Nursing Commons^™

Well-Being And Quality Of Life Of Kenyan Nurses, Midwives And Community Health Volunteers: Measurement Properties And Correlates Of The Bbq And Who-5, Paul Mwangi, Sabina Odero, Rachel Odhiambo, Brenda Nzioka, Constance Shumba, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

Healthcare workers’ quality of life (QoL) and well-being is directly linked to the quality of services they deliver. However, there is a shortage of validated measures to assess QoL, well-being and their predictors among healthcare workers in Kenya, as in other LMICs. This study aimed to assess the reliability and validity of the Brunnsviken Brief Quality of Life Scale (BBQ) and WHO-5 well-being index (WHO-5) among nurses, midwives and community health volunteers (CHVs) in Kenya. The BBQ and WHO-5 were selected due to their established psychometric strengths, brevity, and prior use in healthcare settings. Additionally, the sociodemographic, psychological, and health …

Editorial – Dec 2025, Edwin Van Teijlingen, Rafat Jan

Journal of Asian Midwives (JAM)

No abstract provided.

Effect Of Focussing On Anastatica Hierochuntica Flower On Labour Pain, Duration Of Labour And Perceived Fatigue During Labour: Randomized Controlled Study, Emine Koç, Şükran Başgöl, Sümeyye Bal, Sabire Kirtiloğlu

Journal of Asian Midwives (JAM)

Background: Maternal fatigue and pain during labour can adversely affect the health of the mother, fetus, and newborn. Anastatica hierochuntica is a plant traditionally used in some cultures during childbirth rituals. When placed in water, the dried flower gradually unfolds and symbolically represents the opening of the uterus and birth canal. This study aimed to investigate the effect of focusing on the Anastatica hierochuntica flower during labour on labour pain, duration, and perceived fatigue.
Methods: This randomized controlled trial was conducted in the delivery unit of a mother-friendly hospital with 119 participants 60 in control group and 59 in intervention …

Factors Associated With Preterm Premature Rupture Of Membranes: A Case-Control Study In A Tertiary Hospital In Kabul, Afghanistan, Atia Sharif Nadi, Freshta Sharif Tawakkuli, Zainab Sharif Ezadi, Sayed Murtaza Sadat Hofiani, Shoaib Murtaza Sadat Naeemi, Ahmad Komail Frogh

Journal of Asian Midwives (JAM)

Background: It is essential to identify preterm premature rupture of membranes (PPROM) and its associated risk factors to reduce its impact. This study aims to find the demographic, reproductive, and obstetric factors associated with PPROM among women in Kabul, Afghanistan.
Methods: This case-control study was conducted over six months in 2023 at a tertiary hospital in Kabul, Afghanistan. We included 40 cases of PPROM and 80 controls without PPROM in this study. We used structured questionnaires to collect demographic, reproductive, and obstetric characteristics of the participants. To find the factors associated with PPROM, Logistic regression was performed using IBM SPSS …

A Scoping Review Of Maternal Active Smoking During Pregnancy And Low-Birth Weight, Naomi Sondang, Nindi Oktavia, Qorinah Estiningtyas Sakilah Adnani, Lani Gumilang, Hadi Susiarno, Victor Abiola Adepoju

Journal of Asian Midwives (JAM)

Background: Low-birth weight (LBW; < 2.5 kg) infants are at increased risk of early mortality, impaired growth, neuro-developmental delay and chronic disease later in life. Maternal behavior, especially cigarette smoking, remains one of the most modifiable determinants of birth weight. We therefore synthesized recent evidence on the association between active maternal smoking during pregnancy and LBW.
Methods: Following PRISMA guidance, we systematically searched PubMed, Scopus and ScienceDirect for the period January 2020 to 31 January 2025 for English-language observational studies that quantified the relationship between active prenatal smoking and LBW. Risk of bias was appraised, and findings were summarized narratively.
Results: In total 26,650 papers were found and eight eligible studies (four cohort, three cross-sectional, one case-control) from Asia, Europe and the Middle East were included. Across all designs and exposure metrics—self-report, exhaled carbon-monoxide, urinary cotinine, and cord-blood DNA-methylation, active smoking was consistently associated with …

Exploring Factors Informing The Choice Of Caesarean Sections Among Couples, And Healthcare Workers: A Case Of The Nairobi Hospital, Kenya, Mercy Mukubwa

MSc in Advanced Practice Midwifery

Background: A caesarean section (C/S) is a lifesaving procedure to reduce maternal and newborn morbidity and mortality. It is associated with more risks compared to a vaginal birth. The rates of C/S have been on an upward trend globally and are expected to continue to rise further. C/S predisposes neonates to poor outcomes, some of which could be life-threatening compared to vaginal birth. Similarly, C/S mothers are at greater risk for serious complications.

Objective: The primary objective of this study was to investigate the factors influencing the decision to undergo a caesarean section among couples and healthcare workers …

Lived Experiences Of Chemotherapy-Induced Nausea And Vomiting Among Patients Diagnosed With Cancer At Machakos Level Five Hospital, Nancy Njeri Kamau

MSc in Advanced Practice Nursing

Background: Chemotherapy-induced nausea and vomiting (CINV) remains one of the most prevalent and distressing adverse effects of cancer treatment, affecting a substantial proportion of patients and significantly compromising their physical functioning, nutritional status, treatment adherence, and overall quality of life. However, there is a paucity of localized evidence on the magnitude and functional burden of CINV among patients diagnosed with cancer receiving chemotherapy at county referral hospitals, such as Machakos Level 5 Hospital, hence the current study.

Aim of the study: The study aimed at exploring the lived experiences of chemotherapy induced nausea and vomiting among patients diagnosed with …

Determinants Of Mental Health-Seeking Behaviour Among Upgrading Nursing Students At The Aga Khan University, Kenya, Cecilia Wanjiru Ndungu

MSc in Advanced Practice Nursing

Background: Mental health challenges are increasingly recognised, and nursing students often report higher stress and anxiety than other peers.Working nurses in upgrading programmes face additional pressure from balancing work, study and family,yet remain under-studied. At Aga Khan University in Kenya, the determinants influencing mental health-seeking behaviour among upgrading nursing students have not been documented, which is critical for addressing mental health needs. This study aimed to investigate the biological, psychological, and sociological factors influencing mental health-seeking behavior in this cohort.

Methodology: A descriptive cross-sectional study was conducted among 106 upgrading nursing students at AKU, utilizing structured questionnaires to …

Determinants Of Utilization Of Skilled Birth Attendant Among Women Of Reproductive Age In Habeswein Ward, Wajir County, Kenya, Suada Hassan

MSc in Advanced Practice Midwifery

Background: Maternal care provided by a skilled birth attendant (SBA) during pregnancy, at delivery, childbirth, and the postpartum period is vital for reducing maternal and neonatal mortality. In sub-Saharan Africa, the overall prevalence of usage of SBA in a 2021 study was 63%. Tanzania recorded the lowest rate at 13.8%, while Kenya registered 89.3% in 2023. However, disparities exist within Kenyan counties, for instance, in Wajir County only 57% of births were assisted by skilled health providers, a disparity that could be due to socio-cultural differences.

Aim: This study aimed to determine the factors influencing the utilization of skilled …

Perceived Stress And Coping Mechanisms Among Nurses Working In Oncology Inpatient Units At Kenyatta National Hospital, Bole Ado

MSc in Advanced Practice Nursing

Introduction: Cancer is the second leading cause of death globally and the third leading cause of death in Kenya. Nurses in oncology units often experience stress because of the emotionally demanding nature of providing care for patients diagnosed with cancer. Global studies show that nurses in the oncology unit reported experiencing moderate to extreme work-related stress, with a prevalence of work stress globally varying between 9.2% to 68% globally. Many nurses experience stress, and because of ineffective coping mechanisms, this affects their psychological well-being and negatively impacts the quality of their care as well as patients’ outcomes.

Objective of the …

Neonatal Unit Human Resources: Coverage For Six Cadres And Trends For Staff-To-Baby Ratios In 65 Neonatal Units Implementing With Nest360 In Kenya, Malawi, Nigeria, And Tanzania, Rebecca Penzias, Eric Ohuma, Opeyemi Odedere, Olabisi Dosunmu, George Okello, Hannah Mwaniki, Robert Tillya, Josephine Shabani, Vincent Ochieng, Ekran Rashid, William Macharia

Paediatrics and Child Health, East Africa

Background: Implementing small and sick newborn care (SSNC) requires skilled health workers; however, there is a shortage, adversely impacting patient outcomes and health worker wellbeing. There are limited data and no cur‑ rent World Health Organization (WHO) standards for staftobaby ratios in neonatal units in low and middleincome countries (LMICs) to inform policy, planning, and investment.

Methods: In 65 neonatal units (36 in Malawi, 13 in Kenya, 7 in Tanzania, and 9 in Nigeria), a health facility assessment (HFA) for SSNC and governmentled quality improvement (QI) processes were implemented. Stafng data were col‑ lated from baseline HFA (Sept 2019–March 2021) …

Stakeholders’ Perceptions Of The Roles And Regulations Of Advanced Practice Nursing And Advanced Practice Midwifery, Constance Shumba, Benard Mutwiri, Denis Munene, Rachel Kimani, Beatrice May, Isabel Kambo, Colette Henderson, Irene Mageto, Daniela Lehwaldt, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Background Advanced practice nursing (APN) and advanced practice midwifery (APM) in Kenya are critical in healthcare system strengthening by expanding access to quality care, particularly in underserved regions. Globally, the International Council of Nurses (ICN) defines APN as a level of nursing practice that requires a minimum of a master’s degree, along with advanced clinical training and competency. Similarly, APM involves midwives with advanced training to provide specialized maternal and neonatal care. In Kenya, the APN and APM concepts were launched in 2020 and are still nascent, and their practice is determined by the context as provided by the country …

Palliative Care Conditions Managed At Home And Self-Reported Challenges Experienced By Informal Home-Based Caregivers In Rwanda: A Qualitative Study, Jean Claude Twahirwa, Madeleine Mukeshimana, Margaret Fitch, Godfrey Katende

School of Nursing & Midwifery, East Africa

Introduction: A greater dependency on informal home-based caregivers to assist patients in their homes stems from Rwanda’s rising palliative care needs and the burden of terminal illnesses. These caregivers play a critical role in addressing patients’ physical and emotional needs and assisting with daily activities. However, in low-resource settings like Rwanda, limited attention has been given to understanding their lived experiences and the challenges they face. This study primarily aimed to explore the lived experiences and caregiving challenges of informal home-based caregivers providing palliative care. A secondary aim was to describe the range of life-threatening conditions being managed at home …

Economic Factors Influencing Utilization Of World Health Organisation-Recommended Anc Visits Among Women In Jordan: An Analysis Of Jordan Population And Family Health Survey 2023, Lilian Nuwabaine, Joseph Kawuki, John Baptist Asiimwe, Benjamin Betunga, Mathius Amperiize, Angella Namulema, Imelda Namatovu, Shamim Nabidda, Patience Annet Nakalega, Quraish Sserwanja

School of Nursing & Midwifery, East Africa

Background: Antenatal care (ANC) is crucial for reducing maternal and neonatal mortality by identifying and managing complications early during pregnancy. In 2016, the World Health Organization (WHO) updated its guidelines, recommending a minimum of eight ANC visits to improve maternal health outcomes. Despite Jordan’s efforts to enhance maternal healthcare, disparities in ANC utilization persist, particularly among vulnerable populations such as refugees. This study aimed to assess the economic factors influencing utilization of the WHO-recommended eight ANC visits among women in Jordan.

Methods: The study used data from the 2023 Jordan Population and Family Health Survey (JPFHS). A two-stage sampling technique …

Peer Education Programme To Improve Adolescent Sexual And Reproductive Health In Rwanda, Aimable Nkurunziza, Michael Habtu, Germaine Tuyisenge, Nadja Van Endert, Godfrey Katende, Assumpta Yamuragiye, Justine Bagirisano, B.H. Jean Hitayezu, Olive Tengera, Edward Rwagasore

School of Nursing & Midwifery, East Africa

Background: A peer education programme was developed in response to the tendency of high school students in Rwanda to seek sexual and reproductive health information from peers who are often inadequately informed.

Aim: To assess the effect of Sexual and Reproductive Health Peer Education Programme (SRH PEP) on knowledge and the attitudes of SRH among high school adolescents in Rwanda. Setting: The study was conducted at selected high schools in Rwanda.

Methods: This pre-test and post-test design study was conducted in two selected high schools. The pre-test data were collected in February 2020, followed by the post-test data in May …

Determinants Of Uptake Of Breast Cancer Screening Among Women Of Reproductive Age In Makueni County, Lola Ndirangu

MSc in Advanced Practice Nursing

Background: Breast cancer is the most diagnosed cancer in all women worldwide, with women in low and middle-income countries dying of the disease in disproportionate numbers because of late diagnosis and access to screening services. Sub-Saharan Africa is an under-researched area, and the level of screening uptake in Kenya, especially in rural and semi-arid areas, including Makueni County, is low. This research assessed the factors that determine the reproductive age women's screening uptake of breast cancer in Makueni County.

Methodology: The cross-sectional design was analytical and was conducted in Makueni County Referral Hospital, where 301 randomly chosen women …

Artificial Intelligence And Medical Education (2013-2024): A Scopus-Based Bibliometric Analysis, Festus Mulakoli, Edward Misava

School of Nursing & Midwifery, East Africa

Background: Artificial Intelligence (AI) is transforming medical education by enabling personalised learning, adaptive feedback, simulation-based training, and automated assessments. While AI offers significant benefits, including curriculum optimisation and virtual tutoring, concerns around data privacy, access, and ethical implementation persist. Although bibliometric studies have explored AI in healthcare, comprehensive analyses of global collaboration and publication trends in AI-focused medical education remain limited. Aim: This study aims to analyse global research trends, key contributors, and thematic developments in the application of AI within medical education. Methods: A bibliometric analysis was conducted using the Scopus database. The search strategy included terms …

Association Of Covid-19 Status With Maternal And Neonatal Outcomes Among Pregnant Women At Mombasa County Referral Hospital, Kenya, Salome Mghoi Rajab

MSc in Advanced Practice Midwifery

Background: COVID-19 pandemic has raised global concern regarding maternal and neonatal health owing to physiological and immunological changes that may heighten disease severity. Despite the global evidence linking COVID-19 infection with unfavorable pregnancy outcomes, data from Sub-Saharan Africa remain limited. This leaves an essential vacuum in our understanding of how COVID-19 status affects maternal and neonatal outcomes in counties like Mombasa, where health-care system problems may alter risks. Vertical transmission remains a puzzle to be solved.

Aim: To assess the association of COVID-19 status on maternal and neonatal outcomes between March 2020 to March 2022.

Methodology: A …

Assessing The Psychological Wellbeing And Resilience Of Frontline Health Workers In Uganda: A Cross-Sectional Study, Ahmed Sarki, Joseph Atukwatse, Gideon Mbithi, Sabina Odero, Mary Namuguzi, Bernard Mutwiri, Lestine Bitakwitse, Peninah Wachira, Kevinson Mwangi, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

Background: Health workers in the frontline are the major drivers of health systems in low- and middle-income countries. However, these health workers face both chronic and acute shocks and stressors that expose them to mental health problems which are often overlooked. We examined the prevalence of mental health problems, correlates of psychological functioning, and resilience of frontline health workers in Uganda.

Methods: We conducted a cross-sectional study comprising 1800 frontline health workers across all regions of Uganda from August through October 2023. We used tools such as the PC-PTSD-5, PHQ9, PSS, GAD-7, Oldenburg Burnout Inventory, and CD-RISC-10 to assess PTSD, …

The Relationships Between Sporadic And Repetitive Non-Suicidal Self-Injury And Mental Disorders Among First-Year College Students: Results From The World Mental Health International College Student Initiative, Penelope Hasking, Glenn Kiekens, Maria Petukhova, Yesica Albor, Ahmad Al-Hadi, Jordi Alonso, Nouf Al-Saud, Yasmin Altwaijri, Claes Andersson, Lukoye Atwoli

Brain and Mind Institute

Background: Non-suicidal self-injury (NSSI) is associated with mental disorders, yet work regarding the direction of this association is inconsistent. We examined the prevalence, comorbidity, time–order associations with mental disorders, and sex differences in sporadic and repetitive NSSI among emerging adults.

Methods: We used survey data from n = 72,288 first-year college students as part of the World Mental Health-International College Student Survey Initiative (WMH-ICS) to explore time–order associations between onset of NSSI and mental disorders, based on retrospective age-of-onset reports using discrete-time survival models. We distinguished between sporadic (1–5 lifetime episodes) and repetitive (≥6 lifetime episodes) NSSI in …

Behavior Change Communication Strategies On Human Immunodeficiency Virus /Acquired Immunodeficiency Syndrome Risk Reduction For Long-Distance Truckers In Kenya, Cyrus Mutie, John Gachohi, Kawira Kithuci, Grace Mbuthia

School of Nursing & Midwifery, East Africa

Background Long-distance truckers (LDTs) not only experience heightened risk of human immunodeficiency virus (HIV) infections due to risky sexual networks, but are also hard to reach with consistent risk reduction messages due to their often disruptive work schedules. Besides, evidence of the existing behavior change communication (BCC) strategies to enhance HIV/ acquired immunodeficiency syndrome (AIDS) risk reduction is limited. Thus, the study sought to explore the most effective and preferred BCC strategies for adoption among LDTs in Kenya.

Methods and Methodology Nine key informants and 18 in-depth interviews were used to gather qualitative data from purposively sampled participants at Kenya's …

End User Experiences Of An Electronic Health Records Platform In A Tertiary Hospital System In Kenya, Anmol Shrestha, Jasmit Shah, Zamanali Khakhar, Armando Ruiz, Zohray Talib, Sayed Karar

Internal Medicine, East Africa

Background: Electronic Health Record (EHR) systems allow health care facilities to provide better care to patients and improve overall provider efficiency. They are vital for low-and middle-income countries in achieving the United Nations Sustainable Development Goal of ensuring healthy lives and promoting the well-being of all their citizens. This study aimed to evaluate perceptions and usage of a comprehensive EHR by end-users after its deployment into a tertiary hospital system and its outpatient centers in Kenya and also aimed to understand the effectiveness of various implementation strategies deployed by the institution during their implementation process.

Methods: We conducted …

Factors Informing Referral Of Adult Patients To Palliative Care Services In A Tertiary Facility In Kenya: Physicians' Perspective, Donnah A. Opiyo

Master of Medicine in Family Medicine

Background The growing burden of chronic diseases underscores the urgent need for palliative care integration into healthcare systems worldwide. Despite its benefits, palliative care remains underutilized due to various barriers, including health system limitations, institutional challenges, infrastructure gaps, and individual provider factors. However, limited research has explored the specific factors influencing physicians' decisions to refer patients to palliative care. This study sought to fill that gap by examining the key determinants shaping referral practices in a tertiary facility in Kenya.

Design and Methods This exploratory qualitative study examined 22 physician specialists from five departments at Aga Khan University Hospital, Nairobi. …

Navigating Childhood Asthma Care In Kenya: Barriers Identified By Children And Their Caregivers, Joan Ahimbisibwe, Roselyter Riang’A, Angela Migowa, Samuel Otido

Paediatrics and Child Health, East Africa

Background: Asthma is one of the most common chronic conditions in children, with significant morbidity and mortality, especially in Africa. Achieving adequate asthma control in children remains challenging because of gaps between standard recommended management strategies and actual treatment practices. This study explored barriers to asthma management as perceived by children and their caregivers in a private tertiary care setting in Kenya.

Methods: An exploratory phenomenological qualitative study was conducted at Aga Khan University Hospital (AKUH), Nairobi. Children aged 6–18 years with a confirmed diagnosis of asthma and their caregivers were recruited. The participants had been receiving treatment for at …

Exploring Available Admission Criteria For A Bachelor Of Science In Nursing/Midwifery: A Scoping Review, Jackline Estomihi Kiwelu, Aminieli Usiri, Gadiel Ketto, Tumbwene Mwansisya, Eunice Pallangyo

Libraries

Background: Nursing and midwifery are crucial professions in healthcare systems, and the availability of well-trained professionals in these fields contributes to achieving global and national health goals. The process of equipping nurses and midwives with professional knowledge and skills starts with selecting candidates that are suitable for the profession, and able to complete nursing/midwifery education and become lifelong learners.

Objective: This study aimed to identify and document currently available admission criteria for a Bachelor of Science (BSc) in Nursing/Midwifery.

Methods: This scoping review used Arksey and O’Malley’s five-stage framework to explore admission criteria for BSc in Nursing/Midwifery …

From Diagnosis To Conception: Managing Polycystic Ovary Syndrome-Related Subfertility With A Multimodal Strategy: A Case Study, Uzma Akhtar, Shafiq Ur Rahman, Rafat Jan, Sumaira Naz

Journal of Asian Midwives (JAM)

Polycystic Ovary Syndrome (PCOS) is a leading cause of infertility, primarily due to anovulation caused by hormonal imbalances, insulin resistance, and disrupted ovarian function. This paper describes a 28-year-old woman with PCOS who presented with subfertility after failing to conceive for 10 months. Initial treatment involved Metformin for insulin resistance, vitamin D, folic acid, and Dydrogesterone for cycle regulation. Ovulation induction with Letrozole was initiated but showed a suboptimal response in three cycles. Success was achieved in the fourth cycle by combining Letrozole with injectable Menotropins (HMG), leading to improved follicular growth, endometrial thickness, and successful conception. This case highlights …

Post-Natal Mother’S Perception Of Health Care Workers’ Attitude In Calabar Municipality, Nigeria: A Study In Maternity Care, Inyang E. Eko, Ngozi P. Ogbonnaya, Peace C. Alichie, Stehanie C. Osuorah, Ezioma Lordson

Journal of Asian Midwives (JAM)

This study explores post-natal mothers’ perceptions of health care workers’ attitudes in Calabar Municipality, Cross Rivers State, Nigeria.
Methods: A cross-sectional design was adopted in which the target population of the study involves all post-natal mothers in Calabar Municipality, which amounts to 57229 women and 440 mothers. These women and mothers were selected from the accessible population which included women carefully chosen from three public health facilities - the University of Calabar Teaching Hospital (UCTH), the General Hospital of Calabar (GHC), and a primary health center in Big Qua using multistage stage sampling techniques. Data were collected using a …

What Is Midwifery Work In Low And Middle-Income Countries? A Systematic Review To Enhance Midwifery Practices In Resource-Constrained Contexts, Qorinah Estiningtyas Sakilah Adnani, Ela Nurfitriyani, S. Tr. Keb, Niken Bayu Argaheni, Rufidah Maulina, Victor Abiola Adepoju, Maeve O’Connell

Journal of Asian Midwives (JAM)

Background: Midwifery plays a crucial role in enhancing maternal and newborn health outcomes in low- and middle-income countries (LMIC). This systematic review aims to provide a comprehensive and evidence-based evaluation of midwifery practice in LMIC, beyond specific outcomes and interventions.
Methods: A systematic literature search was conducted using electronic databases including PubMed, Embassy, Scopus, Web of Science, and CINAHL, covering the period from 2019 to 2023. The search strategy employed predefined keywords and Medical Subject Headings (MeSH) terms related to midwives, maternal health, newborn health, and LMIC. The findings were analyzed using a narrative synthesis approach to identify key …

Editorial – July 2025, Edwin Van Teijlingen, Abeer Musaddique, Rafat Jan

Journal of Asian Midwives (JAM)

No abstract provided.

An Exploration Of The Effect Of Covid Restrictions On Maternity Care In Uganda, Hellen Kyakuwaire, Grace Edwards, Ahmed Mohammed Sarki

Journal of Asian Midwives (JAM)

Background: Uganda responded aggressively to the worldwide spread of COVID-19 by imposing a total lockdown, which forbade movement of the whole population, including pregnant women and other vulnerable groups. This phenomenological study explored pregnant women’s experiences during the total lockdown in Uganda and identified factors that influenced the quality of healthcare for pregnant women during the lockdown.
Methods: Thirty-two newly delivered women were selected across a wide geographical area to represent rural and urban areas. The sample was selected from women who had given birth at the selected health facilities from March 18, 2020, to April 30, 2020. …