scholarly journals Quality of pre-service midwifery education in public and private midwifery schools in Afghanistan: a cross sectional survey

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Partamin Manalai ◽  
Sheena Currie ◽  
Massoma Jafari ◽  
Nasratullah Ansari ◽  
Hannah Tappis ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Assessment Tool ◽  
Rapid Assessment ◽  
Newborn Care ◽  
Infrastructure Management ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Public And Private ◽  
Midwifery Education

Abstract Background Midwives are the key skilled birth attendants in Afghanistan. Rapid assessment of public and private midwifery education schools was conducted in 2017 to examine compliance with national educational standards. The aim was to assess midwifery education to inform Afghanistan Nurses and Midwives Council and other stakeholders on priorities for improving quality of midwifery education. Methods A cross-sectional assessment of midwifery schools was conducted from September 12–December 17, 2017. The Midwifery Education Rapid Assessment Tool was used to assess 29 midwifery programs related to infrastructure, management, teachers, preceptors, clinical practice sites, curriculum and students. A purposive sample of six Institute of Health Sciences schools, seven Community Midwifery Education schools and 16 private midwifery schools was used. Participants were midwifery school staff, students and clinical preceptors. Results Libraries were available in 28/29 (97%) schools, active skills labs in 20/29 (69%), childbirth simulators in 17/29 (59%) and newborn resuscitation models in 28/29 (97%). School managers were midwives in 21/29 (72%) schools. Median numbers of students per teacher and students per preceptor were 8 (range 2–50) and 6 (range 2–20). There were insufficient numbers of teachers practicing midwifery (132/163; 81%), trained in teaching skills (113/163; 69%) and trained in emergency obstetric and newborn care (88/163; 54%). There was an average of 13 students at clinical sites in each shift. Students managed an average of 15 births independently during their training, while 40 births are required. Twenty-four percent (7/29) of schools used the national 2015 curriculum alone or combined with an older one. Ninety-one percent (633/697) of students reported access to clinical sites and skills labs. Students mentioned, however, insufficient clinical practice due to low case-loads in clinical sites, lack of education materials, transport facilities and disrespect from school teachers, preceptors and clinical site providers as challenges. Conclusions Positive findings included availability of required infrastructure, amenities, approved curricula in 7 of the 29 midwifery schools, appropriate clinical sites and students’ commitment to work as midwives upon graduation. Gaps identified were use of different often outdated curricula, inadequate clinical practice, underqualified teachers and preceptors and failure to graduate all students with sufficient skills such as independently having supported 40 births.

scholarly journals Quality of Pre-Service Midwifery Education in Public and Private Midwifery Schools in Afghanistan: A Cross Sectional Survey

2021 ◽  
Author(s):  
Partamin Manalai ◽  
Sheena Currie ◽  
Massoma Jafari ◽  
Nasratullah Ansari ◽  
Hannah Tappis ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Assessment Tool ◽  
Rapid Assessment ◽  
Newborn Care ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Public And Private ◽  
Midwifery Education ◽  
Quality Aspects

Abstract Background Midwives are the key skilled birth attendants in Afghanistan. Rapid assessment of public and private midwifery education schools was conducted in 2017 to examine compliance with national educational standards. Aim was to assess midwifery education to inform Afghanistan Nurses and Midwives Council and other stakeholders priorities for improving quality of midwifery education. Methods A cross-sectional assessment was conducted from September 12–December 17, 2017, using a modified Midwifery Education Rapid Assessment Tool to assess education quality aspects related to infrastructure, management, teachers, preceptors, clinical practice sites, curriculum and students in 29 midwifery schools. A purposive sample of six Institute of Health Sciences schools, seven Community Midwifery Education schools and 16 private midwifery schools was used. Participants were midwifery school staff, students and clinical preceptors. Results Libraries were available in 28/29 (97%) schools, active skills labs in 20/29 (69%), childbirth simulators in 17/29 (59%) and newborn resuscitation models in 28/29 (97%). School managers were midwives in 21/29 (72%) schools. Median numbers of students per teacher and students per preceptor were 8 (range 2–50) and 6 (range 2–20). There were insufficient numbers of teachers practicing midwifery (132/163; 81%), trained in teaching skills (113/163; 69%) and trained in emergency obstetric and newborn care (88/163; 54%). There was an average of 13 students at clinical sites in each shift. Students managed an average of 15 births independently during their training, while 40 births are required. Twenty-four percent (7/29) of schools used the national 2015 curriculum alone or combined with an older one. Ninety-one percent (633/697) of students reported access to clinical sites and skills labs. Students mentioned, however, insufficient clinical practice, lack of education materials, transport facilities and disrespect from school teachers, preceptors and clinical site providers as challenges. Conclusions Positive findings included availability of required infrastructure, amenities, approved curricula in 7 of the 29 midwifery schools, appropriate clinical sites and students’ commitment to work as midwives upon graduation. Gaps identified were use of different often outdated curricula, inadequate clinical practice, underqualified teachers and preceptors and failure to graduate all students with sufficient skills such as independently having supported 40 births.

scholarly journals Assessing the Quality of Supervision Experiences in the Different Research Stages at Postgraduate Level

2018 ◽  
Vol 5 (2) ◽  
pp. 8 ◽  
Author(s):  
Tooba Saleem ◽  
Nasir Mahmood
Keyword(s):  
Survey Design ◽  
Personal Communication ◽  
Supervisory Relationship ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Public And Private ◽  
Workload Management ◽  
Research Supervision ◽  
Research Students

<p><em>The nature of supervisory relationship is dynamic that changes over the course of candidacy. Subsequently, the supervision demands of supervisees also change to help them in performing certain tasks at specific research stages. In this context, this research is proposed to investigate the supervision experiences of supervisees in four different research stages (i.e. Stage 1: developing synopsis, Stage 2: collecting data, Stage 3: writing thesis and Stage 4: submitted thesis). In the light of six supervision aspects (i.e. Project management, Intellectual support, pertinent research skills, Inter-personal communication skills, Workload management and Supportive skills) the quality of supervision was assessed from supervisees’ perspective. Cross-sectional survey design was used to assess the supervision experiences of (N=422) supervisees in four distinct stages of research supervision. The data were collected from 12 public and private universities of the Punjab. For this study, a multi-sectioned, self-constructed Supervisor-Supervisee Relationship Questionnaire (Saleem, 2014) was used. The findings of the study highlighted the need to train the supervisors to manage their time not just in terms of teaching and supervision of research students, but also keeping the stages of their research in mind. By addressing the stage specific needs of supervisees the quality of supervision could be improved.</em></p><p><strong>Keywords</strong>: quality of supervision, research stages, supervision dynamics, supervision experiences</p>

scholarly journals Evaluating equity in healthcare: pilot implementation of a self-assessment tool

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Chiarenza ◽  
D Domenig ◽  
S Cattacin
Keyword(s):  
Quality Of Care ◽  
Assessment Tool ◽  
Healthcare Providers ◽  
The Self ◽  
Vulnerable Groups ◽  
Service Users ◽  
Cross Sectional Survey ◽  
Self Assessment ◽  
Cross Sectional

Abstract Background Several sets of standards aiming at improving access and quality of care for service users have been published in recent years. Certain standards focused on improving healthcare providers’ responsiveness to specific target groups. The general goal of this research was to improve organisations’ awareness of equity standards that are not focused on specific groups, but on all contributing factors that put vulnerable groups at risk of exclusion. The specific objective was to evaluate the degree of compliance with a set of equity standards in 52 health care organisations from 16 countries. Methods A self-assessment tool (SAT) was developed to allow healthcare organisations to measure their capacity to provide equitable care for service users. The SAT indicates the main areas that should be addressed: equity in policy; equitable access and utilisation; equitable quality of care; equity in participation; promoting equity. A cross-sectional survey addressing participants from pilot-organisations was used for data collection, concerning both the self-reported compliance score with the standards, as well as the additional information provided to support the score assigned. Data were analysed quantitatively as well as qualitatively. Results The findings confirm that healthcare providers do invest in improving equity in the access and delivery of services to vulnerable groups. However, many health organisations have inadequate strategies to address inequities and are insufficiently engaged in improving equity in participation and promoting equity outside the organisation. Conclusions The participating organisations reported a significant impact from use of the self-assessment tool: some received the support from regional/national authorities to continue working on improving equity in healthcare; others linked the equity standards to existing performance-measurement strategies; others invested in new frameworks to improve service users engagement. Key messages The implementation of the SAT contributes to a self-reflective process, involving health professionals and managers, in which gaps and potential improvements are identified. Pilot organisations utilised the SAT as part of a process of increasing their awareness of equity issues and changing their organisational culture.

scholarly journals Evaluating the performance of South African primary care: a cross-sectional descriptive survey

2019 ◽  
Vol 61 (3) ◽  
pp. 77
Author(s):  
Graham Bresick ◽  
Klaus B. Von Pressentin ◽  
Robert Mash
Keyword(s):  
South Africa ◽  
Primary Care ◽  
South African ◽  
Assessment Tool ◽  
Health Workers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Assessment ◽  
First Contact

Introduction: In 2018 governments reaffirmed their commitment to implementing primary health care (PHC) in the Astana Declaration. South Africa has introduced a number of health reforms to strengthen PHC and enable universal health coverage (UHC). UHC requires access to quality primary care and progress needs to be measured. This study aimed to evaluate the quality of South African primary care using the Primary Care Assessment Tool (PCAT).Methods: A descriptive cross-sectional survey used data derived from a previous analytical observational study. Data from 413 patients, 136 health workers and 55 managers were analysed from 30 community health centres across four provinces of South Africa. Scores were obtained for 10 key domains and an overall primary care score. Scores were compared in terms of respondents, provinces and monthly headcount.Results: Patients rated first contact accessibility, ongoing care and community orientation as the poorest performing elements ( 50% scoring as ‘acceptable to good’); first contact utilisation, informational coordination and family-centredness as weaker elements ( 66% scoring as ‘acceptable to good’); and comprehensiveness, coordination, cultural competency and availability of the PHC team as stronger aspects of primary care (≥ 66% or more scoring as ‘acceptable or good’). Managers and providers were generally much more positive about the performance of PHC.Conclusion: Gaps exist between PHC users’ experience of care and what PHC staff believe they provide. Priorities to strengthen South African primary care include improving access, informational and relational continuity of care, and ensuring the implementation of community-orientated primary care. The PCAT is a useful tool to measure quality of primary care and progress with UHC.

scholarly journals The Status of Emergency Obstetric and Newborn Care in Post-Conflict Eastern DRC: A Facility-Level Cross-Sectional Study.

2020 ◽  
Author(s):  
Serge-André Uwunva MIZERERO ◽  
Calistus Wilunda ◽  
Patou Masika Musumari ◽  
Masako Ono-Kihara ◽  
Gerrye Mubungu ◽  
...  
Keyword(s):  
Newborn Care ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The North ◽  
Post Conflict ◽  
Who Standards ◽  
The Status ◽  
Republic Of The Congo

Abstract Background Pregnancy-related mortality remains persistently higher in post-conflict areas. Part of the blame lies with continued disruption to vital care provision, especially emergency obstetric and newborn care (EmONC). In such settings, assessment of EmONC is essential for informed interventions needed to improve maternal and neonatal survival. In the North Kivu Province (NKP), the epicentre of armed conflict in eastern Democratic Republic of the Congo (DRC) between 2006-2013, the post-conflict status of EmONC is unknown. We assessed the availability, use, and quality of EmONC in 3 health zones (HZs) of the NKP.Method A cross-sectional survey of all 42 public facilities designated to provide EmONC in 3 HZs (Goma, Karisimbi, and Rutshuru), purposively selected based on their relative proximity to previous conflicts and their respective locations encompassing the entire economic landscape of the province, was conducted in 2017. Interviews, reviews of maternity ward records, and observations were used to assess the accessibility, use, and quality of EmONC against WHO standards.Results The 3 HZs fell short of WHO standards. Only three referral facilities (two faith-based facilities in Goma and the MSF-run referral hospital of Rutshuru) met the criteria for comprehensive EmONC, i.e., 1.5 EmONC facilities per 500,000 population. None of the health centres qualified as basic EmONC, nor could offer obstetric and neonatal care services 24 hours, 7 days a week (24/7). Assisted vaginal delivery was the least performed signal function, followed by parenteral administration of anticonvulsants, mostly due to policy restrictions and lack of demand. Moreover, none of the HZs could achieve a direct-obstetric case facility rate of at most 1% and, the met need for EmONC was as low as 6.5% and 5.4% in Goma and Rutshuru, respectively. However, the proportion of births by caesarean section in EmONC facilities met the minimum standard in both HZs. Overall, the intrapartum and very early neonatal death rate was 1.5%.Conclusion This study provides grounds for the development of coordinated and evidence-based programming, involving local and external stakeholders, as part of the post-conflict effort to improve maternal and neonatal health in the NKP. Particular attention to basic EmONC is required, focusing on strengthening human resources, equipment, supply chains, and referral capacity, on the one hand, and on tackling residual insecurity that might hinder 24/7 staff availability, on the other.

PP188 Prevalence And Severity Of Erectile Dysfunction In Patients With Benign Prostatic Hyperplasia In China: A Cross-Sectional Survey

2020 ◽  
Vol 36 (S1) ◽  
pp. 20-20
Author(s):  
Liqun Zhou ◽  
Zhengcun Pei ◽  
Xingqiao Wen ◽  
Yanlei Zhang ◽  
Peng Li ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Erectile Dysfunction ◽  
Benign Prostatic Hyperplasia ◽  
Assessment Tool ◽  
Prostatic Hyperplasia ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Aging Men ◽  
Second Tier

IntroductionErectile dysfunction (ED) and benign prostatic hyperplasia (BPH) are highly prevalent among aging men. However, the rate of coexistence of these two conditions in China is still unclear, especially among men aged 45 to 60 years. Instruments such as the abbreviated five-item version of the International Index of Erectile Function (IIEF-5) and the International Prostate Symptom Score (IPSS) can be used to determine the presence of ED and the symptoms and severity of BPH, respectively. This study aimed to estimate the prevalence of ED in men with BPH and to assess its impact on the quality of life (QoL) of these patients.MethodsBetween October 2018 and March 2019 we enrolled 650 patients aged 45 to 65 years who were diagnosed with BPH by a urologist in nine first- and second-tier cities in China. Information on patients’ demographics, lifestyle, comorbidities, and medication use was collected through an electronic clinical outcome assessment tool. Patients with an IIEF-5 score of less than twenty-two were considered to have ED. The IPSS and the five-level EuroQol questionnaire (EQ-5D-5L) were used to assess BPH severity and overall health-related QoL.ResultsWe enrolled 650 patients with BPH. Of these, only the 607 men who reported sexual intercourse attempts (mean age of 56.6 years, standard deviation 5.5) were included in the analysis because it was assumed that the other patients did not have ED. Signs of ED were present in ninety-seven percent of patients (IIEF-5 score < 22), and eighty-four percent had at least mild to moderate impairment (IIEF score < 17). Up to nineteen percent reported having physician-diagnosed ED previously, and twenty-eight percent had used medication for ED in the past six months. Compared to men without ED, those with ED and BPH had higher IPSS scores (13.2 versus 6.7, p < 0.05) and lower EQ-5D-5L scores (0.90 versus 0.97, p < 0.05).ConclusionsAlthough the prevalence of ED in men with BPH in China is high, it is still underdiagnosed and undertreated. Co-existing ED in patients with BPH is associated with more severe BPH symptoms and lower quality of life.

The Quality of Service Provision to Newborns in the Primary Healthcare, West Gojjam Zone, North-West of Ethiopia: A Cross-sectional Survey

2021 ◽  
Author(s):  
Bizuhan Gelaw Birhanu ◽  
Johanna Mmabojalwa Mathibe-Neke
Keyword(s):  
Rural Health ◽  
Health Workers ◽  
Newborn Care ◽  
Health Facilities ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Signal Functions ◽  
Rural Health Centres ◽  
Health Centres

Abstract Background: During 2019, neonatal conditions in Ethiopia accounted for 56% of under-5 deaths, with 33 neonatal deaths occurring for every 1,000 live births. More than 80% of all newborns deaths are caused by preventable and treatable conditions with available interventions. In Ethiopia, mortality rates for newborn babies have remained stubbornly high over the decades. Methods: A cross-sectional survey design was employed. Interviewer-administered questionnaires were administered to 221 health workers and health extension workers in 142 health facilities from April to July 2017. Data was entered in the EpiData 3.1, exported to SPSS and STATA for analysis. Results: Out of the ten quality of newborn care variables, 8.7 [95%CI: 6.03-11.303], the highest mean was achieved by primary hospitals, followed by urban health centres with a 6.4 mean [95%CI:5.168-7.601]. However, nearly half of the rural health centres were providing quality of newborn care at the mean of 5.7 [95%CI: 5.152-6.18], and below half was provided by health posts, 4.5 [95%CI: 3.867-5.116]. From the seven emergency newborn care signal functions, primary hospitals had a higher mean score, 6.3 [95%CI: 6.007-7.325] and rural health centres had a lowest mean score, 2.3 [95%CI: 2.043-2.623]. The availability of essential equipment is also significantly associated with the quality of neonatal care provision in the health facilities (p < 0.05). Overall, the effectiveness of the neonatal healthcare services has a significant association with the health facilitates readiness score [95%CI: 0.134-0.768]. Conclusion: The quality of newborn care was high at the higher-level health facilities and lower in the lower level health facilities such as rural health centres and health posts; where these facilities are designed to provide the newborn care services to the majority of the rural communities. In addition, the provision of emergency newborn care signal functions were critically low in rural health centres where these are a referral receiving health facilities from health posts. Thus, the rural health centres and health posts should be targeted to improve their readiness to provide the quality of services for newborns as per their expected level of care.

scholarly journals The status of emergency obstetric and newborn care in post-conflict eastern DRC: a facility-level cross-sectional study

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Serge-André Mizerero ◽  
Calistus Wilunda ◽  
Patou Masika Musumari ◽  
Masako Ono-Kihara ◽  
Gerrye Mubungu ◽  
...  
Keyword(s):  
Newborn Care ◽  
Case Fatality ◽  
Newborn Health ◽  
Neonatal Morbidity ◽  
Maternal And Newborn Health ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Post Conflict ◽  
Who Standards

Abstract Background Pregnancy-related mortality remains persistently higher in post-conflict areas. Part of the blame lies with continued disruption to vital care provision, especially emergency obstetric and newborn care (EmONC). In such settings, assessment of EmONC is essential for data-driven interventions needed to reduce preventable maternal and neonatal mortality. In the North Kivu Province (NKP), the epicentre of armed conflict in eastern Democratic Republic of the Congo (DRC) between 2006 and 2013, the post-conflict status of EmONC is unknown. We assessed the availability, use, and quality of EmONC in 3 health zones (HZs) of the NKP to contribute to informed policy and programming in improving maternal and newborn health (MNH) in the region. Method A cross-sectional survey of all 42 public facilities designated to provide EmONC in 3 purposively selected HZs in the NKP (Goma, Karisimbi, and Rutshuru) was conducted in 2017. Interviews, reviews of maternity ward records, and observations were used to assess the accessibility, use, and quality of EmONC against WHO standards. Results Only three referral facilities (two faith-based facilities in Goma and the MSF-supported referral hospital of Rutshuru) met the criteria for comprehensive EmONC. None of the health centres qualified as basic EmONC, nor could they offer EmONC services 24 h, 7 days a week (24/7). The number of functioning EmONC per 500,000 population was 1.5. Assisted vaginal delivery was the least performed signal function, followed by parenteral administration of anticonvulsants, mainly due to policy restrictions and lack of demand. The 3 HZs fell short of WHO standards for the use and quality of EmONC. The met need for EmONC was very low and the direct obstetric case fatality rate exceeded the maximum acceptable level. However, the proportion the proportion of births by caesarean section in EmONC facilities was within acceptable range in the HZs of Goma and Rutshuru. Overall, the intrapartum and very early neonatal death rate was 1.5%. Conclusion This study provides grounds for the development of coordinated and evidence-based programming, involving local and external stakeholders, as part of the post-conflict effort to address maternal and neonatal morbidity and mortality in the NKP. Particular attention to basic EmONC is required, focusing on strengthening human resources, equipment, supply chains, and referral capacity, on the one hand, and on tackling residual insecurity that might hinder 24/7 staff availability, on the other.

SERVICE QUALITY OF PUBLIC AND PRIVATE PHYSIOTHERAPY INSTITUTES: A COMPARATIVE STUDY IN LAHORE

2019 ◽  
Author(s):  
Roohi Abbas
Keyword(s):  
Physical Therapy ◽  
Service Quality ◽  
Cross Sectional Study ◽  
Quality Of Services ◽  
Sectional Study ◽  
Cross Sectional ◽  
Public And Private ◽  
Quality Dimensions ◽  
Service Quality Dimensions

Background: Ever since quality of services is gaining importance in every industry as it is the indicator of consumer/customer satisfaction, it is of utmost importance to measure service quality of educational institutes to determine the satisfaction of students. Thus, the study aimed to determine the important factors in service quality dimensions which contribute to the satisfaction of students. Methods: This was a Comparative Cross Sectional study in which final year department of physical therapy (DPT) students were included from three private and three public physiotherapy institutes. Results: The largest mean Positive Gap scores for Public Physiotherapy Institutes was 0.18 for accessibility and affordability 0.18. The largest negative mean gap score for Private Physiotherapy domain was “Accessibility and Affordability” found to be -1.96. Conclusion: Students were satisfied with service quality of private institutes in all domains except for the “Accessibility and Affordability” whereas, in Public Institutes largest negative quality gaps were found in “Empathy” and “Assurance”.

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