| 1. |
- Balaile, Gunnel, et al.
(författare)
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Poverty and devastation of intimate relations : Tanzanian women's experience of living with HIV/AIDS
- 2007
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Ingår i: Journal of the Association of Nurses in AIDS Care. - : Ovid Technologies (Wolters Kluwer Health). - 1055-3290 .- 1552-6917. ; 18:5, s. 6-16
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Tidskriftsartikel (refereegranskat)abstract
- In Tanzania, women of reproductive age constitute the largest group infected by HIV. This study aimed to explore the lived experiences related to health and sexuality of Tanzanian women who had known their positive serostatus for I year. In-depth interviews with 10 women were analyzed using a phenomeno-logical-hermeneutic approach and showed frustration and despair at not having resources to maintain daily life. The women needed regular medical treatment for themselves and for their HIV-positive children. Their sexual desires had declined or vanished, and they had come to view sexuality as a source of transmittable disease. For some women, casual sex was an option to solve urgent financial needs. Happiness was something for their children, not for them. Access to social support from the women's community would help prevent further HIV transmission and enhance survival so the children could grow up with at least one devoted parent.
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| 2. |
- Hildingsson, Ingegerd, et al.
(författare)
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African midwifery students’ self-assessed confidence in antenatal care : a multi-country study
- 2019
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Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Evidence-based antenatal care is one cornerstone in Safe Motherhood and educated and confident midwives remain to be optimal caregivers in Africa. Confidence in antenatal midwifery skills is important and could differ depending on the provision of education among the training institutions across Africa. Objective: The aim of the study was to describe and compare midwifery students’ confidence in basic antenatal skills, in relation to age, sex, program type and level of program. Methods: A survey in seven sub-Saharan African countries was conducted. Enrolled midwifery students from selected midwifery institutions in each country presented selfreported data on confidence to provide antenatal care. Data were collected using a selfadministered questionnaire. The questionnaire consisted of 22 antenatal skills based on the competency framework from the International Confederation of Midwives. The skills were grouped into three domains; Identify fetal and maternal risk factors and educate parents; Manage and document emergent complications and Physical assessment and nutrition. Results: In total, 1407 midwifery students from seven Sub-Saharan countries responded. Almost one third (25-32%) of the students reported high levels of confidence in all three domains. Direct entry programs were associated with higher levels of confidence in all three domains, compared to post-nursing and double degree programs. Students enrolled at education with diploma level presented with high levels of confidence in two out of three domains. Conclusions: A significant proportion of student midwives rated themselves low on confidence to provide ANC. Midwifery students enrolled in direct entry programs reported higher levels of confidence in all domains. It is important that local governments develop education standards, based on recommendations from the International Confederation of midwives. Further research is needed for the evaluation of actual competence.
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| 3. |
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| 4. |
- Laisser, Rose, 1956-, et al.
(författare)
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Health-care workers’ attitudes and perceptions of intimate partner violence against women in Tanzania
- 2014
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Ingår i: African journal of midwifery and women's health. - : Mark Allen group. - 1759-7374 .- 2052-4293. ; 8:1, s. 28-35
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Tidskriftsartikel (refereegranskat)abstract
- A cross-sectional survey of 345 health-care workers and 312 students was conducted to explore attitudes and perceptions of intimate partner violence against women, and their views on care and prevention. All health-care workers and final-year students were included in the study. Students’ t-test was followed in the analysis using SPPSS computer program. Forty-three percent of female health-care workers recognised acts of controlling behaviour, while 68% of female students agreed to less than one statement justifying physical violence and 32% of men failed to recognise a woman's right to refuse sex. Ninety percent of both students and health-care workers had observed clients having unexplained feelings of sadness or loss of confidence. Between 45 and 70% of students and health-care workers believed that women exposed to violence were difficult to support. The study clearly indicates a need for adequate health-care resources, guidelines and training to influence a change of existing rigid gender norms.
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| 5. |
- Laisser, Rose M, 1956-, et al.
(författare)
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Community perceptions of intimate partner violence : a qualitative study from urban Tanzania
- 2011
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Ingår i: BMC Women's Health. - : BioMed Central. - 1472-6874. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Intimate partner violence against women is a prevailing public health problem in Tanzania, where four of ten women have a lifetime exposure to physical or sexual violence by their male partners. To be able to suggest relevant and feasible community and health care based interventions, we explored community members' understanding and their responses to intimate partner violence.METHODS: A qualitative study using focus group discussions with 75 men and women was conducted in a community setting of urban Tanzania. We analysed data using a grounded theory approach and relate our findings to the ecological framework of intimate partner violence.RESULTS: The analysis resulted in one core category, "Moving from frustration to questioning traditional gender norms", that denoted a community in transition where the effects of intimate partner violence had started to fuel a wish for change. At the societal level, the category "Justified as part of male prestige" illustrates how masculinity prevails to justify violence. At the community level, the category "Viewed as discreditable and unfair" indicates community recognition of intimate partner violence as a human rights concern. At the relationship level, the category "Results in emotional entrapment" shows the shame and self-blame that is often the result of a violent relationship. At the individual level, the risk factors for intimate partner violence were primarily associated with male characteristics; the category "Fed up with passivity" emerged as an indication that community members also acknowledge their own responsibility for change in actions.CONCLUSIONS: Prevailing gender norms in Tanzania accept women's subordination and justify male violence towards women. At the individual level, an increasing openness makes it possible for women to report, ask for help, and become proactive in suggesting preventive measures. At the community level, there is an increased willingness to intervene but further consciousness-raising of the human rights perspective of violence, as well as actively engaging men. At the macro level, preventive efforts must be prioritized through re-enforcement of legal rights, and provision of adequate medical and social welfare services for both survivors and perpetrators.
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| 6. |
- Laisser, Rose Mjawa, 1956-
(författare)
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Prevention of intimate partner violence : community and healthcare workers´ perceptions in urban Tanzania
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Intimate partner violence (IPV) against women is public health and human rights concern. The studies forming this thesis seek to understand healthcare worker and community attitudes and perceptions about IPV; their role in support, care and prevention of IPV, and the feasibility of introducing routine screening for IPV among women attending healthcare. Methods: Four interrelated studies were conducted in Temeke District, Dar es Salaam, Tanzania: 1) a content analysis of 16 in-depth interviews with healthcare workers about their experiences of meeting IPV clients, 2) a grounded theory analysis of seven focus group discussions that explore community perceptions, 3) a cross sectional study of 657 healthcare workers and students to understand their attitudes and perceptions about IPV and future roles in care and support, and 4) evaluation of a pilot intervention that introduces routine screening in an outpatient department. The pilot intervention included screening of 102 women, ten observations of healthcare worker interactions with women clients, three focus group discussions, and five narratives written by healthcare workers about their experiences with the screening tools. Results: Gender inequalities, attitudes, and poverty intersect in the explanation of IPV. Healthcare workers view low economic status among women, rigid gender norms, and stigma that influences women to stay in violent relationships. Alcohol abuse, multiple sexual partners and low levels of income among men were cited as triggers for IPV episodes. Between 20-67% of healthcare workers and students report meeting IPV clients at work. More than 9o% observed clients with unexplained feelings of sadness and/or loss of confidence. Resource and training limitations, heavy workloads and low salaries constrain services. A strong desire to make a difference in the care and support of IPV clients was present, but violence as a hidden agenda with a client resistance to disclosure was a challenge. The community study shows a transition in gender norms is making violence against women less acceptable. Conclusions and suggestions: Healthcare workers and the community strongly wish and are committed to support IPV prevention. Both groups understood the meaning, provocative factors and some IPV effects. This awareness contributes to their desire to be part of a change. At the central level, prevention of IPV should be on the governments’ policy agenda and should be prioritised. Education about gender-based violence must be incorporated into the curricula of healthcare workers. At community level, advocacy is necessary for changing harmful gender norms and measures to combat women’s poverty. Men should be engaged at all levels. Provision of information on the human rights perspectives of IPV should be strengthened and related to other types of violence.
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| 7. |
- Laisser, Rose M, 1956-, et al.
(författare)
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Screening of women for intimate partner violence : a pilot intervention at an outpatient department in Tanzania
- 2011
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Ingår i: Global Health Action. - : CoAction Publishing. - 1654-9716 .- 1654-9880. ; 4, s. Article nr 7288-
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Tidskriftsartikel (refereegranskat)abstract
- Intimate partner violence (IPV) is a public health problem in Tanzania with limited health care interventions.OBJECTIVES: To study the feasibility of using an abuse screening tool for women attending an outpatient department, and describe how health care workers perceived its benefits and challenges.METHODS: Prior to screening, 39 health care workers attended training on gender-based violence and the suggested screening procedures. Seven health care workers were arranged to implement screening in 3 weeks, during March-April 2010. For screening evaluation, health care workers were observed for their interaction with clients. Thereafter, focus group discussions (FGDs) were conducted with 21 health care workers among those who had participated in the training and screening. Five health care workers wrote narratives. Women's responses to screening questions were analyzed with descriptive statistics, whereas qualitative content analysis guided analysis of qualitative data.RESULTS: Of the 102 women screened, 78% had experienced emotional, physical, or sexual violence. Among them, 62% had experienced IPV, while 22% were subjected to violence by a relative, and 9.2% by a work mate. Two-thirds (64%) had been abused more than once; 14% several times. Almost one-quarter (23%) had experienced sexual violence. Six of the health care workers interacted well with clients but three had difficulties to follow counseling guidelines. FGDs and narratives generated three categories Just asking feels good implied a blessing of the tool; what next? indicated ethical dilemmas; and fear of becoming a 'women hospital' only indicated a concern that abused men would be neglected.CONCLUSIONS: Screening for IPV is feasible. Overall, the health care workers perceived the tool to be advantageous. Training on gender-based violence and adjustment of the tool to suit local structures are important. Further studies are needed to explore the implications of including abuse against men and children in future screening.
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| 8. |
- Laisser, Rose M, et al.
(författare)
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Striving to make a difference : health care worker experiences with intimate partner violence clients in Tanzania
- 2009
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Ingår i: Health Care for Women International. - : Informa UK Limited. - 0739-9332 .- 1096-4665. ; 30:1-2, s. 64-78
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Tidskriftsartikel (refereegranskat)abstract
- In this article we describe health care workers' (HCWs') experiences and perceptions of meeting clients exposed to intimate partner violence (IPV). Qualitative content analysis of in-depth interviews from 16 informants resulted in four main themes. The first, "internalizing women's suffering and powerlessness," describes HCWs' perceptions of violence, relating it to gender relations. The second, "caught between encouraging disclosure and lack of support tools," refers to views on possibilities for transparency and openness. The third, "Why bother? A struggle to manage with limited resources," illustrates the consequences of a heavy workload. Last; "striving to make a difference," emphasizes a desire to improve abilities to support clients and advocate for prevention.
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| 9. |
- Lindgren, Helena, et al.
(författare)
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The three pathways to becoming a midwife : self-assessed confidence in selected competencies in intrapartum care from seven African countries
- 2021
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Ingår i: African Journal of Midwifery and Women's Health. - : Mark Allen Group. - 2052-4293. ; 15:1, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- Background/AimsGlobally, there are three pathways to become a midwife: midwifery post nursing, direct entry midwifery and integrated nursing and midwifery. There is limited knowledge on the effectiveness of pre-service midwifery education. The aim of this study was to describe and compare midwifery students' confidence in intrapartum skills and associated factors such as type and level of education.MethodsA multi-country cross-sectional study was conducted, where midwifery students were approached in the final months of their education programme. Data were collected using a questionnaire, based on the basic skills by the International Confederation of Midwives. Intrapartum care comprised 40 skills.ResultsIn total, 1407 midwifery students from seven sub-Saharan countries responded. The 40 skills were grouped into six domains; three related to care during the first and second stage of labour and three related to care during the third stage of labour. Sex and age were significantly associated with confidence, with female students and those 26–35 years old having higher levels of confidence. Students enrolled in a direct entry programme were more confident than other students in all three domains of care related to the first and second stage of labour.ConclusionsDirect entry was found to result in higher confidence for midwifery students than post nursing programmes or integrated programmes. Further research is needed for evaluation of competence.
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| 10. |
- Sharma, Bharati, et al.
(författare)
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African midwifery students' self-assessed confidence in postnatal and newborn care : A multi-country survey
- 2021
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Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 101
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Tidskriftsartikel (refereegranskat)abstract
- Background: Majority of maternal and new-born deaths occur within 28 hours and one week after birth. These can be prevented by well-educated midwives. Confidence in postnatal and newborn care skills depend on the quality of midwifery education. Objective: To assess confidence and its associated factors for basic postnatal and new-born care skills of final year midwifery students , from seven African countries. Methods: A multi-country cross-sectional study where final year midwifery students answered a questionnaire consisting of basic skills of postnatal and newborn care listed by the International Confederation of Midwives. The postnatal care area had 16 and newborn care area had 19 skill statements. The 16 skills of postnatal care were grouped into three domains through principle component analysis (PCA); Basic postnatal care; postnatal complications and educating parents and documentation . The 19 skills under the newborn care area were grouped into three domains; Basic care and care for newborn complications; Support parents for newborn care ; and Care for newborns of HIV positive mothers and documentation. Results: In total 1408 midwifery students from seven Sub-Saharan countries participated in the study namely; Kenya, Malawi, Tanzania, Uganda, Zambia, Zimbabwe, and Somaliland Overall high confidence for all domains under Post Natal Care ranged from 30%-50% and for Newborn care from 39-55%. High confidence for postnatal skills was not found to be associated with any background variables (Age, sex, type and level of educational programme). High confidence for newborn care was associated with being female students, those aged 26-35 years, students from the direct entry programmes and those enrolled in diploma programmes. Conclusions: Almost half of the study participants expressed lack of confidence for skills under postnatal and newborn care. No association was found between high confidence for domains of postnatal care and background variables. High confidence was associated with being a female, between 26-35 years of age, from direct entry or diploma programmes for newborn care area. The results of the study indicate gaps in midwifery education. Countries could use the ICM list of competencies to develop country specific standards for midwifery education. However, actual competence remains to be measured.
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