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Bogren, M., Erlandsson, K., Johansson, A., Kalid, M., Abdi Igal, A., Mohamed, J., . . . Osman, F. (2020). Health workforce perspectives of barriers inhibiting the provision of quality care in Nepal and Somalia: A qualitative study. Sexual and Reproductive Healthcare, 23
Öppna denna publikation i ny flik eller fönster >>Health workforce perspectives of barriers inhibiting the provision of quality care in Nepal and Somalia: A qualitative study
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2020 (Engelska)Ingår i: Sexual and Reproductive Healthcare, ISSN 1877-5756, Vol. 23Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objective

In this paper settings from Nepal and Somalia are used to focus on the perspectives of healthcare providers within two fragile health systems. The objective of this study was to describe barriers inhibiting quality healthcare in Nepal and Somalia from a health workforce perspective.

Methods

Data were collected through 19 semi-structured interviews with healthcare providers working in healthcare facilities. Ten interviews were conducted in Nepal and nine in Somalia.

Results

Various structural barriers inhibiting the availability, accessibility, and acceptability of the quality care were similar in both countries. Barriers inhibiting the availability of quality care were linked to healthcare providers being overburdened with multiple concurrent jobs. Barriers inhibiting the accessibility to quality healthcare included long distances and the uncertain availability of transportation, and barriers to acceptability of quality healthcare was inhibited by a lack of respect from healthcare providers, characterised by neglect, verbal abuse, and lack of competence.

Conclusions

Inequality, poverty, traditional and cultural practices plus the heavy burden placed on healthcare providers are described as the underlying causes of the poor provision of quality care and the consequential shortcomings that emerge from it. In order to improve this situation adequate planning and policies that support the deployment and retention of the healthcare providers and its equitable distribution is required. Another important aspect is provision of training to equip healthcare providers with the ability to provide respectful quality care in order for the population to enjoy good standard of healthcare services.

Ort, förlag, år, upplaga, sidor
Elsevier, 2020
Nyckelord
Healthcare providers, Healthcare services, Health systems, Quality care, Nepal, Somalia
Nationell ämneskategori
Hälsovetenskaper
Forskningsämne
Hälsa och välfärd
Identifikatorer
urn:nbn:se:du-31176 (URN)10.1016/j.srhc.2019.100481 (DOI)2-s2.0-85075517845 (Scopus ID)
Tillgänglig från: 2019-12-06 Skapad: 2019-12-06 Senast uppdaterad: 2019-12-06Bibliografiskt granskad
Bogren, M., Rosengren, J., Erlandsson, K. & Berg, M. (2019). Build professional competence and equip with strategies to empower midwifery students - An interview study evaluating a simulation-based learning course for midwifery educators in Bangladesh.. Nurse Education in Practice, 35, 27-31
Öppna denna publikation i ny flik eller fönster >>Build professional competence and equip with strategies to empower midwifery students - An interview study evaluating a simulation-based learning course for midwifery educators in Bangladesh.
2019 (Engelska)Ingår i: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 35, s. 27-31Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Use of simulation-based learning in midwifery education programmes is crucial. Due to midwifery educators in Bangladesh were lacking competence in using such pedagogical methods in their teaching, they were invited to participate in a simulation-based learning course. In this paper, we present a study on the perceived usefulness of this course. Semi-structured individual interviews were conducted with 17 of the 28 midwifery educators participating on the course and data were analysed using inductive content analysis. Findings showed that the simulation-based learning course for midwifery educators in Bangladesh was useful. It "builds the professional competence of midwifery educators" and "equips them with strategies to empower midwifery students". The findings show that a simulation-based learning course is of major importance in pre-service education in settings where the capacity of midwifery educators needs to be strengthened. However, without continuous in-service training, the midwives' competence will deteriorate and this in turn will threaten the quality of midwifery education and the midwifery profession. Thus, contextualized pre- and in-service simulation-based education to secure midwifery core competencies is necessary. Simultaneously implementing and evaluating pre- and in-service education programmes is the next step in the struggle to increase the quality of maternity care services.

Nyckelord
Capacity building, Midwifery educators, Simulation-based learning, South-Asia
Nationell ämneskategori
Hälsovetenskaper
Forskningsämne
Hälsa och välfärd
Identifikatorer
urn:nbn:se:du-29315 (URN)10.1016/j.nepr.2019.01.002 (DOI)000465053200005 ()30658269 (PubMedID)2-s2.0-85060336294 (Scopus ID)
Tillgänglig från: 2019-01-21 Skapad: 2019-01-21 Senast uppdaterad: 2019-05-09Bibliografiskt granskad
Klingberg-Allvin, M., Hatakka, M., Erlandsson, K., Osman, F., Byrskog, U. & Egal, J. (2019). "Change-makers in midwifery care": Exploring the differences between expectations and outcomes - a qualitative study of a midwifery net-based education programme in the Somali region. Midwifery, 69, 135-142
Öppna denna publikation i ny flik eller fönster >>"Change-makers in midwifery care": Exploring the differences between expectations and outcomes - a qualitative study of a midwifery net-based education programme in the Somali region
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2019 (Engelska)Ingår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 69, s. 135-142Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

The aim of this study is to explore midwifery educators’ expected outcomes in the net-based master's programme, the programmes’ realised outcomes and the reported difference regarding the increased choices for the graduates and the effect on their agency.

Design

In this case study, we focused on a net-based master's programme in sexual and reproductive health in Somalia. Somalia suffers from a shortage of skilled birth attendants and there is a need for building up the capacity of midwifery educators.

Setting and participants

Data was collected in focus group discussions at the start of the programme and eight months after the students graduated. The data were analysed through the lens of the choice framework, which is based on the capability approach.

Findings

Findings show that many of the graduates’ expectations were met, while some were more difficult to fulfil. While the midwives’ choices and resource portfolios had improved because of their role as educators, the social structure prevented them from acting on their agency, specifically in regards to making changes at the social level. Several of the positive developments can be attributed to the pedagogy and structure of the programme.

Conclusion

The flexibility of net-based education gave the midwifery educators a new educational opportunity that they previously did not have. Students gained increased power and influence on some levels. However, they still lack power in government organisations where, in addition to their role as educators, they could use their skills and knowledge to change policies at the social level.

Nyckelord
Net-based education, Quality midwifery education, Midwifery care, Somaliland, Capability approach, Choice framework
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Forskningsämne
Hälsa och välfärd
Identifikatorer
urn:nbn:se:du-29004 (URN)10.1016/j.midw.2018.11.007 (DOI)000454129800018 ()30503998 (PubMedID)2-s2.0-85057779256 (Scopus ID)
Tillgänglig från: 2018-12-03 Skapad: 2018-12-03 Senast uppdaterad: 2019-01-10Bibliografiskt granskad
Erlandsson, K., Byrskog, U., Osman, F., Pedersen, C., Hatakka, M. & Klingberg-Allvin, M. (2019). Evaluating a model for the capacity building of midwifery eduators in Bangladesh through a blended, web-based master's programme. Global Health Action, 12(1), Article ID 1652022.
Öppna denna publikation i ny flik eller fönster >>Evaluating a model for the capacity building of midwifery eduators in Bangladesh through a blended, web-based master's programme
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2019 (Engelska)Ingår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 12, nr 1, artikel-id 1652022Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: While setting international standards for midwifery education has attracted considerable global attention, the education and training of midwifery educators has been relatively neglected, particularly in low-resource settings where capacity building is crucial. Objective: The aim of this study was to describe the expectations of midwifery educators in Bangladesh who took part in a blended web-based master's programme in SRHR and the extent to which these were realized after 12 months of part-time study. Methods: Both quantitative and qualitative methods have been used to collect data. A structured baseline questionnaire was distributed to all participants at the start of the first course (n = 30) and a second endpoint questionnaire was distributed after they (n = 29) had completed the core courses one year later. At the start of the first course, five focus group discussions (FGD) were held with the midwifery educators. Descriptive statistics and content analysis were used for the analyses. Results: Midwifery educators who took part in the study identified expectations that can be grouped into three distinct areas. They hoped to become more familiar with technology, anticipated they would learn pedagogical and other skills that would enable them to better support their students' learning and thought they might acquire skills to empower their students as human beings. Participants reported they realized these ambitions, attributing the master's programme with helping them take responsibility for their own teaching and learning, showing them how to enhance their students' learning and how to foster reflective and critical thinking among them. Conclusions: Midwifery educators have taken part in a creative learning environment which has developed their engagement in teaching and learning. They have done this using a blended learning model which combines online learning with face-to-face contact. This model can be scaled up in low resource and remote settings.

Nyckelord
Bangladesh, Midwifery education, South Asia, capacity building, web-based education
Nationell ämneskategori
Hälsovetenskaper
Forskningsämne
Hälsa och välfärd
Identifikatorer
urn:nbn:se:du-30616 (URN)10.1080/16549716.2019.1652022 (DOI)000480727300001 ()31411128 (PubMedID)2-s2.0-85071029632 (Scopus ID)
Tillgänglig från: 2019-08-16 Skapad: 2019-08-16 Senast uppdaterad: 2019-09-17Bibliografiskt granskad
Kalid, M., Osman, F., Sulaiman, M., Dykes, F. & Erlandsson, K. (2019). Infant and young child nutritional status and their caregivers’ feeding knowledge and hygiene practices in internally displaced person camps, Somalia. BMC Nutrition, 59(5)
Öppna denna publikation i ny flik eller fönster >>Infant and young child nutritional status and their caregivers’ feeding knowledge and hygiene practices in internally displaced person camps, Somalia
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2019 (Engelska)Ingår i: BMC Nutrition, ISSN 2055-0928, Vol. 59, nr 5Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

In an attempt to design an educational programme targeting caregivers of children aged 6 to 59 months in internally displaced persons camps in Somalia, the objective of this study was twofold. First, to explore the nutritional situation of all children aged 6–59 months enrolled in a nutrition programme provided by Save the Children in 2017 in internally displaced persons camps. Second, to identify gaps in the caregivers’ hygiene and feeding practices.

Nationell ämneskategori
Omvårdnad
Forskningsämne
Hälsa och välfärd
Identifikatorer
urn:nbn:se:du-31554 (URN)10.1186/s40795-019-0325-4 (DOI)
Tillgänglig från: 2020-01-02 Skapad: 2020-01-02 Senast uppdaterad: 2020-01-02
Byrskog, U., Members of the Midwifery Faculty Master’s degree holders in Sexual and Reproductive Health and Rights, B., Bogren, M. & Erlandsson, K. (2019). Midwives realities in Bangladesh: A focus group enquiry with midwifery students and educators. In: : . Paper presented at The 21st Congress of the Nordic Federation of Midwives, 2-4 May 2019, Reykjavik, Iceland.
Öppna denna publikation i ny flik eller fönster >>Midwives realities in Bangladesh: A focus group enquiry with midwifery students and educators
2019 (Engelska)Konferensbidrag, Enbart muntlig presentation (Refereegranskat)
Nationell ämneskategori
Hälsovetenskaper
Forskningsämne
Hälsa och välfärd
Identifikatorer
urn:nbn:se:du-30430 (URN)
Konferens
The 21st Congress of the Nordic Federation of Midwives, 2-4 May 2019, Reykjavik, Iceland
Tillgänglig från: 2019-06-26 Skapad: 2019-06-26 Senast uppdaterad: 2019-06-26Bibliografiskt granskad
Mattebo, M., Bogren, M., Brunner, N., Dolk, A., Pedersen, C. & Erlandsson, K. (2019). Perspectives on adolescent girls’ health-seeking behaviour in relation to sexual and reproductive health in Nepal. Sexual & Reproductive HealthCare, 20, 7-12
Öppna denna publikation i ny flik eller fönster >>Perspectives on adolescent girls’ health-seeking behaviour in relation to sexual and reproductive health in Nepal
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2019 (Engelska)Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 20, s. 7-12Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Aim

To explore health care providers’ perspectives on adolescent girls’ health-seeking behaviour in Nepal in relation to their sexual and reproductive health and rights. Twenty health-care providers were included in this interview study. Ethical approval was obtained from the Nepal Health Research Council.

Findings

The main category ‘Barriers affect adolescent girls’ health-seeking behaviour in relation to their sexual and reproductive health’ was divided into five categories: a conservative society with social stigma; lack of information, education and knowledge; lack of facilities and respectful care; insufficient confidentiality and privacy; and unmet needs of adolescent-friendly facilities.

Conclusions

Lack of knowledge among adolescent girls and unmet needs of adolescent-friendly facilities affect their access to sexual and reproductive health care in Nepal. Lack of knowledge could be seen as a barrier, and as a reason why adolescent girls do not seek sexual and reproductive health care.

Nyckelord
Sexual rights, Sexual health, Reproductive health, Adolescent girls, Content analysis
Nationell ämneskategori
Hälsovetenskaper
Forskningsämne
Hälsa och välfärd
Identifikatorer
urn:nbn:se:du-29460 (URN)10.1016/j.srhc.2019.01.006 (DOI)000470192400003 ()31084822 (PubMedID)2-s2.0-85060759440 (Scopus ID)
Tillgänglig från: 2019-02-11 Skapad: 2019-02-11 Senast uppdaterad: 2019-06-20Bibliografiskt granskad
Kiruja, J., Jama, A. & Erlandsson, K. (2019). Risk Factors for Stillbirth and Beliefs: Findings from a Pilot near Miss Questionnaire Study in Somaliland Focusing the Mother-Baby Dyad. In: The 21st congress of the Nordic Federation of Midwives 2-4 may 2019: . Paper presented at The 21st congress of the Nordic Federation of Midwives Island, Reykjavik 2-4 may 2019.
Öppna denna publikation i ny flik eller fönster >>Risk Factors for Stillbirth and Beliefs: Findings from a Pilot near Miss Questionnaire Study in Somaliland Focusing the Mother-Baby Dyad
2019 (Engelska)Ingår i: The 21st congress of the Nordic Federation of Midwives 2-4 may 2019, 2019Konferensbidrag, Muntlig presentation med publicerat abstract (Refereegranskat)
Nationell ämneskategori
Hälsovetenskaper
Forskningsämne
Hälsa och välfärd
Identifikatorer
urn:nbn:se:du-30044 (URN)
Konferens
The 21st congress of the Nordic Federation of Midwives Island, Reykjavik 2-4 may 2019
Tillgänglig från: 2019-05-16 Skapad: 2019-05-16 Senast uppdaterad: 2019-05-20Bibliografiskt granskad
Byrskog, U., Akther, H. A., Khatoon, Z., Bogren, M. & Erlandsson, K. (2019). Social, economic and professional barriers influencing midwives’ realities in Bangladesh: a qualitative study of midwifery educators preparing midwifery students for clinical reality. Evidence Based Midwifery., 17(1), 19-26
Öppna denna publikation i ny flik eller fönster >>Social, economic and professional barriers influencing midwives’ realities in Bangladesh: a qualitative study of midwifery educators preparing midwifery students for clinical reality
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2019 (Engelska)Ingår i: Evidence Based Midwifery., ISSN 1479-4489, Vol. 17, nr 1, s. 19-26Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Introduction

Identifying existing barriers inhibiting the provision of quality care in Bangladesh can guide both the government, in fulfilling its commitment to establishing the midwifery profession, and midwifery educators, in preparing midwifery students for the reality of midwifery clinical work.

Aim

The aim of this study was to describe midwifery educators’ perceptions of midwives’ realities in Bangladesh, focusing on social, economic, and professional barriers preventing them from carrying out quality care.

Methods

Data were collected through focus group discussions with 17 midwifery educators and analysed using qualitative content analysis, guided by the analytical framework “What prevents quality midwifery care?”. Ethical clearance was obtained from Bangladesh’s Directorate General of Nursing and Midwifery.

Results

The results generated by the application of the framework included social barriers of gender structures in Bangladeshi society. This influenced entry into midwifery education, carrying out midwifery work safely, and the development of the profession. Economic barriers included challenges for Bangladesh as a low-income country with a large population, inadequate salaries, and staff shortages, adding extra strain to midwives’ working conditions. These social and economic barriers were further enhanced by professional barriers due to the midwifery profession not yet being fully established or acknowledged in the health system.

Conclusions and implications

The study presents novel country-specific perspectives but confirms the general underlying issues of gender inequality as a base for barriers preventing midwives from carrying out quality care, in line with the framework “What prevents quality midwifery care?”. Addressing these structures can facilitate more students to enter midwifery education, enable quality midwifery work free from discrimination, and provide sufficient working space and professional integrity. Leadership training is pivotal to increasing responsiveness to the needs of the new cadre of midwives. Midwifery educators should take the lead in sensitising clinical supervisors, mentors, and preceptors about midwives’ realities in Bangladesh.

Nationell ämneskategori
Hälsovetenskaper
Forskningsämne
Hälsa och välfärd
Identifikatorer
urn:nbn:se:du-30424 (URN)
Tillgänglig från: 2019-06-26 Skapad: 2019-06-26 Senast uppdaterad: 2020-01-09Bibliografiskt granskad
Egeh, A.-A., Dugsieh, O., Erlandsson, K. & Osman, F. (2019). The views of Somali religious leaders on birth spacing: A qualitative study. Sexual & Reproductive HealthCare, 20, 27-31
Öppna denna publikation i ny flik eller fönster >>The views of Somali religious leaders on birth spacing: A qualitative study
2019 (Engelska)Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 20, s. 27-31Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background

Birth spacing is an important health intervention for women to attain good physical and mental health. In Somalia, religious leaders play a decisive role in approving or rejecting the use of family planning.

Objective

The study aimed to investigate Somali Islamic religious leaders’ views on birth spacing.

Method

Qualitative individual interviews were conducted with 17 Somali Islamic religious leaders aged 28–59 years and analysed through content analysis.

Results

The main category that emerged from the analysis was that the concept “birth spacing should be used and nor family planning to be in accordance with the Islamic religion. Two perspectives of views of birth spacing were identified: accepted ways and unaccepted ways. The accepted ways include breastfeeding, use of contraceptives causing no harm to the women’s health, and coitus interruptus. The preferred method should be determined by a joint agreement between the husband and wife, and that Muslim doctors should play a key role while the couples investigate their preferred method. Using contraceptives with the intention to limit the number of children was against Islamic values and practice. In addition, it was believed that using condoms promoted the temptation to engage in sex outside the marriage and was therefore prohibited.

Conclusion

According to the religious Islamic leaders, selected practice recommendations for contraceptive use is permitted in relation to birth spacing to promote the health of the mother and child. When providing professional contraceptive counselling to Muslim women, the word “birth spacing” is recommended to be used instead of “family planning”.

Nyckelord
Birth spacing, Contraceptives, Religious leaders, Reproductive health, Somalia
Nationell ämneskategori
Omvårdnad Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Forskningsämne
Hälsa och välfärd
Identifikatorer
urn:nbn:se:du-29565 (URN)10.1016/j.srhc.2019.02.003 (DOI)000470192400006 ()31084814 (PubMedID)2-s2.0-85061449485 (Scopus ID)
Anmärkning

Open Access APC beslut 6/2019

Tillgänglig från: 2019-02-25 Skapad: 2019-02-25 Senast uppdaterad: 2019-06-20Bibliografiskt granskad
Organisationer
Identifikatorer
ORCID-id: ORCID iD iconorcid.org/0000-0002-6910-7047

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