Childbearing in Malawi, Africa

Evaluation of the breast cancer train the trainer program for nurses in Turkey

The Breast Cancer Train the Trainer (TTT) program was designed to increase breast cancer awareness, improve knowledge about breast cancer among nurses, and provide quality care for breast cancer patients by trained nurses. A total of three programs were held and 82 nurses from different regions of Turkey attended this training. The educational activities employed several teaching and learning strategies. After completion, we determined that the participating nurses' knowledge on breast cancer had increased significantly, and they were satisfied with the training received. The Breast Cancer TTT program is a unique educational endeavor for nurses in Turkey, and our results showed that the training achieved its goal. Trained nurses in Breast Cancer TTT programs can help educate women about the importance of breast health and the measures they need to take to protect themselves against breast cancer. At the same time, nurses can also increase and enhance the quality of life in patients with breast cancer. This is an example of a program that can easily be spread throughout the world as it was done from England and Australia to Turkey.

Development and evaluation of a childbirth education programme for Malawian women

AIM

This paper is a report of a study to develop and evaluate a childbirth educational programme for Malawian women.

BACKGROUND

Providing parent education is integral to the midwife's role. Malawian midwives face a challenge in fulfilling this role, with no existing childbirth education programme to facilitate this process.

METHOD

A mixed method approach was used for this three-phase study. In Phase 1, childbirth information needs of Malawian women were determined from literature and interviews with midwives. In Phase 2, a structured childbirth education programme was developed. In Phase 3, a quasi-experimental design using sequential sampling was conducted to evaluate the education programme. Participants were pregnant women who attended antenatal clinics in 2002, with 104 in the control group and 105 in the intervention group. Changes in childbirth knowledge were determined over a 6-week period.

FINDINGS

The childbirth education programme included information, teaching strategies and a schedule for implementation for content relevant to the antenatal, labour and birth and postnatal time periods. Results revealed no significant difference in knowledge in the control group between pretest and post-test scores. For the intervention group, however, an overall significant increase in knowledge across all time periods was demonstrated (P < 0.01).

CONCLUSION

A childbirth education programme, developed for the Malawian context, was associated with important increases in maternal knowledge about antenatal, labour and birth and postnatal topics. The findings have implications for midwives in other developing countries and offer an example of a midwifery-led initiative to provide formal childbirth education to these vulnerable women.

Decision making in childbirth: the influence of traditional structures in a Ghanaian village

BACKGROUND

The regional health administration of the Brong-Ahafo Region in Ghana identified that although informed about the advantages of both aspects of care, pregnant women made use of antenatal services but not of the supervised delivery. Quantitative studies have identified economic factors that influence the decisions of pregnant women.

AIM

To describe and understand the traditional structures of childbirth in Kwame Danso/Ghana and to explore why the pregnant women do not make use of supervised deliveries in the modern institutions.

METHODS

A mini-ethnographic study, using participant observation and ethnographic interviews.

FINDINGS

Cultural and social factors have a significant influence on the decisions related to childbirth. One of the most important factors identified was that the responsible persons for decisions related to a delivery were the older female relatives, rather than the mothers themselves. Older females used rational judgements to weigh up the possibilities of risks, interests and advantages related to their cultural, spiritual and social system. Other factors were staff behaviour that was characterized as unfriendly and lacking for respect as to the living conditions and thinking of the pregnant women in the village.

CONCLUSIONS

Ethnographic research provided an understanding of traditional structures that have an influence on the decisions and behaviour of the community related to childbirth. Appreciation of these structures enabled health promotion and structured health services to be delivered in a more culturally appropriate way.

Collaborative International Research

The current age of globalization poses challenges as to how to promote professional interaction to further international scholarly efforts in nursing. Models of global research are defined. Global health priorities are explicated, with recommendations for the conduct of outcomes-focused research leading to the generation of cost-effective interventions that contribute to the health and well-being of individuals, families, communities, and nations throughout the world. The challenges and opportunities in international collaborative nursing research are described based on the experiences of the authors during nearly two decades of collaborative work. International partnerships in globally relevant research, which respect and value equity between nurse researchers practicing in developed and developing countries, are essential.

Jordanian women: Perceptions and practices of first-time pregnancy

A woman's child-bearing encounter is an experience that reflects the cultural beliefs and practices of the society. The purpose of this study was to describe the perceptions and practices of urban, low socioeconomic, Jordanian women (aged 18-30 years) in relation to their pregnancy career. An opportunistic sample consisting of 67 Muslim first-time pregnant women who followed up antenatal care at two maternity-care centres in East Amman was selected. A qualitative approach, including ethnographic semistructured interview, participant observation data from the households and clinics and oblique interviewing in random conversations initiated by the primigravidae, was conducted over 18 months. Women gave elaborative accounts of their pregnancy and childbirth expectations in narrative, phenomenological forms. Qualitative data analysis was performed concurrently with data collection, revealing the essential themes of immediacy of pregnancy; familial support and changing networks, especially for the after-birth period; fear of pain and medical interventions, all emphasizing the traditional and religious perceptions and practices in a familial context.

Health promotion for childbearing women in Rubanda, Uganda

A train-the-trainer intervention, based on the World Health Organization's Safe Motherhood Initiative, was successful in changing some health beliefs and health practices among village men and women of childbearing age in a remote area of Uganda. Specifically, more villagers reported attending postpartum care and beginning prenatal care earlier in pregnancy. Some beliefs were not changed (eg, belief in bewitchment), but some beliefs (eg, use of herbal medicines during labor) were not as widely held as a result of this cost-effective and easily sustainable program.

Health promotion and risk reduction in Malawi, Africa, village women

OBJECTIVE

A train-the-trainer intervention was evaluated in which village leaders in Malawi, Africa, taught other villagers how to improve their health.

DESIGN

Health knowledge and reported health practices were compared before and after the educational intervention in 15 villages in Chimutu, Malawi, Africa.

SETTING

Surveys were completed by trained data gatherers in the village setting.

PATIENTS/PARTICIPANTS

All men and women of childbearing age who were present in the village when data collection occurred were asked to participate. There were 187 participants in the preintervention survey and 175 participants in the postintervention survey.

INTERVENTION

Seventy-six village women were trained, using low literacy techniques, to provide content on health promotion and risk reduction in pregnancy. Over 20,000 persons have received at least one health teaching session from the village trainers.

RESULTS

The intervention resulted in reported changes in prenatal and postpartum care and in more births occurring in the hospital or clinic. Some positive nutritional changes were reported, although few changes in beliefs about use of herbal medicines or about the use of witchcraft were reported.

CONCLUSIONS

A train-the-trainer approach is a sustainable intervention that appears to have positive benefits on the health of village women living in Malawi, Africa.