Tagged / midwifery

Promoting Nursing CPD in Nepal

Bournemouth University facilitated a Strategic planning meeting to develop a Continuing Professional Development (CPD) Framework for Nepal last week in Kathmandu. The planning meeting was held on 30th July 2019 at the Institute of Medicine IOM Maharajgunj Nursing Campus.  Midwifery is not formally recognised in Nepal, i.e. as a profession separate from nursing, therefore when refer to nursing CPD in this blog we mean both ‘nurses’ and ‘nurse-midwives’.

Bournemouth University is collaborating in this project with Liverpool John Moores University (LJMU) in the UK, the IOM Nursing Campus, the Nursing Association of Nepal (NAN), MIDSON, the Nepal Nursing Council (NNC) and several other key stakeholders in Nepal to support nursing regulatory bodies to establish mandatory CPD and/or post-registration training programmes relevant to their current practice in nursing. 

The Bournemouth team (led by Dr. Bibha Simkhada with Prof. Edwin van Teijlingen and Dr.Pramod Regmi) argued that CPD offers nurses the opportunity to maintain, improve and broaden knowledge, expertise and develop their personal and professional qualities to enhance practice and career development. Nepal has had limited process and progress in ensuring CPD for nurses and the uptake of post-registration education and training  programmes or CPD tends to be ad hoc.  Generally, CPD in Nepal remains under-developed as showing evidence of having received CPD is not currently a requirement of nurses when they re-register every five year.

This project is a good example of a BU FUSION project as our earlier Research in the form of a needs assessment will to the introduction of CPD which is of course, post-registration Education in nursing, helping to improve Practice in a low-income country.  We think we have had at least some impact on nursing in Nepal as the general feeling of our strategic planning meeting positive towards introducing CPD in the near future in Nepal.

 

 

New CMMPH publication on health promotion in post-earthquake Nepal

Today saw the publication of a new paper from an international research team from the UK, Japan and Nepal.  Our research article ‘Assessing knowledge and behavioural changes on maternal and newborn health among mothers following post-earthquake health promotion in Nepal’ has been published in the Open Access journal PLoS ONE [1]. 

The paper reminds us that natural disasters often disrupt health systems affecting the whole population, but especially vulnerable people such as pregnant women, new mothers and their babies. Despite the global progress in maternal, newborn and child health (MNCH) programmes over the years, emergency responses after a disaster are often poor. Post-disaster health promotion could play an important role in improving MNCH outcomes. However, evidence remains limited on the effect of post disaster health promotion activities in low-income countries such as Nepal.

The paper reports on an post-disaster intervention study aimed at women in Nepal following the 2015 earthquake. In total, 364 mothers were recruited in the pre-intervention group and 377 in the post-intervention group. The post-intervention group was more likely to have knowledge of at least three danger signs in pregnancy (AOR [Adjusted Odds Ratio] = 2.96, P<0.001), at least three danger signs in childbirth (AOR = 3.8, P<0.001), and at least five danger signs in newborns (AOR = 1.56, P<0.001) compared to the pre-intervention group. The mothers in the post-intervention group were also more likely to ever attend ANC (AOR = 7.18, P<0.001), attend a minimum of four ANC sessions (AOR = 5.09, P<0.001), and have institutional deliveries (AOR = 2.56, P<0.001).

Religious minority groups were less likely to have knowledge of all danger signs compared to the majority Hindu group. Mothers from poorer households were also less likely to attend four ANC sessions. Mothers with higher education were more likely to have knowledge of all the danger signs. Mothers whose husbands had achieved higher education were also more likely to have knowledge of danger signs and have institutional deliveries.  The paper concludes that the health promotion intervention helped the disaster-affected mothers in improving the knowledge and behaviours related to MNCH. However, the authors also comment that vulnerable populations need more support to benefit from such intervention.

 

Reference:

Dhital R, Silwal RC, Simkhada P, van Teijlingen E, Jimba M (2019) Assessing knowledge and behavioural changes on maternal and newborn health among mothers following post-earthquake health promotion in Nepal. PLoS ONE 14(7): e0220191. https://doi.org/10.1371/journal.pone.0220191

Dr. Rachel Arnold’s first paper as BU staff

Congratulations to Dr. Rachel Arnold in the Centre for Midwifery, Maternal & Perinatal Health who had her first paper accepted since she started working at BU two months ago. Her paper ‘Villains or victims? An ethnography of Afghan maternity staff and the challenge of high quality respectful care’ is co-authored with her former PhD supervisors Professor Kath Ryan (BU Visiting Faculy), Professor Emerita Immy Holloway and CMMPH’s Professor Edwin van Teijlingen [1].  The paper is Open Access funded by Bournemouth University’s Open Access Fund which will help promote the visibility of the paper before REF 2021.

I was tempted to head this blog ‘Dr. Arnold only two months at BU and first paper published’, but I decide this would perhaps send the wrong message to other new BU staff.  Rachel completed her PhD in CMMPH and this is paper is the third publication from her thesis.  The other academic publications by Dr. Arnold on Afghanistan have been in BJOG and Social Science & Medicine [2-3].

 

References:

  1. Arnold, R., van Teijlingen, E., Ryan, K., Holloway, I. (2019) Villains or victims? An ethnography of Afghan maternity staff and the challenge of high quality respectful care ,     BMC Pregnancy and Childbirth (accepted).
  2. Arnold R., van Teijlingen E, Ryan K., Holloway I. (2015) Understanding Afghan health care providers: Qualitative study of culture of care in Kabul maternity hospital, BJOG 122: 260-267.
  3. Arnold, R., van Teijlingen, E., Ryan, K., Holloway, I. (2018) Parallel worlds: an ethnography of care in an Afghan maternity hospital, Social Science & Medicine 126:33-40.

Congratulations to PhD student Alice Ladur

FHSS PhD student Alice Ladur has been awarded a small but very competitive grant by FfWG, the Funds for Women Graduates.  FfWG is the trading name of the BFWG Charitable Foundation and the BFWG (British Federation of Women Graduates), which is affiliated to the International Federation of University Women.

Alice is based in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH).  Her PhD research in Uganda is supervised by Prof. Vanora Hundley and Prof. Edwin van Teijlingen. Her thesis research has already resulted in an academic paper published in the international journal BMC Pregnancy & Childbirth, which Open Access.

New BU cross-faculty publication

This week Evidence-Based Midwifery published the latest article from the BU team working on the portrayal of midwifery and maternity in the media.  This qualitative paper ‘Changing the narrative around childbirth: whose responsibility is it?’ is co-authored by a multidisciplinary team including the disciplines of Midwifery, Sociology and Media.[1]  The lead author is Prof. Vanora Hundley in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH), one of longest established centres at BU, her co-authors are Dr. Ann Luce in the Faculty of Media & Communication, Prof. Edwin van Teijlingen director of CMMPH and Sophie Edlund, who was based at BU at the time of the research but who is now at Malmö University in Sweden.

The paper addresses societal’s interest in all aspects of childbirth, which is reflected in both social and traditional media. Stories often focus on dramatic, risky and mostly unrealistic events; misrepresenting childbirth and maternity care professionals. The authors raised the question: “Whose responsibility is it to ensure accurate representations of childbirth?”   Using semi-structured in-depth interviews with ten midwives working in the UK some working in the NHS, some in Higher Education or independent practice, the authors distilled four separate but inter-related themes:

(1) not my responsibility;

(2) fear of retribution;

(3) power balance; and

(4) social media.

The themes sat within two wider societal issues that reflect the current challenges for midwifery, these were (a) the ongoing battle between the social and the medical models of childbirth and (b) the impact of gender.  Finding that midwives fear the media resonates with experiences from a number of countries and professional groups. There is a need to change media discourse in both fictional and factual representations of childbirth and midwives have a critical role to play in this, but to do this they need to equip themselves with the skills necessary to engage with the media. Guidelines on responsible media reporting could ensure that media producers portray pregnancy, midwifery and maternity care as naturally as possible.

This paper is paper of a growing body of interdisciplinary research at BU across faculties, which had already resulted in six earlier publications. [2-7]  In addition last month Dr Chapleo from the Faculty of Management submitted a grant application to the ESRC under the title ‘Rebranding childbirth: understanding the role of marketing in influencing uptake of health services’, a joint application with CMMPH staff (Profs. Hundley & van Teijlingen) and the Media School (Dr. Luce).

 

References:

  1. Hundley, V., Luce, A., van Teijlingen, E., Edlund, S. (2019) Changing the narrative around childbirth: whose responsibility is it? Evidence-based Midwifery 17(2): 47-52.
  2. Luce, A., Cash, M., Hundley, V., Cheyne, H., van Teijlingen, E., Angell, C. (2016) “Is it realistic?” the portrayal of pregnancy and childbirth in the media BMC Pregnancy & Childbirth 16: 40 http://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-016-0827-x
  3. van Teijlingen, E., Simkhada, P., Luce, A., Hundley, V. (2016) Media, Health & Health Promotion in Nepal, Journal of Manmohan Memorial Institute of Health Sciences 2(1): 70-75. http://www.nepjol.info/index.php/JMMIHS/article/view/15799/12744
  4. Luce, A., Hundley, V., van Teijlingen, E. (Eds.) (2017) Midwifery, Childbirth and the Media, London: Palgrave Macmillan.
  5. Hundley, V., Duff, E., Dewberry, J., Luce, A., van Teijlingen, E. (2014) Fear in childbirth: are the media responsible? MIDIRS Midwifery Digest 24(4): 444-447.
  6. Hundley, V., Luce, A., van Teijlingen, E. (2015) Do midwives need to be more media savvy? MIDIRS Midwifery Digest 25(1):5-10.
  7. van Teijlingen, E., De Vries, R., Luce, A., Hundley, V. (2017) Meer bemoeien met media (In Dutch: more engagement with media). Tijdschrift voor Verloskundigen (in Dutch: Journal for Midwives), 41 (6):28-29.

Key role of volunteers in the health system

This week saw the publication of ‘Perceived barriers to accessing Female Community Health Volunteers’ (FCHV) services among ethnic minority women in Nepal: A qualitative study’ [1].  This article in the Open Access journal PLoS ONE highlights the key role volunteers play in delivering health services to minorities/the poorest people, especially in low-income countries like Nepal.

This paper studies community health workers in Nepal, who are known as Female Community Health Volunteers (FCHVs). To address this issue, we conducted a qualitative study to explore perceived barriers to accessing maternal and child healthcare services among ethnic minority groups in two different parts of Nepal with varying degrees of access to local healthcare centres. Semi-structured interviews were conducted with twenty FCHVs, 26 women service users and 11 paid local health workers. In addition, 15 FCHVs participated in four focus group discussions.

A thematic analysis of the data identified five major themes underlying barriers to accessing available maternal and child healthcare services by ethnic minority groups. These themes include: a) lack of knowledge among service users; b) lack of trust in volunteers; c) traditional beliefs and healthcare practices; d) low decision-making power of women; and e) perceived indignities experienced when using health centres.  The paper concluded that community health programmes should focus on increasing awareness of healthcare services among ethnic minority groups, and the programmes should involve family members (husband and mothers-in-law) and traditional health practitioners. Both the FCHVs and local healthcare providers should be trained to communicate effectively in order to deliver respectful care among ethnic minorities if we want to achieve universal healthcare coverage for maternal and child health in low- and -middle income countries.

The paper is based on the PhD research conducted by Dr. Sarita Panday in ScHARR at the University of Sheffield.  Dr. Panday is currently affiliated with the Walter H. Shorenstein Asia-Pacific Research Centre (APARC) at Stanford University in the USA.  Her co-authors are Prof. Paul Bissell at the University of Huddersfield, FHSS’s Visiting Prof. Padam Simkhada at the Liverpool John Moores University and BU Prof. Edwin van Teijlingen.  This is the second paper from Dr. Panday’s excellent thesis, the first paper was also published in an Open Access journal BMC Health Services Research [2].

 

References:

  1. Panday S, Bissell P, van Teijlingen E, Simkhada P (2019) Perceived barriers to accessing Female Community Health Volunteers’ (FCHV) services among ethnic minority women in Nepal: A qualitative study. PLoS ONE 14(6): e0217070.
  2. Panday S, Bissell P, van Teijlingen E, Simkhada P (2017) The contribution of female community health volunteers (FCHVs) to maternity care in Nepal: a qualitative study. BMC Health Services Research 17(1):623.

Breastfeeding paper published today

The journal Women and Birth (by Elsevier) published the latest academic paper by Dr. Alison Taylor today.  Alison’s paper ‘The therapeutic role of video diaries: A qualitative study involving breastfeeding mothers’ had been online as a pre-publication for a while but today in appeared officially in print [1].  Alison is a Senior Lecturer in Midwifery in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) and this scientific paper is part of her completed PhD research project. 

 

 

The paper is based on a large number of video clips recorded by new mothers.  The total recording time exceeded 43 hours. This paper focuses on one theme, the therapeutic role of the camcorder in qualitative research. Four subthemes are discussed highlighting the therapeutic impact of talking to the camcorder: personifying the camcorder; using the camcorder as a confidante; a sounding board; and a mirror and motivator.  Dr. Taylor and colleagues conclude that frequent opportunities to relieve tension by talking to “someone” without interruption, judgement or advice can be therapeutic. Further research needs to explore how the video diary method can be integrated into standard postnatal care to provide benefits for a wider population.

This is the second paper originating from Alison’s PhD research, the first one appeared in Midwifery (also published by Elsevier) [2].   Dr. Taylor’s PhD thesis was supervised by Prof. Emerita Jo Alexander, Prof. Edwin van Teijlingen (in CMMPH) and Prof. Kath Ryan at the University of Reading.

[Drawing of Breastfeeding Woman by Allison Churchill.]

 

REFERENCES:

  1. Taylor AM, van Teijlingen E., Alexander J, Ryan K. (2019) The therapeutic role of video diaries: A qualitative study involving breastfeeding mothers, Women & Birth 32(3):276-83. https://www.sciencedirect.com/science/article/pii/S1871519218300064
  2. Taylor A, van Teijlingen E, Ryan K, Alexander J (2019) ‘Scrutinised, judged & sabotaged’: A qualitative video diary study of first-time breastfeeding mothers, Midwifery 75: 16-23.

Paper in top 30 most cited Journal Advanced Nursing articles

BU’s Dr. Bibha Simkhada’s paper ‘Factors affecting the utilisation of antenatal care in developing countries: a systematic review of the literature’ [1] is currently the 27th most cited paper in the Journal of Advanced Nursing.  This is great achievement considering that the journal has published nearly ten thousand articles since its inception (to be precise 9,847).  The Journal of Advanced Nursing (published by Wiley) is one of the prestigious journals in the nursing field.  This extremely well-cited paper was part of Bibha’s Ph.D. study at the University of Aberdeen.  Dr. Bibha Simkhada is Lecturer in Adult Nursing in the  Department of Nursing and Clinical Sciences.  One of her co-authors also works at BU, Prof. Edwin van Teijlingen and a second co-author, Prof. Padam Simkhada from Liverpool John Moores University is Visiting Professor in the Faculty of Health & Social Sciences.  The third co-author Dr. Maureen Porter retired a few years ago.

 

 

Reference:

  1. Simkhada, B., van Teijlingen E., Porter, M., Simkhada, P. (2008) Factors affecting the utilisation of antenatal care in developing countries: a systematic review of the literature, Journal of Advanced Nursing 61(3): 244-260.

Top ten cited paper in MIDWIFERY

Looking at the SCOPUS data for 5 May 2019 on the International Day of the Midwife showed that the theoretical paper ‘Risk, Theory, Social & Medical Models: critical analysis of the concept of risk in maternity care’ [1] is in the top ten mosted quoted articles in Midwifery.  Now in its 35th year, Midwifery is an international  journal published by Elsevier.  Since its inception in 1985 it has published 2,626 papers, and our paper ”Risk, Theory, Social & Medical Models’ has now been cited by 108 papers, making it the eighth most cited article.

Professor Edwin van Teijlingen

Centre for Midwifery, Maternal & Perinatal Health (CMMPH)

 

Reference:

  1. MacKenzie Bryers H., van Teijlingen, E. (2010) Risk, Theory, Social & Medical Models: critical analysis of the concept of risk in maternity care, Midwifery 26(5): 488-496.