1
|
Bogren M, Jha P, Sharma B, Erlandsson K. Development of a Quality Assurance Assessment Tool to meet accreditation standards for midwifery education: A Delphi study. Women Birth 2024; 37:101660. [PMID: 39047523 DOI: 10.1016/j.wombi.2024.101660] [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: 04/04/2024] [Revised: 06/20/2024] [Accepted: 07/13/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Ensuring the quality of midwifery education is critical for producing a qualified and competent midwifery workforce for sexual, reproductive, maternal, and newborn care services. While global standards advocate for quality enhancement and accreditation systems, challenges persist, particularly in low-income countries like Bangladesh. AIM To validate and culturally adapt a Quality Assurance Assessment tool aligned with global midwifery education standards for application in Bangladesh. The goal of the tool is to guide and assess an internal quality education assurance process tailored to meet the national accreditation standards. METHODS A modified Delphi technique was conducted with a panel of 55 experts, including educators, principals, and researchers from Bangladesh, India, and Sweden. The study underwent three rounds: tool development, field testing, and consensus building. RESULTS The first round was completed by 25 workshop panel members, the second was completed by 30 participants during field testing, and the third was completed by the 25 workshop panel members from the first round. The developed Quality Assurance Assessment Tool demonstrated face and content validity through expert consultation and field testing, aligning with both global education and national accreditation standards. Minor revisions enhanced clarity and feasibility. CONCLUSION The Delphi rounds resulted in a validated Quality Assurance Assessment Tool that offers a robust framework for assessing and enhancing midwifery education quality, aiding progress towards meeting national accreditation standards. This study provides a valuable resource for countries seeking to develop similar tools aligned with global and national education priorities.
Collapse
Affiliation(s)
- Malin Bogren
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens backe 1, Gothenburg 413 46, Sweden.
| | - Paridhi Jha
- Foundation for Research in Health Systems, Bangalore, Karnataka, India
| | - Bharati Sharma
- Indian Institute of Public Health, Gandhinagar, Gujarat, India
| | | |
Collapse
|
2
|
Fraser R, Downer T, Oprescu F. Midwifery education in Bangladesh: An in-depth analysis through a systematic review. Women Birth 2024; 37:101661. [PMID: 39079342 DOI: 10.1016/j.wombi.2024.101661] [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: 04/01/2024] [Revised: 07/25/2024] [Accepted: 07/26/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND While midwifery education in Bangladesh has expanded since its establishment in 2013, there is little information available about the quality of education. The aim of this project was to analyse the literature related to midwifery education in Bangladesh in reference to the Global Standards for Midwifery Education. METHODS A systematic review was conducted using PubMed, CINAHL, Web of Science and Scopus databases. A search using keywords was conducted in January 2024. Abstracts were screened against inclusion and exclusion criteria. Data was assessed using the Mixed Methods Appraisal Tool and grouped into the Global Standards for Midwifery Education for analytical purposes. RESULTS A total of 14 articles met the inclusion criteria and were included in the study. There was a combination of quantitative (n = 1), qualitative (n = 8) and mixed method studies (n = 5). Key themes included a lack of professional recognition, limited learning and economic resources and sociocultural barriers for students. The implementation of an accreditation tool, upskilling of educators and an improved comprehensive curriculum were found to have positive impacts. This review highlights the progress in midwifery education in Bangladesh in the last decade as there is advancement towards enhancing educator knowledge and programme quality assessment. Some challenges remain such as the limited autonomy and professional acknowledgement, inadequate educational resources, poor financial support, as well as social and cultural barriers. CONCLUSION Interventions designed to address these issues are needed to enhance midwifery education in Bangladesh, with a long-term view of contributing to improvements in maternal and neonatal health.
Collapse
Affiliation(s)
- Ryan Fraser
- School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, QLD 4556, Australia.
| | - Terri Downer
- School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, QLD 4556, Australia
| | - Florin Oprescu
- School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, QLD 4556, Australia
| |
Collapse
|
3
|
Koh PX, Tan K, Chan YC, Soon DTL, See SJ, Tan NCK. Implementing a modified neurology objective structured clinical examination during the COVID-19 pandemic: an implementation science perspective. Singapore Med J 2024; 65:S5-S8. [PMID: 35650716 PMCID: PMC11073653 DOI: 10.11622/smedj.2022057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 09/21/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Pei Xuan Koh
- Department of Neurology, National Neuroscience Institute, Singapore
| | - Kevin Tan
- Department of Neurology, National Neuroscience Institute, Singapore
| | - Yee Cheun Chan
- Department of Neurology, National University Hospital, Singapore
| | | | - Siew Ju See
- Department of Neurology, National Neuroscience Institute, Singapore
| | | |
Collapse
|
4
|
Griffin G, Bradfield Z, Than KK, Smith R, Tanimizu A, Raina N, Homer CSE. Strengthening midwifery in the South-East Asian region: A scoping review of midwifery-related research. PLoS One 2023; 18:e0294294. [PMID: 38100488 PMCID: PMC10723687 DOI: 10.1371/journal.pone.0294294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 10/29/2023] [Indexed: 12/17/2023] Open
Abstract
Improving sexual, reproductive, maternal, newborn, and adolescent health outcomes necessitates greater commitment to, and investments in, midwifery. To identify future research priorities to advance and strengthen midwifery, we conducted a scoping review to synthesise and report areas of midwifery that have been explored in the previous 10 years in the 11 countries of the World Health Organization's South-East Asia region. Electronic peer-reviewed databases were searched for primary peer-reviewed research published in any language, published between January 2012 and December 2022 inclusive. A total of 7086 citations were screened against the review inclusion criteria. After screening and full text review, 195 sources were included. There were 94 quantitative (48.2%), 67 qualitative (34.4%) and 31 mixed methods (15.9%) studies. The majority were from Indonesia (n = 93, 47.7%), India (n = 41, 21.0%) and Bangladesh (n = 26, 13.3%). There were no sources identified from the Democratic People's Republic of Korea or the Maldives. We mapped the findings against six priority areas adapted from the 2021 State of the World's Midwifery Report and Regional Strategic Directions for Strengthening Midwifery in the South-East Asia region (2020-2024): practice or service delivery (n = 73, 37.4%), pre-service education (n = 60, 30.8%), in-service education or continuing professional development (n = 51, 26.2%), workforce management (n = 46, 23.6%), governance and regulation (n = 21, 10.8%) and leadership (n = 12, 6.2%). Most were published by authors with affiliations from the country where the research was conducted. The volume of published midwifery research reflects country-specific investment in developing a midwifery workforce, and the transition to midwifery-led care. There was variation between countries in how midwife was defined, education pathways, professional regulation, education accreditation, governance models and scope of practice. Further evaluation of the return on investment in midwifery education, regulation, deployment and retention to support strategic decision-making is recommended. Key elements of leadership requiring further exploration included career pathways, education and development needs and regulatory frameworks to support and embed effective midwifery leadership at all levels of health service governance.
Collapse
Affiliation(s)
- Georgia Griffin
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
- Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Zoe Bradfield
- Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Kyu Kyu Than
- Burnet Myanmar Program, Burnet Institute, Yangon, Myanmar
| | - Rachel Smith
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
| | - Ai Tanimizu
- Family and Gender through the Life Course, South-East Asia Regional Office, World Health Organization, New Delhi, India
| | - Neena Raina
- Family and Gender through the Life Course, South-East Asia Regional Office, World Health Organization, New Delhi, India
| | - Caroline S. E. Homer
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
| |
Collapse
|
5
|
Khatun M, Akter P, Yunus S, Alam K, Pedersen C, Byrskog U, Erlandsson K. Challenges to implement evidence-based midwifery care in Bangladesh. An interview study with medical doctors mentoring health care providers. SEXUAL & REPRODUCTIVE HEALTHCARE 2021; 31:100692. [PMID: 34990978 DOI: 10.1016/j.srhc.2021.100692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 12/05/2021] [Accepted: 12/17/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND In 2013 the first midwives in Bangladesh to be educated according to international standards completed their course and were awarded a diploma. Sixty percent of their training took place in clinical placement sites. In order to achieve appropriate mentor support while in clinical practice, a mentorship programme was initiated whereby local doctors were appointed by Save the Children. The aim of this study is to describe the mentors' purpose and the actions they took to improve midwifery care at clinical placement sites. Their appointment was intended to support local Health Care Providers (HCPs) at clinical placement sites meant for educating midwifery students in evidence-based midwifery care. METHODS An open-ended interview study with 14 mentors. The data was analysed using content analysis. RESULTS The main category, the theme that emerged from the analysis was "Creating commitment". "Creating commitment" describe how the mentors; the medical doctors employed by Save the Children, "Motivate", "Educate", "Mentor", "Advocate" and "Communicate" (subcategories) to creating commitment for quality midwifery care "In the organization of care" and "In clinical care practices" (categories). As intended, they enabled HCPs, midwifery students, and newly graduated midwives to provide quality midwifery care. CONCLUSIONS Using medical doctors' status and power to support the development of a newly emerging midwifery cadre in a country where midwifery is just emerging as a profession is because midwives integrated in the health system will improve the birthing process, improve life chances for newborns, and reduce morbidity and mortality in Bangladesh. It is recommended for implementation in other similar national contexts.
Collapse
Affiliation(s)
| | | | - Samiha Yunus
- Save the Children Bangladesh, House No-CWN(A)35, House No-43; Gulshan-2, Dhaka, Bangladesh
| | - Khairul Alam
- Save the Children Bangladesh, House No-CWN(A)35, House No-43; Gulshan-2, Dhaka, Bangladesh
| | - Christina Pedersen
- School of Education, Health and Social Studies, Dalarna University, 791 88 Falun, Sweden
| | - Ulrika Byrskog
- School of Education, Health and Social Studies, Dalarna University, 791 88 Falun, Sweden
| | - Kerstin Erlandsson
- School of Education, Health and Social Studies, Dalarna University, 791 88 Falun, Sweden. https://twitter.com/erlandsson_kerstin
| |
Collapse
|
6
|
Bogren M, Alesö A, Teklemariam M, Sjöblom H, Hammarbäck L, Erlandsson K. Facilitators of and barriers to providing high-quality midwifery education in South-East Asia-An integrative review. Women Birth 2021; 35:e199-e210. [PMID: 34217676 DOI: 10.1016/j.wombi.2021.06.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 06/19/2021] [Accepted: 06/21/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND With a diversity in midwifery education across the South-East Asia region, and with the knowledge about the lifesaving competency of the midwife profession, this study's aim is to describe facilitators of and barriers to providing high-quality midwifery education in South-East Asia. METHODS Inspired by Whittemore and Knafl, we conducted a systematic integrative literature review including the five key stages of problem identification, literature search, data evaluation, data analysis, and presentation of results. The literature searches were conducted in October 2020 in the databases CINAHL, PubMed, and Scopus. A deductive data analysis based on global standards was performed. RESULTS The search identified 1257 articles, 34 of which were included. Countries in South-East Asia did not fully comply with the ICM global standards. Midwifery education was not separated from that of nursing, and educators lacked formal qualifications in midwifery. Curriculum implementation in the clinical area was a key barrier to achieving learning outcomes. Higher academic education for midwifery educators and mentorship programs facilitated the pedagogic and assessment process, focusing on the abilities of critical thinking, reflection, and decision-making. CONCLUSIONS Countries in South-East Asia still have a long way to go before they can provide high-quality midwifery education. The identified facilitators can lead to a difference in students' academic achievement and confidence in their clinical work. Coordinated actions will enable the progress in achieving competent midwives matching national health priorities. The findings highlight a need for more research on midwifery education in both theory and practice across the region.
Collapse
Affiliation(s)
- Malin Bogren
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens backe 1, 413 46 Gothenburg, Sweden.
| | - Anna Alesö
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens backe 1, 413 46 Gothenburg, Sweden
| | - Milena Teklemariam
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens backe 1, 413 46 Gothenburg, Sweden
| | - Helen Sjöblom
- Biomedical Library, Gothenburg University Library, University of Gothenburg, Gothenburg, Sweden
| | - Linda Hammarbäck
- Biomedical Library, Gothenburg University Library, University of Gothenburg, Gothenburg, Sweden
| | - Kerstin Erlandsson
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden; Department of Women's and Children's Health, Karolinska Institute, Solna, Sweden. https://www.twitter.com/erlandsson_kerstin
| |
Collapse
|
7
|
Bogren M, Banu A, Parvin S, Chowdhury M, Erlandsson K. Findings from a context specific accreditation assessment at 38 public midwifery education institutions in Bangladesh. Women Birth 2021; 34:e76-e83. [DOI: 10.1016/j.wombi.2020.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/30/2020] [Accepted: 06/25/2020] [Indexed: 01/05/2023]
|