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Midwives and Nurses Compliance with Standard Precautions in Palestinian Hospitals  [PDF]
Imad Fashafsheh, Ahmad Ayed, Mahdiah Koni, Safaa Hussein, Imad Thultheen
Open Journal of Nursing (OJN) , 2016, DOI: 10.4236/ojn.2016.64030
Abstract: Midwives and nurses should use the standard precautions as the basic level of infection control precautions when delivering care to all patients, regardless of their presumed infection status. Therefore midwifes and nurses should have sound knowledge and compliance with standard precaution. Aim of the study: The study aimed to assess the level of the compliance of standard precautions among the midwives and nurses in the Palestinian Hospitals. Method: A cross sectional study was conducted from May to June 2015 on 81 midwives and nurses from Palestinian hospitals. The data were collected from labor rooms and postpartum departments of Palestinian hospitals. Data were collected using pretested questionnaire on 81 midwives and nurses selected by convenience sample. Results: The current study showed that the average of standard precautions knowledge level and compliance are 74.6% and 83.8% respectively. There are an association between age, education, work experience, and compliance with standard precautions at p < 0.05 (0.000, 0.031, and 0.043) respectively. At the same time no significant association between training courses and compliance to standard precautions at p < 0.05 (0.191). Conclusion: The midwives and nurses in the current study for both knowledge and compliance have high level regarding standard precautions. There is an association between age, education, work experience, and compliance with standard precautions. Recommendations: Knowledge of midwives and nurses should be updated; the importance of latest evidence-based practices of infection control in continuing education/training program should be emphasized; and training programs for newly midwives and nurses about standard precaution and at regular intervals should be provided.
Knowledge and Practices of Neonatal Resuscitation by Health Providers in C?te d’Ivoire  [PDF]
Cisse Lassina, Joseph Gnegneri Ouattara, Kouadio Vincent Asse, Line Couitchere, Jacob Enoh, Kouadio Richard Azagoh, Jean-Jacques Attebi, Soumahoho Oulai
Open Journal of Pediatrics (OJPed) , 2017, DOI: 10.4236/ojped.2017.73018
Cote d’Ivoire ranks third among African countries with the highest neonatal mortality rate (38‰). Perinatal asphyxia is one of the major causes of neonatal mortality. In its severe form, it imposes an efficient neonatal resuscitation in the birth room. This can only be done when the proven competence of the staff in charge of the newborn and the availability of the appropriate equipment are met. What is the situation in the birth facilities of these two challenges for the response to the high rate of neonatal mortality in Cote d’Ivoire? Method: It is a cross-sectional study, which took place from March 28 to July 28, 2016, in three health districts of Cote d’Ivoire (Bouaké, Gagnoa, Yopougon). Public health structures offering delivery activities were selected. Based on a fact sheet, the practitioners present have been interviewed and a direct observation of the organization and equipment set up to perform neonatal resuscitation in the birth room has been done. In addition, an observation grid made it possible to evaluate the practical skills of providers in neonatal resuscitation on a newborn mannequin. The data were entered using the Epi-Info 7 software. Based on the data collected, we determined the numbers and frequencies of the responses of the target agents of the survey. Results: The membership structures included 46 first contact health facilities (FCHFs) and 4 reference hospitals (HRs). The heating system, mucus suction, oxygen, timers and self-inflating balloons were available in HR and in six, eight, four, 34 and 10 FCHFs respectively. The 253 midwives surveyed came from Bouaké (86), Gagnoa (62) and Yopougon (105). They had a seniority of at least eight years. Their knowledge for newborns’ care was acquired in initial training (75% of cases). They knew the golden minute in 95.6% of the cases. Inadequacies in the recognition of risk situations, useful equipment and in the execution of neonatal resuscitation steps were noted. Conclusion: The survival of the newborn is still very worrying in Cote d’Ivoire. An analysis of the results of this survey shows that many challenges remain not only at the structural level but also at the level of quality of care.
Relationship of High Work Engagement among Staff Midwives with Their Immediate Superiors’ Burnout on Maternity and Labor Wards in Japan  [PDF]
Emiko Kawauchi, Reiko Inoue, Kazutomo Ohashi
Open Journal of Nursing (OJN) , 2017, DOI: 10.4236/ojn.2017.71004
Abstract: Introduction: Mental conditions for work among workers are related to clinical performance and influenced by colleagues within the same workplace. The aim of study was to examine the work engagement and burnout of staff midwives working on maternity and labor wards and to determine the factors related to high work engagement of staff midwives, including their immediate superiors’ work engagement and burnout. Methods: A cross-sectional questionnaire survey was employed in Japan. Questionnaires were distributed to 452 midwives/nurses working on maternity and labor wards of 20 hospitals and responses from 96 staff midwives and 17 of their immediate superiors were analyzed. Work engagement and burnout (exhaustion, cynicism, and professional efficacy) were assessed by the Utrecht Work Engagement Scale and the Maslach Burnout Inventory-General Survey, respectively. To examine the association of work engagement among staff midwives with their ages, marital status and work engagement and burnout of their superiors, logistic regression analysis was conducted. Results: Immediate superiors showed significantly higher level of work engagement than staff midwives, while there was no difference in the burnout. High work engagement of staff midwives was significantly correlated with the professional efficacy (AOR 1.93, 95% CI 1.12 - 3.33) and cynicism (AOR 2.01, 95% CI, 1.04 - 3.90) of their immediate superiors. There was no correlation of work engagement between them. Conclusions: High work engagement of staff midwives was correlated to high professional efficacy and cynicism of their immediate superiors, suggesting that there might be crossover effects on mental conditions for work between staff midwives and their immediate superiors.
Scaling up Nigeria’s Midwives Service Scheme and Reducing Inequality Gaps in Maternal Mortality  [PDF]
Emmanuel Onyebuchi Onugha
Open Journal of Obstetrics and Gynecology (OJOG) , 2017, DOI: 10.4236/ojog.2017.78089
Abstract: The Federal Government of Nigeria in December 2009 launched midwives service scheme to address the shortage of skilled healthcare workforce needed to drive the efforts at improving maternal and infant health, towards the attainment of MDGS 4 and 5. This was in response to the unrelenting increase in maternal mortality in Nigeria. This review explores the implementation of the scheme and the extent to which its set-goals are achieved vis-à-vis many challenges confronting it. The review first explores the ecologic perspective on maternal mortality to identify factors responsible for high mortality among Nigerian women and the inequality gaps in maternal mortality. The review identifies the need to scale up midwives service scheme to areas in dire health needs, identifies the need for health needs assessment, and recognizes community participation as an essential ingredient in ensuring the sustainability of midwives service scheme. Routine evaluation of midwives service scheme is identified as an important tool for assessing the effectiveness of the scheme in achieving its objectives towards improvement in maternal health and reduction in inequality gaps in maternal mortality. The review proposes multi-sectoral interventions in tackling inequality gaps in maternal mortality with strategic focus on addressing inequalities in health and social determinants of health.
Daughter of time: the postmodern midwife (Part 1)
Davis-Floyd, Robbie;
Revista da Escola de Enfermagem da USP , 2007, DOI: 10.1590/S0080-62342007000400023
Abstract: this article presents the notion of the postmodern midwife, defining her as one who takes a relativistic stance toward bio-medicine and other knowledge systems, alternative and indigenous, moving fluidly between them to serve the women she attends. she is locally and globally aware, culturally competent, and politically engaged, working with the resources at hand to preserve midwifery in the interests of women. her informed relativism is most accessible to professional midwives but is also beginning to characterize some savvy traditional midwives in various countries. thus the concept of the postmodern midwife can serve as a bridge across the ethnic, racial, and status gaps that divide the professional from the traditional midwife, and as an analytical focal point for understanding how the members of each group negotiate their identities and their roles in a changing world.
Daughter of time: the postmodern midwife (Part 2)
Davis-Floyd, Robbie;
Revista da Escola de Enfermagem da USP , 2008, DOI: 10.1590/S0080-62342008000100022
Abstract: any effort to make sense of the complexities of contemporary midwifery must deal not only with biomedical and governmental power structures but also with the definitions such structures impose upon midwives and the ramifications of these definitions within and across national and cultural borders. the international definition of a midwife requires graduations from a government-recognized educational program. those who have not are not considered midwives but are labeled traditional birth attendants. since there are myriad local names for midwives in myriad languages, the impact of this naming at local levels can be hard to assess. but on the global scale, the ramifications of the distinction between midwives who meet the international definition and those who do not have been profound. those who do are incorporated into the health care system. those who do not remain outside of it, and suffer multiple forms of discrimination as a result.
Tempos modernos, novos partos e novas parteiras: o parto no Jap?o de 1868 aos Anos 1930
Homei, Aya;
Revista Estudos Feministas , 2002, DOI: 10.1590/S0104-026X2002000200012
Abstract: the shin-sanba, or medical 'new-midwife' who emerged during the meiji period (1868-1912) in japan seems, looked at from the present, to have successfully replaced the 'old-midwife' (ky?-sanba) and the increasingly criminalised 'non-licensed midwife' (mumenkyo-sanba), while midwifery was constantly developing as a modern medical profession. this paper suggests that the history of the midwife during the modern time was more complex than what we see today. first, the emergence and prosperity of shin-sanba were specific to the historical contingencies of modern japan and the interplay of various groups of historical actors - hygiene officers, sankai (obstetrician-gynaecologists), other midwives, and 'clients'. second, through the course of the modern period, shin-sanba did not replace other types of midwives and in fact, different kinds of midwives did coexist. finally, the existence and status of midwives greatly depended upon the laissez faire medical market, and the market's realities often contradicted the medical rhetoric that favoured shin-sanba over other kinds of midwives.
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.
"A Comparison of Advice About Breast-Feeding Given by Community Midwives in Swansea (UK) and Shahrekord (Iran)"
?K Shahandeh
Iranian Journal of Public Health , 2002,
Abstract: The most common reason for women ceasing breast-feeding were lack of support and appropriate advice. To explore the advice about breast-feeding given by community midwives and compare and contrast their advice in Swansea (UK) and Shahrekord (Iran). Data collected through semi-structured interview with a sample of 12 community midwives, 6 from each country. Purposive sample was selected as capable of giving a wide range of responses. Following transcriptions of the interviews, data were analyzed using a content analysis approach.Within Education, Support, Antenatal and Postnatal Advice Themes, categories and sub-categories emerged from the data. Participants were generally aware of their role in supporting women in the process of breast-feeding.The knowledge obtained through research and education should be shared with women so that informed decision of feeding method can be made. More training staff might produce better outcome.
Midwifery and Midwives Service Scheme: A Panacea for Improvement of Some Maternal and Neonatal Indices in Nigeria—A Brief Review  [PDF]
Prosper Adogu
Open Journal of Obstetrics and Gynecology (OJOG) , 2014, DOI: 10.4236/ojog.2014.47051

Introduction: Midwifery is the art of caring for women during childbearing. It is practiced throughout the world according to the norms, traditions and cultural practices found in each country. Maternal mortality in Nigeria is high but there are wide variations between the geopolitical zones of the country. Government has established the midwives service scheme (MSS) as part of efforts towards reversing the country’s unacceptably high maternal mortality trends. To improve these indices, the MSS in Nigeria engaged newly graduated unemployed and retired midwives to work temporarily in rural areas. The midwives are posted for twelve months to selected primary care facilities linked through a cluster model in which four such facilities with the capacity to provide basic essential obstetric care are clustered around a secondary care facility with the capacity to provide comprehensive emergency obstetric care. This brief review is an attempt at exploring the impact of the midwives service scheme on maternal and neonatal indices in Nigeria. Main content: The outcome of the MSS four years has been an improvement though unevenly and marginally, in these indices in the various geopolitical zones of Nigeria. Improvements have been noticed in maternal indices such as antenatal care attendance, women receiving two doses of tetanus toxoid and number of deliveries by skilled personnel. Also reduction in maternal and neonatal mortality has been observed over the years following introduction of the scheme. Major challenges however, include lack of essential drugs, poor accommodation facilities for MSS staff, irregular payment of their remuneration and lack of water/power supply to some designated facilities for the scheme. Recommendations and conclusions: It is therefore recommended that 24 hours availability of essential drugs at primary healthcare centers be maintained. This should happen in conjunction with regular payment of full entitlements and benefits and provision of secured, habitable and good accommodation for MSS staff. Finally, aggressive community mobilization should continue in order to engender community involvement and participation for sustainable program development.

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