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Asemu YM, Yigzaw T, Ayalew F, Akalu L, Scheele F, van den Akker T. Ethiopian Anesthetist Licensing Examination: A Qualitative Study of Concerns and Unintended Consequences. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2023; 14:1055-1064. [PMID: 37789925 PMCID: PMC10542504 DOI: 10.2147/amep.s418743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 09/17/2023] [Indexed: 10/05/2023]
Abstract
Background Ethiopia increased its anesthesia workforce drastically by expanding the training of associate clinician anesthetists. Following this expansion, the Ministry of Health established an entry-level anesthesia licensing examination to ensure patient safety. However, there is limited empirical evidence on the impacts of licensing exams in low- and middle-income countries. This study aimed to explore the concerns and undesirable consequences of the anesthetist licensing examination in Ethiopia. Methods A qualitative design using a grounded theory approach was employed by collecting data from 10 anesthesia teaching institutions. We conducted 15 in-depth interviews with instructors and six focus groups with students and graduates who took the exam recently. Interviews and focus groups were audio-recorded, transcribed verbatim, and analyzed using Atlas.ti 23. We also extracted secondary data from the academic committee meeting minutes, curricula, faculty appraisal reports, and program quality self-review reports. Results Qualitative analysis revealed three central categories of concerns and untoward consequences of the anesthetist NLE: exam management, educational management, and student behavior. Exam management concerns were related to exam validity, fairness, and consistent enforcement of pass/fail decisions. The unintended consequences of the exam on education management were perceived as promoting teaching and learning for the exam, increasing faculty workload, and resulting in superficial and patchy educational reforms. Study participants also reported adverse psychosocial effects and increased cheating behaviors among students as undesirable consequences of the exam on student behavior. Conclusion Our study identified some concerns and unintended consequences of the Ethiopian anesthetist licensing examination. These lessons learned may contribute to improving the quality of licensing examinations in Ethiopia and beyond.
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Affiliation(s)
- Yohannes Molla Asemu
- Health Workforce Improvement Program, Jhpiego, An Affiliate of Johns Hopkins University, Ethiopia Country Office, Addis Ababa, Ethiopia
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Tegbar Yigzaw
- Health Workforce Improvement Program, Jhpiego, An Affiliate of Johns Hopkins University, Ethiopia Country Office, Addis Ababa, Ethiopia
| | - Firew Ayalew
- Health Workforce Improvement Program, Jhpiego, An Affiliate of Johns Hopkins University, Ethiopia Country Office, Addis Ababa, Ethiopia
| | - Leulayehu Akalu
- Ethiopian Association of Anesthetists (EAA), Addis Ababa, Ethiopia
- School of Anesthesia, Addis Ababa University, Addis Ababa, Ethiopia
| | - Fedde Scheele
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Obstetrics and Gynecology, OLVG Teaching Hospital, Amsterdam, the Netherlands
- Department of Obstetrics and Gynecology, Amsterdam University Medical Center (AUMC), Amsterdam, the Netherlands
| | - Thomas van den Akker
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Obstetrics and Gynecology, Leiden University Medical Centre (LUMC), Leiden, the Netherlands
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Leslie K, Bourgeault IL, Carlton AL, Balasubramanian M, Mirshahi R, Short SD, Carè J, Cometto G, Lin V. Design, delivery and effectiveness of health practitioner regulation systems: an integrative review. HUMAN RESOURCES FOR HEALTH 2023; 21:72. [PMID: 37667368 PMCID: PMC10478314 DOI: 10.1186/s12960-023-00848-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 07/23/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Health practitioner regulation (HPR) systems are increasingly recognized as playing an important role in supporting health workforce availability, accessibility, quality, and sustainability, while promoting patient safety. This review aimed to identify evidence on the design, delivery and effectiveness of HPR to inform policy decisions. METHODS We conducted an integrative analysis of literature published between 2010 and 2021. Fourteen databases were systematically searched, with data extracted and synthesized based on a modified Donabedian framework. FINDINGS This large-scale review synthesized evidence from a range of academic (n = 410) and grey literature (n = 426) relevant to HPR. We identified key themes and findings for a series of HPR topics organized according to our structures-processes-outcomes conceptual framework. Governance reforms in HPR are shifting towards multi-profession regulators, enhanced accountability, and risk-based approaches; however, comparisons between HPR models were complicated by a lack of a standardized HPR typology. HPR can support government workforce strategies, despite persisting challenges in cross-border recognition of qualifications and portability of registration. Scope of practice reform adapted to modern health systems can improve access and quality. Alternatives to statutory registration for lower-risk health occupations can improve services and protect the public, while standardized evaluation frameworks can aid regulatory strengthening. Knowledge gaps remain around the outcomes and effectiveness of HPR processes, including continuing professional development models, national licensing examinations, accreditation of health practitioner education programs, mandatory reporting obligations, remediation programs, and statutory registration of traditional and complementary medicine practitioners. CONCLUSION We identified key themes, issues, and evidence gaps valuable for governments, regulators, and health system leaders. We also identified evidence base limitations that warrant caution when interpreting and generalizing the results across jurisdictions and professions. Themes and findings reflect interests and concerns in high-income Anglophone countries where most literature originated. Most studies were descriptive, resulting in a low certainty of evidence. To inform regulatory design and reform, research funders and governments should prioritize evidence on regulatory outcomes, including innovative approaches we identified in our review. Additionally, a systematic approach is needed to track and evaluate the impact of regulatory interventions and innovations on achieving health workforce and health systems goals.
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Affiliation(s)
- Kathleen Leslie
- Athabasca University, Athabasca, Canada.
- Canadian Health Workforce Network, Ottawa, Canada.
| | - Ivy Lynn Bourgeault
- University of Ottawa, Ottawa, Canada
- Canadian Health Workforce Network, Ottawa, Canada
| | - Anne-Louise Carlton
- Royal Melbourne Institute of Technology (RMIT) University, Melbourne, Australia
| | - Madhan Balasubramanian
- College of Business, Government and Law, Flinders University, Adelaide, Australia
- Menzies Centre for Health Policy and Economics, The University of Sydney, Sydney, Australia
| | - Raha Mirshahi
- University of Ottawa, Ottawa, Canada
- Canadian Health Workforce Network, Ottawa, Canada
| | | | - Jenny Carè
- University of Technology Sydney, Sydney, Australia
| | | | - Vivian Lin
- University of Hong Kong, Hong Kong, China
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Warren N, Gresh A, Mkhonta NR, Kazembe A, Engelbrecht S, Feraud J, Patel K, Adandogou-d'Almeida H, Marole P, Reynolds N, Johnson P. Pre-service midwifery education in sub-Saharan Africa: A scoping review. Nurse Educ Pract 2023; 71:103678. [PMID: 37413740 DOI: 10.1016/j.nepr.2023.103678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 05/03/2023] [Accepted: 05/25/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND In response to a global call for more midwives, maternal health stakeholders have called for increased investment in midwifery pre-service education. Given the already long list of challenges and the increasing burden on health care systems due to the COVID-19 pandemic, the need to prioritize investment is acute, particularly in sub-Saharan Africa. An important first step is to examine the current evidence. METHODS We conducted a scoping review of the peer-reviewed literature about pre-service midwifery education in sub-Saharan Africa. A search of studies published between 2015 and 2021 in French or English was conducted using six databases (PubMed, CINAHL, Embase, Scopus, Web of Science and African Index Medicus). RESULTS The search yielded 3061 citations, of which 72 were included. Most were a mix of qualitative and quantitative cross-sectional, country-specific studies. Organized by pre-service educational domain, the literature reflected a misalignment between international standards for midwifery education and what schools and clinical sites and the larger administrative systems where they operate, reliably provide. Inadequate infrastructure, teaching capacity in school and clinical settings and clinical site environment were factors that commonly impede learning. Literature related to faculty development and deployment were limited. CONCLUSION Schools, faculty and clinical sites are overwhelmed yet recommendations by key stakeholders for change are substantive and complex. Efforts are needed to help schools map their current status by pre-service education domain and prioritize where scarce resources should be directed. These results can inform research and investments in pre-service midwifery education in sub-Saharan Africa.
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Affiliation(s)
- Nicole Warren
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205, USA.
| | - Ashley Gresh
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205, USA.
| | | | - Abigail Kazembe
- African Forum for Research and Education in Health, PMB, University Post Office, KNUST, Kumasi, Ghana.
| | | | - Jenna Feraud
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205, USA.
| | - Kalin Patel
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205, USA.
| | - Heloise Adandogou-d'Almeida
- La Fédération des Associations des Sages-Femmes d'Afrique Francophone (FASFAF), 229 Rue Sagouda Tokoin Wuiti, Lome, Togo.
| | - Phelelo Marole
- Jhpiego, Plot 155, Unit 4 Kgale Mews, Baborone International Financial Park, Baorone, Botswana.
| | - Nancy Reynolds
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205, USA.
| | - Peter Johnson
- Jhpiego, 1615 Thames Street, Baltimore, MD 21231, USA.
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Ginbeto T, Debie A, Geberu DM, Alemayehu D, Dellie E. Work engagement among health professionals in public health facilities of Bench-Sheko zone, southwest Ethiopia. BMC Health Serv Res 2023; 23:697. [PMID: 37370107 DOI: 10.1186/s12913-023-09680-5] [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: 05/31/2022] [Accepted: 06/10/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The level of health professional work engagement affects retention, burnout, job satisfaction, patient satisfaction, and outcomes; however, there is a paucity of evidence that benefit health professional work engagement. Therefore, this study aimed to assess work engagement and associated factors among health professionals at public health facilities in the Bench-Sheko zone in southwest Ethiopia. METHODS Facility-based cross-sectional study was conducted among 605 health professionals from 29 March to 29 April 2021. A simple random sampling technique was used to select the participants. Data were collected using a self-administered questionnaire. Linear regression was fitted and those variables with p-value < 0.2 in simple linear regression were entered into multiple linear regression analysis. Unstandardized β-coefficient with 95% CI and p-value < 0.05 were used as the cut of points to determine the factors associated with work engagement. RESULTS Mean score percentage of work engagement was 71.8%. Health center staff (β = 0.31; 95% CI: 0.22, 0.40), married professionals (β = 0.10; 95% CI: 0.005, 0.17), co-worker support (β = 0.06; 95% CI: 0.004, 0.11), role clarity (β = 0.14; 95% CI: 0.07, 0.21), reward (β = 0.10; 95% CI: 0.05, 0.15), resilience (β = 0.14 95%; CI: 0.07, 0.21), self-efficacy (β = 0.24; 95% CI: 0.16, 0.31) and optimism (β = 0.20; 95% CI: 0.15, 0.26) were positively associated with work engagement. On the contrary, cognitive demand (β= -0.06; 95% CI: -0.11, -0.01) was negatively associated with work engagement. CONCLUSION In this study, health professionals had a moderate level of work engagement. Health facilities shall improve their culture of co-worker support, role clarity, reward, resilience, self-efficacy, and optimism to enhance work engagement. Future researchers shall be done further studies to evaluate the relationship between cognitive demand and work engagement among health professionals.
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Affiliation(s)
- Temesgen Ginbeto
- Department of Public Health, School of Public Health, College of Health Sciences, Mizan-Tepi University, Tepi, Ethiopia
| | - Ayal Debie
- Department of Health Systems and Policy, Institute of Public Health, University of Gondar, Gondar, Ethiopia.
- College of Medicine and Public Health, Flinders University, Adelaide, Australia.
| | - Demiss Mulatu Geberu
- Department of Health Systems and Policy, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Dereje Alemayehu
- Department of Public Health, School of Public Health, College of Health Sciences, Mizan-Tepi University, Tepi, Ethiopia
| | - Endalkachew Dellie
- Department of Health Systems and Policy, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Misganaw E, Yigzaw T, Tezera R, Gelitew A, Gedamu S. The Promise of the New Educational Strategy for Curriculum Development (SPICES) Model on the Development of Students' Clinical Reasoning Ability. A Comparative Cross-Sectional Study. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:71-79. [PMID: 35068943 PMCID: PMC8769052 DOI: 10.2147/amep.s344933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/07/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Clinical reasoning skills are a core competency that must be taught at all levels of health-care education. In the last decade, several health professional education curricula in Ethiopia have been redesigned with the goal of improving student competence in key health-care delivery skills. Despite the fact that some academic programs followed the conventional educational strategy, a significant number of academic programs adopted a new educational strategy for curriculum development: Student-centered, Problem-based, Integrated, Community-based, Elective, and Systematic (SPICES) model. More empirical evidence, however, is required to determine whether the new curricular approach is effective in improving students' clinical reasoning. The purpose of this study is to determine whether the new educational strategy for curriculum development improves the clinical reasoning ability of midwifery students when compared to a peer institution that follows a traditional curriculum. METHODS A comparative cross-sectional study was conducted to compare the clinical reasoning skills of midwifery students who completed the new curricular approach versus students who completed a traditional curriculum. A Script Concordance Test (SCT) was used to collect data. The mean SCT score and an independent two-sample t-test were calculated to see if the two groups differed significantly in terms of clinical reasoning skills in managing Post-Partum hemorrhage (PPH). RESULTS A total of 77 final-year midwifery students participated (38 from the new and 39 from the traditional curriculum approach). Midwifery students who completed the new and conventional curriculum approaches had mean clinical reasoning SCT scores of 0.7 (SD = 0.35) and 0.53 (SD = 0.37), respectively. There was a statistically significant difference in the overall mean SCT score between the two study groups in terms of clinical reasoning skills (p = 0.008). CONCLUSION Our study found that the new SPICES model curricular approach is promising in fostering the development of clinical reasoning skills of Midwifery students in managing PPH.
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Affiliation(s)
- Equlinet Misganaw
- CIH Center for International Health, University Hospital, LMU Munich, Munich, Germany
| | | | - Robel Tezera
- Addis Ababa University, College of Medicine and Health Science, Addis Ababa, Ethiopia
| | - Awoke Gelitew
- Debre-Tabor University, College of Medicine and Health Science, Debre-Tabor, Ethiopia
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Kebede AA, Taye BT, Wondie KY, Tiguh AE, Eriku GA, Mihret MS. Healthcare provider's adherence to immediate postpartum care guidelines in Gondar province hospitals, northwest Ethiopia: A multicenter study. PLoS One 2021; 16:e0259263. [PMID: 34710191 PMCID: PMC8553061 DOI: 10.1371/journal.pone.0259263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 10/18/2021] [Indexed: 11/19/2022] Open
Abstract
Background The immediate postpartum period is the most critical time for both the mother and the newborn. However, it is the most neglected part of the maternal continuum of care, and evidence in this regard was scarce in Ethiopia. Therefore, this study aimed to assess the healthcare provider’s adherence to immediate postpartum care guidelines and associated factors in hospitals of Gondar province. Methods A multicenter observational cross-sectional study was conducted among 406 healthcare providers from 15th November 2020 to 10th March 2021. Data were collected through face-to-face interviews and direct observation using a structured questionnaire and standardized checklist respectively. Data was entered into EPI INFO 7.1.2 and analyzed by SPSS version 25. Both bivariable and multivariable logistic regression analyses were carried out. The level of significance was declared based on the adjusted odds ratio (AOR) with a 95% confidence interval (CI) at a p-value of ≤ 0.05. Results Overall, 42.4% (95% CI: 37.5, 47.2) of healthcare providers had complete adherence to immediate postpartum care guidelines. Having birth assistant (AOR = 1.87; 95% CI: 1.10, 9.67), being married (AOR = 1.59; 95% CI: 1.15, 3.31), availability of postpartum care guidelines at the maternity ward (AOR = 2.39; 95% CI: 1.44, 3.98), received basic emergency obstetric and newborn care (BEmONC) training (AOR = 2.1; 95% CI: 1.2, 3.6), monthly income of ≥ 10001 Ethiopian birr (AOR = 3.55; 95% CI: 1.30, 9.67), and work experience of ≥ 6 years (AOR = 0.15; 95% CI: 0.06, 0.38) were significantly associated with healthcare providers adherence to immediate postpartum care guidelines. Conclusion This study indicated that health worker’s adherence to immediate postpartum care guidelines was low. Hiring adequate health workers, availing postpartum guidelines at the maternity ward, improving the salary and education opportunities for healthcare workers of healthcare workers, and provision of BEmONC training will have a great role in improving healthcare provider’s adherence to immediate postpartum care guidelines.
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Affiliation(s)
- Azmeraw Ambachew Kebede
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Birhan Tsegaw Taye
- Department of Clinical Midwifery, College of Medicine and Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Kindu Yinges Wondie
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Agumas Eskezia Tiguh
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getachew Azeze Eriku
- Department of Physiotherapy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Muhabaw Shumye Mihret
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Asefa F, Cummins A, Dessie Y, Foureu M, Hayen A. Midwives' and obstetricians' perspectives about pregnancy related weight management in Ethiopia: A qualitative study. PLoS One 2020; 15:e0244221. [PMID: 33332406 PMCID: PMC7746277 DOI: 10.1371/journal.pone.0244221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 12/04/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Midwives and obstetricians are key maternity care providers; they are the most trusted source of information regarding nutrition and gestational weight gain. However, their views, practices and perceived barriers to managing pregnancy related weight gain have not been studied in Ethiopia. The aim of this study was to explore midwives' and obstetricians' observations and perspectives about gestational weight gain and postpartum weight management in Ethiopia. METHODS We conducted face-to-face interviews with 11 midwives and 10 obstetricians, from January 2019 to March 2019. All interview data were transcribed verbatim. We analysed the data using thematic analysis with an inductive approach. RESULTS We identified three themes and associated subthemes. Midwives and obstetricians had limited knowledge of the optimal gestational weight gain. Almost all participants were unaware of the presence of the Institute of Medicine recommendations for optimal weight gain in pregnancy. According to the study participants, women in Ethiopia do not want to gain weight during pregnancy, but do want to gain weight after the birth. Counselling about gestational weight gain and postpartum weight management was not routinely provided for pregnant women. This is mostly because gestational weight gain counselling was not considered to be a priority by maternity care providers in Ethiopia. CONCLUSIONS The limited knowledge of and low attention to pregnancy related weight management by midwives and obstetricians in this setting needs appropriate intervention. Adapting a guideline for pregnancy weight management and integrating it into antenatal care is essential.
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Affiliation(s)
- Fekede Asefa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Allison Cummins
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Maralyn Foureu
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
- Hunter New England Health, Nursing and Midwifery Research Centre, University of Newcastle, Newcastle, NSW, Australia
| | - Andrew Hayen
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
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Dejene D, Yigzaw T, Mengistu S, Wolde Z, Hiruy A, Woldemariam D, Awol M. Practice analysis of junior doctors in Ethiopia: implications for strengthening medical education, practice and regulation. Glob Health Res Policy 2018; 3:31. [PMID: 30456305 PMCID: PMC6223018 DOI: 10.1186/s41256-018-0086-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 10/21/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A high performing physician workforce is critical to attain nationally set health sector goals. Ethiopia has expanded training of medical doctors. However, little is known about junior doctors' performance. Understanding medical practice is essential to inform medical education and practice, establish licensure examination and guide workforce management decisions. We conducted a practice analysis study to identify gaps in Ethiopian medical education and practice, and to determine composition of subjects in national licensing examination. METHODS We conducted a cross-sectional study with national representative sample of junior doctors. After calculating a sample size of 198, we used a two-stage stratified cluster sampling method to select study participants. We collected data using a structured questionnaire comprising 222 tasks. Study participants reported in interviews on frequency of, competence at, and importance of doing each task for improved health outcome. We developed proportions, averages, graphs and tables. Using the results of practice analysis and experts' ratings, relative weights of subjects in the national licensing examination for medical undergraduates were determined. RESULTS A total of 191 junior doctors participated. Most were males (74.6%) and had less than 2 years of experience (69.8%). Junior doctors frequently performed tasks of internal medicine and pediatrics. Their participation in obstetrics and gynecology, ophthalmology, psychiatry and dentistry services was infrequent. Junior doctors had competency gaps to conduct clinical procedures, research and health programming tasks. Practice analysis results and expert ratings generated comparable recommendations for composition of a national licensing examination, with more than three-quarters of the items focusing on internal medicine, pediatrics, surgery, obstetrics and gynecology, and public health. CONCLUSION Junior doctors in Ethiopia rarely managed psychiatry, ophthalmology and dental patients. They had competence gaps in clinical procedures, research and health programming skills. The findings have implications for establishing licensing examination, and reviewing curriculum, continuing professional development, placement and rotation policy, and distribution of responsibilities.
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Affiliation(s)
- Daniel Dejene
- Jhpiego, Kirkos Subcity, Box 2881, Code, 1250 Addis Ababa, PO Ethiopia
| | - Tegbar Yigzaw
- Jhpiego, Kirkos Subcity, Box 2881, Code, 1250 Addis Ababa, PO Ethiopia
| | - Samuel Mengistu
- Jhpiego, Kirkos Subcity, Box 2881, Code, 1250 Addis Ababa, PO Ethiopia
| | - Zerihun Wolde
- University of Maryland Prince George’s Hospital center, Cheverly, Maryland USA
| | - Abiy Hiruy
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | | | - Miftah Awol
- Ethiopian Medical Association, Addis Ababa, Ethiopia
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Strengthening nursing education and practice in Ethiopia: A cross sectional task analysis study. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2018. [DOI: 10.1016/j.ijans.2018.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Yigzaw T, Abebe F, Belay L, Assaye Y, Misganaw E, Kidane A, Ademie D, van Roosmalen J, Stekelenburg J, Kim YM. Quality of Midwife-provided Intrapartum Care in Amhara Regional State, Ethiopia. BMC Pregnancy Childbirth 2017; 17:261. [PMID: 28814285 PMCID: PMC5558781 DOI: 10.1186/s12884-017-1441-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 08/02/2017] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Despite much progress recently, Ethiopia remains one of the largest contributors to the global burden of maternal and newborn deaths and stillbirths. Ethiopia's plan to meet the sustainable development goals for maternal and child health includes unprecedented emphasis on improving quality of care. The purpose of this study was to assess the quality of midwifery care during labor, delivery and immediate postpartum period. METHODS A cross-sectional study using multiple data collection methods and a 2-stage cluster sampling technique was conducted from January 25 to February 14, 2015 in government health facilities of the Amhara National Regional State of Ethiopia. Direct observation of performance was used to determine competence of midwives in providing care during labor, delivery, and the first 6 h after childbirth. Inventory of drugs, medical equipment, supplies, and infrastructure was conducted to identify availability of resources in health facilities. Structured interview was done to assess availability of resources and performance improvement opportunities. Data analysis involved calculating percentages, means and chi-square tests. RESULTS A total of 150 midwives and 56 health facilities were included in the study. The performance assessment showed 16.5% of midwives were incompetent, 72.4% were competent, and 11.1% were outstanding in providing routine intrapartum care. Forty five midwives were observed while managing 54 obstetric and newborn complications and 41 (91%) of them were rated competent. Inventory of resources found that the proportion of facilities with more than 75% of the items in each category was 32.6% for drugs, 73.1% for equipment, 65.4% for supplies, 47.9% for infection prevention materials, and 43.6% for records and forms. Opportunities for performance improvement were inadequate, with 31.3% reporting emergency obstetric and newborn care training, and 44.7% quarterly or more frequent supportive supervision. Health centers fared worse in provider competence, physical resources, and quality improvement practices except for supportive supervision visits and in-service training. CONCLUSIONS Although our findings indicate most midwives are competent in giving routine and emergency intrapartum care, the major gaps in the enabling environment and the significant proportion of midwives with unsatisfactory performance suggest that the conditions for providing quality intrapartum care are not optimal.
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Affiliation(s)
| | | | | | | | | | | | | | - Jos van Roosmalen
- Faculty of Earth and Life Sciences, Vrije Universiteit, Amsterdam, Netherlands
| | - Jelle Stekelenburg
- Department of Obstetrics and Gynecology, Leeuwarden Medical Centre, Leeuwarden, Netherlands
- Department of Health Sciences, Global Health, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
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Shrivastava SR, Shrivastava PS, Ramasamy J. Training Midwives and Other Cadre of Health Workers Using a Solar-Charged Device in Ethiopia. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2017; 22:170-171. [PMID: 28584557 PMCID: PMC5443000 DOI: 10.4103/ijnmr.ijnmr_229_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Saurabh R Shrivastava
- Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chennai, Tamil Nadu, India
| | - Prateek S Shrivastava
- Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chennai, Tamil Nadu, India
| | - Jegadeesh Ramasamy
- Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chennai, Tamil Nadu, India
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