Medicine and Health Sciences Commons^™

Right To Play's Intervention To Reduce Peer Violence Among Children In Public Schools In Pakistan: A Cluster-Randomized Controlled Trial, Rozina Karmaliani, Judith Mcfarlane, Hussain Maqbool Ahmed Khuwaja, Yasmeen Hassan Somani, Shireen Shehzad, Tazeen Saeed Ali, Nargis Asad, Esnat D. Chirwa, Rachel Jewkes

School of Nursing & Midwifery

Background: Peer violence is common globally, but a little researched topic in low-and middle-income countries. This study presents the evaluation of a two-year randomized controlled trial of a structured play-based life-skills intervention implemented in schools in Hyderabad, Pakistan.
Objective: To determine the impact of the intervention on school-based peer violence (victimization and perpetration) and depression among school children.
Methods: 40 single-sex public schools were randomized into two study arms (20 per arm 10 of each sex). A total of 1752 grade 6 students (929 from intervention and 823 from control schools) were enrolled in the trial. The two-year intervention was …

Burden Of Care As Perceived By Informal Caregivers Of The Patients Receiving Chemotherapy In Tertiary Care Hospital Of Karachi, Pakistan, Asher Ghori, Rubina Barolia, Naghma Rizvi, Ghulam Qadir

School of Nursing & Midwifery

Background: Almost 32.5 million people are diagnosed with cancer annually. The huge number of cancer patients with deteriorating health renders a far greater number of informal caregivers bearing the burden of care in different forms and magnitude. The main purpose of the study was to explore the types of burden perceived by the informal caregivers and the factors associated with the caregiving burden.
Methods: A quantitative descriptive cross-sectional study design was adopted to answer the research questions from April to May 2016. Around 200 informal caregivers were recruited from one of the tertiary hospitals of Karachi, Pakistan. The modified ZBIS …

Evolving Nurse Leadership Role In 2020, Nasreen Rafiq, Farida Bibi Mughal

School of Nursing & Midwifery

No abstract provided.

Nursing Education Amidst Covid-19: Obstacles And Way Forward, Farida Bibi Mughal, Nasreen Rafiq, Bibi Hajira Irshad Ali

School of Nursing & Midwifery

No abstract provided.

Critical Social Determinants Of Childbirth Outcomes In Remote Mountains: Voices Of Women From Nepal, Sabitra Kaphle, Lareen Newman

Journal of Asian Midwives (JAM)

Objectives: Despite efforts made by the Government of Nepal to reduce maternal and newborn mortality nationally, the rate is still significantly higher in remote mountain areas. This research aimed to fill a gap by asking women about socio-cultural factors influencing childbirth outcomes in remote mountain areas of Nepal.
Methods: This study used a qualitative approach guided by the principles of social constructionist and feminist critical theories to derive factors influencing women’s experiences of giving birth and childbirth outcomes. In-depth interviews were conducted with 25 pregnant and postnatal women. A thematic approach was used for data analysis.
Results: Childbirth outcomes in …

The Year 2020: Loss Of Women And Midwives’ Voices, Rafat Jan, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

No abstract provided.

Promoting Positive Birth Experiences: Supporting Pregnant And Lactating Women During The Covid-19 Crisis, Marina Baig, Shelina Bhamani, Zohra Kurji, Lumaan Sheikh, Rozina Karmaliani

Journal of Asian Midwives (JAM)

The World Health Organization (WHO) declared the COVID-19 outbreak a public health emergency of international concern, in January 2020. While international organizations and governments strive to strengthen the world’s emergency response mechanism to combat the pandemic, the public in general faces anxiety and fear. One of the most vulnerable groups is pregnant and lactating women. The pandemic has given rise to many apprehensions about the state of their health and well-being as well as that of their unborn or newly born child. A live Facebook session was conducted by a group of experts from a private university in Karachi, Pakistan, …

How Do Pregnant Women Perceive The Role Of The Midwife In Thailand? A Descriptive Study, Sudjit Liblub, Lyn Gum, Maryam Bazargan

Journal of Asian Midwives (JAM)

Background: Midwives are globally recognised as health professionals who specialise in caring for childbearing women with a vital role in maternal and neonatal health care. Despite the midwifery profession being an autonomous profession, there are many struggles to attain recognition within its formal scope of practice in some countries.
Objective: This study was undertaken to explore the views of pregnant women in Thailand regarding the role of midwifes and their selection of intrapartum care providers in order to understand their perceptions about giving birth with a midwife for normal pregnancies.
Design and setting: An online descriptive survey collected the views …

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 …

Association Of Depression And Resilience With Fertility Quality Of Life Among Patients Presenting To The Infertility Centre For Treatment In Karachi, Pakistan, Shireen Shehzad Bhamani, Nida Zahid, Wajeeha Zahid, Salima Farooq, Saima Sachwani, Marilyn Chapman, Nargis Asad

School of Nursing & Midwifery

Background: In Pakistan there is a dire need to explore the quality of life in infertile males and females and its undesirable psychological outcomes. This, study aimed to compare the quality of life (QoL) of males and females visiting an infertility centre for treatment and to assess its association with resilience, depression, and other socio-demographic factors.
Methods: An Analytical Cross-Sectional study was conducted amongst infertile males and females at the Australian Concept Infertility Medical Centre (ACIMC), Karachi, Pakistan. The non-probability (purposive) sampling strategy was used to recruit the participants. The sample size was 668. Data was analysed using STATA version …

Ratings Of Performance In Multisource Feedback: Comparing Performance Theories Of Residents And Nurses, Muhammed Tariq, Marjan Govaerts, Azam Afzal, Syed Ahsan Ali, Tabassum Zehra

Department for Educational Development

Background: Multisource feedback (MSF) is increasingly being used to assess trainee performance, with different assessor groups fulfilling a crucial role in utility of assessment data. However, in health professions education, research on assessor behaviors in MSF is limited. When assessing trainee performance in work settings, assessors use multidimensional conceptualizations of what constitutes effective performance, also called personal performance theories, to distinguish between various behaviors and sub competencies., This may not only explain assessor variability in Multi Source Feedback, but also result in differing acceptance (and use) of assessment data for developmental purposes. The purpose of this study was to explore …

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. …

Challenges In Teaching Palliative Care Module Virtually During Covid-19 Era, Shanaz Hussein Cassum, Khairunnisa Mansoor, Amina Hirji, Amber David, Amina Aijaz Khowaja

School of Nursing & Midwifery

With the COVID-19 pandemic hitting the global community, routine activities of universities, offices, and industries have been hindered. People are being forced to rethink the ways of working virtually from home for providing education, business, and health services in this social distancing during the COVID era. This sudden shift also posed challenges of online teaching in a private university, in urban Karachi, Pakistan. The Aga Khan University, School of Nursing and Midwifery recently conducted an online palliative care module using a virtual learning environment and Microsoft Teams for Trainee Nurse Interns. Although the first experience of online teaching and learning …

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.

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 …

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 …

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 …

Prevalence Of Needlestick Injury And Nursing Practices Regarding Safe Injection And Sharp Disposal While Working In Critical Care Settings Of Two Tertiary Care Hospitals, Shah Zeb, Tazeen Saeed Ali

School of Nursing & Midwifery

This observational cross-sectional study design (Pilot) was conducted to assess the prevalence of needle stick injury (NSI) and nursing practices regarding safe injection and sharp disposal in critical care units of two tertiary care hospitals from 1st July to 30th August 2014. Data was collected using a self-developed questionnaire about the prevalence of NSI and nurses’ pract­ices regarding safe injection and sharp disposal after a thorough literature review and then was given to the expert for review. Finally, the data was collected from the participants after verbal consent. The study result showing that about half of the nurses have no …

Effectiveness Of High-Fidelity Simulation In Nursing Education For End-Of-Life Care: A Quasi-Experimental Design, Salma Rattani, Zohra Kurji, Amina Aijaz Khowaja Ap, Jacqueline Maria Dias, Anila Naz Alisher

School of Nursing & Midwifery

Background: Providing end of life (EOL) care is a component of palliative care but dealing with dying patients and their family members is stressful for the healthcare providers. To prepare them for providing EOL care, the high-fidelity simulation could be used as a pedagogy in which real-life scenarios are used on the computerized manikins mimicking the real patients.
Aims: The aim of this study was to measure the effectiveness of high-fidelity simulation to teach EOL care in the palliative nursing course in the undergraduate nursing education program at the School of Nursing and Midwifery at Aga Khan University which is …

Covid-19: The New Corona Virus Upsetting Our World, Rafat Jan, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

No abstract provided.

Developing And Piloting A Midwifery Audit Tool In Bangladesh’S Upazila Health Complexes (Uhcs), Achiya Khatun, Mahfuja Aktar Jhumu, Sarah Gregson, Joy Kemp

Journal of Asian Midwives (JAM)

Midwifery is a new profession in Bangladesh. Diploma-prepared midwives were first deployed in 2018. Recent studies suggest that newly qualified midwives in Bangladesh may not be able to fully perform their midwifery role due to a number of complex factors. This paper describes a pilot study of a midwifery audit undertaken in 2019 by the Bangladesh Midwifery Society, supported by the Royal College of Midwives. These two organisations are in a formal twinning partnership funded by UNFPA Bangladesh with support from UK-Aid, Sweden and Canada. The audit was successful in improving the quality of midwifery care and addressing health system …

Maternal Health Challenges During Covid-19 And Way Forward, Muskaan Dosani, Salima Muhammad Farooq, Shahnaz Shahid Ali

Journal of Asian Midwives (JAM)

The COVID-19 pandemic has affected nearly every country around the globe. Although every individual is at risk of getting the virus, maternal, fetal and newborn clients face specific and potentially unknown challenges which can make them highly compromised. The purpose of this paper is to discuss the maternal health challenges faced by women during COVID-19 and to propose possible strategies using the socio-ecological model (SEM) to promote the physical, social, and mental well-being of women and their infants during the perinatal period. SEM can be used as a framework to plan and implement strategies focusing on health promotion and disease …

Health Care Provider’S Perspectives On The Content And Structure Of A Culturally Tailored Antenatal Care Programme To Expectant Parents And Family Members In Nepal, Annika Ekström, Laxmi Tamang, Christina Pedersen, Ulrika Byrskog, Edwin Van Teijlingen, Kerstin Erlandsson

Journal of Asian Midwives (JAM)

Background: In Nepal childbirth is one of the most vulnerable periods of a woman's life and knowledge about the normal birth process, as well as danger signs, could be a life-saving intervention. Antenatal care programmes are therefore particularly relevant in Nepal where women deliver on their own in rural areas as well as in facility and hospital settings.

Aim: This study aimed to describe the relevant content and structure of a culturally tailored antenatal care programme in Nepal to be developed from the input of healthcare providers.

Methods: Qualitative semi-structured interviews with 26 health care providers were analyzed using Elo …

Effects Of Vitamin D Deficiency On Neurobehavioural Outcomes In Children: A Systematic Review, Agnes M. Mutua, Reagan M. Mogire, Alison M. Elliott, Thomas N. Williams, Emily L. Webb, Amina Abubakar, Sarah H. Atkinson

Institute for Human Development

Introduction: Vitamin D plays an important role in brain development in experimental studies; however, the effect of vitamin D deficiency on child development remains inadequately characterized. We aimed to estimate the effects of vitamin D deficiency on neurobehavioural outcomes in children up to 18 years of age.

Methods: We searched PubMed, EMBASE, PsycINFO, Scopus, Cochrane Library, Web of Science and Open Grey for published studies up to 10th January 2020. We included all studies that assessed the effects of maternal or child vitamin D status or vitamin D supplementation on neurobehavioural outcomes in children. Study findings were synthesized qualitatively as …

Reflections: Bravo Breastfeeding Mother! A Covid Positive Mother And Midwifery Instinct, Rafat Jan

Journal of Asian Midwives (JAM)

No abstract provided.

Insight Into Covid-19 Responses And Initiatives From Pakistan, Salima Farooq, Sonia Ijaz Haider, Saima Sachwani, Yasmin Parpio

School of Nursing & Midwifery

The coronavirus pandemic is a rapidly evolving outbreak that has tremendously distressed people worldwide. The paper aims to present some key rapid responses and initiatives to COVID-19 undertaken in Pakistan. The information has been gathered by reviewing material and documents pertinent to COVID-19 in the context of Pakistan. The incidences of COVID-19 cases are gradually increasing; however, the case fatality rate is relatively lower in Pakistan as compared to developed countries. The government has taken massive actions, in terms of lockdowns, quarantine homes, testing facilities, closure of schools, and mass gatherings at places, to combat COVID-19. However, the measures seem …

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 …

Community Stakeholders' Views On Reducing Violence Against Women In Pakistan, Tazeen S. Ali, Rozina Karmaliani Professor, Hussain Maqbool Ahmed Khuwaja, Nasim Zahid Shah, Zahid Hyder Wadani, Saher Aijaz, Asli Kulane

School of Nursing & Midwifery

Background: Nearly half of the women experience violence across their lifespan in all the provinces of Pakistan at an alarming rate. Despite knowing the prevalence, there has been meager progress in developing strategies to combat violence at individual, family, or community level. Many interventions suggested in other countries have been pilot tested but the effects of those interventions had been limited. Therefore, the aim of this study is to understand the voices of stakeholders to reduce Violence Against Women (VAW) and to explore the possible community-based strategies that could be implemented in Pakistan.
Methods: A total of 14 Key Informant …