Career development expectations and challenges of midwives in Urban Tanzania: a preliminary study

Status and related factors of professional growth among young nursing talents: a cross-sectional study in China

BACKGROUND

The shortage of nurses has been a global human resources problem. A good professional growth environment is essential to developing potential nursing students and attracting nurses to join, and it has great significance in reducing nurse turnover. However, nurses' comprehensive perceptions of professional growth have not yet been examined.

METHODS

A cluster sampling method was used to conduct a professional growth questionnaire survey on young nursing talents from a large Chinese public tertiary A hospital in March 2022.

RESULTS

The score of professional growth among 243 young nursing talents was 57.92 ± 9.607, with a scoring rate of 77.23%. The scores for dimensions of professional growth, from lowest to highest, were rehabilitation growth, promotion speed, professional goal progress, and professional ability development. Attitudes towards participating in training, service as the quality manager or clinical teacher, self-efficacy, professional title, work-family support, education, and organizational commitment of young nursing talents were significantly associated with professional growth.

CONCLUSION

The professional growth of young nursing talents was at a moderate level and needed to be strengthened. Nursing leaders and managers are expected to develop management practices to enhance young nursing talents' professional growth in combination with the related factors.

Strengthening midwives' competencies for addressing maternal and newborn mortality in Tanzania: Lessons from Midwifery Emergency Skills Training (MEST) project

INTRODUCTION

In Low- and Middle-Income Countries (LMICs), maternal and infant mortality remains a significant problem. Inadequate healthcare provider competencies, including those of midwives, are cited as one of the major contributors to the high maternal and newborn mortality rates. Thus, enhancing the skills of midwives is a prerequisite for enhancing positive maternal and newborn health outcomes. This study describes the lessons learned from a Midwifery Emergencies Skills Training (MEST) project implemented in Tanzania between 2013 and 2018.

METHODS

An exploratory qualitative study was used to purposefully recruit and interview twelve health facility in-charges and eighteen midwives from twelve selected health facilities in six districts of Tanzania mainland to discover their perceptions about the midwifery practice after MEST training. The data were transcribed verbatim and analysed with qualitative content analysis.

RESULTS

Four categories were generated from the analysis (i) enhanced knowledge and skills in the provision of midwifery care and management of obstetric emergencies, (ii) improved midwives' communication skills, (iii) increased trust and support between midwives and community and (iv) transformed attitudes of midwives toward continued professional development (CPD).

CONCLUSION

MEST enhanced the knowledge and skills of midwives in the management of obstetric emergencies and referral protocol practice. However, notable gaps remain in the capacity of midwives to provide human rights-based respectful maternity care. Continued professional development for nurses and midwives through training, mentorship and supervision programs is recommended for improving maternal and newborn health.

Continuing Midwifery Education: Midwifery Encouragements of Continuing Professional Education in Profession Stage in Indonesia: A Qualitative Study

BACKGROUND: High maternal and child morbidity and problems related to maternal and child health requires increasing the professionalism of the midwife profession through continuing education. The main competencies of midwives as service providers, educators, community leaders, managers, and decision-makers are carried out to provide midwifery services. AIM: The purpose of this study was to determine the motivation of midwives in continuing education at the professional level. METHODS: This research is qualitative research with a theoretical basis. Collecting data through focus group discussion and followed by in-depth interviews with nine midwives who are continuing their professional education four midwives education and professional organization. Analysis of the data used using fixed comparison analysis. RESULTS: The results of the qualitative analysis produced two themes, namely: internal encouragement with the sub-themes of midwives’ understanding of the body of knowledge of professional education, academic progress, self-development, professional recognition; and external encouragement with the sub-themes of career paths, policies, workplace, and professional organization. CONCLUSION: There are internal and external incentives that affect midwives who have worked to continue their education to a higher level.

Challenges in day-to-day midwifery practice; a qualitative study from a regional referral hospital in Dar es Salaam, Tanzania

BACKGROUND

Maternal and infant mortality rates in Tanzania have decreased over the past decades, but remain high. One of the challenges the country faces, is the lack of skilled health care workers. High fertility rates make midwives and their patients particularly susceptible to stress as a result of understaffing.

OBJECTIVE

This paper explores the challenges midwives face in their day-to-day practice at a regional referral hospital in Tanzania, and investigates which measures the midwives themselves find necessary to implement to improve their situation.

METHODS

A qualitative study design with focus group discussions (FGDs) was employed to explore which challenges the midwives experienced. Each focus group consisted of five to six midwives. A FGD topic guide covering challenges, consequences, motivation, ideal situation and possible solutions was used. These data were analyzed using Systematic Text Condensation.

RESULTS

A total of 28 Midwives, six men and 22 women, participated in five FGDs. Four categories emerged from the collected material: Feelings of demoralization, shortage of resources, societal challenges and personal struggles. A feeling of demoralization was especially prevalent and was caused by a lack of support from the leaders and little appreciation from the patients. Shortage of resources, and shortage of personnel in particular, was also highlighted as it led to an excessive workload resulting in difficulties with providing adequate care. These difficulties were intensified by lack of equipment, facilities and a non-optimal organization of the healthcare system.

CONCLUSION

The challenges revealed during the FGDs prevent the midwives from providing sufficient midwifery care. To improve the situation, measures such as supportive leadership, reduction of workload, increasing availability of equipment and increasing knowledge of reproductive health in society, should be taken.

'Without ultrasound you can't reach the best decision' - Midwives' experiences and views of the role of ultrasound in maternity care in Dar Es Salaam, Tanzania

OBJECTIVE

To explore Tanzanian midwives' experiences and views of the role of obstetric ultrasound in relation to clinical management of pregnancy, and in situations where maternal and fetal health interests conflict.

METHOD

In 2015, five focus group discussions were conducted with midwives (N = 31) at three public referral hospitals in the Dar es Salaam region as part of the CROss Country Ultrasound Study (CROCUS).

RESULTS

Ultrasound was described as decisive for proper management of pregnancy complications. Midwives noted an increasing interest in ultrasound among pregnant women. However, concerns were expressed about the lack of ultrasound equipment and staff capable of skilful operation. Further, counselling regarding medical management was perceived as difficult due to low levels of education among pregnant women.

CONCLUSION

Ultrasound has an important role in management of pregnancy complications. However, lack of equipment and shortage of skilled healthcare professionals seem to hamper use of obstetric ultrasound in this particular low-resource setting. Increased availability of obstetric ultrasound seems warranted, but further investments need to be balanced with advanced clinical skills' training as barriers, including power outages and lack of functioning equipment, are likely to continue to limit the provision of pregnancy ultrasound in this setting.

Saving lives with caring assessments: How Tanzanian nurse-midwives and obstetricians negotiate postpartum practices

AIMS AND OBJECTIVES

To explore the nurse-midwives' and obstetricians' experiences delivering postpartum care assessments and how it was constructed through personal, social and institutional discourses.

INTRODUCTION

The Tanzanian Government has prioritised maternal and child health as an urgent healthcare issue. Nurse-midwives and obstetricians are the two main providers of care throughout the prenatal and postpartum periods.

DESIGN

A qualitative design guided by a feminist poststructuralist methodology.

METHODS

Ten nurse-midwives and three obstetricians from three Regional Hospitals in Dar es Salaam participated in individual semi-structured in-depth interviews.

RESULTS

Assessment emerged as a significant theme with three subthemes. Nurse-midwives shared their beliefs and values about assessments that focused on the safety of mothers and babies. They felt proud working with mothers and babies and shared their frustrations having to deal with inadequate working conditions. Guidelines and practices were part of the institutional discourse that impacted the day-to-day experiences of nurse-midwives and obstetricians. The nurse-midwives held the belief that it was vital to complete a comprehensive assessment to identify danger signs, keep mothers and babies safe and look for any abnormalities. They were concerned that mothers were being sent home too early.

CONCLUSIONS

Nurse-midwives' experiences in the provision of postpartum care portray that these health providers work heartedly to make sure that the mothers and their newborns receive the best care they can provide. The health system is challenged to address the needed supplies and equipment for reproductive health in particular postpartum care services.

RELEVANCE TO CLINICAL PRACTICE

Institutional health discourses significantly affect the practice of nurse-midwives and obstetricians to deliver timely and effective postpartum assessments. Immediate and ongoing postpartum assessments conducted by nurse-midwives and obstetricians can save lives. This study presents the first theme of the study: Caring assessments save lives.

Establishing an Online Continuing and Professional Development Library for Nurses and Midwives in East, Central, and Southern Africa

Over the past 4 years, the African Health Profession Regulatory Collaborative for nurses and midwives has supported 12 countries establish national continuing and professional development frameworks and programs, linking continuing education to nursing and midwifery re-licensure through technical assistance and improvement grants. However, lack of electronic media and rural practice sites, differences in priority content, and varying legal frameworks make providing accessible, certifiable, and up-to-date online continuing education content for the more than 300,000 nurses and midwives in the 17 member countries of the East, Central, and Southern Africa College of Nursing a major challenge. We report here on how the East, Central, and Southern Africa College of Nursing, with technical assistance from an Afya Bora Fellow, developed an online continuing professional development library hosted on their Web site using data collected in a survey of nursing and midwifery leaders in the region.