scholarly journals The three pathways to becoming a midwife: self-assessed confidence in selected competencies in intrapartum care from seven African countries

2021 ◽  
Vol 15 (1) ◽  
pp. 1-10
Author(s):  
Helena Lindgren ◽  
Ingegerd Hildingsson ◽  
Kyllike Christensson ◽  
Lena Bäck ◽  
Christina Mudokwenyu–Rawdon ◽  
...  

Background/Aims Globally, 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. Methods A 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. Results In 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. Conclusions Direct 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.

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
T. Makumbi ◽  
M. Galukande ◽  
A. Gakwaya

Introduction. Mastalgia is a common breast condition among women referred to breast clinics worldwide. Whereas the prevalence is known in the Western world and Asia, the prevalence of the disease is unknown in many African countries. The aim of this study therefore was to determine the prevalence and describe factors associated with mastalgia among women attending a tertiary hospital in sub-Saharan Africa. Methods. A cross-sectional study was done in Kampala, Uganda. Mastalgia was defined as self-reported breast pain (unilateral or bilateral) for a period not less than two months. A pretested questionnaire was used to collect the data and statistical analysis was performed using SPSS version 11. Ethical approval was obtained. Results. Out of the 1048 women who presented to the breast clinic during the study period, 168 (16%) were diagnosed with mastalgia in the absence of breast cancer. Noncyclical and cyclical mastalgia were 22/168 (13%) and 5/168 (3%), respectively. The onset of noncyclical category as compared to the cyclical type of mastalgia was observed to manifest before 24 years of age (P=0.006). Conclusion. Mastalgia was a common condition among women in this sub-Saharan African setting as is elsewhere. The early onset mastalgia in this sub-Saharan African study requires further exploration for determination of its risk factors.


Author(s):  
Luchuo Engelbert Bain ◽  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Eugene Budu ◽  
Joshua Okyere ◽  
...  

Abstract Background In this article we report the prevalence and determinants of intended or wanted pregnancies among young women 15–24 y of age in selected sub-Saharan African countries. Methods This cross-sectional study used pooled data from current Demographic and Health Surveys conducted between 1 January 2010 and 31 December 2019 in 29 countries in sub-Saharan Africa (SSA). The sample size comprised 14 257 young women (15–24 y of age). Multivariable binary logistic regression models were used to present the results as adjusted odds ratios. Results The prevalence of intended pregnancies was 67.7%, with the highest and lowest prevalence in Gambia (89.9%) and Namibia (37.7%), respectively. Intended pregnancy was lower among young women who had knowledge of modern contraceptives, those with a secondary/higher education and those with four or more births. Lower odds of intended pregnancy were observed among young women in the richer wealth quintile and those who lived in southern Africa. Conclusions To reduce intended pregnancies in sub-Saharan African countries such as Gambia, Burkina Faso and Nigeria, there is a need for government and non-governmental organisations to recalibrate current and past interventions such as investment in increasing formal education for women and poverty alleviation programmes, as well as augmenting job creation, including skill-building. These interventions have to be sensitive to the cultural realities of each setting, especially with regards to early marriages and womanhood.


2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Nikolas A. S. Chotta ◽  
Sia E. Msuya ◽  
Melina Mgongo ◽  
Tamara H. Hashim ◽  
Arne Stray-Pedersen

Background. Infections transmitted from mother to child (MTCT) during pregnancy, childbirth, and breastfeeding contribute significantly to the high infant and childhood morbidity and mortality in sub-Saharan African countries. The most significant and preventable of these include HIV, syphilis, and rubella. To achieve elimination, mothers need to be aware of and to understand effective preventive measures against these infections. Lack of comprehensive knowledge on transmission and prevention of MTCT infections is one of the factors hindering achievement of the elimination goals for these infections. The aim of this study was to assess the knowledge of HIV, syphilis, rubella, and associated factors among mothers in the Kilimanjaro region of Tanzania. Methods. We conducted a community-based cross-sectional study in three districts of the Kilimanjaro region from September to October 2016. The study involved mothers with children up to five years of age. Data collection involved the use of a questionnaire, administered by face-to-face interviews. Logistic regression analysis was used to assess predictors of mothers’ knowledge on MTCT infections. Results. A total of 618 mothers were recruited, with a mean age of 29.6 (SD 7.6) years. The overall knowledge on MTCT infections was low. The highest level of knowledge on MTCT infections was regarding HIV (89.2%). Fewer mothers had knowledge of syphilis (27.8%). Rubella was the least known; only 12% of mothers were aware of rubella infection. District of residence and having knowledge of syphilis were predictors for rubella knowledge, while for syphilis knowledge, significant predictors were age group, occupation, and those having knowledge on HIV and rubella. Predictors for HIV knowledge were residential district, having a mobile phone, and those having knowledge of syphilis and rubella. Conclusions. This study confirmed that mothers have low overall knowledge on MTCT infections. To achieve the MTCT elimination goals, targeted interventions to improve knowledge among women of childbearing age are recommended.


Author(s):  
Anusha S. R. ◽  
Deepak A. V. ◽  
K. J. Jacob

Background: Cesarean Section is the most commonly performed abdominal operation in women all over the world. Variable rates of cesarean section are reported between and within countries. Cesarean section at full cervical dilatation with an impacted fetal head can be technically difficult and is associated with increased trauma to the lower uterine segment and adjacent structures, as well as increased hemorrhage and infection.Methods: This is a comparative cross-sectional study comparing maternal and neonatal outcome between first stage and second stage cesarean section performed at Govt Medical College Thrissur.Results: In present study out of 90 cesarean sections 30 were performed in second stage and 60 in first stage.74 % were primigravida in second stage cs group. Arrest due to malposition was major indication for second stage (76% of cases). The most important complication among second stage cs group was PPH (76.7%) and majority of them needed blood transfusion. These complications were less in first stage cs group. Other Complications like increased duration of surgery (mean=53.3 min), post op fever (36% post op Wound infection (13.3%) was seen in second stage group. Fetal complications like low APGAR scores were seen in 16.7% of cases compared to first stage group and most of them needed resuscitation.Conclusions: Women undergoing cesarean section in second stage of labour had increased maternal and fetal morbidity. They required special care and hence Operation should ideally perform and supervised by an experienced obstetrician. Timely decision for cesarean section should be made especially when risk factors for failure to progress are present.


Author(s):  
Uchechukwu Levi Osuagwu ◽  
Chikasirimobi G Timothy ◽  
Raymond Langsi ◽  
Emmanuel K Abu ◽  
Piwuna Christopher Goson ◽  
...  

This study investigated risk perception of contracting and dying of SARS-CoV-2 in sub-Sahara Africa during and after the lockdown periods. Two online surveys were conducted one year apart, with participants 18 years and above living in sub-Sahara Africa or the diaspora. Each survey took four weeks. The first survey was taken from 18 April to 16 May 2020, i.e., during the lockdown. The second survey was taken from 14 April to 14 May 2021, i.e., after the lockdown. A cross-sectional study using adopted and modified questionnaires for both surveys were distributed through online platforms. Question about risks perception of contracting and dying of SARS-CoV-2 were asked. The Helsinki declaration was applied, and ethical approvals were obtained. Total responses for both surveys, i.e., both during and after the lockdown, was 4605. The mean age was similar in both surveys (18–28 years). The mean risk perception scores were higher after lockdown by 3.59%. Factors associated with risk perception of COVID-19 were survey period, age group, region of residence, and occupation. Non-health care workers had a lower risk perception of COVID-19. This first comparative study on the level of risk perception of Africans during and after the lockdown shows that one in every three and every four persons in sub-Sahara Africa felt at high risk of contracting COVID-19 and thought they could die from contracting the same, respectively.


2021 ◽  
pp. postgradmedj-2020-139382
Author(s):  
Asrat Hailu Dagne ◽  
Shimeles Biru Zewude

BackgroundPostpartum haemorrhage is one of the direct and the leading causes of maternal morbidity and mortality. There are many risk factors of postpartum haemorrhage, which vary in different settings. Therefore, the purpose of this study was to assess postpartum haemorrhage and associated factors among mothers who gave birth in public health facilities.MethodsA cross-sectional study was employed from 17 November 2019 to 15 February 2020. The study participants were selected using a systematic sampling technique. The data were entered and cleaned using EpiData V.3.1 then exported to SPSS V.20 for analysis. Factors associated with postpartum haemorrhage were selected for multiple logistic regression at the probability value (p value) of less than 0.2 in the χ2 analysis. Statistically significant associated factors were identified at probability value (p value) less than 0.05 and adjusted OR (AOR) with a 95% CI.ResultsThe mean age of participants was 31.3 (SD ±5.7) years. This study found that the prevalence of postpartum haemorrhage was 13.6% (67). Age of participants (AOR 12.5, 95% CI 4.0 to 38.6), disrespectful maternity care (AOR 8.4, 95% CI 3.2 to 22.0), labour induction and augmentation (AOR 6.97, 95% CI 2.34 to 20.8), the prolonged second stage of labour (AOR 9.9, 95% CI 2.6 to 37.1) and no antenatal care visit (AOR 10.1, 95% CI 3.4 to 29.7) were statistically significant associated factors of postpartum haemorrhage.ConclusionsThe prevalence of postpartum haemorrhage is high. The age of the participants, disrespectful maternity care, labour induction and augmentation, the prolonged second stage of labour and no antenatal care visit were independent predictors of postpartum haemorrhage.


Author(s):  
Emmanuel Nii-Boye Quarshie ◽  
Samuel Kofi Odame

AbstractSuicidal ideation is a critical risk for attempted suicide and eventual suicide. Little is known about suicidal ideation among rural adolescents in most sub-Saharan African countries. We aimed to estimate the 12-month prevalence of suicidal ideation and to describe some of the common and gender-specific associated factors among in-school adolescents in rural Ghana. We conducted a cross-sectional survey involving a random sample of 1101 in-school adolescents aged 10–19 years in a rural district in Eastern Ghana. The Suicidal Behavior Questionnaire-Revised was used to assess suicidal ideation. Overall, 25.1% participants (95% CI = 22.5–27.7), representing 28.3% females (95% CI = 24.7–32.2) and 21.5% males (95% CI = 18.0–25.2) reported suicidal ideation during the previous 12 months. Females who experienced personal and interpersonal adversities mainly outside the family context were likely to report suicidal ideation, while suicidal ideation among males was associated with conflict with parents. Regardless of gender, adolescents who reported exposure to a friend’s attempted suicide were about two times more likely to report suicidal ideation. The prevalence of suicidal ideation among adolescents in rural Ghana compares with in-school estimates from other countries within sub-Saharan Africa, but also underscores the need for targeted and universal prevention programmes and intervention efforts to mitigate the potential transition from suicidal ideations to suicidal attempts and eventual deaths by suicide among rural adolescents.


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