Evaluating health workers attitude towards implementation of maternal and perinatal deaths surveillance and response system in Morogoro region; analytical cross-sectional study

Maternal and Perinatal Deaths Review and Surveillance (MPDSR) is a technical system which was issued by the World Health Organization in 2013 to help developing countries improve maternal health. The major purpose of the system was to reduce the ongoing high numbers of maternal deaths and perinatal deaths from avertable causes. Tanzania adopted MPDSR system in 2015. The study aimed to assess health workers attitude towards implementation of MPDSR system in Morogoro Region. This analytical cross-sectional study was conducted in three districts of Morogoro region from April 27, 2020 to May 29, 2020 involving 360 health workers from 38 health facilities. A semi-structured questionnaire was used for data collection. SPSS software version 25 was used to analyze the obtained data. Descriptive analysis was done to describe the characteristics of study participants. Binary logistic regression analysis was used to assess predictors of health workers attitude towards the MPDSR system. A total of 255(70.8%) of respondents had positive attitude towards MPDSR system. After controlling of confounders predictor of positive attitude were location of health facility [rural (AOR = 0.216 at 95% CI = 0.121-0.387, p = <0.001)], Age group [Below 30(AOR = 0.459 at 95%CI = 0.264-0.796, p = 0.006)] and status of training on MPDSR [Yes (AOR = 4.892 at 95%CI = 2.187-10.942, P = <0.001)]. Substantial number of health workers had positive attitude towards the MPDSR system. Health workers who were residing in rural settings and younger than 30 years were less likely to have positive attitude towards the system. Health workers who had access to be trained about the system were more likely to have positive attitude towards MPDSR system. The study recommends the training of health workers about the system so as to increase their attitude and hence the use of the system.

Dataset comparing the effectiveness of perineal cold pack application over oral paracetamol 1000mg on postpartum perineal pain among women after spontaneous vaginal delivery in Dodoma region

The data were collected from the Dodoma Regional Referral Hospital randomized clinical trial among postnatal women. The raw and analyzed data includes 228 postnatal women with the following information: age(years), marital status, education level, occupation, religion, residence, and income. It also includes the number of Antenatal Visits, perineal condition, birth weight of the newborn, and the magnitude of perineal pain at the start(time=zero), at 20,40 and 60 minutes. The participants were randomly allocated to either an intervention or control group. The intervention group received the cold pack, while the control group received the Paracetamol 1000mg start. Data were collected using a standardized questionnaire and then analyzed using Stata™ software (StataCorp LLC, College Station, TX, US) version 14 and IBM SPSS statistics 25. The outcome was pain intensity measured using a pain rating scale at the interval of 20 minutes up to 60 minutes. The intervention's effect was estimated using an analysis of variance(repeated measure ANOVA). Omega square test was used to establish the effect size. These data will help nurse midwives in health facilities analyze data and demonstrate the effectiveness of cold packs in relieving pain instead of oral paracetamol, hence increasing scaling up its utilization.

Understanding the preference for homebirth; an exploration of key barriers to facility delivery in rural Tanzania

BACKGROUND

There is limited information on the effect of expectant parents' socio-cultural perceptions and practices on the use of skilled birth attendants (SBAs) in rural Tanzania. The purpose of this study was to explore the socio-cultural barriers to health facility birth and SBA among parents choosing home birth in rural Tanzania, specifically in the Rukwa Region.

METHODS

This study used a descriptive exploratory methodology. Purposive sampling was used to recruit study participants for both in-depth interviews (IDIs) and focused group discussions (FGDs). Qualitative research methods, including FGDs and IDIs, were utilized in data collection. The respondents were men and women whose youngest child had been born at home within the prior 12 months. A thematic approach was used for data analysis.

RESULTS

The main themes that emerged regarding barriers to the use of health facility were 1) limited decision-making by men on place of delivery; 2) low risk perception by men and its interference with health facility birth; 3) men's limited resource mobilization for health facility birth and 4) females' perceptions that pregnancy and childbirth are low-risk events.

CONCLUSION

This qualitative study demonstrates that apart from well-documented structural barriers to skilled birth attendance in rural Tanzania, the low risk perception among both men and women plays a substantial role. The low risk perception among both men and women affects the use of SBAs in two ways. First, women become negligent and take risk of delivering at home. Second, male partners do not seriously mobilize resources for health facility childbirth. These findings reinforce the urgent need to implement creative programs to increase genuine male participation in facilitation of health facility childbirth.

The Global Health Service Partnership: An Academic-Clinical Partnership to Build Nursing and Medical Capacity in Africa

The World Health Organization estimates a global deficit of about 12.9 million skilled health professionals (midwives, nurses, and physicians) by 2035. These shortages limit the ability of countries, particularly resource-constrained countries, to deliver basic health care, to respond to emerging and more complex needs, and to teach, graduate, and retain their future health professionals—a vicious cycle that is perpetuated and has profound implications for health security. The Global Health Service Partnership (GHSP) is a unique collaboration between the Peace Corps, President’s Emergency Plan for AIDS Relief, Seed and host-country institutions, which aims to strengthen the breadth and quality of medical and nursing education and care delivery in places with dire shortages of health professionals. Nurse and physician educators are seconded to host institutions to serve as visiting faculty alongside their local colleagues. They serve for 1 year with many staying longer. Educational and clinical best practices are shared, emphasis is placed on integration of theory and practice across the academic–clinical domains and the teaching and learning environment is expanded to include implementation science and dissemination of locally tailored and sustainable practice innovations. In the first 3 years (2013–2016) GHSP placed 97 nurse and physician educators in three countries (Malawi, Tanzania, and Uganda). These educators have taught 454 courses and workshops to 8,321 trainees, faculty members, and practicing health professionals across the curriculum and in myriad specialties. Mixed-methods evaluation included key stakeholder interviews with host institution faculty and students who indicate that the addition of GHSP enhanced clinical teaching (quality and breadth) resulting in improved clinical skills, confidence, and ability to connect theory to practice and critical thinking. The outputs and outcomes from four exemplars which focus on the translation of evidence to practice through implementation science are included. Findings from the first 3 years of GHSP suggest that an innovative, locally tailored and culturally appropriate multi-country academic–clinical partnership program that addresses national health priorities is feasible and generated new knowledge and best practices relevant to capacity building for nursing and medical education. This in turn has implications for improving the health of populations who suffer a disproportionate burden of global disease.