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 …

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 …

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 …

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 …

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 …

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 …

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 …

Midwives’ Perceptions On Using A Fetoscope And Doppler For Fetal Heart Rate Assessments During Labor: A Qualitative Study In Rural Tanzania, Paschal Francis Mdoe, Hege Langli Ersdal, Estomih Mduma, Robert Moshiro, Hussein Kidanto, Columba Mbekenga

School of Nursing & Midwifery, East Africa

Background: The Doppler is thought to be more comfortable and effective compared to the fetoscope for assessing the fetal heart rate (FHR) during labor. However, in a rural Tanzanian hospital, midwives who had easy access to both devices mostly used fetoscope. This study explored midwives’ perception of factors influencing their preference for using either a Pinard fetoscope or a FreePlay wind-up Doppler for intermittent FHR monitoring.

Methods: Midwives who had worked for at least 6 months in the labor ward were recruited. Focus group discussion (FGD) was used to collect data. Five FGDs were conducted between December 2015 and February …

“I Was Relieved To Know That My Baby Was Safe”: Women’S Attitudes And Perceptions On Using A New Electronic Fetal Heart Rate Monitor During Labor In Tanzania, Sara Rivenes Lafontan, Johanne Sundby, Hege L. Ersdal, Muzdalifat Abeid, Hussein L. Kidanto, Columba Mbekenga

School of Nursing & Midwifery, East Africa

To increase labor monitoring and prevent neonatal morbidity and mortality, a new wireless, strap-on electronic fetal heart rate monitor called Moyo was introduced in Tanzania in 2016. As part of the ongoing evaluation of the introduction of the monitor, the aim of this study was to explore the attitudes and perceptions of women who had worn the monitor continuously during their most recent delivery and perceptions about how it affected care. This knowledge is important to identify barriers towards adaptation in order to introduce new technology more effectively. We carried out 20 semi-structured individual interviews post-labor at two hospitals in …

Factors Deterring Dentistry, Medical, Pharmacy, And Social Science Undergraduates From Pursuing Nursing As A Healthcare Career: A Cross-Sectional Study In An Asian University, Ling Ting Wu, Wenru Wang, Eleanor Holroyd, Violeta Lopez, Sok Ying Liaw

School of Nursing & Midwifery, East Africa

Background: Globally more registered nurses need to be recruited to meet the needs of aging populations and increased co-morbidity. Nursing recruitment remains challenging when compared to other healthcare programs. Despite healthcare students having similar motivation in joining the healthcare industry, many did not consider nursing as a career choice. This study aims to identify the deterrents to choosing nursing among healthcare undergraduates by examining the differences in the factors influencing healthcare career choices and nursing as a career choice.

Methods: A cross sectional study was conducted using a 35-parallel items instrument known as Healthcare Career Choice and Nursing Career Choice …

Factors Affecting Effective Ventilation During Newborn Resuscitation: A Qualitative Study Among Midwives In Rural Tanzania, R. Moshiro, H. L. Ersdal, P. Mdoe, H. L. Kidanto, Columba Mbekenga

School of Nursing & Midwifery, East Africa

Background: Intrapartum-related hypoxia accounts for 30% of neonatal deaths in Tanzania. This has led to the introduction and scaling-up of the Helping Babies Breathe (HBB) programme, which is a simulation-based learning programme in newborn resuscitation skills. Studies have documented ineffective ventilation of non-breathing newborns and the inability to follow the HBB algorithm among providers.

Objective: This study aimed at exploring barriers and facilitators to effective bag mask ventilation, an essential component of the HBB algorithm, during actual newborn resuscitation in rural Tanzania.

Methods: Eight midwives, each with more than one year’s working experience in the labour ward, were interviewed individually …

Assessment Of Participation Of Nursing Faculty In Clinical Practice In The Kenyan Universities, Beth Waweru, Job Mapesa, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Purpose: The purpose of this study was to assess the participation of nursing faculty in faculty clinical practice in the Kenyan universities.

Methodology: This was a cross sectional descriptive survey. All the universities with nursing programs in the country were purposively selected. Data was then analyzed through descriptive statistics using the Statistical Package for Social Science (SPSS version 23.0).Chi-square test was used to test associations between selected independent and dependent variables.

Results: The study found out that most nursing faculty is participating in clinical practice though they have limited knowledge of the models of faculty clinical practice. …

Examining Nursing Practices For Management Of Sepsis In Low Income Countries: The Case Of Uganda, Cliff Aliga, Judith Mutyabule, Grace Nakate, Abigail Emelonye

School of Nursing & Midwifery, East Africa

Examining nursing practice guidelines to improve quality of care for patients with sepsis in low income countries is required.

A large amount of information about best practice standards in sepsis management is available for healthcare professionals; however, implementation and adherence to practice guidelines recommended by the Surviving Sepsis Campaign remains low in low income countries.

A formal scope of practice for nursing and midwifery as a professional guideline is absent and national clinical guideline for Uganda remains unclear regarding the specific management of sepsis.

Inadequate documentation of patient care in Uganda makes sepsis cases difficult to be early detected.

Research …

Implementation Of A Facilitation Intervention To Improve Postpartum Care In A Low-Resource Suburb Of Dar Es Salaam, Tanzania, Eunice Pallangyo, Columba Mbekenga, P. Olsson, L. Eriksson, A. Bergström

School of Nursing & Midwifery, East Africa

Background: Implementation of evidence into practice is inadequate in many low-income countries, contributing to the low-quality care of mothers and newborns. This study explored strategies used in a facilitation intervention to improve postpartum care (IPPC) in a low-resource suburb in Dar es Salaam, Tanzania. The intervention was conducted during 1 year in government-owned health institutions providing reproductive and child health services. The institutions were divided into six clusters based on geographic proximity, and the healthcare providers of postpartum care (PPC) (n = 100) in these institutions formed IPPC teams. Each team was supported by a locally recruited facilitator who was …

Midwives’ Knowledge Of Baby Friendly Hospital Initiative In Uganda, Jaliah Namutebi, Hanifah Nakanwagi, Leila Naluyima, Grace Edwards

School of Nursing & Midwifery, East Africa

The Baby Friendly Hospital Initiative (BFHI) is a worldwide programme well known to midwives globally for supporting the initiation of successful breastfeeding. In low resource countries, initiation of breastfeeding immediately after birth would help to reduce neonatal complications such as infection. Knowledge of the 10 steps is critical for midwives in developing countries, yet our research in Uganda suggested that midwives’ knowledge is poor, despite a commitment at government level. There is a disconnect between policy and practice which must be addressed to ensure that midwives give standardised advice to new mothers to ensure successful and exclusive breastfeeding. This is …

Nursing And Midwifery Research Output In Africa: A Review Of The Literature, Rose Chalo Nabirye, Alison Annet Kinengyere, Grace Edwards

School of Nursing & Midwifery, East Africa

Background: Nurses and midwives form the backbone of health service delivery and satisfaction with care often depends on the competencies of nurses and midwives who provide the care (World Health Organization [WHO], 2002). Healthcare has become complex, challenging, and demanding across diverse sociocultural and socioeconomic changes and environments. To optimize their impact, nurses and midwives therefore need to be prepared with evidence-based competences. Nursing research therefore, is the cornerstone for evidence-based practice and for establishing the professional status of nursing and building research capacity. However, although nursing research began in the 19th century, it is limited in Africa, with little …

Factors Influencing High Prevalence Of Fresh Still Births In Mbagathi County Hospital, Nairobi - Kenya, Abednego Ongeso, Magdalene Lukorito, Jane Kabo

School of Nursing & Midwifery, East Africa

Background: The annual global burden of stillbirths is approximately 2.6 million, 98% of which occur in Sub Saharan Africa. In 2016, approximately 24 still births per month occurred in Mbagathi County Hospital (MCH) representing a 33.3% increase from 2015. A third of these were Fresh Still Births (FSBs).

Objectives: To establish factors influencing increase in FSB among women delivering at MCH.

Methodology: The study was conducted at MCH postnatal ward. A descriptive cross sectional study design was employed. Forty three respondents with FSBs were consecutively sampled. Clearance to conduct the study was sought from Ethics Review Committee, MCH and respondents. …