African midwifery students’ self-assessed confidence in postnatal and newborn care: A multi-country survey

Sharma, Bharati; Christensson, Kyllike; Bäck, Lennart; Karlström, Annika; Lindgren, Helena; Mudokwenyu–Rawdon, Christina; Maimbolwa, Margaret; Laisser, Rose; Omoni, Grace; Chimwaza, Angela; Mwebaza, Enid; Kiruja, Jonah; Hildingsson, Ingegerd

doi:10.1016/j.midw.2021.103051

Cited by 10 publications

(5 citation statements)

References 19 publications

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“…Another gap was identified beyond labor and delivery and was present in immediate postnatal newborn care. Consistent with studies in Bangladesh (19) and India (30), immediately after birth, most neonates received all four elements of essential newborn care. Also, all newborns were examined and received vitamin K and full immunization.…”

Section: Quality Of Healthcare In the Postnatal Periodsupporting

confidence: 81%

“…Despite WHO recommending the provision of postnatal care for both the mother and baby ( 5 ), that it has a protective effect on neonatal death outcomes ( 31 ) and that postnatal care is an opportune time to provide care that prevents maternal and newborn deaths ( 30 ) there was a minimal implementation of WHO/UNICEF/UNFPA recommended standard interventions for postnatal newborn care, confirming the vulnerability of the neonates and their mothers around childbirth, immediately after birth, or in the postnatal period ( 32 – 35 ). The Namibia DHS reports similar low maternal postnatal care coverage within 48 h postdelivery ( 16 ), suggesting and confirming that the training provided to providers since then has not translated into improved actions around childbirth and immediate postnatal care.…”

Section: Discussionmentioning

confidence: 99%

“…Providers are also in constant direct contact with mothers and newborns (36). Yet, most staff in this study and other settings lack knowledge and skills in postnatal care (30) and breastfeeding management (3,37), implying that only a few staff members were capable providers. Thus, without providers' regular training/ refreshers on maternal and newborn care, quality care around birth will not improve.…”

Section: Quality Of Healthcare In the Postnatal Periodmentioning

confidence: 92%

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Baseline assessment of the WHO/UNICEF/UNFPA maternal and newborn quality-of-care standards around childbirth: Results from an intermediate hospital, northeast Namibia

Siseho

Mathole²,

Jackson³

2023

Front. Pediatr.

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BackgroundQuality of care around childbirth can reduce above half of the stillbirths and newborn deaths. Northeast Namibia’s neonatal mortality is higher than the national level. Yet, no review exists on the quality of care provided around childbirth. This paper reports on baseline assessment for implementing WHO/UNICEF/UNFPA quality measures around childbirth.MethodsA mixed-methods research design was used to assess quality of care around childbirth. To obtain good saturation and adequate women opinions, we purposively sampled the only high-volume hospital in northeast Namibia; observed 53 women at admission, of which 19 progressed to deliver on the same day/hours of data collection; and interviewed 20 staff and 100 women who were discharged after delivery. The sampled hospital accounted for half of all deliveries in that region and had a high (27/1,000) neonatal mortality rate above the national (20/1,000) level. We systematically sampled every 22nd delivery until the 259 mother–baby pair was reached. Data were collected using the Every Mother Every Newborn assessment tool, entered, and analyzed using SPSS V.27. Descriptive statistics was used, and results were summarized into tables and graphs.ResultsWe reviewed 259 mother–baby pair records. Blood pressure, pulse, and temperature measurements were done in 98% of observed women and 90% of interviewed women at discharge. Above 80% of human and essential physical resources were adequately available. Gaps were identified within the WHO/UNICEF/UNFPA quality standard 1, a quality statement on routine postpartum and postnatal newborn care (1.1c), and also within standards 4, 5, and 6 on provider–client interactions (4.1), information sharing (5.3), and companionship (6.1). Only 45% of staff received in-service training/refresher on postnatal care and breastfeeding. Most mothers were not informed about breastfeeding (52%), postpartum care and hygiene (59%), and family planning (72%). On average, 49% of newborn postnatal care interventions (1.1c) were practiced. Few mothers (0–12%) could mention any newborn danger signs.ConclusionThis is the first study in Namibia to assess WHO/UNICEF/UNFPA quality-of-care measures around childbirth. Measurement of provider–client interactions and information sharing revealed significant deficiencies in this aspect of care that negatively affected the client’s experience of care. To achieve reductions in neonatal death, improved training in communication skills to educate clients is likely to have a major positive and relatively low-cost impact.

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Section: Quality Of Healthcare In the Postnatal Periodsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Quality Of Healthcare In the Postnatal Periodmentioning

confidence: 92%

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Baseline assessment of the WHO/UNICEF/UNFPA maternal and newborn quality-of-care standards around childbirth: Results from an intermediate hospital, northeast Namibia

Siseho

Mathole²,

Jackson³

2023

Front. Pediatr.

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“…However, in LMICs, there remains a scarcity of health workers trained to meet international standards, even among those holding the professional title of midwife (Hobbs et al, 2019 ; World Health Organization, 2019 ). Numerous midwifery institutions encounter difficulties in delivering high-quality teaching and learning experiences (Sharma et al, 2021 ; United Nations Population Fund et al, 2021 ; World Health Organization, 2019 ; Yigzaw et al, 2015 ), impacting the self-assurance and fundamental skills of midwifery students and recent graduates, particularly in critical obstetric domains (Ahmadi et al, 2018 ; Moller et al, 2022 ; Sharma et al, 2021 ). The quality of support provided by midwifery educators and clinical personnel poses a significant challenge to attaining excellence in midwifery education ((Berhe & Gebretensaye, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Barriers to clinical learning skills development among midwifery students and newly qualified midwives in Morocco: A qualitative study

Mramel,

El Alaoui,

El Janati Idrissi

2024

Belitung Nurs J

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Background: In Morocco, despite various initiatives to improve the quality of reproductive healthcare, the indicators remain unfavorable. To strengthen the skills of midwives and support the achievement of Millennium Development Goals (MDGs) 4 and 5 by 2030, Morocco has developed and implemented a competency-based training framework. However, there is a lack of information on the successful implementation of this program and its impact on the quality of student midwives’ preparation for practice. Objective: This study aimed to gain a deeper understanding and explore the barriers affecting the development of clinical learning skills among midwifery students and newly qualified midwives. Methods: This study employed a descriptive, exploratory qualitative approach. Data were collected through nine focus group discussions with 30 midwifery students and 24 newly graduated midwives between April and June 2023 from six higher education institutions in northern and central Morocco. Inductive content analysis was used to analyze the transcribed discussions. Results: The barriers varied between locations. Overall, the internship design was inadequate, and the clinical environment was insufficient. Participants highlighted limited opportunities to experience the full range of midwifery skills. However, most midwifery students and new graduates had deficient competencies in managing high-risk situations and emergencies. Conclusion: This work provides an overview of the nature and extent of the challenges faced by many student midwives in Morocco, resulting in newly graduated midwives being poorly prepared for the full range of midwifery practice. These findings can inform various initiatives to strengthen midwifery education at the global, regional, and national levels.

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“…Furthermore, in India, there is a serious deficit of nurses and midwives compared to international standards [13] at 0.5 per 1000 population which is quite low compared to high-income countries (7.1 per 1000 population) and other Southeast Asian region countries (1.5 per 1000 population) [3,14]. There is pronounced regional variation in the availability of ANMs ranging from 0.7 in Bihar and Telangana to 26.6 in Andhra Pradesh suggestive of a correlation with the health system performance [15,16]. Also, there are few regulations governing nursing, midwifery coexists with nursing, and the private health industry is responsible for 88% of nursing and midwifery education, which accentuates the challenge of deficiencies in regular curricular training [17,18].…”

Section: Introductionmentioning

confidence: 99%

Perceived Gaps in Academic Training and Expectations From Refresher Training in Primary Care Nurses at an Urban Metropolis in Northern India: A Qualitative Study

Basu,

Dwivedy,

Sharma

et al. 2023

Cureus

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BackgroundNursing professionals, comprising the largest workforce engaged in the primary healthcare system, play a pivotal role in addressing population health needs. However, gaps in the training of nurses and midwives in lower-middle-income countries may undermine their performance and necessary skill development for fulfilling key population health needs. Substantial challenges exist in improving the regular curricular and refresher training of diplomate nurses and midwives working in primary care facilities and supporting both clinical care and health promotion functions. The study objective was to conduct a gap analysis in the present nursing curriculum and training profile of general duty midwives working in urban primary health facilities and understand their expectations and preferences from the planned refresher training course. MethodsWe conducted a qualitative explorative study among General Nursing midwives (GNMs) working in urban primary health facilities in the Gurugram district of Haryana, India to conduct a gap analysis in their present curriculum and training preferences. ResultsA total of 17 nurses with a mean (SD) age of 33.52 (4.75) years and an average nursing work experience of 5.35 (0.56) years were interviewed in-depth. Lack of practical applicability, complex study material, inexperienced tutors, and weak English language comprehension were key barriers in the existing nursing curriculum. The nurses expressed willingness to participate in refresher training with varied expectations, although there existed a distinct preference for short, flexible, and blended online-offline modes of training. ConclusionsStrengthening GNM nursing education should be prioritized in Indian health settings with the focus on improving student comprehension through vernacular instruction when feasible, and capacity building of tutors, with avenues for continued training and education. There is also a need for strengthening the curriculum related to key emergent public health challenges related to non-communicable diseases and mental health, as also skills for client and patient counseling and communication.

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African midwifery students’ self-assessed confidence in postnatal and newborn care: A multi-country survey

Cited by 10 publications

References 19 publications

Baseline assessment of the WHO/UNICEF/UNFPA maternal and newborn quality-of-care standards around childbirth: Results from an intermediate hospital, northeast Namibia

Baseline assessment of the WHO/UNICEF/UNFPA maternal and newborn quality-of-care standards around childbirth: Results from an intermediate hospital, northeast Namibia

Barriers to clinical learning skills development among midwifery students and newly qualified midwives in Morocco: A qualitative study

Perceived Gaps in Academic Training and Expectations From Refresher Training in Primary Care Nurses at an Urban Metropolis in Northern India: A Qualitative Study

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