Nursing Commons^™

Indications And Outcomes Of Emergency And Elective Cesarean Section Deliveries In A Tertiary Care Hospital In Karachi, Pakistan: A Retrospective Study, Bakhtawar Muhammad Hanif Khowaja Bk, Sabahat Naz, Komal Valliani, Aqsa Nizar Maknojia, Asfa Anwer Ali, Mahek Zaheer Maknojia, Tabish Ali Shalwani, Sheikh Irfan Ahmed, Farida Mughal

Journal of Asian Midwives (JAM)

Background: This study identified major determinants of Cesarean-sections and the outcomes in one referral center.
Methods: A retrospective study was conducted at a tertiary healthcare facility and all women who had cesarean section between January 2020 to July 2021 were enrolled. A chi-square or independent t-test was used to compare maternal and pregnancy characteristics, and neonatal outcomes between emergency c-sections (EmCS) and elective c-sections (ElCS) groups. A multivariable logistic regression analysis compared indications and outcomes between the two groups.
Results: Among 767 women, there were 417 (54.4%) emergency and 350 (45.6%) elective cesarean sections. A multivariable logistic regression revealed that …

Impact Of Climate Change On Maternal Health In Pakistan: A Review Paper, Ihsan Ullah, Kiran Mubeen, Dilshad Begum, Rafat Jan

Journal of Asian Midwives (JAM)

Pakistan is one of the country’s most susceptible to the effects of climate change. Recent floods, heavy snowfall and rain have significantly impacted maternal and infant health. Indigenous women of child-bearing age especially those in rural areas are among the most vulnerable, facing food insecurity, disruptive food systems, rising food prices, and disrupted food production due to climate change. This review highlights a critical gap in research on indigenous women's maternal nutrition in the context of climate change, particularly in low- and middle-income countries. It emphasized the necessity for culturally responsive approaches and a deeper understanding of how climate change …

Maternal Care Providers’ Perspectives Of Selective Vs Routine Episiotomy, Uzma Akhtar, Salma Rattani, Rahila Meghani, Nadeem F. Zuberi

Journal of Asian Midwives (JAM)

Background: Normal Vaginal delivery is considered the favorable mode of delivery, but perineal trauma due to episiotomy is a significant concern in obstetric care nowadays. Although, routine episiotomy practice is discouraged because there is no evidence regarding its benefits, the rate of episiotomy is very high especially in lower-middle-income countries as compared to recommended rate given by the World Health Organization (WHO) which is 10% of all normal vaginal deliveries.
Method: Utilizing Preferred Reporting Items for Systematic Reviews and Meta-Analyses. (PRISMA) guidelines, the study searched for appropriate literature on Investigating Healthcare Professionals' Views on Selective versus Routine Episiotomy. Significant databases: …

Editorial – Dec 2024, Edwin Van Teijlingen, Abeer Musaddique, Rafat Jan

Journal of Asian Midwives (JAM)

No abstract provided.

Enhancing Respiratory Health With Post-Yoga Exercises During Pregnancy, Hiromi Ito-Kaneko, Masayuki Uehara

Journal of Asian Midwives (JAM)

Pregnancy results in enlarged uterus and diaphragm elevation, which may cause shallow breathing. These changes often cause nocturnal dyspnea, chest discomfort, and difficulty breathing, especially late pregnancy. Training of pregnant women for extending their exhalation reduces suffocation during movement, increasing comfort during pregnancy. In prenatal yoga, deep breathing is practiced and has a relaxing effect.
The purpose of this study is to determine whether yoga exercises during pregnancy improves exhalation length.
We enrolled 152 pregnant women and used a chronograph to measure their exhalation length pre- and post-yoga exercises and compared exhaled breath length by gestational age group. The pre-yoga …

The Role Of Midwives In Achieving The Global Sustainable Development Goals, Bakhtawar Muhammad Hanif Khowaja Bk, Elizabeth K. Darling

Journal of Asian Midwives (JAM)

The sustainable development goals (SDGs) provide a comprehensive framework for global development. Midwives are playing an important role in achieving the targets of the world’s priority agendas. They are actively involved in achieving the targets of SDG#2 by providing education to women on their nutritional requirements, supporting postnatal women with breastfeeding, and educating communities on the use of clean water, sanitation, and hygiene management. Beyond counseling and educating communities on nutrition and hygiene management, they are also involved in improving other health-related outcomes that are indicators for SDG#3, such as improving maternal and child immunization, counseling mothers on tobacco …

Factors Influencing Colostrum Avoidance In Developing Countries: Insights From A Literature Review, Muhammad Zeeshan Aslam, Jonathan Johnson, Marina Baig, Abeer Musaddique

Journal of Asian Midwives (JAM)

Introduction: Colostrum is a thick, sticky, clear and yellowish-coloured milk produced after the first few hours of birth until day 3. It consists of vitamin A, proteins, lipids, potassium, and maternal antibodies, including lactoferrin, immunoglobulin, growth factors and antimicrobial factors. Colostrum avoidance is the practice of squeezing out, pumping, and discarding the first milk. Various studies have reported colostrum avoidance worldwide, but its prevalence is higher in developing countries. Every day, approximately 3000 to 4000 infants die due to diarrhea and respiratory infections in developing countries, and one of the leading causes is colostrum avoidance. Infants are unable to take …

Compassionate Care In Times Of Loss: Unraveling Nurses’ And Midwives’ Perspectives To Assess Preparedness In Stillbirth: A Review Article, Nabila Salim Ali, Arusa Lakhani, Salma Rattani, Sidrah Nausheen

Journal of Asian Midwives (JAM)

Perinatal death, including stillbirth, is a tragic event that significantly impacts holistically the well-being of affected families, particularly in low-middle-income countries (LMICs), where the incidence is alarmingly high. This paper explores the profound effects of stillbirth on parental mental health, emphasizing the associated risks of mental health challenges and examining the crucial role of nurses and midwives in managing stillbirth, from providing immediate emotional support to facilitating long-term coping strategies. Despite their essential role, they face significant challenges, including inadequate training, emotional burdens, and the need for culturally sensitive care practices. Through a comprehensive review of the literature, this paper …

Improve The Referral System Of Health Care Organizations In Rural Community Settings Of Pakistan Using Health Information Technology (Hit) - A Protocol, Saleema A. Gulzar, Alishah Aziz Gulzar, Zahid Ali Faheem, Ayesha Arif, Aamir Sarfaraz

Journal of Asian Midwives (JAM)

Pakistan is a developing country, with 65% of the population residing in rural areas. The rural population is considered vulnerable mainly due to several factors, including poverty. Climate change and the area's topography limit their access to basic human needs such as basic healthcare, affecting their quality of life. Most people lack basic information about the location and availability of healthcare facilities, including hospitals, diagnostic centres, pharmacies, and general clinics. Hence, the rural healthcare system lacks primary care physicians, nurses, midwives and allied health professionals. Inappropriate infrastructure makes it challenging to retain qualified professionals. A non-profit and non-governmental entity aims …

Kolcaba’S Comfort Theory: A Framework For Understanding The Significance Of Skin-To-Skin Care After Childbirth, Aqsa Nizar Ali

Journal of Asian Midwives (JAM)

Despite the WHO recommendations and evidenced-based results of skin-to-skin contact, it is quite an uncommon practice witnessed after childbirth. Compared to research conducted in low and middle-income nations, the majority of the studies conducted in high-income countries revealed greater rates of SSC [11]. Skin-to-skin contact, a nurturing practice, has gained significant recognition as a cornerstone of early infant care. Beyond its physiological benefits, skin-to-skin contact fosters a profound sense of comfort and connection between mother and infant. Kolcaba's theory of comfort, a comprehensive framework for understanding and promoting comfort, provides a valuable lens to explore the multifaceted benefits of skin-to-skin …

Management Of Possible Serious Bacterial Infections In Young Infants Where Referral Is Not Possible In The Context Of Existing Health System Structure In Mbeya, Tanzania: Experience And Lessons From The End Line Assessment, Esther Ngadaya, Alexander Manu, Mary Mmweteni, Dorica Burengelo, Doreen Philbert, Gibson Kagaruki, Kahabi Isangula, Mbazi Senkoro, Godfather Kimaro, Amos Kahwa

School of Nursing & Midwifery, East Africa

Severe bacterial infections (SBIs) are a leading cause of neonatal deaths in low- and middle-income countries. World Health Organization’s (WHO’s) guideline for outpatient management of danger signs indicating possible serious bacterial infections (PSBI) when referral is not possible was adopted by three pilot district councils in Mbeya Region, in Tanzania (Busekelo, Kyela and Mbarali Districts) in 2018 (the PSBI project). This study documented changes in practice during the PSBI project, and lessons learned. A cross-sectional study was conducted using both qualitative and quantitative data collection methods between July 2021 and January 2022, post-implementation. The study participants comprised stakeholders, health workers, …

An Evaluation Of The Effectiveness Of An Updated Pre-Service Midwifery Curriculum Integrated With Emergency Obstetric And Newborn Care In Kenya: A Cluster Randomised Controlled Trial, Duncan N. Shikuku, Catherine Mwaura, Peter Nandikove, Alphonce Uyara, Helen Allott, Lucy Waweru, Lucy Nyaga, Edna Tallam, Issak Bashir, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Introduction Quality midwifery education is central to improving midwifery service delivery and maternal and newborn health outcomes. In many settings, midwifery educators insufciently prepared for their teaching role and defcient curriculum compared to international standards afect the quality of healthcare provided by the midwifery graduates. This study assessed the efectiveness of an EmONC enhanced midwifery curriculum delivered by trained and mentored midwifery educators on the quality of education and student performance in Kenya.

Methods A cluster randomised controlled trial in 20 midwifery colleges (12 intervention, 8 control colleges). Educators in both arms received training in teaching/EmONC skills to deliver the …

Effectiveness Of Clinical Training In Influencing The Outcome Of Visual Inspection With Acetic Acid In Selected Facilities At A County In Kenya, Evah Maina, Abednego Ongeso, Nancy Maingi

School of Nursing & Midwifery, East Africa

Background: Cervical cancer remains a major health concern in developing countries, primarily due to the presence of human papillomavirus (HPV) types 16 and 18. Visual Inspection with Acetic Acid (VIA) is a common and affordable screening method, yet its effectiveness is closely tied to the skills and competency of healthcare providers. This study aimed to assess the impact of clinical training on improving VIA screening outcomes for cervical cancer in a county in Kenya.

Methods: Seven government health facilities equipped with cryotherapy machines were selected, with two healthcare providers sampled from each. A six-day VIA training intervention was conducted, combining …

Factors Associated With Quality Of Postnatal Care In Kenya: An Analysis Of The 2022 Kenya Demographic And Health Survey, Lilian Nuwabaine, Angella Namulem, Quraish Sserwanja, Joseph Kawuki, Earnest Amwiine, Mathius Amperiize, Grace Nakate, John Baptist Asiimwe

School of Nursing & Midwifery, East Africa

Introduction: Despite the significant contribution of postnatal care (PNC) to maternal and newborn survival, few studies have explored the concept of the quality of PNC received by mothers in Kenya. Therefore, this study aimed to determine the prevalence and factors associated with the quality of PNC in Kenya.

Methods: Secondary data from the Kenya Demographic and Health Survey (KDHS) of 2022 were analyzed, comprising 11,863 women who were aged 15 to 49 years. The quality of PNC was indicated as receiving all components of PNC in the first two days after childbirth. Multivariable logistic regression was conducted to determine the …

Quality Of Newborn Care And Associated Factors: An Analysis Of The 2022 Kenya Demographic And Health Survey, John Baptist Asiimwe, Earnest Amwiine, Angella Namulema, Quraish Sserwanja, Joseph Kawuki, Mathius Amperiize, Shamim Nabidda, Imelda Namagembe, Lilian Nuwabaine

School of Nursing & Midwifery, East Africa

Kenya one of the African countries has pledged to reduce neonatal death as per the 2030 World Health Organization target. Providing high-quality newborn care is critical in minimizing neonatal mortality. This study aimed to determine the factors that influence the quality of newborn care in Kenya. Secondary data from 11,863 participants of the 2022 Kenya Demographic and Health Survey (KDHS) were analyzed. The participants were chosen using two-stage stratified sampling. The quality of newborn care was operationalized as receiving all components of newborn care after childbirth, as reported by the mother. Using SPSS (version 29), univariate and multivariable logistic regression …

Factors Influencing Abortion Care-Seeking Outside Of Formal Healthcare Settings: Lived Experiences From Rwandan Young Women, Jean Pierre Ndayisenga, Assumpta Yamuragiye, Abe Oudshoorn, Godfrey Katende, Aimable Nkurunziza, Olive Tengera, Jean Bosco Henri Hitayezu, Justine Bagirisano, Jeanne D’ Arc Ayinkamiye, Gilbert Uwitonze

School of Nursing & Midwifery, East Africa

Background: Informal abortions, commonly known as unsafe abortions, refer to all induced abortions that occur outside of formal healthcare settings conducted without the assistance of a licensed, trained healthcare provider. Despite the legalization of safe induced abortion care services, informal abortions continue to be among the major causes of maternal mortality and morbidity among young women in Rwanda living in rural areas with limited or no access to safe abortion care services. The purpose of this qualitative study was to gain an in-depth understanding of the lived experience of seeking informal abortions from the perspective of young women in …

Academic Partnerships In Transforming Nursing And Midwifery Education In Africa: A Systematic Scoping Review Protocol, Claudine Muraraneza, Donatilla Mukamana, Godfrey Katende, Oliva Bazirete, Liz Wolvaardt

School of Nursing & Midwifery, East Africa

Background. In recent decades, the literature on global partnerships in nursing and midwifery education, to enhance the quality of education and produce competent graduates in the labor market, is on the rise in Africa. However, there is a gap regarding the best practices and barriers in the African context. This systematic scoping review aims to map the evidence of academic partnerships in transforming nursing and midwifery education in Africa.

Methods. The review will be guided by Arksey and O’Malley’s methodology framework through five stages: (1) Identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, …

Peer Counseling For Perinatal Depression In Low- And Middle-Income Countries: A Scoping Review, Alexander Cuncannon, Kailyn Seitz, Aneel Signh, Aliyah Dosani

Brain and Mind Institute

Perinatal depression is associated with adverse maternal, newborn and child health outcomes. Treatment gaps and sociocultural factors contribute to its disproportionate burden in low- and middle-income countries (LMICs). Task-sharing approaches, such as peer counseling, have been developed to improve access to mental health services. We conducted a scoping review to map the current literature on peer counseling for perinatal women experiencing depression in LMICs. We searched CINAHL, MEDLINE, APA PsycINFO, Global Health and EMBASE for literature with no date limits. We included 73 records in our analysis, with most being systematic reviews and meta-analyses, randomized controlled trials and qualitative studies. …

A Scoping Review Of Substance Use Brief Interventions In Africa, Florence Jaguga, Sarah Kiburi, Eunice Temet, Matthew Aalsma, Mary Ott, Rachel Maina, Cyprian Mostert, Lukoye Atwoli, Juddy Wachira, Gilliane Kosgei

Internal Medicine, East Africa

Background: The burden of substance use in Africa is substantial. Brief interventions (BIs) are a recommended public health strategy for the prevention and early intervention for substance use problems. The objective of this scoping review was to map the literature on substance use BIs in Africa, identify gaps, and provide directions for future research.

Methods: The scoping review was guided by the Arksey O’Malley Framework and the PRISMA-Scoping review (PRISMA-ScR) guidelines. A search of five bibliographic databases (PubMed, PsychINFO, Web of Science, Cumulative Index of Nursing and Allied Professionals (CINAHL) and Cochrane Library) was conducted from inception until 1st November …

Vaccine Decision-Making Among Pregnant Women: A Protocol For A Cross-Sectional Mixed-Method Study In Brazil, Ghana, Kenya And Pakistan, Jessica Schue, Prachi Singh, Berhaun Fesshaye, Emily Miller, Shanelle Quinn, Ruth Karron, Renato Souza, Maria Laura Costa, Ferdinand Okwaro, Marleen Temmerman

Centre of Excellence in Women and Child Health

Maternal immunization is a critical strategy to prevent both maternal and infant morbidity and mortality from several infectious diseases. When the first COVID-19 vaccines became available during the pandemic, there was mixed messaging and confusion amongst the broader public and among those associated with health care systems about the recommendations for COVID-19 vaccinations in pregnancy in many countries. A multi-country, mixed-methods study is being undertaken to describe how vaccine decision-making occurs amongst pregnant and postpartum women, with a focus on COVID-19 vaccines. The study is being conducted in Brazil, Ghana, Kenya, and Pakistan. In each country, participants are being recruited …

Determinants Of Quality Antenatal Care Use In Kenya: Insights From The 2022 Kenya Demographic And Health Survey, John Baptist Asiimwe, Angella Namulem, Quraish Sserwanja, Joseph Kawuki, Mathius Amperiize, Earnest Amwiine, Lilian Nuwabaine

School of Nursing & Midwifery, East Africa

Provision of quality antenatal care (ANC) is important to reduce maternal and newborn fatalities worldwide. However, the use of quality ANC by women of reproductive age and associated factors remain unclear in many developing countries. Therefore, this study aimed to determine factors associated with receiving quality ANC in Kenya among women of reproductive age. We analyzed secondary data from the 2022 Kenya Demographic Health Survey, which included 11,863 women. Participants were selected using two-stage stratified sampling. Univariate and multivariable logistic regression analyses were used to analyze the data. Of the 11,863 participating women, 61.2% (95% confidence interval (CI): 59.7%–62.6%) received …

Assessing Nurse Educators' Competencies For Adopting Blended Learning In The Skills Labs In Uganda's Public Nursing Schools, Eva Kakonge Nampiima, Mathias M Bwanika Ulumba, Musisi Badru, Grace Nakate

School of Nursing & Midwifery, East Africa

Blended learning has become an integral part of nursing education, offering a blend of online and face-to-face instruction that enhances learning experiences, particularly within skills labs. However, the effectiveness of blended learning largely depends on the competencies of nurse educators in utilizing digital tools and methodologies. This study assessed the competencies of nurse educators in Uganda's public nursing schools concerning blended learning adoption. Data was collected from 40 randomly selected nursing educators in 4 public nursing schools in Uganda. The findings indicate significant inadequacies: only 25% are proficient with Learning Management Systems (LMS) like Moodle, 20% can effectively use platforms …

World Allergy Organization (Wao) Diagnosis And Rationale For Action Against Cow's Milk Allergy (Dracma) Guideline Update – Xi – Milk Supplement/Replacement Formulas For Infants And Toddlers With Cma – Systematic Review, Antonio Bognanni, Ramon Firmino, Stefania Arasi, Derek Chu, Alexandro Chu, Siw Waffenschmidt, Arnav Agarwal, Piotr Dziechciarz, Andrea Horvath, Rose Kamenwa

Paediatrics and Child Health, East Africa

Background: Cow's milk allergy (CMA) is the most complex and common food allergy in infants. Elimination of cow's milk from the diet and replacement with a specialized formula for infants with cow's milk allergy who cannot be breastfed is an established approach to minimize the risk of severe allergic reactions while avoiding nutritional deficiencies. Given the availability of multiple options, such as extensively hydrolyzed cow's milk-based formula (eHF-CM), aminoacid formula (AAF), hydrolyzed rice formula (HRF), and soy formula (SF), there is some uncertainty regarding which formula might represent the most suitable choice with respect to health outcomes. The addition of …

Covid-19 Lockdowns: A Catalyst For Rethinking Assessments In Skill-Based Nursing Courses, Zeenar Salim, Anil Khamis, Shanaz Cassum, Zohra Kurji, Pammla Petrucka

Book Chapters / Conference Papers

No abstract provided.

E-Gaming: An Active Learning Pedagogy For Engaging Learners In A Private University In Karachi, Pakistan, Laila Akber Cassum, Syeda Sadia Fatima

School of Nursing & Midwifery

There is a radical shift in teaching and learning pedagogies to engage the learners in healthcare profession. It was a tough challenge for Pakistani educators of an esteemed university to motivate and assess the learners for concept absorption and critical reasoning using creative approaches. Teaching and learning styles have changed fundamentally from conventional teacher centred to inquiry-based student-centred approach. Classroom teaching in recognised nursing and medical institutes in Pakistan have transformed to blended and entirely online methodologies with the integration of diverse active learning strategies. The educators grapple to engage the millennials and to encounter this, gaming technological platform was …

Stress And Its Associated Factors In Mothers With Preterm Infants In A Private Tertiary Care Hospital Of Karachi, Pakistan, Salima Akbar, Yasmin Parpio, Sumia Andleeb Abbasi, Tazeen S. Ali

Journal of Asian Midwives (JAM)

Background: Preterm births are the leading cause of death worldwide. Preterm births not only have devastating effects on the newborn, but they also have psychological effects on the mothers. Identifying stress related to preterm births, and the factors associated with the stress among mothers with preterm infants is of great importance, for providing sound care to the newborns and their mothers. The aim of this protocol paper outlines an extensive approach to assess the level of stress and its associated factors among mothers with preterm infants.
Methods: An analytical cross sectional study design will be used to achieve the study …

Exploring Maternal Perspectives On Human Milk Banks In Pakistan And Identifying Barriers And Enablers For Establishment, Hina Baba Jan, Naghma Rizvi, Kiran Mubeen, Marina Baig

Journal of Asian Midwives (JAM)

Background: Low-and middle-income countries including Pakistan still have low breastfeeding rates and infant feeding remains a concern. Human milk banks (HMBs) play a crucial role in neonatal and infant health by providing safe, pasteurized donor human milk to infants who do not have access to their mother's own milk, particularly preterm and low-birth-weight infants. The perception regarding the concept and use of HMBs has yet to be explored in several contexts, especially in the low-and middle-income countries including Pakistan.
Aim: To explore the perceptions of mothers regarding human milk banks in Pakistan, focusing on the barriers and enablers to …

Assessing Association Between Socio-Demographic Variables And Contraceptive Usage In Married Men Residing In Korangi District, Karachi, Pakistan, Fahmida Khawaja, Gloria Noble Khan, Alia Nasir, Kiran Khowaja

Journal of Asian Midwives (JAM)

Background: Population growth remains an alarming concern for Pakistan as it not only exhausts scarce resources but further impedes socioeconomic development. One potential solution is to advance modern Family Planning (FP), which in the Pakistani context requires specific and rigorous attention towards male contraception in conjunction with female family planning usage. This study aims to determine the association between socio demographic factors and contraceptive use in married men of squatter settlement of Korangi Karachi.
Methods and Materials: A cross-sectional study was carried out from March, 2017 to June 2017, using a non-probability convenience sampling technique to select married men …

Balancing Life After Spousal Loss: A Cross-Sectional Study Investigating The Mental Well-Being And Life Satisfaction Of Martyrs’ Wives, Mehreen Aslam, Ambreen Tharani, Yasmin Parpio, Rafat Jan

Journal of Asian Midwives (JAM)

Background: The wives who have lost their spouses in conflict zones are known as martyrs’ wives. After sacrificing the martyrs’ lives, their wives not only face the traumatic experience of losing their loved ones, but this loss may substantially affect their physical, socioeconomic, and emotional health. It may serve as a "vulnerability factor," raising the risk of depression.
Objective: To assess the levels of life satisfaction and mental well-being within the wives of martyrs residing in Karachi, Pakistan.
Methodology: A descriptive cross-sectional study was conducted to assess the mental well-being and life satisfaction of martyrs’ wives living in Karachi Pakistan. …

The Effectiveness Of Nurse Assistants Training Programme On Safe Motherhood: A Study On Bhutanese Nurse Assistants, Jureerat Kijsomporn, Nualyai Pitsachart, Phayong Thepaksorn, Ling Shing Wong, Vinodhkumar Ramalingam, Voon Wan Niu

Journal of Asian Midwives (JAM)

Background: This study aims to investigate the ability of nurse assistants in midwifery care in Bhutan to apply their knowledge and skills after attending the training programme.
Methods: A qualitative methodology was utilized in this study, in-depth interviews using a semi-structured interview guide questionnaire with five nurse assistants, three district health officers, and two medical doctors from hospitals. The interviews (n=10) were conducted on-site at basic health units in URA and Tang, Bhutan.
Results: The data analysis of their perceptions yielded three major categories: (1) Confirmability, the Quality of knowledge and skills of the program; (2) Credibility, Effectiveness, and comprehensiveness …