Tagged / CMMPH

Editorial by Dr. Way in top journal highlights midwifery education

Way editorial 2016The forthcoming editorial in Midwifery (Elsevier) by FHSS’s Dr Susan Way highlights the importance of midwifery education and its educators.[1]  This editorial makes reference to the recent series on midwifery in The Lancet.[2]  Of course, midwifery plays a vital role in improving the quality of care of women and infants globally. Dr. Way reminds us that consistent, high-quality midwifery care has a vital role to play in the reduction of maternal and newborn mortality. Outcomes are enhanced when care is led by midwives who are educated, licensed, regulated, integrated in the health system, and working in interdisciplinary teams, with ready access to specialised care when needed.

Midwifery one of the leading academic journals globally in the field of midwifery and maternity care.  Dr.Way is based in the Centre for Midwifery, Maternal & Perinatal Health in FHSS at the Lansdowne Campus.

 

Congratulations!

Prof. Edwin van Teijlingen

CMMPH

 

References:

  1. Way, S. (2015) Consistent, quality midwifery care: How midwifery education and the role of the midwife teacher are important contributions to the Lancet Series, Midwifery (online first) see: http://www.midwiferyjournal.com/article/S0266-6138(16)00021-8/abstract
  2. Renfrew, M.J., McFadden, A., Bastos, M.H. et al. (2014) Midwifery and quality care: findings from a new evidence-informed framework for maternal and newborn care. the Lancet. 384:1129–1145.

Presentation by PhD student Preeti Mahato Jan 27th.

On Wednesday Jan. 27th CMMPH PhD student Preeti Mahato will present her PhD research ideas under the title “Addressing quality of care and equity of services available at birthing centres to improve maternal and neonatal health in western Nepal.”  Her presentation will be held at the Lansdowne Campus at 13.00 in room 301 in Royal London House.

IMG_6459Preeti’s research focuses on birthing centres in western Nepal; and quality and equity of service available at these facilities. In Nepal, birthing centres act as first contact point for the women seeking maternity services especially the basic obstetric care. The focus of this presentation will be to talk about the first review article Preeti Mahato wrote for the ‘Journal of Asian Midwives’ entitled “Birthing centres in Nepal: Recent development, obstacles and opportunities”. The article has been accepted for publication in June 2016 and focuses on introducing birthing centres, their current state of operation under the health system of Nepal, barriers they are facing and what could be done to improve their present state. The quality of care issue available at birthing centre is emphasised, since the number of these facilities are increasing however there is a growing trend to bypass and uptake services at hospitals. Despite barriers to utilisation of services at birthing centres, they can play an important role in increasing institutional delivery rate and proportion of births benefiting from a skilled birth attendant.IMG_6591

The second part of presentation will provide a brief summary on what Preeti has done since writing a review article, as she has worked on a systematic review on quality of basic obstetric care facilities in low and middle income countries.

Preeti Mahato has worked in the field of public health in Nepal for three years after completing her Master of Public Health. She has an interest in sexual and reproductive health, women’s health and maternal and child health. Working as a public health officer she was involved in maternal and neonatal health that developed her interest in pursuing a doctorate related to maternal and neonatal health. Part of her work in Nepal also included monitoring and supervision of birthing centres in rural areas of Nepal and that is how she became motivated to start a PhD at BU.

 

Prof. Edwin van Teijlingen

CMMPH

New CMMPH international midwifery publication

Congratulations to Professor Vanora Hundley in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) on the publication of her latest international paper ‘How do midwives in Slovenia view their professional status?’ [1]. slovenia midwifery 2015

The paper explores Slovenian midwives’ views of their professional status, linkng this to the participants’ educational background. Most participants did not consider midwifery to be a profession in its ow right. Midwives with secondary education were more likely to consider practical skills to be important than theoretical midwifery knowledge. In general Slovenian midwives did not feel enabled to practise autonomously causing them several ethical dilemmas. All participants with midwifery secondary school education thought that obstetrics jeopardises midwifery scope of practice, but only half of the B.Sc. participants thought this. One-fifth of all participants estimated that midwifery is also threatened by nursing. The respondents reported feeling a lack of control over their professional activity and policy making; however the majority of midwives claimed that they were willing to take on more responsibility for independent practice. The authors conclude that Slovenian midwifery cannot be considered to be a profession yet. It faces several hindrances, due to its historical development.

 

Prof. Edwin van Teijlingen

CMMPH

 

Reference:

Mivšek, P., Pahor, M., Hlebec, V., Hundley, V. (2015) How do midwives in Slovenia view their professional status? Midwifery 31(12):1193-201

Mental health & maternity care in Nepal: THET-funded training

group work NawalparasiIMG_6649

A few days I posted a short report of our first session as part of the THET-funded project ‘Mental Health Training for Community-based Maternity Providers in Nepal’, see this previous post here.  Yesterday we completed the final third day training of the first session of this BU-led project.  Over three days we had 70 ANMs (Auxiliary Nurse Midwives) in attendance, which we think is (nearly) all such staff based in all birthing centres in the district (=province).  The three days were the same, i.e. each session was repeated twice so each day one third of the ANMs could attend, and two-third could be at work in the birthing centre ensuring women could deliver safely.

logo THETAs part of this project we send UK volunteers (health and/or education) experts to Nepal to offer high quality training in areas where it is most needed.  Further detail on this BU-led THET project can be found in our scientific paper Mental health issues in pregnant women in Nepal  published in the Nepal Journal of Epidemiology available through Open Access.  Mental illness is still very much a taboo topic in Nepal as it has often a serious stigma attached to it.  Moreover, the relatively short training of ANMs is often fairly basic and the national curriculum does not cover mental health issues in any detail.  This joint project between Bournemouth University, Liverpool John Mooores University, Tribhuvan University and the local charity Green Tata Nepal addresses issues about mental health in general and in pregnant women and new mothers in particular.  Tribhuvan University is the oldest university in Nepal and one of the ten largest universities in the world (based on student numbers).  The project is multi-disciplinary involving midwives, (mental health) nurses, and doctors as well as global health researchers, educationalists and sociologists.

 

Prof. Edwin van Teijlingen

CMMPH

 

 

Mixed methods: not without its downside?

Prof Edwin van Teijlingen

Conducting mixed-methods research has become very popular over the past decade especially in the health research field.1-4 This development ties in with the growth in inter-disciplinary and multi-disciplinary research. Many grant applications, PhD project and the resulting papers especially in the health field apply a mixed-methods approach, where in the past a single approach would have dominated.   This interest in combining methods seems to be the case even in the more traditional quantitative field of clinical effectiveness and randomised controlled trials. Whilst I find this development encouraging as a mixed-methods social scientist, it also makes me wonder whether the applicants putting forward a mixed-methods project have thought about the disadvantages or at least the opportunity costs of using such approach.

A mixed-methods approach is ‘simply’ combining two or more research methods to address a research question, i.e. what the label suggests. It is often perceived as the combining of qualitative with quantitative methods, but it can technically also be a mix of quantitative methods or a combination of qualitative methods. The advantage of a mixed-methods approach is that the different methods in the mix address different aspects of the research question and that combining these methods offers a synergetic effect. So what are the possible limitations of or barriers to mixed-methods research?

First, using a mixed-methods approach means you need an understanding of two different philosophies and how to bring the findings of these two different methods together.4-6   One requires expertise in two different research approaches, either as individual or in the team as well as someone who can do the combining of the findings. For the latter you really need someone in the team who understand the pragmatic approach commonly used in mixed-methods approaches. Otherwise there is a great risk that the original mixed-methods study will be analysed and reported as two or more separate papers each based on data from one of the methods applied in the mixed-methods study.

Secondly, you can spend your money only once, hence there are opportunity costs. Thus if the maximum grant is £200,000 or £300,000 you can’t spend the full amount on the designing a large-scale quantitative study/survey, as you need to spend a proportion of your money and your attention and time on your qualitative study.

Thirdly, and related the above, both quantitative and qualitative methods have ‘rules’ about sampling and sample-size.5 Just because you have two methods this does not mean you can necessarily do a study with a smaller sample. The sample size calculations will still say you need at least xxx participants. Similarly, although perhaps not so rigidly you need a certain number of interviews or focus groups to do you qualitative study appropriately.

Fourthly, a common mistake seems to be to add a bit of qualitative research to a larger quantitative study, perhaps a bit tokenistic.7 Often it is so obvious in a grant application that the qualitative research is an add-on, an afterthought perhaps from a reviewer in the previous failed grant application.

Finally, not all mixed-methods studies are the same, in fact each mixed-methods study is more or less unique in the way in the way it mixes and matched individual research methods.3 So although mixed-methods may be the best way to address a particular research question, your particular proposed mixed of quantitative and qualitative research might not be the most appropriate to answer the overall research question.8

As with all research methods and research proposals my recommendation is if in doubt go and find an expert for advice.6 If necessary get an expert on your team of researchers to strengthen your application.

 

Professor Edwin van Teijlingen

CMMPH

 

References:

  1.  Barbour, R.S. (1999) The case of combining qualitative and quantitative approaches in health services research. Journal of Health Services Research Policy, 4(1): 39-43.
  2. Simkhada, P., van Teijlingen, E., Wasti, S.P., Sathian, B. (2014) Mixed-methods approaches in health research in Nepal, Nepal Journal of Epidemiology 4(5): 415-416.
  3. Plano Clark, V.L., Anderson, N., Wertz, J.A., Zhou, Y., Schumacher, K., Miaskowski, C. (2015) Conceptualizing Longitudinal Mixed Methods Designs: A Methodological Review of Health Sciences Research, Journal of Mixed Methods Research, 9: 297-319.
  4. MacKenzie Bryers, H., van Teijlingen, E. Pitchforth, E. (2014) Advocating mixed-methods approaches in health research, Nepal Journal of Epidemiology 4(5): 417-422. http://www.nepjol.info/index.php/NJE/article/view/12018/9768
  5. Bryman, A. (1988) Quality and Quantity in Social Research, London: Routledge
  6. Bazeley, P. (2003) Teaching mixed methods. Qualitative Research Journal, 4: 117-126.
  7. Maxwell, J.A. (2016) Expanding the History and Range of Mixed Methods Research, Journal of Mixed Methods Research, 10: 12-27.
  8. Brannen, J. (2005) Mixing methods: The entry of qualitative & quantitative approaches into the research process. International Journal of Social Research Methodology 8(3): 173-85.

 

Congratulations to Dr. Caroline Ellis-Hill

NIHRDr. Caroline Ellis-Hill  has just been accepted as a qualitative methodologist on the NIHR (National Institute for Health Research) panel for Programme Grants for Applied Research (PGfAR).  Caroline from the Centre for Qualitative Research (CQR) in FHSS is the second BU academic to join a NIHR panel this year.  Earlier this year Prof. Edwin van Teijlingen was invited to be a member of the NIHR’s HTA Clinical Evaluation & Trials Board ( http://www.nets.nihr.ac.uk/programmes/hta/our-people ).

Congratulations!

Professors Vanora Hundley & Edwin van Teijlingen

CMMPH

Open Access publishing discussion at EU

EU Open Access 2015The European Commission held a workshop in October about alternatives to Green and Gold Open Access publishing.  The presentations held at this workshop are freely available online, click here.  Discussions included questions such as: how might these alternatives work, how they have evolved, whether they work well, and what challenges they don’t manage to tackle. This report synthesises the presentations and discussions from the workshop.   For more details see: https://ec.europa.eu/digital-agenda/en/news/report-workshop-alternative-open-access-publishing-models

Open-Access-logo

Prof. Edwin van Teijlingen

CMMPH

New joint AECC and FHSS publication

journal 2015

Congratulations to Joyce Miller, Monica Beharie and Elisabeth Simmenes based at the Anglo-European College of Chiropractic (AECC) and FHSS’s Alison Taylor and Sue Way who just had their paper ‘Parent reports of exclusive breastfeeding after attending a combined midwifery and chiropractic feeding clinic in the UK: A cross sectional service evaluation’ accepted in the journal Journal of Evidence-Based Complementary & Alternative Medicine.

Congratulations!

Prof. Edwin van Teijlingen

CMMPH