered? A Qualitative Approach To Unfold The Experiences Of Female Nurses In Pakistan, Saleema A. Gulzar, Rozina Karmaliani, Nasreen Lalani, Qurratulain Nasiruddin

School of Nursing & Midwifery

The disparity of men and women in certain societies, such as Pakistan, is a growing concern. The disparity, unchanging mind-set, and definitions rooted in traditions do not free individuals from the socially bound gender identities. In such circumstances, educational institutions can become a way of transforming social structures. Considering female nurses in Pakistan as a case study, this paper explores the notion of “empowerment” and the factors responsible for empowerment or disempowerment of female nurses. The study also evaluates the role of a leading nursing institution in Pakistan namely the Aga Khan University- School of Nursing and Midwifery (AKUSONAM) in …

Hiv Testing For Pmtct In Tanzania: Time To Move From ‘Voluntary’ To ‘Mandatory’?, Kahabi Isangula, Audrey Holmes, Sharon Brownie

School of Nursing & Midwifery, East Africa

Introduction: Every year many infants are infected with HIV, mostly in sub Saharan Africa. This is predominantly attributed to mother-to-child or “vertical” transmission during pregnancy, labor and delivery, and breastfeeding. Advances in antiretroviral therapy (ART) and funding have made the prevention of mother-to-child transmission (PMTCT) of HIV more affordable in sub-Saharan Africa. However, despite this advance and its potential in PMTCT, the uptake of HIV testing among pregnant women as an entry point to PMTCT services remains unsatisfactory in many countries.

Methods & Results: In the present paper, authors’ present a viewpoint that supports mandatory HIV testing for pregnant women …

Immigrant Women's Experiences Of Maternity-Care Services In Canada: A Systematic Review Using A Narrative Synthesis, Gina M A. Higginbottom, Myfanwy Morgan, Mirande Alexandre, Yvonne Chiu, Joan Forgeron, Deb Kocay, Rubina Barolia

School of Nursing & Midwifery

Background: Canada's diverse society and its statutory commitment to multiculturalism means that a synthesis of knowledge related to the healthcare experiences of immigrants is essential to realise the health potential for future Canadians. Although concerns about the maternity experiences of immigrants in Canada are relatively new, recent national guidelines explicitly call for the tailoring of services to user needs. We therefore assessed the experiences of immigrant women accessing maternity-care services in Canada. In particular, we investigated the experiences of immigrant women in Canada in accessing and navigating maternity and related healthcare services from conception to 6 months postpartum in Canada. …