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Awareness and Attitude of Midwives and Midwifery Students toward Community Oriented Midwifery  [PDF]
afsaneh keramat,Rihane Arab,Lila Khorasani
Knowledge & Health Journal , 2012,
Abstract: Introduction: As the literature indicates community-oriented midwifery can play an important role in woman health improvement. This study aimed at investigating midwives’ and midwifery students' awareness about and attitude toward community oriented midwifery in Shahroud University of Medical Sciences in 2009. Methods: In this cross sectional study, a self –made questionnaire including 20 items on awareness about and 25 items on attitude toward community oriented midwifery was used for data collection. The questionnaires were distributed among 102 midwifery students and midwives and 90 questionnaires were answered back. Awareness scores were categorized into three groups: low (less than 75), moderate (75-95) and high (more than 95) awareness scores, and attitude scores were categorized into three groups of negative (25-55), no idea (56-85) and positive (more than 85). The validity and reliability of the questionnaire were evaluated using expert opinion and test- retest respectively. Results: Mean of attitude score was 95.8±10.4 and mean of awareness score was 89.8±12.1. There were no significant differences between midwives and midwifery students in their awareness and attitude (P>0.05). Awareness scores of midwifery student with continuous education were significantly higher than students that their education was non-continuous (P<0.05). Conclusion: Positive attitude towards community oriented among participants indicates the appropriacy of the background for any intervention to apply a community-oriented midwifery program. The moderate level of awareness scores in the sample population and their opinions about current educational programs imply the necessity of further specific education on community oriented midwifery.
A randomised controlled trial of caseload midwifery care: M@NGO (Midwives @ New Group practice Options)
Sally K Tracy, Donna Hartz, Bev Hall, Jyai Allen, Amanda Forti, Anne Lainchbury, Jan White, Alec Welsh, Mark Tracy, Sue Kildea
BMC Pregnancy and Childbirth , 2011, DOI: 10.1186/1471-2393-11-82
Abstract: Models of midwifery have proliferated in an attempt to offer women less fragmented hospital care. One of these models that is gaining widespread consumer, disciplinary and political support is caseload midwifery care. Caseload midwives manage the care of approximately 35-40 a year within a small Midwifery Group Practice (usually 4-6 midwives who plan their on call and leave within the Group Practice.) We propose to compare the outcomes and costs of caseload midwifery care compared to standard or routine hospital care through a randomised controlled trial.A two-arm RCT design will be used. Women will be recruited from tertiary women's hospitals in Sydney and Brisbane, Australia. Women allocated to the caseload intervention will receive care from a named caseload midwife within a Midwifery Group Practice. Control women will be allocated to standard or routine hospital care. Women allocated to standard care will receive their care from hospital rostered midwives, public hospital obstetric care and community based general medical practitioner care. All midwives will collaborate with obstetricians and other health professionals as necessary according to the woman's needs.Data will be collected at recruitment, 36 weeks antenatally, six weeks and six months postpartum by web based or postal survey. With 750 women or more in each of the intervention and control arms the study is powered (based on 80% power; alpha 0.05) to detect a difference in caesarean section rates of 29.4 to 22.9%; instrumental birth rates from 11.0% to 6.8%; and rates of admission to neonatal intensive care of all neonates from 9.9% to 5.8% (requires 721 in each arm). The study is not powered to detect infant or maternal mortality, however all deaths will be reported. Other significant findings will be reported, including a comprehensive process and economic evaluation.Australian New Zealand Clinical Trials Registry ACTRN12609000349246Australia has an enviable record of safety for women in childbirth [
A Survey on Knowledge of Midwives and Midwifery’s Students About Hepatitis B
M Pakgohar,Granmayeh,GH Babaie,Nazari
Hayat Journal of Faculty of Nursing & Midwifery , 2003,
Abstract: Introduction: Hepatitis is a serious danger to heath of delivery room s personnels since direct exposure to the blood occurs in 25 percents of viginal labours. Materials and Methods: This descriptive study carried out in order to evaluate knowledge about hepatitis B among midwives and midwifery’s students in delivery rooms in hospitals related to Medical Sciences universities in Tehran. The study group consisted of 120 persons (60 midwives and 60 midwifery’s students) and hospitals were selected through cluster sampling and samples selected randomly. Data collected by a questionnaire from June to September 2002. Data were analyzed with descriptive statistics and chi-square test. Results: Results showed that knowledge were moderate in majority of midwives and midwifery s students. There was no significant difference between knowledge about hepatitis B in three universities. Conclusion: This research showed that knowledge of midwives and midwifery s students about hepatitis B wasn t adequate hence training courses is recommended in order to increase knowledge of midwives and more attention must be paid to education of midwifery’s students about blood born diseases, especially hepatitis B.
Public health education for midwives and midwifery students: a mixed methods study
Jenny McNeill, Jackie Doran, Fiona Lynn, Gail Anderson, Fiona Alderdice
BMC Pregnancy and Childbirth , 2012, DOI: 10.1186/1471-2393-12-142
Abstract: This was a mixed methods study incorporating a survey of Higher Educational Institutions providing pre registration midwifery education across the UK and focus groups with midwifery students and registered midwives.Twenty nine institutions (53% response) participated in the survey and nine focus groups were conducted (59 participants). Public health education was generally integrated into pre registration midwifery curricula as opposed to taught as a discrete subject. There was considerable variation in the provision of public health topics within midwifery curricula and the hours of teaching allocated to them. Focus group data indicated that it was consistently difficult for both midwifery students and midwives to articulate clearly their understanding and definition of public health in relation to midwifery.There is a unique opportunity to impact on maternal and infant health throughout the reproductive period; however the current approach to public health within midwifery education should be reviewed to capitalise on the role of the midwife in delivering public health interventions. It is clear that better understanding of midwifery public health roles and the visibility of public health within midwifery is required in order to maximise the potential contribution of midwives to achieving short and long term public health population goals.UK policies [1-3] have increasingly recognised the importance of maximising health for infants and children at the start of life, and more recently since the Marmott review of health inequalities [4]. Internationally, there has been a similar focus in recent policy [5,6] and also seen in a report by the World Health Organisation [7]. Ensuring infants have a good start in life is at the cornerstone of good maternity care, as the origins of adult ill health have been linked with intrauterine fetal development, particularly size at birth, which is often referred to as the Barker Hypothesis [8,9]. Opportunities for all maternity care
The training and development needs of midwives in Indonesia: paper 2 of 3
Deborah Hennessy, Carolyn Hicks, Harni Koesno
Human Resources for Health , 2006, DOI: 10.1186/1478-4491-4-9
Abstract: A psychometrically valid training-needs instrument was administered to 332 midwives from three provinces, covering both hospital and community staff and a range of midwifery grades. The instrument had the capacity to identify occupational roles and education/training needs of the respondents.The occupational roles of the midwives varied significantly by province, indicating regional service delivery distinctions, but very little difference in the roles of hospital and community midwives. The most educated midwives attributed more importance to 35 out of the 40 tasks, suggesting an implicit role distinction in terms of level of activity. All midwives reported significant training needs for all 40 tasks. The most-educated midwives recorded training needs for 24 tasks, while the less-educated had training requirements for all tasks, which suggests that new training programmes are effective. Few differences in training needs were revealed between hospital and community midwivesThe results from this survey suggest important regional differences in how the midwife's role is discharged and underline the importance of this sort of research, in order to ensure the suitability of basic and postbasic educational provision. The study also highlights the need for further development and training of midwives in a wide range of tasks. These results provide a systematic and reliable overview of current midwifery roles and development needs and could serve to inform future training.Midwifery in Indonesia plays a particular role in improving community, maternal and neonatal health, as well as contributing towards the health targets set by the Ministry of Health. However, despite their acknowledged importance, in 2001/2002 there were still only 26 midwives per 100 000 of the population, which in absolute and relative terms represents a severe shortfall [1].One consequence of this is the high maternal and perinatal mortality rates, the former being estimated at 307 per 100 000 live bir
Knowledge of dermatoses during pregnancy by midwifery students and midwives. Znajomo problemów dermatologicznych okresu ci y przez studentki kierunku po o nictwo i zawodowo czynne po o ne.
El?bieta Krajewska-Ku?ak,Magdalena Anna Chilicka,Anna Sienkiewicz,Ewa Kropiwnicka
Clinical Dermatology , 2010,
Abstract: Introduction: In the opinion of many authors, the pregnancy is the period when it is possible to encounter numerous physiological changes in the skin and oral mucosa and the development of pathological changes occurring only in that period. Aim of the study: To examine the level of knowledge students of obstetrics and professional midwives on dermatological problems in pregnancy. Material and methods: The study was conducted on a group of 44 midwifery students, and 50 midwives using a questionnaire survey. Results: Overall 40.9% students and 17.0% of midwives did not know the correct distribution changes during pregnancy. In all, 90.9% of students and 95.0% of midwives could describe the skin symptoms of pregnancy. Disease modified by pregnancy, whose clinical condition is generally improving during a pregnancy knew 43.2% of students, and 5.0%, midwives, and that symptoms are more severe knew 45.6% of students, and 56.0% of midwives. Properly, characteristic of the dermatoses during the Ist trimester-2.8% of students, and 32.0% of midwives, for the IInd trimester - 10.3% of students and 68.0% of midwives, the IIIed trimester - 38% of students and 25.0% of midwives described. Pregnancy dermatoses may develop in any pregnancy could describe - 4.1% of students and 42.0% of midwives, a condition typical of a gestation period, located exclusively on the oral mucosa - 42.0% of students and 14.0% of midwives, and penetrations with changes in the skin and oral mucosa - 71.4% of students and 16.0% of midwives. In the opinion of 95.5% students and 72.0% of midwives dermatoses in pregnancy were not discussed in the course of their studies at the University. Student of his knowledge on these subjects and preparation for educational activities generally (40.9%) assessed a sufficient, and midwives were unable to assess - 28.0%. According to the students, the most appropriate person to function as an educator is a gynecologist/obstetrician - 27.3% in the opinion of 27.3% midwives: dermatologist - 66.0%. The educational activities should support the midwife: gynecologist / obstetrician (63.6% students, 54.0% of midwives). In the opinion of 72.7% students and 62.0% of midwives, these issues must be discussed during the studies. Conclusion: Knowledge of midwifery students and midwives on the gestation period of dermatological problems is insufficient. Respondents emphasized that the pregnancy dermatoses were not discussed during their studies. They saw the desirability of introducing the content of dermatology teaching midwives.
The Impact and Cost of Scaling up Midwifery and Obstetrics in 58 Low- and Middle-Income Countries  [PDF]
Linda Bartlett, Eva Weissman, Rehana Gubin, Rachel Patton-Molitors, Ingrid K. Friberg
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0098550
Abstract: Background and Methods To guide achievement of the Millennium Development Goals, we used the Lives Saved Tool to provide a novel simulation of potential maternal, fetal, and newborn lives and costs saved by scaling up midwifery and obstetrics services, including family planning, in 58 low- and middle-income countries. Typical midwifery and obstetrics interventions were scaled to either 60% of the national population (modest coverage) or 99% (universal coverage). Findings Under even a modest scale-up, midwifery services including family planning reduce maternal, fetal, and neonatal deaths by 34%. Increasing midwifery alone or integrated with obstetrics is more cost-effective than scaling up obstetrics alone; when family planning was included, the midwifery model was almost twice as cost-effective as the obstetrics model, at $2,200 versus $4,200 per death averted. The most effective strategy was the most comprehensive: increasing midwives, obstetricians, and family planning could prevent 69% of total deaths under universal scale-up, yielding a cost per death prevented of just $2,100. Within this analysis, the interventions which midwifery and obstetrics are poised to deliver most effectively are different, with midwifery benefits delivered across the continuum of pre-pregnancy, prenatal, labor and delivery, and postpartum-postnatal care, and obstetrics benefits focused mostly on delivery. Including family planning within each scope of practice reduced the number of likely births, and thus deaths, and increased the cost-effectiveness of the entire package (e.g., a 52% reduction in deaths with midwifery and obstetrics increased to 69% when family planning was added; cost decreased from $4,000 to $2,100 per death averted). Conclusions This analysis suggests that scaling up midwifery and obstetrics could bring many countries closer to achieving mortality reductions. Midwives alone can achieve remarkable mortality reductions, particularly when they also perform family planning services - the greatest return on investment occurs with the scale-up of midwives and obstetricians together.
Development of midwifery services in Vojvodina
Maksimovi? Jovan
Medicinski Pregled , 2003, DOI: 10.2298/mpns0308385m
Abstract: This paper deals with the beginnings and development of midwifery services as well as schooling modalities and professional education of midwives in Vojvodina after gaining freedom from Turkish rule. Obstetrical services in the Military Border Region of Vojvodina were much better organized than in the civil, so-called 'provincial' part. In the second half of the 18th century, law regulations were brought and only midwives with certificates of universities and training courses of special midwifery schools in bigger towns could practice midwifery. At that time most trained midwives in Vojvodina were of German nationality, because Serbs knew neither German nor Hungarian and could not get education in Vienna and Budapest. A century later the situation was practically the same. Dr. Svetozar Maksimovi , Master of Obstetrics and the first director of the Maternity Hospital and a city physician in Novi Sad, was well aware that this town had no midwifery service. That is why on July 27, 1879 he submitted a suggestion for foundation of a 'Government Training Institute for Midwives and Pregnant Women'. Although this suggestion was not realized, it was the first attempt to establish a school for midwives in Novi Sad in Serbian language and was of great importance for history of medicine in Vojvodina, especially in Novi Sad. Furthermore, it points to the fact that physicians in Novi Sad, especially Dr. Svetozar Maksimovi , were informed about current medicine in the world. In the frame of public health special attention was paid to Women’s Care Services concerning especially pregnancy, delivery and puerperium. However, it was not possible to realize his vision in Vojvodina at that time, due to insufficient number of trained midwives.
Job satisfaction of midwives
Mirmolaei T,Dargahi H,Kazemnejad A,Mohajerrahbari M
Hayat Journal of Faculty of Nursing & Midwifery , 2005,
Abstract: Introduction: Job satisfaction of midwives, as key members of healthcare system, has special importance in the quality of midwifery care to the vulnerable groups of the society i.e. mothers and children. Materials and Methods: This is a survey and cross sectional study. Sampling size was 251 midwives, which were chosen through cluster sampling. Data were gathered by questionnaire in one stage and were analyzed by SPSS software, using descriptive and analytic ( 2, Pearson correlation) statistical methods. Results: Results of this research demonstrated that satisfaction level of midwives in two aspects of job position (62.9%) and relationship with colleagues (48.2%) was moderate. It was low in the aspects of salary and benefits (92.8%), job security (69.7%), managerial policies and work condition (64.9%), supervisory (48.6%) and relationship with personal life (49.8%). There was a significant relationship and correlation between job satisfaction and all of its aspects, strongest with the aspect of managerial policies (r=0.87) and weakest with the relationship with colleagues (r=0.547). There was no significant relationship between job satisfaction and demographic characteristics such as age, academic degree, marital status, the number of children and monthly salary but there was a significant relationship between job satisfaction and the condition of house ownership, the years of job experience, the condition of employment, the place of work, work shift and whether they liked midwifery when they chose it (p<0.05). Conclusion: Half of midwives (49.4%) had moderate job satisfaction, 49% had low and only 1.6% had high job satisfaction. Considering the results of this research, it can be concluded that the authorities must take efficient measures to omit the most important causes of low job satisfaction through increasing salaries and benefits, promoting job security, improving work condition, reformation of managerial and supervisory systems and using midwives’ professional ability in areas of their skill’s.
The role of midwives in the maternal safety and reproductive health
T . Mirmolaei,M . Shakari
Hayat Journal of Faculty of Nursing & Midwifery , 2001,
Abstract: In an international project in 1987, the world health organization (WHO), UNICEF, UNFPA and the world bank suggested the maternal safety program and the following objectives were considered:"n1. Reducing maternal mortality from 1990 to 2000 to the half of the"npresent rate throughout the prenatal care"n2. Availability of the whole pregnant women to the prenatal care,"nqualified personnel during the delivery and required facilities for"ntransferring women in high risk pregnancies and midwifery emergencies."n3. Availability of appropriate services and information to prevent low age"nand high age pregnancies ,short interval pregnancies and multiparous."nSince 1987, an international cooperation has been established to support the maternal safety program."nRelating to this program, essential changes in the structure of the health services system, in laws and policies and also in training programs of medical doctors ,midwives and other related professions have been made."nThe international confederation of midwifery (ICM), a professional organization of midwifery, and also midwifery societies in the developed countries are the most active organizations involved in providing maternal safety program. Some researches relating to this program was performed in some undeveloped and developing countries such as Africa, Asia and latin America. Some confernces and congresses were also held."nResearchers have indicated that traditional midwifery can not be successed in reducing the rate of maternal mortality unless be supervised by qualified midwives."nSince in our country and some other developing countries, the rate of maternal mortality and morbidity is high, therefore the maternal safety program should be perfectly performed and midwives should do their best in applying this program."nWHO declared midwives are responsible for the maternal safety program performance, and they will be supported by WHO in different ways, WHO also announced the year 1998 as the maternal safety year."nThus, as midwives, we should recognize our essential role in this program and in other national and international reproductive health programs.
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