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Ku Carbonell SE, Ogba P, Vanstone M, Gombay C, Darling EK. Midwives' adaptation of their practice, role, and scope to ensure access to sexual and reproductive services during humanitarian crises: A scoping review. Midwifery 2024; 136:104065. [PMID: 38963995 DOI: 10.1016/j.midw.2024.104065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 05/27/2024] [Accepted: 06/11/2024] [Indexed: 07/06/2024]
Abstract
PROBLEM Limited research has examined and synthesized the adaptation of midwives and midwife-led interventions during crises. BACKGROUND Evidence suggests that midwives are essential to respond to sexual and reproductive health care needs during disruptive times, and that they adapt to continue to provide their services during those circumstances. AIM To map the adaptations of midwives when providing care during crises globally. Secondary objectives include identifying which midwives adapted, what services were adapted and how, and the demographic receiving care. STUDY METHODS Scoping review using Levac's modifications of Arksey and O'Malley's methods. Publications and grey literature, in English and Spanish, with no limitations based on study design or date were included. Data was extracted and mapped using Wheaton and Maciver's Adaptation framework. FINDINGS We identified 3329 records, of which forty-two were included. Midwives' prior training impacted adaptation. Midwives adapted to the COVID-19 pandemic, epidemics, natural disasters, and World War II. They adapted in hospital and community settings around the provision of antenatal, labor and birth, postpartum, and contraceptive care. However, no specific data identified population demographics. Midwifery adaptations related to their practice, role, and scope of practice. CONCLUSION The limited available evidence identified the challenges, creativity, and mutual aid activities midwives have undertaken to ensure the provision of their services. Evidence is highly concentrated around maternal health services. Further high-quality research is needed to provide a deeper understanding of how midwifery-led care can adapt to guide sustainable responses to ensure access to sexual and reproductive health services during crises.
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Affiliation(s)
- Susana E Ku Carbonell
- McMaster Midwifery Research Center, McMaster University, 1280 Main St W, HSC 4H24, Hamilton, ON L8S 4K1, Canada; Global Health Graduate Programs, McMaster University, 1280 Main Street W, MDCL 3500, Hamilton, ON L8S 4K1, Canada
| | - Patricia Ogba
- Global Health Graduate Programs, McMaster University, 1280 Main Street W, MDCL 3500, Hamilton, ON L8S 4K1, Canada
| | - Meredith Vanstone
- Department of Family Medicine, David Braley Health Sciences Centre, McMaster University, 100 Main Street West, Hamilton, ON L8P 1H6, Canada; Department of Health Research Methods, Evidence and Impact, McMaster University, HSC 2C, Hamilton, ON L8S 4K1, Canada
| | - Christy Gombay
- Global Health Graduate Programs, McMaster University, 1280 Main Street W, MDCL 3500, Hamilton, ON L8S 4K1, Canada
| | - Elizabeth K Darling
- McMaster Midwifery Research Center, McMaster University, 1280 Main St W, HSC 4H24, Hamilton, ON L8S 4K1, Canada; Department of Health Research Methods, Evidence and Impact, McMaster University, HSC 2C, Hamilton, ON L8S 4K1, Canada; Department of Obstetrics and Gynaecology, McMaster University, 1280 Main St W, HSC 2F, Hamilton, ON L8S 4K1, Canada.
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Perez KM, Asim M, Weiss EM, Valentine GC, Kavi A, Somannavar MS, Iwuh I, Chiweza C, Tickell KD, Singa BO, Beima-Sofie K, Batra M, Walson JL, Umoren R, Kelley M, Saleem S. Considering Risks to Researchers and Staff in Low-Resource Settings during Public Health Crises: A Proposed Conceptual Model. CHILDREN 2023; 10:children10030463. [PMID: 36980021 PMCID: PMC10047058 DOI: 10.3390/children10030463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/20/2023] [Accepted: 02/24/2023] [Indexed: 03/03/2023]
Abstract
Human subjects research protections have historically focused on mitigating risk of harm and promoting benefits for research participants. In many low-resource settings (LRS), complex and often severe challenges in daily living, poverty, geopolitical uprisings, sociopolitical, economic, and climate crises increase the burdens of even minimal risk research. While there has been important work to explore the scope of ethical responsibilities of researchers and research teams to respond to these wider challenges and hidden burdens in global health research, less attention has been given to the ethical dilemmas and risk experienced by frontline researcher staff as they perform research-related activities in LRS. Risks such as job insecurity, moral distress, infection, or physical harm can be exacerbated during public health crises, as recently highlighted by the COVID-19 pandemic. We highlight the layers of risk research staff face in LRS and present a conceptual model to characterize drivers of this risk, with particular attention to public health crises. A framework by which funders, institutions, principal investigators, and/or research team leaders can systematically consider these additional layers of risk to researchers and frontline staff is an important and needed addition to routine research proposals and protocol review.
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Affiliation(s)
- Krystle M. Perez
- Department of Pediatrics, University of Washington, Seattle, WA 98195, USA
- Correspondence:
| | - Muhammad Asim
- Department of Community Health Sciences, Aga Khan University, Karachi 74800, Pakistan
| | - Elliott M. Weiss
- Department of Pediatrics, University of Washington, Seattle, WA 98195, USA
| | - Gregory C. Valentine
- Department of Pediatrics, University of Washington, Seattle, WA 98195, USA
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Avinash Kavi
- KLE Academy of Higher Education and Research, Jawaharlal Nehru Medical College, Belagavi 590010, India
| | - Manjunath S. Somannavar
- KLE Academy of Higher Education and Research, Jawaharlal Nehru Medical College, Belagavi 590010, India
| | - Ibezimako Iwuh
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, USA
- Texas Children’s Global Women’s Health Centre of Excellence, Lilongwe Private Bag B-397, Malawi
| | - Chikondi Chiweza
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, USA
- Texas Children’s Global Women’s Health Centre of Excellence, Lilongwe Private Bag B-397, Malawi
| | - Kirkby D. Tickell
- Department of Global Health, University of Washington, Seattle, WA 98195, USA
| | - Benson O. Singa
- Department of Global Health, University of Washington, Seattle, WA 98195, USA
- Kenya Medical Research Institute (KEMRI), Nairobi P.O. Box 54840-00200, Kenya
| | - Kristin Beima-Sofie
- Department of Global Health, University of Washington, Seattle, WA 98195, USA
| | - Maneesh Batra
- Department of Pediatrics, University of Washington, Seattle, WA 98195, USA
| | - Judd L. Walson
- Department of Global Health, University of Washington, Seattle, WA 98195, USA
| | - Rachel Umoren
- Department of Pediatrics, University of Washington, Seattle, WA 98195, USA
| | - Maureen Kelley
- Center for Ethics in Health Care, Oregon Health and Science University, Portland, OR 97239, USA
| | - Sarah Saleem
- Department of Community Health Sciences, Aga Khan University, Karachi 74800, Pakistan
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Kula Y, Cohen O, Clempert N, Grinstein-Cohen O, Slobodin O. Educating nursing students for cultural competence in emergencies: a randomized controlled trial. BMC Nurs 2021; 20:184. [PMID: 34587960 PMCID: PMC8479710 DOI: 10.1186/s12912-021-00704-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 09/15/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Racial and ethnic minorities suffer significantly more than others in the wake of disasters. Despite the growing recognition of the importance of culturally competent health services, systematic cultural competence training in the medical education system is still scarce, especially in the field of emergency. The current study aimed to examine the effectiveness of an online culturally informed intervention for increasing cultural competence in emergencies among nursing students. METHODS A randomized controlled trial was used to test the intervention effectiveness in increasing nursing students' cultural competence in four domains: attitudes, knowledge, skills, and encounters. The study included 72 undergraduate nursing students recruited from two academic institutes. Participants were randomized (1:1 ratio) to an intervention (n = 34) and control group (n = 38). The study adheres to the Consolidated Standards of Reporting Trials (CONSORT). Data analysis was based on multivariate analysis of variance with repeated measures, followed by post hoc analyses with Bonferroni correction for multiple comparisons. RESULTS Results showed that the intervention was effective in increasing the participants' culturally competent knowledge. The effect of the intervention on the skills domain approached significance. No group differences were identified in the attitudes and the encounters domains. CONCLUSIONS An online culturally informed intervention, incorporated in the curriculum, was effective in enhancing the cognitive aspect of cultural competence (especially at the basic knowledge and understanding levels), but not other domains. Our results encourage the development of future intervention programs that are based on a deep understanding of local values, needs, and preferences.
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Affiliation(s)
- Yosef Kula
- School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Odeya Cohen
- Department of Nursing, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Neta Clempert
- Department of Middle East Studies, Ben-Gurion Universityof the Negev, Beer-Sheva, Israel
| | - Orli Grinstein-Cohen
- Department of Nursing, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ortal Slobodin
- Department of Education, Ben-Gurion University of the Negev, 84105, Beer-Sheva, Israel.
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Nurses at the frontline of public health emergency preparedness and response: lessons learned from the HIV/AIDS pandemic and emerging infectious disease outbreaks. THE LANCET. INFECTIOUS DISEASES 2021; 21:e326-e333. [PMID: 33743850 PMCID: PMC7972309 DOI: 10.1016/s1473-3099(20)30983-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 12/03/2020] [Accepted: 12/07/2020] [Indexed: 12/20/2022]
Abstract
The years 2020–21, designated by WHO as the International Year of the Nurse and Midwife, are characterised by unprecedented global efforts to contain and mitigate the COVID-19 pandemic. Lessons learned from successful pandemic response efforts in the past and present have implications for future efforts to leverage the global health-care workforce in response to outbreaks of emerging infectious diseases such as COVID-19. Given its scale, reach, and effectiveness, the response to the HIV/AIDS pandemic provides one such valuable example, particularly with respect to the pivotal, although largely overlooked, contributions of nurses and midwives. This Personal View argues that impressive achievements in the global fight against HIV/AIDS would not have been attained without the contributions of nurses. We discuss how these contributions uniquely position nurses to improve the scale, reach, and effectiveness of response efforts to emerging infectious diseases with pandemic potential; provide examples from the responses to COVID-19, Zika virus disease, and Ebola virus disease; and discuss implications for current and future efforts to strengthen pandemic preparedness and response.
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Marbán-Castro E, Villén-Gonzalvo A, Enguita-Fernàndez C, Marín-Cos A, Menéndez C, Maixenchs M, Bardají A. Uncertainties, Fear and Stigma: Perceptions of Zika Virus among Pregnant Women in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186643. [PMID: 32933007 PMCID: PMC7559627 DOI: 10.3390/ijerph17186643] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 08/28/2020] [Accepted: 09/04/2020] [Indexed: 02/07/2023]
Abstract
Similar to other epidemics, knowledge about Zika virus (ZIKV) relies upon information often coming from outside the health system. This study aimed to explore views, perceptions and attitudes towards ZIKV among migrant women from Central and South America, diagnosed with ZIKV infection during pregnancy, and to comprehend healthcare professionals’ perceptions of ZIKV. An exploratory qualitative study, based on phenomenology and grounded theory, was conducted in Barcelona, Spain. Data were collected through in-depth and paired interviews with women diagnosed with ZIKV infection during pregnancy, and semi-structured interviews with healthcare professionals. Women showed good level of awareness of ZIKV, despite some knowledge gaps. The most consulted source of information about ZIKV was the Internet. Women expressed they suffered from anxiety and depression due to potential effects of ZIKV on their babies. They conveyed their sources of support came primarily from their partners and relatives, as well as healthcare professionals. This study stresses the dramatic health, social and emotional burden that the epidemic imposed on migrant women infected with ZIKV during pregnancy. These results may help guide psychosocial support and health measures for pregnant women and their children as part of the public health emergency response in emergent epidemics.
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Affiliation(s)
- Elena Marbán-Castro
- ISGlobal, Hospital Clínic—Universitat de Barcelona, 08036 Barcelona, Spain; (A.V.-G.); (C.E.-F.); (A.M.-C.); (C.M.); (M.M.); (A.B.)
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Correspondence:
| | - Ana Villén-Gonzalvo
- ISGlobal, Hospital Clínic—Universitat de Barcelona, 08036 Barcelona, Spain; (A.V.-G.); (C.E.-F.); (A.M.-C.); (C.M.); (M.M.); (A.B.)
| | - Cristina Enguita-Fernàndez
- ISGlobal, Hospital Clínic—Universitat de Barcelona, 08036 Barcelona, Spain; (A.V.-G.); (C.E.-F.); (A.M.-C.); (C.M.); (M.M.); (A.B.)
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Anna Marín-Cos
- ISGlobal, Hospital Clínic—Universitat de Barcelona, 08036 Barcelona, Spain; (A.V.-G.); (C.E.-F.); (A.M.-C.); (C.M.); (M.M.); (A.B.)
| | - Clara Menéndez
- ISGlobal, Hospital Clínic—Universitat de Barcelona, 08036 Barcelona, Spain; (A.V.-G.); (C.E.-F.); (A.M.-C.); (C.M.); (M.M.); (A.B.)
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique
| | - Maria Maixenchs
- ISGlobal, Hospital Clínic—Universitat de Barcelona, 08036 Barcelona, Spain; (A.V.-G.); (C.E.-F.); (A.M.-C.); (C.M.); (M.M.); (A.B.)
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Azucena Bardají
- ISGlobal, Hospital Clínic—Universitat de Barcelona, 08036 Barcelona, Spain; (A.V.-G.); (C.E.-F.); (A.M.-C.); (C.M.); (M.M.); (A.B.)
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique
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Thorson A, Aslanyan G, Brizuela V, Perez F, Gómez Ponce de León R, Reeder JC, Serruya SJ, Espinal M, Askew I. Research and research capacity strengthening in the context of an emerging epidemic: Zika virus in Latin America. Int J Gynaecol Obstet 2020; 148 Suppl 2:1-3. [PMID: 31975399 DOI: 10.1002/ijgo.13040] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Anna Thorson
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Garry Aslanyan
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
| | - Vanessa Brizuela
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Freddy Perez
- Communicable Diseases and Environmental Determinants of Health Department, Pan American Health Organization (PAHO), Washington, DC, USA
| | | | - John C Reeder
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
| | - Suzanne J Serruya
- Center for Perinatology, Women's Health, and Reproduction (CLAP/PAHO), Montevideo, Uruguay
| | - Marcos Espinal
- Communicable Diseases and Environmental Determinants of Health Department, Pan American Health Organization (PAHO), Washington, DC, USA
| | - Ian Askew
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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