Medicine and Health Sciences Commons^™

Acquiring Knowledge About The Use Of A Newly Developed Electronic Fetal Heart Rate Monitor: A Qualitative Study Among Birth Attendants In Tanzania, Sara Rivenes Lafontan, Johanne Sundby, Hussein Kidanto, Columba Mbekenga, Hege L. Ersdal

School of Nursing & Midwifery, East Africa

In an effort to reduce newborn mortality, a newly developed strap-on electronic fetal heart rate monitor was introduced at several health facilities in Tanzania in 2015. Training sessions were organized to teach staff how to use the device in clinical settings. This study explores skilled birth attendants’ perceptions and experiences acquiring and transferring knowledge about the use of the monitor, also called Moyo. Knowledge about this learning process is crucial to further improve training programs and ensure correct, long-term use. Five Focus group discussions (FGDs) were carried out with doctors and nurse-midwives, who were using the monitor in the labor …

Routine Episiotomies Without Consent, Komal Abdul Rahim, Nasreen Rafiq

School of Nursing & Midwifery

No abstract provided.

Effect Of Psychological Distress On The Emerging Cause Of Infertility, Faiza Kausar

Journal of Asian Midwives (JAM)

Background: Infertility is a growing issue of the recent era, and it represents significant crises for most couples. Psychological distress has often been suggested as a cause of unexplained infertility. Male infertility accounts for 40% of all infertility problems, while female infertility accounts for 40% of all infertility problems; others are unexplained. Previous studies have indicated that stress and depression negatively impact various infertility parameters in both partners. To determine the relationship between infertility and psychological distress and the level of different types of stress among infertile couples, and to relate the significant stressors responsible for worsening infertility or …

The Politics Of Abortion And Maternal Health: A Discussion Paper, Ihsan Ullah, Ayaz Ayub, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

Abortion should be legally allowed for women because it can save mothers from childbirth-related complications and death. Legal abortion is one of the safest methods to terminate a pregnancy when there is a risk to the mother’s health by childbirth or severe deformity of the fetus or it is unwanted. Unfortunately, approximately half of all abortions worldwide mostly in nations where abortion is severely restricted and are performed in dangerous settings. These risky abortions are a significant contributor to maternal morbidity and disability. Limiting a woman's access to an abortion does not stop abortion; rather, it just encourages more risky …

Labor Companionship: A Concept Of Doula Care, 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 …

Nursing & Midwifery: The Key To The Rapid And Cost Effective Expansion Of High Quality Universal Healthcare, Nigel Crisp, Sharon Brownie, Charlotte Refsum

School of Nursing & Midwifery, East Africa

Nurses and midwives play a central role in all health systems. They support people in every aspect of their health and wellbeing – from health promotion to chronic disease management and specialist services. Together they make up half of the professional health workforce globally and account for about 90 percent of the contacts between patients and health professionals. This report argues that countries that invest in and develop their nursing and midwifery workforce can achieve a rapid, cost-effective expansion of high-quality UHC. This will also help to realize the World Health Assembly (WHA) target of 1 billion more people benefiting …

Nursing And #Metoo, Nasreen Rafiq, Shyrose Sultan, Afsheen Hirani, Samreen Verasiya, Zainish Hajani, Neelam Rafiq

School of Nursing & Midwifery

The year 2018 revealed a number of sexual harassment stories into public conversation as part of the #MeToo movement. The campaign has relatively spread across all professions and work industries. Today, the society is already hypersensitive towards sexual talks, and the campaigns such as #MeeToo make it even more difficult to overlook these stories; it has challenged the demarcation of important and superfluous accusations which gives rise to various ethical dilemmas. Therefore, the #MeToo movement becomes significant to evaluate both sides of a coin, and assess a situation from various ethical paradigms in order to reach an ethically acceptable solution.

The Intersection Of School Corporal Punishment And Associated Factors: Baseline Results From A Randomized Controlled Trial In Pakistan, Hussain Maqbool Ahmed Khuwaja, Rozina Karmaliani Professor, Judith Mcfarlane, Rozina Somani, Saleema Gulzar, Tazeen S. Ali, Zahra Shaheen Premani, Esnat D. Chirwa, Rachel Jewkes

School of Nursing & Midwifery

Violence against youth is a global issue; one form of youth victimization is school corporal punishment. We use baseline assessments from a cluster randomized controlled trial to examine the prevalence of school corporal punishment, by gender, and the relationship to levels of peer violence at school, parent corporal punishment, youth food security and youth academic performance and school attendance in Pakistan. Forty homogenous public schools in the urban city of Hyderabad, Pakistan were chosen for randomization into the trial evaluating a youth violence prevention intervention. 1752 6th graders, age 11-14 years, were selected as the target population. Since schools are …

Comparison Of Undergraduate Educational Environment In Medical And Nursing Program Using The Dreem Tool, Salima Farooq, Rehana Rehman, Mehwish Hussain, Jacqueline Maria Dias

School of Nursing & Midwifery

Introduction: Educational environment (EE) in a health educational institute can bring about an enduring impact on the students' motivation, knowledge, critical thinking along with their social life. Therefore, identifying strengths and the need for change in the education environment is vital for the enhancement of the students' learning.
Objective: This study aimed to compare the perceptions of nursing and medical students about their EE in a private university, Karachi Pakistan.
Methodology: Data from two cross-sectional studies of 884 students from both medical and nursing schools of Aga Khan University was acquired and analyzed. EE was measured by …

Supporting The Nationally Mandated Transition To Competency-Based Nursing Curricula In Egypt, Sharon Brownie, Rachel Rossiter

School of Nursing & Midwifery, East Africa

Egypt has a substantive and rich history in nursing education with continuous evolution over many years. A government commitment to further enhance the capacity of the nursing workforce recently required all nursing curricula to be upgraded and presented in a competency-based format. In response to this directive, lead agencies in Egypt, including the Educational Development Fund and the Nursing Sector Group of the Supreme Council of Universities, have garnered internal and external nursing expertise to provide guidance in the curriculum reform process. The authors of this presentation are currently working in close partnership with several Egyptian nursing education providers supporting …

Using Theories And Models For Operationalization Of Patient Trust In Doctors In Chronic Disease Response In Low Income Africa: ‘Best Fit Approach’, Kahabi Isangula

School of Nursing & Midwifery, East Africa

Background: Recent evidence suggest that improved patient trust in doctors can facilitate their healthcare seeking, adherence and continuity with care. With the growing burden of chronic disease in low income Africa (LIA) characterized by challenges of poor patient healthcare seeking, non-adherence and poor continuity with care, trust forms an important entry point for addressing these challenges. However, the topic of trust has generally received weaker attention among researchers in LIA contexts. To date, there has been no attempts to generate a clear guide for theory-driven inquiries as a means of operationalization of trust as a public health lens for chronic …

A Framework For Cyclical Nursing Curriculum Review Across Multi-Site And Multi-Country Campuses, Sharon Brownie, Rachel Rossiter

School of Nursing & Midwifery, East Africa

Cyclical curriculum review and continuous course improvement is an unarguable measure of quality nursing education. Higher education and professional regulators across the Middle East and North Africa (MENA) and African (Afro) regions are increasingly mandating cyclical review within accreditation and programme approval standards. Many nursing education providers in the region operate multi-site and multi-country campuses. A key challenge is to ensure that programmes keep pace with international standards in nursing education, and, that inter-campus drift does not occur in programme content and quality. Cyclical review offers a process whereby programmes can be updated to current best practice and consistent cross-campus …

Setting The Stage: Reviewing Current Knowledge On The Health Of New Zealand Immigrants—An Integrative Review, Blessing Kanengoni, Sari Andajani-Sutjahjo, Eleanor Holroyd

School of Nursing & Midwifery, East Africa

The growth of migrant communities continues to rise globally, creating unique and complex health challenges. Literature on immigrant health in New Zealand (NZ) remains scant. This integrative literature review was conducted drawing on peer-reviewed research articles on immigrant health in NZ published between 2012 and 2018. The objectives were to: (i) provide a critical overview of immigrant health in NZ; (ii) identify general trends in health research conducted in NZ on immigrants; (iii) compare, contrast, and evaluate the quality of the information; (iv) develop a summary of research results and; (v) identify priorities and recommendations for future research. A search …

A Pilot Study Exploring Nursing Knowledge Of Depression And Suicidal Ideation In Kenya, Timothy Muga, Gladys Mbuthia, Samwel Gatimu, Rachel Rossiter

School of Nursing & Midwifery, East Africa

Nurses play key roles in recognizing, diagnosing, managing, and referring persons with mental disorders. This cross-sectional study assessed mental health literacy (depression and suicidal ideation) among nurses in a private urban referral hospital in Kenya. Nurses read a vignette and answered questions regarding diagnosis, treatment/interventions, and related attitudes and beliefs. Thirty-seven nurses (12 males) completed the questionnaire. Three correctly identified the diagnosis and 23 identified depression only. Although 75% noted the symptoms were extremely distressing, fear, and stigma were common reactions. This highlights challenges in mental health promotion/prevention in Kenya, and suggests continuous nursing education and curriculum enhancement is needed.

The Socio-Political Debate Of Dying Today In The United Kingdom And New Zealand: ‘Letting Go’ Of The Biomedical Model Of Care In Order To Develop A Contemporary Ars Moriendi, Rhona Winnington, Eleanor Holroyd, Shelaine Zambas

School of Nursing & Midwifery, East Africa

Death is a reality of life. Despite this inevitability, death today remains unwelcome and has been sequestered into the enclaves of medical practice as a means of quelling the rising tide of fear it provokes. Medical practice currently maintains power over the dying individual, actualised through the selective collaboration between medicine and law as a means of subverting the individual who attempts to disrupt the contemporary accepted norms of dying. There is, however, a shift on the horizon as to whether we can make the notion of a true choice become a reality in New Zealand. This serves to offer …

Health In Surroundings: Application Of The Theory Of Environment In Nursing Practice, Nasreen Rafiq

School of Nursing & Midwifery

Nursing practices are guided by theoretical frameworks which provide functional basis to nursing care. This paper discusses the application of Nightingale’s theory of environment in nursing practices. The theory highlights and explains 13 environmental cannons which include ventilation, cleanliness of walls/rooms, light, noise, personal cleanliness, bed and bedding, and taking food. Florence exquisitely explains the influence of environmental health on patients wellbeing. The application of the theory in nursing practices will help to understand and reflect the direct relation of environment on patients health.

Assessing The Impact Of A Partnership‐Based Work/Study Nursing Upgrade Programme In A Low And Middle‐Income Setting, Sharon Brownie, Samwel Gatimu, Abdul Haq Wahedna, Isabel Kambo, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Aim: To evaluate the 15‐years impact of the work‐study nursing upgrading programme in East Africa.

Background: Working nurses in Africa are often primary family income earners, with limited ability to leave jobs and upgrade qualifications. In 2001, the university established a work‐study upgrade programme for enrolled‐ and diploma‐level nurses, allowing them to upgrade their qualifications while continuing to work and support families. Donor partnerships provided scholarships to further increase programme access.

Design: A mixed method design was used involving an online alumni survey and 24 interviews and 23 focus groups with 172 purposively selected representatives of nursing graduates, employers, regulatory …

Knowledge, Attitudes, And Practices Among Nurses In Pakistan Towards Diabetic Foot, Muhammad Bilal, Abdul Haseeb, Abdur Rehman, Mohammad Hussham Arshad, Aashir Aslam, Sana Godil, Saif N. Husain, Mohammad A. Qamar, Muhammad H. Polani, Araib Ayaz, Altamash S. Ghazanfar, Zaki M. Ghazali, Khurram A. Khoja, Maarij Malik, Hania Ahmad

Medical College Documents

Introduction:
Diabetic foot ulcers are a pressing complication of diabetes mellitus. Wound care requires a significant proportion of healthcare resources. It is imperative, therefore, for healthcare professionals to possess sound knowledge of the disease along with a positive attitude to ensure better clinical practice. Our literature search revealed a scarcity of data pertaining to diabetic foot ulcers. Therefore, this study aims to evaluate the knowledge and attitudes of nurses regarding diabetic foot care.
Methods:
A cross-sectional study design was employed, a pre-validated and pre-tested questionnaire was used to collect data from a sample size of 250 nurses working at two …

Physicians’ And Nurses’ Perspectives On The Importance Of Advance Directives In Tertiary Care Hospitals, Nasreen Panjwani, Raisa B. Gul, Fauziya Ali, Robyna Irshad Khan

School of Nursing & Midwifery

Objective: This study aimed to explore and identify the nurses’ and physicians’ views about Advance Directives and identified their perspectives on its importance, in the context of Pakistan.
Methodology: Using a purposive sample, six physicians and seven nurses from two tertiary care hospitals in Karachi participated in the study. Data was collected using semi structured interviews that were transcribed verbatim. The interviews were coded and categorized manually. Analysis of the data drew four categories: roles of physicians and nurses in the End of life care, challenges they faced while taking end of life care decisions; their perspectives about Advance Directives, …

Dose-Response Of Cotton Dust Exposure With Lung Function Among Textile Workers: Multitex Study In Karachi, Pakistan, Naureen Akber Ali, Asaad Ahmed Nafees, Zafar Fatmi, Iqbal Azam Syed

School of Nursing & Midwifery

Background: Cotton dust exposure among textile mill workers lead to impaired lung function. However, only few studies have investigated the dose-response relationship between cotton dust and lung function.
Objective: To determine the dose-response relationship between cotton dust exposure and lung function among textile workers.
Methods: This cross-sectional survey was conducted from January to March 2016 and included 303 adult male textile workers from spinning and weaving sections of 5 mills in Karachi, Pakistan. We collected data through a translated version of the American Thoracic Society respiratory questionnaire (ATS-DLD-78A) and using spirometry. Mill-level airborne cotton dust was measured …

Trends And Factors Associated With Early Initiation Of Breastfeeding In Namibia: Analysis Of The Demographic And Health Surveys 2000–2013, M. N. Ndirangu, Samwel Gatimu, H. M. Mwinyi, D. C. Kibiwott

School of Nursing & Midwifery, East Africa

Background: Early initiation of breastfeeding (EIBF) lowers the risk for all-cause mortality in babies, including those with low birth weight. However, rates of neonatal mortality and delayed initiation of breastfeeding remain high in most low- and middle-income countries. This study aimed to assess the trends and factors associated with EIBF in Namibia from 2000 to 2013.

Methods: An analysis of EIBF trends was conducted using data from three Namibia Demographic Health Surveys. The present sample included singleton children younger than 2-years from 2000 (n = 1655), 2006–2007 (n = 2152) and 2013 (n = 2062) surveys. Descriptive statistics were used …

Asian Midwifery In 2018, Rafat Jan, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

No abstract provided.

Relationship Of Family Members’ Support With Practice Of Community Midwives In Rural Sindh, Pakistan, Farida Shah, Farhana Shahid, Jamila Haider, Syfoor Ali, Bibi Ara, Misri Bano

Journal of Asian Midwives (JAM)

Background: Pakistan has one of the highest maternal mortality rates in the world. Community Midwives (CMWs) were introduced in 2006 as a new cadre of birth attendants who would bring midwifery services to rural areas by being based in designated communities. The CMWs face many obstacles and retaining them in practice is a challenge. This study aimed to examine whether there was a relationship between family support and CMWs retention in midwifery practice. We hoped to learn about influences on retention that might improve the Maternal Newborn and Child Health (MNCH) programme.
Methods: This was a cross-sectional survey conducted in …

Gender Inequalities And Childbearing: A Qualitative Study Of Two Maternity Units In Nepal, Lesley Milne, Jillian C M Ireland Ms, Edwin Van Teijlingen, Vanora Hundley, Padam P. Simkhada

Journal of Asian Midwives (JAM)

The role and status of women in South Asian countries like Nepal are widely recognised to be lower than that of men. This gender inequality can be found throughout all levels of society. Our study is about the influence of gender on pregnancy and childbirth, which are very much in the female domain in South Asia, both at home and in health facilities.
A mixed-method, qualitative research study was undertaken in two birthing facilities in Kathmandu Valley to examine barriers to women accessing these services from the perspective of hospital staff. Thematic analysis identified seven subthemes related to gender, namely: …

Determinants Of Inadequate Provision And Utilization Of Post Abortion Care Services In Pakistan, Marina Baig, Kiran Mubeen

Journal of Asian Midwives (JAM)

Access to safe abortion services remain a challenge in many low and middle income countries like Pakistan. Evidence suggests that Pakistan shares a huge burden of abortion related morbidities and mortalities. Timely provision of Post Abortion Care (PAC) services could assist in preventing maternal deaths associated with unsafe abortions. However, there are certain socio-cultural, financial and political factors that restricts the provision and utilization of effective PAC services. This paper explores these determinants and suggest recommendations for policy and practice to promote PAC services in Pakistan.

Out-Of-School Children: Examining The Reasons In Semi- Urban Setting In Pakistan, Nousheen Pradhan, Tanzil Jamali, Shireen Shehzad Bhamani, Tazeen Saeed Ali, Rozina Karmaliani

Community Health Sciences

Globally, 57 million primary age children remain out-of-school. In South Asia, Pakistan has the highest (34%) out-of-primary school age children. This paper highlights the proportion of out-of-school children with reasons and children’s educational attainment in the semi-urban community of Pakistan. A cross-sectional survey was conducted by using systematic sampling in a semi-urban town in Karachi, Pakistan. Chi-square was used to describe the difference in the educational achievements with age and gender of the children with p-value < 0.05, considered as significant. Among 254 surveyed households, 22.9% of the children (age 3-15 years) were found out-of-school, with no significant gender difference among boys (11.6%) and girls (11.1 %). A large group of young children (3-6 years of age) were found out-of-school with boys 71.6% (n=68) and girls 67.03% (n=61). Children’s lack of interest in education was the major (42%) reason, followed by high school expenses (23%). Children’s educational attainment was significantly (p<0.000) related to age and gender. At the local community level, teachers and Taluka Education Officers have a pivotal role to play towards increasing primary school enrollment and mobilizing the resources to overcome financial hardships faced by the parents for their children’s education in early years. Nousheen Akber Pradhan is a Senior Instructor at the Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan

Physical And Psychological Violence Against Married Men In District Dir (Lower), Khyber Pukhtoonkhwa, Pakistan, Hizbullah Khan, Tazeen Saeed Ali, Aamir Abdullah, Shadbehr Shahid

School of Nursing & Midwifery

No abstract provided.

A Qualitative Exploration Ofdoctors And Nurses Experienceson The Management Of Tubercu-Losis And Hiv Co-Infection In Atuberculosis-Hiv High Burdencommunity In Northernkwazulu-Natal, South Africa, Mbuso Mabuza, Constance Shumba

School of Nursing & Midwifery, East Africa

South Africa is faced with a huge challenge of addressing the high burden of tuberculosis-human immune virus (TBHIV) co-infection, and this challenge is more pronounced in the province of KwaZulu-Natal which has one of the highest burdens of TB-HIV co-infection in the world. The study explored the experiences of doctors and nurses with regard to the management of tuberculosis and HIV coinfection in a TB-HIV high burden community in northern KwaZulu-Natal, South Africa. The particular focus was to provide insight and to inform policy and programme development for effective management of TB-HIV co-infection in the TB-HIV high burden community of …

Collaborative Task-Sharing To Enhance The Point-Of-Care Ultrasound (Pocus) Access Among Expectant Women In Kenya: The Role Of Midwife Sonographers, Sudhir Vinayak, Sharon Brownie

Imaging & Diagnostic Radiology, East Africa

Unrealized maternal and child health goals continue to challenge Kenya where adverse outcomes remain high and diagnostic services are limited. The acute shortage of doctors and radiographers requires alternate human resources for health (HRH) with the ability to identify risk factors in pregnancy through Point-Of-Care Ultrasound (POCUS). A specialist radiologist and ultrasonography team partnered with midwives to adopt interprofessional task sharing and capacity building. Faculty from the Radiology Department of our hospital designed and implemented the project which was carried out at three outreach health service centres. Designing and implementing a training model to skill midwife sonographers with the capacity …

Children’S Perspectives Of Their Psychosocial Wellbeing In Tanzanian Orphanages, Agnes Msoka, Eleanor Holroyd

School of Nursing & Midwifery, East Africa

The aim of this study was to explore factors affecting the wellbeing of institutionalized orphaned children in Dar es Salaam, Tanzania. A descriptive qualitative study was used to collect data from Tanzanian orphaned children receiving orphanage care. Purposive sampling was employed to select 10 orphanage centers from which 123 orphaned children were recruited. A semi-structured interview guide relevant to the study objectives was developed from the literature and was used to guide the focus group interviews. Data was analysed by way of thematic analysis. There were 76 male and 47 female orphans; orphans without one or both parents were 87 …