1
|
Nguyen QT, Yeh ML, Ngo LTH, Chen C. Translating and Validating the Vietnamese Version of the Health Sciences Evidence-Based Practice Questionnaire. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5325. [PMID: 37047941 PMCID: PMC10093985 DOI: 10.3390/ijerph20075325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/15/2023] [Accepted: 02/24/2023] [Indexed: 06/19/2023]
Abstract
No validated instrument is available for assessing the evidence-based practice capacity of Vietnamese health professionals. This study aimed to translate and validate the Health Sciences Evidence-Based Practice questionnaire (HS-EBP) from English to Vietnamese and ascertain its psychometric properties. Data were collected from two obstetric hospitals in Vietnam. Participants: A total of 343 midwives were randomly selected. The HS-EBP questionnaire was translated by a group of bilingual experts into Vietnamese (HS-EBP-V). Content validity was assessed by two experts. Internal consistency and test-retest reliabilities were assessed using Cronbach's α and intraclass correlation (ICC), respectively. Construct validity was assessed using the contrasted groups approach. As a result, the content validity index of the HS-EBP-V reached 1.0. For the individual subscales, Cronbach's α was 0.92-0.97 and ICC was between 0.45 and 0.66. The validity of the contrasted-groups approach showed discrimination by a significant difference in the subscale scores among diploma holders compared with bachelor's degree holders (p < 0.001). The validation of the HS-EBP questionnaire indicated satisfactory psychometric properties. The results indicate that the HS-EBP is a reliable and valid instrument which assesses the competencies of as well as facilitators of and barriers to the five steps of EBP among midwives. The HS-EBP-V was deemed a reliable and validated tool for assessing the competency and application of EBP among Vietnamese healthcare professionals.
Collapse
Affiliation(s)
- Quyen Thao Nguyen
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365 Mingde Road, Taipei City 112, Taiwan;
- Department of Midwifery, Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy at Ho Chi Minh City, 201 Nguyen Chi Thanh Street, Ho Chi Minh City 70000, Vietnam;
| | - Mei-Ling Yeh
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365 Mingde Road, Taipei City 112, Taiwan;
- Cochrane Taiwan, Taipei Medical University, 252 Wuxing Street, Taipei City 110, Taiwan;
| | - Ly Thi Hai Ngo
- Department of Midwifery, Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy at Ho Chi Minh City, 201 Nguyen Chi Thanh Street, Ho Chi Minh City 70000, Vietnam;
| | - Chiehfeng Chen
- Cochrane Taiwan, Taipei Medical University, 252 Wuxing Street, Taipei City 110, Taiwan;
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, 252 Wuxing Street, Taipei City 110, Taiwan
- Division of Plastic Surgery, Department of Surgery, Evidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical University, No. 111, Sec. 3, Xinglong Street, Taipei City 116, Taiwan
| |
Collapse
|
2
|
Chanie ES, Kassaw A, Senbeta M, GebreEyesus FA, Tesfaw A, Melkie A, Birlie TA, Demissie B, Belay DM, Mekone DK, Birhan BM, Bayih WA. The shadow challenges to improve the state essential newborn care practices in healthcare providers: evidence from a multicentre cross-sectional study in Ethiopia. BMC Pediatr 2021; 21:439. [PMID: 34620140 PMCID: PMC8495988 DOI: 10.1186/s12887-021-02903-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background Neonatal mortality can be reduced by providing essential newborn care. However, it is overlooked by most healthcare providers in Ethiopia. Hence, this study aims to examine immediate essential newborn care practices and associated factors among healthcare providers in Ethiopia. Methods Institution-based cross-sectional study was conducted among 214 healthcare providers from November 11 to December 19, 2020, at a selected South Gondar health facility. Data were entered into Epi-data 4.2 and then exported to STATA14.0 for analysis. Both bivariable and multivariable logistic regression with a 95% confidence interval were computed. The variable that had a p-value less than 0.25 in bivariable logistic regression was entered into the multivariable logistic regression. In multivariable logistic regression, variables having a p-value < 0.05 were considered a statistically significant association with the poor practice of essential newborn care practice. Results The overall essential newborn care practice among healthcare providers was found to be 74.8% (95% CI: 68.4, 80.2). Diploma educational status (AOR = 7.8, 95% CI:2.80–21.9), presence of workload (AOR = 9.7, 95% CI: 2.76–23.9), unavailability of drugs and vaccines (AOR = 9.8, 95% CI: 6.95–17.7), and having no training (AOR = 3.9, 95% CI: 1.73–8.92) were found to be predictors for poor essential newborn care practices. Conclusion Essential newborn care practice among healthcare providers at South Gondar health institutions was found to be low. Being diploma educational status, presence of workload, unavailability of drugs and vaccines, and having no training were found to be independent predictors for poor practice of essential newborn care. Hence, periodic evaluation and strategies are needed for those predictor variables to address the gaps.
Collapse
|
3
|
Karim T, Dossetor R, Huong Giang NT, Dung TQ, Son TV, Hoa NX, Tuyet NH, Van Anh NT, Chau CM, Bang NV, Badawi N, Khandaker G, Elliott E. Data on cerebral palsy in Vietnam will inform clinical practice and policy in low and middle-income countries. Disabil Rehabil 2021; 44:3081-3088. [PMID: 33397164 DOI: 10.1080/09638288.2020.1854872] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To document known risk factors, clinical severity, associated impairments and rehabilitation status of children presenting with cerebral palsy (CP) to the National Children's Hospital (NCH) in Hanoi, Vietnam. MATERIALS AND METHODS Active prospective ascertainment of cases of CP presenting between June and November 2017 to the NCH using surveillance modelled on the Paediatric Active Enhanced Disease Surveillance system in Australia. RESULTS Data were collected on 765 children with CP (mean age: 2 years 7 months (SD 2 y 6 mo). Mean age at diagnosis was 1 year 8 months (SD 1 y 9 mo). Children predominantly had spastic CP (95.2%, n = 729), most were quadriplegic (69.6%, n = 532) and 60.3% (n = 454) were Gross Motor Functional Classification System level III-V. Of the children 76.2% (n = 583) had one/more associated impairments. 36.3% (n = 276) had presumed perinatal asphyxia, 26.5% (n = 202) were preterm. Physiotherapy (94.3%, n = 663) was the most common form of intervention used. Only 2.6% (n = 12) of the children who would have benefitted from assistive devices had wheelchairs. CONCLUSION We established hospital-based surveillance of CP in Hanoi and confirmed a high burden and severity of CP with potentially preventable risk factors. These data will inform clinician training and health policy and identify need for evidence-based care and assistive devices.IMPLICATIONS FOR REHABILITATIONWe identified a high number of children with severe forms of cerebral palsy (CP) in Hanoi, Vietnam through hospital-based surveillance.There is an urgent need for clinician training and access to and use of evidence-based interventions including assistive technology.This study will inform local capacity building and health policy for improved diagnosis and care of children with CP in Vietnam and other low and middle-income countries.
Collapse
Affiliation(s)
- Tasneem Karim
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh.,Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
| | - Rachael Dossetor
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | | | - Trinh Quang Dung
- Rehabilitation Department, National Children's Hospital, Hanoi, Vietnam
| | - Tran Vinh Son
- Rehabilitation Department, National Children's Hospital, Hanoi, Vietnam
| | - Nguyen Xuan Hoa
- Rehabilitation Department, National Children's Hospital, Hanoi, Vietnam
| | - Nguyen Hong Tuyet
- Rehabilitation Department, National Children's Hospital, Hanoi, Vietnam
| | - Nguyen Thi Van Anh
- Medical Education and Skills-Lab Department, Hanoi Medical University, Hanoi, Vietnam
| | - Cao Minh Chau
- Rehabilitation Department, Hanoi Medical University (Bach Mai Hospital), Hanoi, Vietnam.,Faculty of Health Sciences, Phenikaa University, Hanoi, Vietnam
| | - Nguyen Van Bang
- Department of Paediatrics, Hanoi Medical University, Hanoi, Vietnam.,Faculty of Medicine, Hanoi University of Business and Technology, Hanoi, Vietnam
| | - Nadia Badawi
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
| | - Gulam Khandaker
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,CSF Global, Dhaka, Bangladesh.,Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh.,Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Australia
| | - Elizabeth Elliott
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Kid's Research, The Sydney Children's Hospitals Network (Westmead), Sydney, Australia
| |
Collapse
|
4
|
Ayenew A, Abebe M, Ewnetu M. Essential Newborn Care and Associated Factors Among Obstetrical Care Providers in Awi Zone Health Facilities, Northwest Ethiopia: An Institutional-Based Cross-Sectional Study. Pediatric Health Med Ther 2020; 11:449-458. [PMID: 33204205 PMCID: PMC7667187 DOI: 10.2147/phmt.s276698] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 10/16/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Each year, millions of newborns die as a result of birth asphyxia, infections, and complications of preterm birth. This burden of death is disproportionately concentrated in low-income countries including Ethiopia. As a result, the care given immediately after birth is crucial for making a successful transition from intrauterine to extrauterine function and to reduce neonatal mortality. METHODS Facility-based cross-sectional study design was carried out on a sample size of 208 obstetrical care providers. A simple random sampling technique was used to select the study subjects. The data were collected through Interview-administered questionnaires and observational checklists. The data were entered into Epi-info version 7 and exported to SPSS 23 for analysis. RESULTS A total of 201 obstetric care providers participated in the study, making a response rate of (96.6%). This study revealed that 62.7% of obstetric care providers practiced essential newborn care properly. The factors significantly associated were received in-service training (AOR = 2.7, 95% CI: 1.35, 5.51), level of education (AOR = 0.46, 95% CI: 0.22, 0.96), midwifery profession (AOR = 3.1, 95% CI: 1.35, 7.39), having good knowledge of essential newborn care (AOR = 2.1, 95% CI: 1.03, 4.49), availability of drugs for essential newborn care (AOR = 2.3, 95% CI: 1.16, 4.72), and availability of medical equipment to perform essential newborn care (AOR = 2, 95% CI: 1.01, 3.96). CONCLUSION The practice of essential newborn care was generally low. Having in-service training, midwifery profession, a good knowledge of essential newborn care, availability of drugs, level of education, and availability of medical equipment for essential newborn care were the determinant factors for essential newborn care practice. Improvement in essential newborn care practices could be attained through modifiable proven interventions like provision of in-service training, availed drugs, and medical equipment for essential newborn care.
Collapse
Affiliation(s)
- Asteray Ayenew
- Department of Midwifery, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Mahlet Abebe
- Department of Midwifery, School of Health Sciences, College of Medicine and Health Sciences, Mizan Tepi University, Mizan Teferi, Ethiopia
| | - Mesafint Ewnetu
- Department of Midwifery, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| |
Collapse
|
5
|
Mungai IG, Baghel SS, Soni S, Vagela S, Sharma M, Diwan V, Tamhankar AJ, Lundborg CS, Pathak A. Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers-a cross-sectional study from Ujjain, India. BMC Health Serv Res 2020; 20:966. [PMID: 33087124 PMCID: PMC7576775 DOI: 10.1186/s12913-020-05805-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 10/06/2020] [Indexed: 11/10/2022] Open
Abstract
Background More than a quarter of global neonatal deaths are reported from India, and a large proportion of these deaths are preventable. However, in the absence of robust public health care systems in several states in India, informal health care providers (IHCPs) with no formal medical education are the first contact service providers. The aim of this study was to assess the knowledge of IHCPs in basic evidence-based practices in neonatal care in Ujjain district and investigated factors associated with differences in levels of knowledge. Methods A cross-sectional survey was conducted using a questionnaire with multiple-choice questions covering the basic elements of neonatal care. The total score of the IHCPs was calculated. Multivariate quantile regression model was used to look for association of IHCPs knowledge score with: the practitioners’ age, years of experience, number of patients treated per day, and whether they attended children in their practice. Results Of the 945 IHCPs approached, 830 (88%) participated in the study. The mean ± SD score achieved was 22.3 ± 7.7, with a median score of 21 out of maximum score of 48. Although IHCPs could identify key tenets of enhancing survival chances of neonates, they scored low on the specifics of cord care, breastfeeding, vitamin K use to prevent neonatal hemorrhage, and identification and care of low-birth-weight babies. The practitioners particularly lacked knowledge about neonatal resuscitation, and only a small proportion reported following up on immunizations. Results of quantile regression analysis showed that more than 5 years of practice experience and treating more than 20 patients per day had a statistically significant positive association with the knowledge score at higher quantiles (q75th and q90th) only. IHCPs treating children had significantly better scores across quantiles accept at the highest quantile (90th). Conclusions The present study highlighted that know-do gap exists in evidence-based practices for all key areas of neonatal care tested among the IHCPs. The study provides the evidence that some IHCPs do possess knowledge in basic evidence-based practices in neonatal care, which could be built upon by future educational interventions. Targeting IHCPs can be an innovative way to reach a large rural population in the study setting and to improve neonatal care services.
Collapse
Affiliation(s)
- Isaac Gikandi Mungai
- Department of Global Public Health-Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, 17177, Stockholm, Sweden
| | - Sumit Singh Baghel
- Department of Pediatrics, RD Gardi Medical College, Ujjain, MP, 456010, India
| | - Shuchi Soni
- Department of Pediatrics, RD Gardi Medical College, Ujjain, MP, 456010, India
| | - Shailja Vagela
- Department of Pediatrics, RD Gardi Medical College, Ujjain, MP, 456010, India
| | - Megha Sharma
- Department of Global Public Health-Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, 17177, Stockholm, Sweden.,Department of Pharmacology, RD Gardi Medical College, Ujjain, MP, 4560101, India
| | - Vishal Diwan
- Department of Global Public Health-Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, 17177, Stockholm, Sweden.,National Institute for Research in Environmental Health (NIREH), Bhopal, MP, India
| | - Ashok J Tamhankar
- Department of Global Public Health-Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, 17177, Stockholm, Sweden.,Indian Initiative for Management of Antibiotic Resistance, Department of Environmental Medicine, R.D. Gardi Medical College, Ujjain, 456006, India
| | - Cecilia Stålsby Lundborg
- Department of Global Public Health-Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, 17177, Stockholm, Sweden
| | - Ashish Pathak
- Department of Global Public Health-Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, 17177, Stockholm, Sweden. .,Department of Pediatrics, RD Gardi Medical College, Ujjain, MP, 456010, India. .,Department of Women and Children's Health, International Maternal and Child Health Unit, Uppsala University, SE-751 85, Uppsala, Sweden.
| |
Collapse
|
6
|
Van Giang N, Lin SY, Thai DH. A psychometric evaluation of the Vietnamese version of the Evidence-Based Practice Attitudes and Beliefs Scales. Int J Nurs Pract 2020; 27:e12896. [PMID: 33058371 DOI: 10.1111/ijn.12896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 09/06/2020] [Accepted: 09/19/2020] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study is to develop and to test the construct validity and reliability of the Vietnamese versions of the Evidence-Based Practice Attitude and Evidence-Based Practice Beliefs scales. METHODS This is a psychometric evaluation study. Three hundred and fifty-three nurses and midwives were recruited from a national hospital in Vietnam from September to December 2018. Data were obtained from two scales. Content validity, face validity and construct validity measures were all conducted, whereas exploratory and confirmatory factor analyses were performed from data collected from two cohorts of participants. Cronbach's alpha coefficient represented reliability, and data were analysed in SPSS 20 and AMOS 24. RESULTS The four-factor model developed with openness, requirements, appeal and divergence factors accounted for 55% of total variance in the Attitude scale. A three-factor model labelled as value beliefs, knowledge beliefs and resource beliefs with 59% of total variance was explained in the Beliefs scale. Cronbach's α coefficients were .72 for the Attitude scale and .81 for the Beliefs scale. CONCLUSIONS The two scales could be used to assess Vietnamese nurses' attitudes and beliefs to adopt evidence-based practice enabling hospitals to align individual and organizational goals for developing evidence-based practice and enable comparison of the results with international samples.
Collapse
Affiliation(s)
- Nguyen Van Giang
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Nursing, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - Shu-Yuan Lin
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Duong Hong Thai
- Thai Nguyen National Hospital, Thai Nguyen, Vietnam.,Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| |
Collapse
|
7
|
Armson H, Perrier L, Roder S, Shommu NS, Wakefield J, Shaw E, Zahorka S, Elmslie T, Lofft M. Assessing Unperceived Learning Needs in Continuing Medical Education for Primary Care Physicians: A Scoping Review. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2020; 40:257-267. [PMID: 33284177 DOI: 10.1097/ceh.0000000000000300] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
INTRODUCTION Assessing needs before developing continuing medical education/continuing professional development (CME/CPD) programs is a crucial step in the education process. A previous systematic literature review described a lack of objective evaluation for learning needs assessments in primary care physicians. This scoping review updates the literature on uses of objective evaluations to assess physicians' unperceived learning needs in CME/CPD. Identifying and understanding these approaches can inform the development of educational programs that are relevant to clinical practice and patient care. The study objectives were to (1) scope the literature since the last systematic review published in 1999; (2) conduct a comprehensive search for studies and reports that explore innovative tools and approaches to identify physicians' unperceived learning needs; (3) summarize, compare, and classify the identified approaches; and (4) map any gaps in the literature to identify future areas of research. METHODS A scoping review was used to "map" the literature on current knowledge regarding approaches to unperceived needs assessment using conceptual frameworks for planning and assessing CME/CPD activities. RESULTS Two prominent gaps were identified: (1) performance-based assessment strategies are highly recommended in nonresearch articles yet have low levels of implementation in published studies and (2) analysis of secondary data through patient input or environmental scanning is emphasized in grey literature implementation strategies more so than in peer-reviewed theoretical and research articles. DISCUSSION Future evaluations should continue to incorporate multiple strategies and focus on making unperceived needs assessments actionable by describing strategies for resource management.
Collapse
Affiliation(s)
- Heather Armson
- Dr. Armson: Assistant Dean, Continuing Medical Education and Professional Development and Professor, Department of Family Medicine, University of Calgary; Research Director, The Foundation for Medical Practice Education, McMaster University. Dr. Perrier: Research Data Management Librarian, University of Toronto Libraries, University of Toronto. Dr. Roder: Research Program Coordinator, The Foundation for Medical Practice Education, McMaster University. Dr. Shommu: Research Coordinator, Department of Medicine, Cumming School of Medicine, University of Calgary. Dr. Wakefield: Professor Emeritus, Department of Family Medicine, McMaster University; Senior Editor, Module Development, The Foundation for Medical Practice Education, McMaster University. Dr. Shaw: Professor; Associate Chair of Education, Department of Family Medicine; Director, Module Development, The Foundation for Medical Practice Education, McMaster University. Ms. Zahorka: Education Coordinator, The Foundation for Medical Practice Education, McMaster University. Dr. Elmslie: Professor Emeritus, Department of Family Medicine, University of Ottawa; Executive Director, The Foundation for Medical Practice Education, McMaster University. Ms. Lofft: Research Assistant, The Foundation for Medical Practice Education, McMaster University
| | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Abdu H, Gebrselassie M, Abdu M, Mare KU, Tadesse W, Liben ML. Knowledge and practice of immediate newborn care among midwives and nurses in public health facilities of Afar regional state, Northeast Ethiopia. BMC Pregnancy Childbirth 2019; 19:422. [PMID: 31744464 PMCID: PMC6862785 DOI: 10.1186/s12884-019-2581-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 11/05/2019] [Indexed: 11/10/2022] Open
Abstract
Background The care given to newborns immediately within the first few hours of birth is critical for their survival. However, their survival depends on the health professional’s knowledge and skills to deliver appropriate newborn care interventions. Therefore, this study aimed to assess the knowledge and practice of immediate newborn care among nurses and midwives in public health facilities of Afar Regional State, Northeast Ethiopia. Methods Institution based cross-sectional study design was employed on 357 nurses and midwives working in 48 public health facilities (45 health centers and 3 hospitals) during April 2018. Data were collected using interviewer-administered questionnaire and observation checklist. Then, data were entered into Epi-info version 7.0 and exported to SPSS version 20 for analysis. Univariable and multivariable logistic regression analyses were carried out to estimate odds ratio with 95% confidence interval. A p-value less than 0.05 was used to declare statistical significance. Results Overall, 53.8% [95% CI: (48.6, 59.0%)] and 62.7% [(95% CI: (57.7, 67.8%))] of the health professionals (midwives and nurses) had adequate knowledge and good practice on immediate newborn care, respectively. Working in hospital [AOR: 4.62; 95% CI (1.76, 12.10)], being a female [AOR: 0.59; 95% CI (0.39, 0.98)] and interested in providing newborn care [AOR: 0.29; 95% CI (0.13, 0.68)] were positively associated with having adequate knowledge on immediate newborn care. On the other hand, having work experience of < 5 years [AOR: 0.33; 95% CI (0.14, 0.78)], inadequate knowledge [AOR: 0.39; 95% CI (0.25, 0.64)], having work load [AOR: 2.09; 95% CI (1.17, 3.73)], being not interested to provide immediate newborn care [AOR: 0.35; 95% CI (0.16, 0.74)] and working in health center [AOR: 8.56; 95% CI (2.39, 30.63)] were negatively associated with good immediate newborn care practices. Conclusions A significant number of nurses and midwives had inadequate knowledge and poor practice on immediate newborn care. Therefore, providing a comprehensive newborn care training and creating an opportunity for nurses and midwives working at health centers to share experience from those hired in hospitals are very crucial to improve their knowledge and skills on newborn care.
Collapse
Affiliation(s)
- Hawa Abdu
- Family Health Case Team Coordinator, Regional Health Bureau, Samara, Afar, Ethiopia
| | - Measho Gebrselassie
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Mohammed Abdu
- Department of Midwifery, College of Medical and Health Sciences, Samara University, Samara, Afar, Ethiopia
| | - Kusse Urmale Mare
- Department of Nursing, College of Medical and Health Sciences, Samara University, Samara, Afar, Ethiopia.
| | - Woldemichael Tadesse
- Department of Nursing, College of Medical and Health Sciences, Samara University, Samara, Afar, Ethiopia
| | - Misgan Legesse Liben
- Department of Public Health, College of Health Sciences, Woldia University, Woldia, Amhara, Ethiopia
| |
Collapse
|
9
|
Immediate newborn care of knowledge, practice and associated factors among health care providers in Northwestern Zonal health facilities Tigray, Ethiopia, 2018. BMC Res Notes 2019; 12:427. [PMID: 31315651 PMCID: PMC6637593 DOI: 10.1186/s13104-019-4465-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 07/11/2019] [Indexed: 11/10/2022] Open
Abstract
Objective The aim of this study was to assess the immediate newborn care of knowledge, practice and associated factors among healthcare providers in Northwestern Zonal health facilities Tigray, Ethiopia, 2018. Results Among the total healthcare providers, who participated in this study, 64.8% had good knowledge and 59.8% of the respondents had a good level of essential newborn care practice. Unavailability of adequate materials (like guidelines, drug, etc.) and training status were significant variables with knowledge and practice of newborn care.
Collapse
|
10
|
Dao HT, Pichaiyongwongdee S, Sullivan PE, Prasertsukdee S, Apinonkul B. Are physical therapists in Viet Nam ready to implement evidence-based practice? A survey. BMC MEDICAL EDUCATION 2018; 18:317. [PMID: 30577798 PMCID: PMC6303861 DOI: 10.1186/s12909-018-1428-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 12/10/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Evidence-based practice (EBP) enhances healthcare services and keeps providers current with best practices. EBP has been adopted and spread worldwide. However, people will not apply it if they do not know, understand, or believe it. Few studies have considered EBP application in Viet Nam. This study explores whether Vietnamese physical therapists' attitude, knowledge, skills toward EBP and barriers to its use make them ready to implement its practice. METHODS A survey questionnaire was sent directly to physical therapists in governmental healthcare organizations in Ho Chi Minh City, Viet Nam, from July to October, 2017. It consisted of 41 closed- and open-ended questions related to knowledge, attitude, behaviors, frequency of use, and barriers of EBP and the demographic characteristics of participants. Descriptive statistics and significant correlations were determined from Chi-Square statistics or odds ratios between the variables. RESULTS The return rate was 93% (421 out of 453). Eliminated were 40 responses inconsistent with inclusion criteria. The 381 eligible participants were more female (62%) than male, about 53% had vocational degrees, less than 1% had M.S. degrees. Participants reported a positive attitude toward EBP. An incongruity existed between knowledge/ skills of EBP and the frequency of using its 5 steps. English competence was the most critical barrier to applying EBP. The significant associations between attitude and knowledge, and demographical attributes indicated that younger therapists with lower educational degrees had less knowledge of EBP and they rarely employed the application and analytical steps 4 and 5. CONCLUSIONS The incongruity between knowledge and use of EBP may result from the lack of EBP in academic education. The skills of reading professional articles in the English language and understanding and applying the steps of EBP should be emphasized in academic physical therapy programs. Additionally, policy makers should consider the number of patients a day per physical therapist which impacts EBP use and the quality of healthcare service.
Collapse
Affiliation(s)
- Hiep Thi Dao
- Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom, 73170 Thailand
| | - Sopa Pichaiyongwongdee
- Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom, 73170 Thailand
| | - Patricia E. Sullivan
- Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom, 73170 Thailand
| | - Saipin Prasertsukdee
- Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom, 73170 Thailand
| | - Benjawan Apinonkul
- Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom, 73170 Thailand
| |
Collapse
|
11
|
Pallangyo E, Mbekenga C, Olsson P, Rubertsson C, Källestål C. Improved postpartum care after a participatory facilitation intervention in Dar es Salaam, Tanzania: a mixed method evaluation. Glob Health Action 2018; 10:1295697. [PMID: 28498737 PMCID: PMC5496052 DOI: 10.1080/16549716.2017.1295697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: In order to improve the health and survival of mothers/newborns, the quality and attendance rates of postpartum care (PPC) must be increased, particularly in low-resource settings. Objective: To describe outcomes of a collegial facilitation intervention to improve PPC in government-owned health institutions in a low-resource suburb in Dar es Salaam, Tanzania. Methods: A before-and-after evaluation of an intervention and comparison group was conducted using mixed methods (focus group discussions, questionnaires, observations, interviews, and field-notes) at health institutions. Maternal and child health aiders, enrolled nurse midwives, registered nurse midwives, and medical and clinical officers participated. A collegial facilitation intervention was conducted and healthcare providers were organized in teams to improve PPC at their workplaces. Facilitators defined areas of improvement with colleagues and met regularly with a supervisor for support. Results: The number of mothers visiting the institution for PPC increased in the intervention group. Some care actions were noted in more than 80% of the observations and mothers reported high satisfaction with care. In the comparison group, PPC continued to be next to non-existent. The healthcare providers’ knowledge increased in both groups but was higher in the intervention group. The t-test showed a significant difference in knowledge between the intervention and comparison groups and between before and after the intervention in both groups. The difference of differences for knowledge was 1.3. The providers perceived the intervention outcomes to include growing professional confidence/knowledge, improved PPC quality, and mothers’ positive response. The quality grading was based on the national guidelines and involved nine experts and showed that none of the providers reached the level of good quality of care. Conclusions: The participatory facilitation intervention contributed to improved quality of PPC, healthcare providers’ knowledge and professional confidence, awareness of PPC among mothers, and increased PPC attendance.
Collapse
Affiliation(s)
- Eunice Pallangyo
- a School of Nursing and Midwifery , Aga Khan University , Dar es Salaam , Tanzania.,b International Maternal and Child Health (IMCH), Department of Women's and Children's Health , Uppsala University , Uppsala , Sweden
| | - Columba Mbekenga
- c School of Nursing, Department of Community Health , Muhimbili University of Health and Allied Sciences , Dar es Salaam , Tanzania
| | - Pia Olsson
- b International Maternal and Child Health (IMCH), Department of Women's and Children's Health , Uppsala University , Uppsala , Sweden
| | - Christine Rubertsson
- b International Maternal and Child Health (IMCH), Department of Women's and Children's Health , Uppsala University , Uppsala , Sweden
| | - Carina Källestål
- b International Maternal and Child Health (IMCH), Department of Women's and Children's Health , Uppsala University , Uppsala , Sweden
| |
Collapse
|
12
|
McBride B, Nguyen LT, Wiljer D, Vu NC, Nguyen CK, O'Neil J. Development of a Maternal, Newborn and Child mHealth Intervention in Thai Nguyen Province, Vietnam: Protocol for the mMom Project. JMIR Res Protoc 2018; 7:e6. [PMID: 29326095 PMCID: PMC5785686 DOI: 10.2196/resprot.7912] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 08/28/2017] [Accepted: 11/17/2017] [Indexed: 11/15/2022] Open
Abstract
Background Ethnic minority women (EMW) living in mountainous areas of northern Vietnam have disproportionately high infant and maternal mortality rates as a result of low maternal health knowledge, poverty, and remoteness from low-capacity health centers. Objective The objective of this study was to describe the protocol for the development and evaluation of the mMom intervention, which is an integrated mobile health (mHealth) system designed to improve maternal and infant health knowledge, and behavior among women in remote areas of Thai Nguyen, Vietnam. Methods This project featured the following four phases: (1) development of an mHealth platform integrated into the existing health management information system in partnership with the provincial health department; (2) ethnographic fieldwork and intervention content development; (3) intervention piloting and implementation; and (4) evaluation of the intervention’s impact on participants’ maternal health knowledge, behavior, and interactions with the health system. Results The mMom project development process resulted in the following: (1) the successful development of the mMom system, including the mHealth platform hardware and integration, the intervention plan and content, and the monitoring and evaluation framework; (2) the piloting and implementation of the intervention as planned; and (3) the implementation of the monitoring and evaluation framework components. Conclusions This protocol outlines the development of the mMom intervention and describes critical next steps in understanding the impact of the intervention on participants and the wider health system in Thai Nguyen province, Vietnam.
Collapse
Affiliation(s)
- Bronwyn McBride
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.,Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Liem Thanh Nguyen
- Institute of Population, Health and Development, Hanoi, Viet Nam.,Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia
| | - David Wiljer
- Education Technology Innovation, University Health Network, Toronto, ON, Canada.,Institute for Health Policy Management and Evaluation, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Nguyen C Vu
- Institute of Population, Health and Development, Hanoi, Viet Nam
| | - Cuong K Nguyen
- Vietnam eHealth Medical Investment and Communication, Hanoi, Viet Nam
| | - John O'Neil
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| |
Collapse
|
13
|
Eriksson L, Bergström A, Hoa DTP, Nga NT, Eldh AC. Sustainability of knowledge implementation in a low- and middle- income context: Experiences from a facilitation project in Vietnam targeting maternal and neonatal health. PLoS One 2017; 12:e0182626. [PMID: 28806744 PMCID: PMC5555694 DOI: 10.1371/journal.pone.0182626] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 07/07/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In a previous trial in Vietnam, a facilitation strategy to secure evidence-based practice in primary care resulted in reduced neonatal mortality over a period of three years. While little is known as to what ensures sustainability in the implementation of community-based strategies, the aim of this study was to investigate factors promoting or hindering implementation, and sustainability of knowledge implementation strategies, by means of the former Neonatal Knowledge Into Practice (NeoKIP) trial. METHODS In 2014 we targeted all levels in the Vietnamese healthcare system: six individual interviews with representatives at national, provincial and district levels, and six focus group discussions with representatives at the commune level. The interviews were transcribed verbatim, translated to English, and analysed using inductive and deductive thematic analysis. RESULTS To achieve successful implementation and sustained effect of community-based knowledge implementation strategies, engagement of leaders and key stakeholders at all levels of the healthcare system is vital-prior to, during and after a project. Implementation and sustainability require thorough needs assessment, tailoring of the intervention, and consideration of how to attain and manage funds. The NeoKIP trial was characterised by a high degree of engagement at the primary healthcare system level. Further, three years post trial, maternal and neonatal care was still high on the agenda for healthcare workers and leaders, even though primary aspects such as stakeholder engagement at all levels, and funding had been incomplete or lacking. CONCLUSIONS The current study illustrates factors to support successful implementation and sustain effects of community-based strategies in projects in low- and middle-income settings; some but not all factors were represented during the post-NeoKIP era. Most importantly, trials in this and similar contexts require deliberate management throughout and beyond the project lifetime, and engagement of key stakeholders, in order to promote and sustain knowledge implementation.
Collapse
Affiliation(s)
- Leif Eriksson
- International Maternal and Child Health (IMCH), Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Departmant of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Anna Bergström
- International Maternal and Child Health (IMCH), Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Institute for Global Health, London, United Kingdom
| | | | | | - Ann Catrine Eldh
- Departmant of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| |
Collapse
|
14
|
Berhe AK, Tinsae F, Gebreegziabher G. Knowledge and practice of immediate newborn care among health care providers in eastern zone public health facilities, Tigray, Ethiopia, 2016. BMC Pediatr 2017; 17:157. [PMID: 28693501 PMCID: PMC5504861 DOI: 10.1186/s12887-017-0915-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 06/29/2017] [Indexed: 11/16/2022] Open
Abstract
Background According to WHO (2013) report the number of under five-year mortality in Ethiopia was 195,504, out of this 84,437 was from neonatal death and this mortality is related to immediate obstetric and newborn care of babies provided by health care providers; But little was known about the level of knowledge and practice related to immediate newborn care and their associated factors among health care providers generally in Tigray region and specifically in the Eastern Zone so the aim of this study was to assess knowledge and practice of immediate newborn care and associated factors among health care providers in the Eastern zone public health facilities, Tigray, Ethiopia. Methods A cross-sectional study was conducted from December 2015 to February 2016. A total of 16 health care facilities were selected for study using simple random sampling techniques and all health care providers in the selected health care facilities who participated in immediate newborn care were involved in the study. Data were entered, cleaned and analyzed using SPSS version 20.0. Ethical clearance was obtained from Adigrat University institutional ethical review board and Tigray regional health bureau. Consent was obtained from participants to conduct the study. Result In this study 215 participants were contacted, with a response rate of 99.1%. Generally, from the health care providers who participated in this study, 74.65% had adequate knowledge on newborn care and overall 72.77% of the participants were having good newborn care practice. Among the health care providers participated in the study, 151 (70.9%) were getting access to newborn care national guideline and only 99 (46%) of the health care providers get training in newborn care within the past two years before the study. Availability of national guideline, having adequate materials, the period of taking training and type of health facility were significant predictors for the health care providers newborn care practice. Conclusion Even though some improvement observed in the knowledge and practice of health care providers on newborn care, but still this study identified knowledge and practice gap. Regional health bureau and district health offices should provide refreshment training on immediate newborn care regularly, equipping all health facilities with necessary materials and national guideline of newborn care and there should be sharing experience between hospital and health center staffs working on newborn care through mentoring.
Collapse
Affiliation(s)
| | - Fitiwi Tinsae
- Department of Nursing, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
| | | |
Collapse
|
15
|
Gallagher K, Partridge C, Tran HT, Lubran S, Macrae D. Nursing & parental perceptions of neonatal care in Central Vietnam: a longitudinal qualitative study. BMC Pediatr 2017; 17:161. [PMID: 28697746 PMCID: PMC5505145 DOI: 10.1186/s12887-017-0909-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Accepted: 06/29/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Neonatal mortality accounts for nearly three quarters of all infant deaths in Vietnam. The nursing team are the largest professional group working with newborns, however do not routinely receive neonatal training and there is a lack of research into the impact of educational provision. This study explored changes in nursing perceptions towards their role following a neonatal educational intervention. Parents perceptions of nursing care were explored to determine any changes as nurses gained more experience. METHOD Semi-Structured qualitative interviews were conducted every 6 months over an 18 month period with 16 nurses. At each time point, parents whose infant was resident on the neonatal unit were invited to participate in an interview to explore their experiences of nursing care. A total of 67 parents participated over 18 months. Interviews were conducted and transcribed in Vietnamese before translation into English for manifest content analysis facilitated by NVivo V14. RESULTS Analysis of nursing transcripts identified 14 basic categories which could be grouped (23) into 3 themes: (1) perceptions of the role of the neonatal nurse, (2) perception of the parental role and (3) professional recollections. Analysis of parent transcripts identified 14 basic categories which could be grouped into 3 themes: (1) information sharing, (2) participation in care, and (3) personal experience. CONCLUSIONS Qualitative interviews highlighted the short term effect that the introduction of an educational intervention can have on both nursing attitudes towards and parental experience of care in one neonatal unit in central Vietnam. Nurses shared a growing awareness of their role along with its ethical issues and challenges, whilst parents discussed their overall desire for more participation in their infants care. Further research is required to determine the long term impact of the intervention, the ability of nurses to translate knowledge into clinical practice through assessment of nursing knowledge and competence, and the impact and needs of parents. A greater understanding will allow us to continue to improve the experiences of nurses and parents, and highlight how these areas may contribute towards the reduction of infant mortality and morbidity in Vietnam.
Collapse
Affiliation(s)
- Katie Gallagher
- Institute for Women's Health, University College London, 74 Huntley Street, London, WC1E 6AU, UK.
| | - Colin Partridge
- Department of Pediatrics, University of California, San Francisco, USA
| | - Hoang T Tran
- Neonatal Unit, Da Nang Hospital for Women and Children, Da Nang, Vietnam
| | | | - Duncan Macrae
- Pediatric Intensive Care, Royal Brompton and Harefield NHS Trust, London, UK
| |
Collapse
|
16
|
Pallangyo EN, Mbekenga C, Källestål C, Rubertsson C, Olsson P. "If really we are committed things can change, starting from us": Healthcare providers' perceptions of postpartum care and its potential for improvement in low-income suburbs in Dar es Salaam, Tanzania. SEXUAL & REPRODUCTIVE HEALTHCARE 2016; 11:7-12. [PMID: 28159132 DOI: 10.1016/j.srhc.2016.09.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 06/02/2016] [Accepted: 09/05/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To explore healthcare providers' perceptions of the current postpartum care (PPC) practice and its potential for improvement at governmental health institutions in low-resource suburbs in Dar es Salaam, Tanzania. DESIGN Qualitative design, using focus group discussions (8) and qualitative content analysis. SETTING Healthcare institutions (8) at three levels of governmental healthcare in Ilala and Temeke suburbs, Dar es Salaam. PARTICIPANTS Registered, enrolled and trained nurse-midwives (42); and medical and clinical officers (13). RESULTS The healthcare providers perceived that PPC was suboptimal and that they could have prevented maternal deaths. PPC was fragmented at understaffed institutions, lacked guidelines and was organized in a top-down structure of leadership. The participants called for improvement of: organization of space, time, resources, communication and referral system; providers' knowledge; and supervision and feedback. Their motivation to enhance PPC quality was high. KEY CONCLUSIONS The HCP awareness of the suboptimal quality of PPC, its potential for promoting health and their willingness to engage in improving care are promising for the implementation of interventions to improve quality of care. Provision of guidelines, sensitization of providers to innovate and maximize utilization of existing resources, and supportive supervision and feedback are likely to contribute to the sustainability of any improvement.
Collapse
Affiliation(s)
- Eunice N Pallangyo
- School of Nursing and Midwifery/TIHE, Aga Khan University, P.O. Box 38129, Ufukoni Road, Dar es Salaam, Tanzania; International Maternal and Child Health/IMCH, Department of Women's and Children's Health, Uppsala University, Akademiska Sjukhuset, SE 751 85 Uppsala, Sweden.
| | - Columba Mbekenga
- School of Nursing, Department of Community Health, Muhimbili University of Health and Allied Sciences/MUHAS, Dar es Salaam, Tanzania
| | - Carina Källestål
- International Maternal and Child Health/IMCH, Department of Women's and Children's Health, Uppsala University, Akademiska Sjukhuset, SE 751 85 Uppsala, Sweden
| | - Christine Rubertsson
- International Maternal and Child Health/IMCH, Department of Women's and Children's Health, Uppsala University, Akademiska Sjukhuset, SE 751 85 Uppsala, Sweden
| | - Pia Olsson
- International Maternal and Child Health/IMCH, Department of Women's and Children's Health, Uppsala University, Akademiska Sjukhuset, SE 751 85 Uppsala, Sweden
| |
Collapse
|
17
|
Nguyen TNM, Wilson A. Hospital readiness for undertaking evidence-based practice: A survey. Nurs Health Sci 2016; 18:465-472. [PMID: 27345522 DOI: 10.1111/nhs.12293] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 04/25/2016] [Accepted: 04/26/2016] [Indexed: 10/21/2022]
Abstract
Despite the fact that evidence-based practice has increasing emphasis in health care, organizations are not always prepared for its implementation. Identifying organizational preparedness for implementing evidence-based practice is desirable prior to application. A cross-sectional survey was developed to explore nurses' perception of organizational support for evidence-based practice and was implemented via a self-enumerated survey completed by 234 nurses. Data were analyzed with descriptive and inferential statistics. Nurses reported that implementation of evidence-based practice is complex and fraught with challenges because of a lack of organizational support. A conceptual framework comprising three key factors: information resources, nursing leadership, and organizational infrastructure was proposed to assist health authorities in the implementation of evidence-based practice. Suggestions of how organizations can be more supportive of research utilization in practice include establishing a library, journal clubs/mentoring programs, nurses' involvement in decision-making at unit level, and a local nursing association.
Collapse
Affiliation(s)
- Thi Ngoc Minh Nguyen
- Nursing Faculty, Danang University of Medical Technologies and Pharmacy, Danang City, Vietnam
| | - Anne Wilson
- School of Medicine, Flinders University, Adelaide, South Australia, Australia.,School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| |
Collapse
|
18
|
Knowledge, skills, and attitudes to implementing best practice in hospitals in Central Vietnam. INT J EVID-BASED HEA 2016; 14:142-149. [PMID: 27089395 DOI: 10.1097/xeb.0000000000000081] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although nurses recognize the importance of evidence-based practice (EBP) to improve health outcomes, they still find its implementation complex. Successful EBP requires nurses to have the knowledge and expertise to appraise and critically apply evidence into practice. OBJECTIVES The study sought to identify Central Vietnam nurses' knowledge, skills, and attitudes to implementing EBP. METHODS A cross-sectional descriptive research design was implemented to identify nurses' ability to conduct EBP in two large hospitals in Central Vietnam. A total of 234 nurses returned completed surveys. Data were analyzed with descriptive and inferential statistics. RESULTS Nurses in Central Vietnam were not prepared for undertaking EBP. Only 29.5% of the respondents said they were familiar with the term EBP. Although they embraced a positive attitude toward EBP, they felt less confident to implement this innovation. Many failed to engage with research and still relied most heavily on informal information to guide their practice. IMPLICATIONS The evidence obtained from this study supports the need for an education intervention to develop nurses' knowledge and skills of research and research usage.
Collapse
|
19
|
Duong DM, Bergström A, Wallin L, Bui HTT, Eriksson L, Eldh AC. Exploring the influence of context in a community-based facilitation intervention focusing on neonatal health and survival in Vietnam: a qualitative study. BMC Public Health 2015; 15:814. [PMID: 26297314 PMCID: PMC4546163 DOI: 10.1186/s12889-015-2142-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 08/11/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND In the Neonatal health - Knowledge into Practice (NeoKIP) trial in Vietnam, local stakeholder groups, supported by trained laywomen acting as facilitators, promoted knowledge translation (KT) resulting in decreased neonatal mortality. In general, as well as in the community-based NeoKIP trial, there is a need to further understand how context influences KT interventions in low- and middle-income countries (LMICs). Thus, the objective of this study was to explore the influence of context on the facilitation process in the NeoKIP intervention. METHODS A secondary content analysis was performed on 16 Focus Group Discussions with facilitators and participants of the stakeholder groups, applying an inductive approach to the content on context through naïve understanding and structured analysis. RESULTS The three main-categories of context found to influence the facilitation process in the NeoKIP intervention were: (1) Support and collaboration of local authorities and other communal stakeholders; (2) Incentives to, and motivation of, participants; and (3) Low health care coverage and utilization. In particular, the role of local authorities in a KT intervention was recognized as important. Also, while project participants expected financial incentives, non-financial benefits such as individual learning were considered to balance the lack of reimbursement in the NeoKIP intervention. Further, project participants recognized the need to acknowledge the needs of disadvantaged groups. CONCLUSIONS This study provides insight for further understanding of the influence of contextual aspects to improve effects of a KT intervention in Vietnam. We suggest that future KT interventions should apply strategies to improve local authorities' engagement, to identify and communicate non-financial incentives, and to make disadvantaged groups a priority. Further studies to evaluate the contextual aspects in KT interventions in LMICs are also needed.
Collapse
Affiliation(s)
- Duc M Duong
- Hanoi School of Public Health, 138 Giang Vo Street, Ba Dinh District, Ha Noi, Vietnam.
- International Maternal and Child Health (IMCH), Department of Women's and Children's Health, Uppsala University, SE-751 85, Uppsala, Sweden.
| | - Anna Bergström
- International Maternal and Child Health (IMCH), Department of Women's and Children's Health, Uppsala University, SE-751 85, Uppsala, Sweden.
- Division of Global Health/IHCAR, Department of Public Health Sciences, Karolinska Institutet, Nobels vag 9, SE-171 77, Stockholm, Sweden.
| | - Lars Wallin
- School of Education, Health and Social Studies, Dalarna University, SE-791 88, Falun, Sweden.
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
| | - Ha T T Bui
- Hanoi School of Public Health, 138 Giang Vo Street, Ba Dinh District, Ha Noi, Vietnam.
| | - Leif Eriksson
- International Maternal and Child Health (IMCH), Department of Women's and Children's Health, Uppsala University, SE-751 85, Uppsala, Sweden.
| | - Ann Catrine Eldh
- School of Education, Health and Social Studies, Dalarna University, SE-791 88, Falun, Sweden.
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
| |
Collapse
|
20
|
Alameddine M, Saleh S, Natafgi N. Assessing health-care providers' readiness for reporting quality and patient safety indicators at primary health-care centres in Lebanon: a national cross-sectional survey. HUMAN RESOURCES FOR HEALTH 2015; 13:37. [PMID: 25997430 PMCID: PMC4450474 DOI: 10.1186/s12960-015-0031-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Accepted: 05/09/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Successful endorsement of quality indicators hinges on the readiness and acceptability of care providers for those measures. This paper aims to assess the readiness of care providers in the primary health-care sector in Lebanon for the implementation of quality and patient safety indicators. METHODS A cross-sectional survey methodology was utilized to gather information from 943 clinical care providers working at 123 primary health-care centres in Lebanon. The questionnaire included two sections: the first assessed four readiness dimensions (appropriateness, management support, efficacy, and personal valence) of clinical providers to use quality and safety indicators using the Readiness for Organization Change (ROC) scale, and the second section assessed the safety attitude at the primary care centre utilizing the Agency of Health Research and Quality (AHRQ) Safety Attitude Questionnaire (SAQ)-Ambulatory version. RESULTS Although two thirds (66%) of respondents indicated readiness for implementation of quality and patient safety indicators in their centres, there appear to be differences by professional group. Physicians displayed the lowest scores on all readiness dimensions except for personal valence which was the lowest among nurses (60%). In contrast, allied health professionals displayed the highest scores across all readiness dimensions. Generally, respondents reflected a positive safety attitude climate in the centres. Yet, there remain a few areas of concern related to punitive culture (only 12.8% agree that staff should not be punished for reported errors/incidents), continuity of care (41.1% believe in the negative consequences of lack in continuity of care process), and resources (48.1% believe that the medical equipment they have are adequate). Providers with the highest SAQ score had 2.7, 1.7, 7 and 2.4 times the odds to report a higher readiness on the appropriateness, efficacy, management and personal valence ROC subscales, respectively (P value <0.01). Nurses displayed relatively lower odds of readiness across all other ROC subscales as compared to all other providers. CONCLUSION Health-care providers at the primary health care (PHC) centres in Lebanon are ready to engage in employing quality and patient safety indicators. This is a key finding given the active efforts by the MoPH to strengthen the quality culture in the PHC sector through various strategies.
Collapse
Affiliation(s)
- Mohamad Alameddine
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, PO Box 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon.
| | - Shadi Saleh
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, PO Box 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon.
| | - Nabil Natafgi
- Department of Health Management and Policy, College of Public Health, University of Iowa, CPHB - N277, 145 N. Riverside Dr., Iowa City, IA, 52242, USA.
| |
Collapse
|
21
|
Huchon C, Arsenault C, Tourigny C, Coulibaly A, Traore M, Dumont A, Fournier P. Obstetric competence among referral healthcare providers in Mali. Int J Gynaecol Obstet 2014; 126:56-9. [PMID: 24800659 DOI: 10.1016/j.ijgo.2014.01.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 12/20/2013] [Accepted: 03/26/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the factors associated with obstetric competency and clinical practice among obstetric care providers in referral health centers in Mali. METHODS The present cross-sectional study was conducted between March and May 2012 among 140 obstetric care providers (obstetric nurses, midwives, and physicians) working in referral health centers in Mali. Emergency obstetric care knowledge and skills were evaluated with clinical vignettes developed using national Malian guidelines. The vignettes covered 5 areas of emergency obstetric care, and the results were used to generate a competency score. A backward stepwise random-effects model using a maximum likelihood estimator was applied to evaluate variables independently associated with competency score. RESULTS Out of 100, the mean±SD score was 57.8±11.2 for obstetric nurses, 66.4±14.7 for midwifes, and 78.6±13.4 for physicians (P<0.001). Three variables were significantly associated with a higher competency score: professional qualification, working in an urban setting, and working in a health center with a smaller number of obstetric care providers. CONCLUSION Increasing the in-service training of both rural staff and lower-level healthcare workers working in larger health centers via facility-based maternal death reviews might help to improve clinical practice and maternal health outcomes.
Collapse
Affiliation(s)
- Cyrille Huchon
- Centre de recherche du CHU Sainte Justine, Montréal, Canada; Axe de Santé Mondiale, CRCHUM, Université de Montréal, Montréal, Canada
| | | | - Caroline Tourigny
- Axe de Santé Mondiale, CRCHUM, Université de Montréal, Montréal, Canada
| | - Aliou Coulibaly
- Axe de Santé Mondiale, CRCHUM, Université de Montréal, Montréal, Canada
| | - Mamadou Traore
- URFOSAME, Faculté de Médecine, Université de Bamako, Bamako, Mali
| | - Alexandre Dumont
- Unité 216, Institut de recherche pour le développement, Paris, France
| | - Pierre Fournier
- Axe de Santé Mondiale, CRCHUM, Université de Montréal, Montréal, Canada.
| |
Collapse
|
22
|
Traoré M, Arsenault C, Schoemaker-Marcotte C, Coulibaly A, Huchon C, Dumont A, Fournier P. Obstetric competence among primary healthcare workers in Mali. Int J Gynaecol Obstet 2014; 126:50-5. [DOI: 10.1016/j.ijgo.2014.01.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 12/20/2013] [Accepted: 03/26/2014] [Indexed: 10/25/2022]
|
23
|
Ayiasi RM, Criel B, Orach CG, Nabiwemba E, Kolsteren P. Primary healthcare worker knowledge related to prenatal and immediate newborn care: a cross sectional study in Masindi, Uganda. BMC Health Serv Res 2014; 14:65. [PMID: 24511880 PMCID: PMC3931348 DOI: 10.1186/1472-6963-14-65] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 02/04/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Global neonatal mortality remains unacceptably high. Health workers who attend to prenatal and postnatal mothers need to be knowledgeable in preventive and curative care for pregnant women and their newborn babies. This study aimed to determine the level of knowledge related to prenatal and immediate newborn care among primary healthcare workers in Masindi, Uganda. METHODS A cross-sectional study was conducted. Interviews comprised of 25 multiple-choice questions were administered to health workers who were deployed to offer prenatal and postnatal care in Masindi in November 2011. Questions were related to four domains of knowledge: prenatal care, immediate newborn care, management of neonatal infections and identifying and stabilizing Low-Birth Weight (LBW) babies. Corresponding composite variables were derived; level of knowledge among health workers dichotomized as 'adequate' or 'inadequate'. The chi-square statistic test was used to examine associations with independent variables including level of training (nursing assistant, general nurse or midwife), level of care (hospital/health centre level IV or health centre level III/II) and years of service (five years or less, six years or more). RESULTS 183 health workers were interviewed: general nurses (39.3%), midwives (21.9%) and nursing assistants (38.8%). Respectively, 53.6%, 46.5%, 7.1% and 56.3% were considered to have adequate knowledge in prenatal care, newborn care, management of neonatal infections and identifying/stabilizing LBW babies. Being a general nurse was significantly associated with having adequate knowledge in identifying and stabilizing LBW babies (p < 0.001) compared to being a nursing assistant. Level of care being hospital/health centre level IV was not significantly associated with having adequate knowledge in prenatal or newborn care with reference to health centres of level III/II. CONCLUSION Knowledge regarding prenatal and newborn care among primary healthcare workers in Masindi was very low. The highest deficit of knowledge was in management of neonatal infections. Efforts are needed to orientate health workers regarding prenatal and newborn care especially the offer of infection management among newborns. Similar levels of knowledge between health workers deployed to hospital/health centre level IV and health centres of level III/II raise important implementation questions for the referral system which is crucial for maternal and newborn survival.
Collapse
Affiliation(s)
- Richard Mangwi Ayiasi
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Mulago Hospital Complex, P,O Box 7072, Kampala, Uganda.
| | | | | | | | | |
Collapse
|
24
|
Kim YM, Ansari N, Kols A, Tappis H, Currie S, Zainullah P, Bailey P, Semba R, Sun K, van Roosmalen J, Stekelenburg J. Assessing the capacity for newborn resuscitation and factors associated with providers' knowledge and skills: a cross-sectional study in Afghanistan. BMC Pediatr 2013; 13:140. [PMID: 24020392 PMCID: PMC3846444 DOI: 10.1186/1471-2431-13-140] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 09/05/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Resuscitation with bag and mask is a high-impact intervention that can reduce neonatal deaths in resource-poor countries. This study assessed the capacity to perform newborn resuscitation at facilities offering comprehensive emergency obstetric and newborn care (EmONC) in Afghanistan, as well as individual and facility characteristics associated with providers' knowledge and clinical skills. METHODS Assessors interviewed 82 doctors and 142 midwives at 78 facilities on their knowledge of newborn resuscitation and observed them perform the procedure on an anatomical model. Supplies, equipment, and infrastructure were assessed at each facility. Descriptive statistics and simple and multivariate regression analyses were performed using STATA 11.2 and SAS 9.1.3. RESULTS Over 90% of facilities had essential equipment for newborn resuscitation, including a mucus extractor, bag, and mask. More than 80% of providers had been trained on newborn resuscitation, but midwives were more likely than doctors to receive such training as part of pre-service education (59% and 35%, respectively, p < 0.001). No significant differences were found between doctors and midwives on knowledge, clinical skills, or confidence in performing newborn resuscitation. Doctors and midwives scored 71% and 66%, respectively, on knowledge questions and 66% and 71% on the skills assessment; 75% of doctors and 83% of midwives felt very confident in their ability to perform newborn resuscitation. Training was associated with greater knowledge (p < 0.001) and clinical skills (p < 0.05) in a multivariable model that adjusted for facility type, provider type, and years of experience offering EmONC services. CONCLUSIONS Lack of equipment and training do not pose major barriers to newborn resuscitation in Afghanistan, but providers' knowledge and skills need strengthening in some areas. Midwives proved to be as capable as doctors of performing newborn resuscitation, which validates the major investment made in midwifery education. Competency-based pre-service and in-service training, complemented by supportive supervision, is an effective way to build providers' capacity to perform newborn resuscitation. This kind of training could also help skilled birth attendants based in the community, at private clinics, or at primary care facilities save the lives of newborns.
Collapse
Affiliation(s)
- Young Mi Kim
- Jhpiego/USA, an affiliate of Johns Hopkins University, 1615 Thames Street, Baltimore, MD 21231, USA
| | - Nasratullah Ansari
- Jhpiego/Afghanistan, an affiliate of Johns Hopkins University, Kabul, Afghanistan
| | - Adrienne Kols
- Jhpiego/USA, an affiliate of Johns Hopkins University, 1615 Thames Street, Baltimore, MD 21231, USA
| | - Hannah Tappis
- Johns Hopkins School of Public Health (JHSPH), Baltimore, MD, USA
| | - Sheena Currie
- Jhpiego/USA, an affiliate of Johns Hopkins University, 1615 Thames Street, Baltimore, MD 21231, USA
| | - Partamin Zainullah
- Jhpiego/Afghanistan, an affiliate of Johns Hopkins University, Kabul, Afghanistan
| | - Patricia Bailey
- FHI 360 and Averting Maternal Death & Disability, Durham, NC, USA
| | - Richard Semba
- Johns Hopkins Medical Institute (JHMI), Baltimore, MD, USA
| | - Kai Sun
- Johns Hopkins Medical Institute (JHMI), Baltimore, MD, USA
| | | | - Jelle Stekelenburg
- Department of Obstetrics & Gynecology, Leeuwarden Medical Center, Leeuwarden, The Netherlands
| |
Collapse
|
25
|
Persson LÅ, Nga NT, Målqvist M, Thi Phuong Hoa D, Eriksson L, Wallin L, Selling K, Huy TQ, Duc DM, Tiep TV, Thi Thu Thuy V, Ewald U. Effect of Facilitation of Local Maternal-and-Newborn Stakeholder Groups on Neonatal Mortality: Cluster-Randomized Controlled Trial. PLoS Med 2013; 10:e1001445. [PMID: 23690755 PMCID: PMC3653802 DOI: 10.1371/journal.pmed.1001445] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 04/04/2013] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Facilitation of local women's groups may reportedly reduce neonatal mortality. It is not known whether facilitation of groups composed of local health care staff and politicians can improve perinatal outcomes. We hypothesised that facilitation of local stakeholder groups would reduce neonatal mortality (primary outcome) and improve maternal, delivery, and newborn care indicators (secondary outcomes) in Quang Ninh province, Vietnam. METHODS AND FINDINGS In a cluster-randomized design 44 communes were allocated to intervention and 46 to control. Laywomen facilitated monthly meetings during 3 years in groups composed of health care staff and key persons in the communes. A problem-solving approach was employed. Births and neonatal deaths were monitored, and interviews were performed in households of neonatal deaths and of randomly selected surviving infants. A latent period before effect is expected in this type of intervention, but this timeframe was not pre-specified. Neonatal mortality rate (NMR) from July 2008 to June 2011 was 16.5/1,000 (195 deaths per 11,818 live births) in the intervention communes and 18.4/1,000 (194 per 10,559 live births) in control communes (adjusted odds ratio [OR] 0.96 [95% CI 0.73-1.25]). There was a significant downward time trend of NMR in intervention communes (p = 0.003) but not in control communes (p = 0.184). No significant difference in NMR was observed during the first two years (July 2008 to June 2010) while the third year (July 2010 to June 2011) had significantly lower NMR in intervention arm: adjusted OR 0.51 (95% CI 0.30-0.89). Women in intervention communes more frequently attended antenatal care (adjusted OR 2.27 [95% CI 1.07-4.8]). CONCLUSIONS A randomized facilitation intervention with local stakeholder groups composed of primary care staff and local politicians working for three years with a perinatal problem-solving approach resulted in increased attendance to antenatal care and reduced neonatal mortality after a latent period.
Collapse
Affiliation(s)
- Lars Åke Persson
- International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Nguyen T. Nga
- International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Vietnam-Sweden Uong Bi General Hospital, Uong Bi, Viet Nam
| | - Mats Målqvist
- International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Leif Eriksson
- International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Lars Wallin
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden, and School of Health and Social Studies, Dalarna University, Falun, Sweden
| | - Katarina Selling
- International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Duong M. Duc
- International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Hanoi School of Public Health, Hanoi, Viet Nam
| | - Tran V. Tiep
- Vietnam-Sweden Uong Bi General Hospital, Uong Bi, Viet Nam
| | | | - Uwe Ewald
- International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| |
Collapse
|
26
|
Shrestha S, Petrini M, Turale S. Newborn care in Nepal: the effects of an educational intervention on nurses' knowledge and practice. Int Nurs Rev 2013; 60:205-11. [PMID: 23692004 DOI: 10.1111/inr.12017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To determine the effectiveness of an educational intervention for improving nurses' knowledge and practice regarding newborn care in Kathmandu, Nepal. BACKGROUND Four million neonatal deaths occur annually, especially in developing countries. In 2010 in Nepal, the neonatal mortality rate was 28/1000 births. Modern nursing and research education is still developing in Nepal, but the country's nurses are in a unique position to help combat avoidable morbidity and mortality. This study was designed to assist nurses working in maternity units to obtain and/or sustain knowledge and competence in practice to ensure the health and safety of vulnerable newborns, and thereby to help reduce mortality and morbidity. THEORETICAL FRAMEWORK Concepts from the Transtheoretical Model of behaviour change developed in the USA informed this study in the belief that an educational intervention would assist in behaviour changes in nurses caring for newborns. DESIGN Quasi-experimental, time-series pre-test/post-test. SETTING Maternity and women's hospitals in Kathmandu, Nepal. PARTICIPANTS Convenience sample of 30 nurses working in emergency room, delivery room and birthing centre. METHODS Nurses were measured on study outcomes at multiple time points: before a self-directed educational intervention and discussion, immediately, 1 and 3 months after intervention. Data were collected using three instruments: a demographics questionnaire, the Knowledge Survey Questionnaire and the Skills Learning Checklist (SLC). The SLC was completed during nursing practice in observations by the researcher. RESULTS Significant findings suggested that this educational intervention was effective for improving nurses' knowledge and practice regarding newborn care, and there was a positive correlation between knowledge and practice. CONCLUSION This was the first study of its kind in Nepal, a small step in enhancing nurses' abilities to improve their knowledge and competence regarding care of newborns. However, continued education and guidance are required to sustain knowledge and competence in practice, and our educational intervention needs further testing with other populations of nurses. There are various policy implications required to enable this to happen. This includes health ministry funding and support for in-service education; hospitals and universities working together to offer in-service education, competency testing and revised curricula; and nurse registering authorities requiring ongoing nurse education programmes and competency testing.
Collapse
Affiliation(s)
- S Shrestha
- HOPE School of Nursing, Wuhan University, Wuhan, Hubei Province, China.
| | | | | |
Collapse
|
27
|
Murila F, Obimbo MM, Musoke R. Assessment of knowledge on neonatal resuscitation amongst health care providers in Kenya. Pan Afr Med J 2012; 11:78. [PMID: 22655112 PMCID: PMC3361216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 03/14/2012] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Competence in neonatal resuscitation, which represents the most urgent pediatric clinical situation, is critical in delivery rooms to ensure safety and health of newly born infants. The challenges experienced by health care providers during this procedure are unique due to different causes of cardio respiratory arrest. This study aimed at assessing the knowledge of health providers on neonatal resuscitation. METHODS Data were gathered among 192 health providers drawn from all counties of Kenya. The clinicians were asked to complete questionnaires which were in two parts as; demographic information and assessment of their knowledge by different scenarios which were formatted in the multiple choice questions. Data were analyzed using SPSS version 15.0 for windows. The results are presented using tables. RESULTS All the participants were aged 23 years and above with at least a certificate training. Most medical providers had heard of neonatal resuscitation (85.4%) with only 23 receiving formal training. The average duration of neonatal training was 3 hours with 50% having missed out on practical exposure. When asked on steps of resuscitation, only 68 (35.4%) of the participants scored above 85%. More than 70% of them considered their knowledge about neonatal resuscitation inadequate and blamed it on inadequate medical training programs. CONCLUSION Health providers, as the key personnel in the management of neonatal resuscitation, in this survey seem to have inadequate training and knowledge on this subject. Increasing the duration and quality of formal training should be considered during the pre-service medical education to ensure acceptable neonatal outcome.
Collapse
Affiliation(s)
| | - Moses Madadi Obimbo
- University of Nairobi, Kenya,
Corresponding author: Moses M. Obimbo, Department of Human Anatomy, University of Nairobi, P.O. Box 00100 – 30197, Kenya
| | | |
Collapse
|
28
|
Wallin L, Målqvist M, Nga NT, Eriksson L, Persson LÅ, Hoa DP, Huy TQ, Duc DM, Ewald U. Implementing knowledge into practice for improved neonatal survival; a cluster-randomised, community-based trial in Quang Ninh province, Vietnam. BMC Health Serv Res 2011; 11:239. [PMID: 21951770 PMCID: PMC3192673 DOI: 10.1186/1472-6963-11-239] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Accepted: 09/27/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Globally, almost 4 million newborns die during the first 4 weeks of life every year. By increased use of evidence-based knowledge in the healthcare system a large proportion of these neonatal deaths could be prevented. But there is a severe lack of knowledge on effective methods for successful implementation of evidence into practice, particularly in low- and middle-income countries. Recent studies have demonstrated promising results with increased survival among both mothers and newborns using community-based approaches. In Vietnam evidence-based guidelines on reproductive health were launched in 2003 and revised in 2009. The overall objective of the current project is to evaluate if a facilitation intervention on the community level, with a problem-solving approach involving local representatives if the healthcare system and the community, results in improvements of neonatal health and survival. METHODS/DESIGN The study, which has been given the acronym NeoKIP (Neonatal Health - Knowledge Into Practice), took place in 8 districts composed by 90 communes in a province in northern Vietnam, where neonatal mortality rate was 24/1000 in 2005. A cluster randomised design was used, allocating clusters, as defined as a commune and its correponding Commune Health Center (CHC) to either intervention or control arm. The facilitation intervention targeted staff at healthcare centres and key persons in the communes. The facilitator role was performed by lay women (Women's Union representatives) using quality improvement techniques to initiate and sustain improvement processes targeting identified problem areas. The intervention has been running over 3 years and data were collected on the facilitation process, healthcare staff knowledge in neonatal care and their behaviour in clinical practice, and reproductive and perinatal health indicators. Primary outcome is neonatal mortality. DISCUSSION The intervention is participatory and dynamic, focused on developing a learning process and a problem-solving cycle. The study recognises the vital role of the local community as actors in improving their own and their newborns' health, and applies a bottom-up approach where change will be accomplished by an increasing awareness at and demand from grass root level. By utilising the existing healthcare structure this intervention may, if proven successful, be well suited for scaling up. TRIAL REGISTRATION Current Controlled Trials ISRCTN44599712.
Collapse
Affiliation(s)
- Lars Wallin
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, SE-171 76 Stockholm, Sweden
| | - Mats Målqvist
- International Maternal and Child Health (IMCH), Department of Women's and Children's Health, Uppsala University, SE-751 85 Uppsala, Sweden
| | - Nguyen T Nga
- International Maternal and Child Health (IMCH), Department of Women's and Children's Health, Uppsala University, SE-751 85 Uppsala, Sweden
- Vietnam Sweden Uong Bi General Hospital, Quang Ninh, Việt Nam
| | - Leif Eriksson
- International Maternal and Child Health (IMCH), Department of Women's and Children's Health, Uppsala University, SE-751 85 Uppsala, Sweden
| | - Lars-Åke Persson
- International Maternal and Child Health (IMCH), Department of Women's and Children's Health, Uppsala University, SE-751 85 Uppsala, Sweden
| | - Dinh P Hoa
- Hanoi School of Public Health, 138 Giảng Võ St., Ba ĐÌnh District, Hà Nội, Việt Nam
| | - Tran Q Huy
- Ministry of Health, 138A Giảng Võ St., Ba ĐÌnh District, Hà Nội, Việt Nam
| | - Duong M Duc
- International Maternal and Child Health (IMCH), Department of Women's and Children's Health, Uppsala University, SE-751 85 Uppsala, Sweden
- Hanoi School of Public Health, 138 Giảng Võ St., Ba ĐÌnh District, Hà Nội, Việt Nam
| | - Uwe Ewald
- Neonatology, Department of Women's and Children's Health, Uppsala University, SE-751 85 Uppsala, Sweden
| |
Collapse
|
29
|
Newborn care and knowledge translation - perceptions among primary healthcare staff in northern Vietnam. Implement Sci 2011; 6:29. [PMID: 21447179 PMCID: PMC3080332 DOI: 10.1186/1748-5908-6-29] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Accepted: 03/29/2011] [Indexed: 11/17/2022] Open
Abstract
Background Nearly four million neonatal deaths occur annually in the world despite existing evidence-based knowledge with the potential to prevent many of these deaths. Effective knowledge translation (KT) could help to bridge this know-do gap in global health. The aim of this study was to explore aspects of KT at the primary healthcare level in a northern province in Vietnam. Methods Six focus-group discussions were conducted with primary healthcare staff members who provided neonatal care in districts that represented three types of geographical areas existing in the province (urban, rural, and mountainous). Recordings were transcribed verbatim, translated into English, and analyzed using content analysis. Results We identified three main categories of importance for KT. Healthcare staff used several channels for acquisition and management of knowledge (1), but none appeared to work well. Participants preferred formal training to reading guideline documents, and they expressed interest in interacting with colleagues at higher levels, which rarely happened. In some geographical areas, traditional medicine (2) seemed to compete with evidence-based practices, whereas in other areas it was a complement. Lack of resources, low frequency of deliveries and, poorly paid staff were observed barriers to keeping skills at an adequate level in the healthcare context (3). Conclusions This study indicates that primary healthcare staff work in a context that to some extent enables them to translate knowledge into practice. However, the established and structured healthcare system in Vietnam does constitute a base where such processes could be expected to work more effectively. To accelerate the development, thorough considerations over the current situation and carefully targeted actions are required.
Collapse
|
30
|
Målqvist M, Sohel N, Do TT, Eriksson L, Persson LÅ. Distance decay in delivery care utilisation associated with neonatal mortality. A case referent study in northern Vietnam. BMC Public Health 2010; 10:762. [PMID: 21144058 PMCID: PMC3009650 DOI: 10.1186/1471-2458-10-762] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Accepted: 12/13/2010] [Indexed: 11/23/2022] Open
Abstract
Background Efforts to reduce neonatal mortality are essential if the Millennium Development Goal (MDG) 4 is to be met. The impact of spatial dimensions of neonatal survival has not been thoroughly investigated even though access to good quality delivery care is considered to be one of the main priorities when trying to reduce neonatal mortality. This study examined the association between distance from the mother's home to the closest health facility and neonatal mortality, and investigated the influence of distance on patterns of perinatal health care utilisation. Methods A surveillance system of live births and neonatal deaths was set up in eight districts of Quang Ninh province, Vietnam, from July 2008 to December 2009. Case referent design including all neonatal deaths and randomly selected newborn referents from the same population. Interviews were performed with mothers of all subjects and GIS coordinates for mothers' homes and all health facilities in the study area were obtained. Straight-line distances were calculated using ArcGIS software. Results A total of 197 neonatal deaths and 11 708 births were registered and 686 referents selected. Health care utilisation prior to and at delivery varied with distance to the health facility. Mothers living farthest away (4th and 5th quintile, ≥1257 meters) from a health facility had an increased risk of neonatal mortality (OR 1.96, 95% CI 1.40 - 2.75, adjusted for maternal age at delivery and marital status). When stratified for socio-economic factors there was an increased risk for neonatal mortality for mothers with low education and from poor households who lived farther away from a health facility. Mothers who delivered at home had more than twice as long to a health facility compared to mothers who delivered at a health care facility. There was no difference in age at death when comparing neonates born at home or health facility deliveries (p = 0.56). Conclusion Distance to the closest health facility was negatively associated with neonatal mortality risk. Health care utilisation in the prenatal period could partly explain this risk elevation since there was a distance decay in health system usage prior to and at delivery. The geographical dimension must be taken into consideration when planning interventions for improved neonatal survival, especially when targeting socio-economically disadvantaged groups.
Collapse
Affiliation(s)
- Mats Målqvist
- International Maternal and Child Health (IMCH), Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
| | | | | | | | | |
Collapse
|
31
|
Ariff S, Soofi SB, Sadiq K, Feroze AB, Khan S, Jafarey SN, Ali N, Bhutta ZA. Evaluation of health workforce competence in maternal and neonatal issues in public health sector of Pakistan: an Assessment of their training needs. BMC Health Serv Res 2010; 10:319. [PMID: 21110888 PMCID: PMC3012669 DOI: 10.1186/1472-6963-10-319] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Accepted: 11/27/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND More than 450 newborns die every hour worldwide, before they reach the age of four weeks (neonatal period) and over 500,000 women die from complications related to childbirth. The major direct causes of neonatal death are infections (36%), Prematurity (28%) and Asphyxia (23%). Pakistan has one of the highest perinatal and neonatal mortality rates in the region and contributes significantly to global neonatal mortality. The high mortality rates are partially attributable to scarcity of trained skilled birth attendants and paucity of resources. Empowerment of health care providers with adequate knowledge and skills can serve as instrument of change. METHODS We carried out training needs assessment analysis in the public health sector of Pakistan to recognize gaps in the processes and quality of MNCH care provided. An assessment of Knowledge, Attitude, and Practices of Health Care Providers on key aspects was evaluated through a standardized pragmatic approach. Meticulously designed tools were tested on three tiers of health care personnel providing MNCH in the community and across the public health care system. The Lady Health Workers (LHWs) form the first tier of trained cadre that provides MNCH at primary care level (BHU) and in the community. The Lady Health Visitor (LHVs), Nurses, midwives) cadre follow next and provide facility based MNCH care at secondary and tertiary level (RHCs, Taluka/Tehsil, and DHQ Hospitals). The physician/doctor is the specialized cadre that forms the third tier of health care providers positioned in secondary and tertiary care hospitals (Taluka/Tehsil and DHQ Hospitals). The evaluation tools were designed to provide quantitative estimates across various domains of knowledge and skills. A priori thresholds were established for performance rating. RESULTS The performance of LHWs in knowledge of MNCH was good with 30% scoring more than 70%. The Medical officers (MOs), in comparison, performed poorly in their knowledge of MNCH with only 6% scoring more than 70%. All three cadres of health care providers performed poorly in the resuscitation skill and only 50% were able to demonstrate steps of immediate newborn care. The MOs performed far better in counselling skills compare to the LHWs. Only 50 per cent of LHWs could secure competency scale in this critical component of skills assessment. CONCLUSIONS All three cadres of health care providers performed well below competency levels for MNCH knowledge and skills. Standardized training and counselling modules, tailored to the needs and resources at district level need to be developed and implemented. This evaluation highlighted the need for periodic assessment of health worker training and skills to address gaps and develop targeted continuing education modules. To achieve MDG4 and 5 goals, it is imperative that such deficiencies are identified and addressed.
Collapse
Affiliation(s)
- Shabina Ariff
- Department of Paediatrics & Child Health, Aga Khan University, Karachi, Pakistan
| | | | | | | | | | | | | | | |
Collapse
|
32
|
Nga NT, Målqvist M, Eriksson L, Hoa DP, Johansson A, Wallin L, Persson LÅ, Ewald U. Perinatal services and outcomes in Quang Ninh province, Vietnam. Acta Paediatr 2010; 99:1478-83. [PMID: 20528791 DOI: 10.1111/j.1651-2227.2010.01866.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM We report baseline results of a community-based randomized trial for improved neonatal survival in Quang Ninh province, Vietnam (NeoKIP; ISRCTN44599712). The NeoKIP trial seeks to evaluate a method of knowledge implementation called facilitation through group meetings at local health centres with health staff and community key persons. Facilitation is a participatory enabling approach that, if successful, is well suited for scaling up within health systems. The aim of this baseline report is to describe perinatal services provided and neonatal outcomes. METHODS Survey of all health facility registers of service utilization, maternal deaths, stillbirths and neonatal deaths during 2005 in the province. Systematic group interviews of village health workers from all communes. A Geographic Information System database was also established. RESULTS Three quarters of pregnant women had ≥3 visits to antenatal care. Two hundred and five health facilities, including 18 hospitals, provided delivery care, ranging from 1 to 3258 deliveries/year. Totally there were 17 519 births and 284 neonatal deaths in the province. Neonatal mortality rate was 16/1000 live births, ranging from 10 to 44/1000 in the different districts, with highest rates in the mountainous parts of the province. Only 8% had home deliveries without skilled attendance, but those deliveries resulted in one-fifth of the neonatal deaths. CONCLUSION A relatively good coverage of perinatal care was found in a Vietnamese province, but neonatal mortality varied markedly with geography and level of care. A remaining small proportion of home deliveries generated a substantial part of mortality.
Collapse
Affiliation(s)
- Nguyen T Nga
- Vietnam Sweden General Hospital, Uongbi, Vietnam.
| | | | | | | | | | | | | | | |
Collapse
|