| 1. |
- Hildingsson, Ingegerd, et al.
(författare)
-
African midwifery students’ self-assessed confidence in antenatal care : a multi-country study
- 2019
-
Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 12:1
-
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.
|
|
| 2. |
- Lindgren, Helena, et al.
(författare)
-
The three pathways to becoming a midwife : self-assessed confidence in selected competencies in intrapartum care from seven African countries
- 2021
-
Ingår i: African Journal of Midwifery and Women's Health. - : Mark Allen Group. - 2052-4293. ; 15:1, s. 1-10
-
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.
|
|
| 3. |
- Maimbolwa, Margaret C
(författare)
-
Maternity care in Zambia : with special reference to social support
- 2004
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The Zambian woman starts childbearing early and gives birth to an average of 5.9 children during her reproductive period. The already high levels of maternal deaths are increasing in Zambia. Only 43 per cent of the women deliver with the assistance of a skilled attendant. Maternity care is in focus in this thesis because of the crucial impact it may have on childbearing women and their newborns' health. The aim of this thesis is to describe prevalent maternity care routines during normal childbirth in Zambian maternities and the views of staff, newly delivered mothers and social support women (relatives, friends) on providing extra social support to labouring women. The aim is also to measure the effects of extra social support to primiparous women during labour, on labour outcome and mothers' early childbirth and breastfeeding experiences. A cross-sectional study, including primi- and multiparous women (n=84), health staff (n=40), and social support women (n=36) were carried out at the University Teaching Hospital (UTH) in Lusaka, at two Urban Health Centres in Lusaka, and at eight district hospitals in the Southern Province of Zambia. A Randomised Control Trial was performed at UTH and 299 healthy primigravidae women attending antenatal care were randomised to routine labour and delivery care (Group I) or offered to have extra social support during labour by a female companion, social support person (Group II) or a doula (Group 111). Observations, semi-structured interviews and questionnaires, record reviews and field notes were used to collect data. It was found that the maternity routines were not evidence-based and culturally appropriate. Labouring women were confined to bed during the whole labour and delivery period. Food and drinks were withheld, and no gowns to maintain women's privacy were provided. Foetal monitoring was inconsistent and the partograph was either not used or partly lacking. All women were delivered in a lithotomy position and there was lack of support for early motheribaby contact, prevention of hypothermia in the babies and early initiation of breastfeeding. None of the women were allowed to have any companion present during labour (Paper I). Newly delivered mothers expressed a desire for having a supporting person present during labour to provide emotional and practical support. Those who were not in favour of the idea gave reasons such as relatives would interfere with the care provided. Health care staff cited hospital policy and administration of traditional medicine as reasons for not allowing a social support person to stay with a labouring woman (Paper II). The majority of the social support women accompanying pregnant women to maternity units were aware of ongoing Zambian traditional childbirth practices and beliefs. Half of them considered themselves as traditional birth assistants (mbusas). They advised the pregnant women on the use of traditional medicine and sexual relations during pregnancy. One third of the social support women were in favour of the idea to give extra social support to labouring women in Zambian maternity units (Paper III). About 40 per cent of the primigravidae were adolescents (14-19 years of age) who had significantly less education than the older age groups (p=0.000). In total, 68 per cent were unemployed with inadequate living facilities and financial resources. The majority (78 %) had never used a family planning method and the main sources of information on sexual issues were friends and mass media. Sixty-three per cent made their first antenatal visit during the second trimester, and 22 per cent of the teenagers attended the antenatal clinic during the third trimester. Most of the women reported that they had a social support person, assisting them at home during the antenatal period and that a relative would escort them to a maternity unit, when labour commenced (Paper IV). There were significantly more use of analgesia (p=0.033), caesarean sections (p=0.010), and episiotomies (p=0.008) in the control group. Significantly, more mothers in the intervention groups perceived that they coped well with labour (p=0.000). There was no difference in labour outcome, whether a doula or a social support person (SSP) supported a labouring woman. There was no difference found in the groups regarding time of first breastfeeding after birth in the labour ward (Paper V). Significantly more mothers in the supported groups stated that their labour had been very easy (p=0.02) and more mothers in the supported groups had enjoyed their birth experience. All the mothers had had their infants 'skin-to-skin' contact with them, shortly after birth. More mothers in the supported groups reported that they were going to have enough milk for their babies (p=0.01). There were misconceptions about the value of colostrum and about one fourth of the mothers had had no or poor assistance from the staff regarding breastfeeding. Fifty-five per cent of the fathers (Groups I-III) had not seen their newborns before the mother and baby were discharged from the maternity unit (Paper VI). Implications for practice: Physiological, psychosocial, and cultural aspects including preparation for parenthood should be included in the plan of maternity care. Midwives should reorient their practices to evidence based and culturally appropriate care. Social support, including fathers of the newborn, should be encouraged in the practice of midwifery in Zambia.
|
|
| 4. |
- Sharma, Bharati, et al.
(författare)
-
African midwifery students' self-assessed confidence in postnatal and newborn care : A multi-country survey
- 2021
-
Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 101
-
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.
|
|
