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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
Open this publication in new window or tab >>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 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 35, p. 27-31Article in journal (Refereed) 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.

Keywords
Capacity building, Midwifery educators, Simulation-based learning, South-Asia
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29315 (URN)10.1016/j.nepr.2019.01.002 (DOI)30658269 (PubMedID)2-s2.0-85060336294 (Scopus ID)
Available from: 2019-01-21 Created: 2019-01-21 Last updated: 2019-02-04Bibliographically approved
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
Open this publication in new window or tab >>"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 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 69, p. 135-142Article in journal (Refereed) 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.

Keywords
Net-based education, Quality midwifery education, Midwifery care, Somaliland, Capability approach, Choice framework
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29004 (URN)10.1016/j.midw.2018.11.007 (DOI)000454129800018 ()30503998 (PubMedID)2-s2.0-85057779256 (Scopus ID)
Available from: 2018-12-03 Created: 2018-12-03 Last updated: 2019-01-10Bibliographically approved
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
Open this publication in new window or tab >>Perspectives on adolescent girls’ health-seeking behaviour in relation to sexual and reproductive health in Nepal
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2019 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 20, p. 7-12Article in journal (Refereed) 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.

Keywords
Sexual rights, Sexual health, Reproductive health, Adolescent girls, Content analysis
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29460 (URN)10.1016/j.srhc.2019.01.006 (DOI)2-s2.0-85060759440 (Scopus ID)
Available from: 2019-02-11 Created: 2019-02-11 Last updated: 2019-02-11Bibliographically approved
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
Open this publication in new window or tab >>The views of Somali religious leaders on birth spacing: A qualitative study
2019 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 20, p. 27-31Article in journal (Refereed) 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”.

Keywords
Birth spacing, Contraceptives, Religious leaders, Reproductive health, Somalia
National Category
Nursing Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29565 (URN)10.1016/j.srhc.2019.02.003 (DOI)2-s2.0-85061449485 (Scopus ID)
Note

Open Access APC beslut 6/2019

Available from: 2019-02-25 Created: 2019-02-25 Last updated: 2019-02-25
Erlandsson, K., Doraiswamy, S., Wallin, L. & Bogren, M. (2018). Capacity building of midwifery faculty to implement a 3-years midwifery diploma curriculum in Bangladesh: a process evaluation of a mentorship programme. Nurse Education in Practice, 29, 212-218
Open this publication in new window or tab >>Capacity building of midwifery faculty to implement a 3-years midwifery diploma curriculum in Bangladesh: a process evaluation of a mentorship programme
2018 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 29, p. 212-218Article in journal (Refereed) Published
Abstract [en]

When a midwifery diploma-level programme was introduced in 2010 in Bangladesh, only a few nursing faculty staff members had received midwifery diploma-level. The consequences were an inconsistency in interpretation and implementation of the midwifery curriculum in the midwifery programme. To ensure that midwifery faculty staff members were adequately prepared to deliver the national midwifery curriculum, a mentorship programme was developed. The aim of this study was to examine feasibility and adherence to a mentorship programme among 19 midwifery faculty staff members who were lecturing the three years midwifery diploma-level programme at ten institutes/colleges in Bangladesh. The mentorship programme was evaluated using a process evaluation framework: (implementation, context, mechanisms of impact and outcomes). An online and face-to-face blended mentorship programme delivered by Swedish midwifery faculty staff members was found to be feasible, and it motivated the faculty staff members in Bangladesh both to deliver the national midwifery diploma curriculum as well as to carry out supportive supervision for midwifery students in clinical placement. First, the Swedish midwifery faculty staff members visited Bangladesh and provided a two-days on-site visit prior to the initiation of the online part of the mentorship programme. The second on-site visit was five-days long and took place at the end of the programme, that being six to eight months from the first visit. Building on the faculty staff members' response to feasibility and adherence to the mentorship programme, the findings indicate opportunities for future scale-up to all institutes/collages providing midwifery education in Bangladesh. It has been proposed that a blended online and face-to-face mentorship programme may be a means to improving national midwifery programmes in countries where midwifery has only recently been introduced.

Keywords
Capacity building, Mentorship, Midwifery faculty staff members, Process evaluation
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-27269 (URN)10.1016/j.nepr.2018.02.006 (DOI)000429755000033 ()29448231 (PubMedID)
Available from: 2018-02-22 Created: 2018-02-22 Last updated: 2018-06-08Bibliographically approved
Bogren, M., Sathyanarayanan, D., Erlandsson, K., Akhter, H., Akter, D., Begum, M., . . . Khatun, Y. A. (2018). Development of a context specific accreditation assessment tool for affirming quality midwifery education in Bangladesh. Midwifery, 61, 74-80
Open this publication in new window or tab >>Development of a context specific accreditation assessment tool for affirming quality midwifery education in Bangladesh
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2018 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 61, p. 74-80Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: using the International Confederation of Midwives (ICM) Global Standards for Midwifery Education as a conceptual framework, the aim of this study was to explore and describe important 'must haves' for inclusion in a context-specific accreditation assessment tool in Bangladesh.

DESIGN: A questionnaire study was conducted using a Likert rating scale and 111 closed-response single items on adherence to accreditation-related statements, ending with an open-ended question. The ICM Global Standards guided data collection, deductive content analysis and description of the quantitative results.

SETTING: twenty-five public institutes/colleges (out of 38 in Bangladesh), covering seven out of eight geographical divisions in the country.

PARTICIPANTS: one hundred and twenty-three nursing educators teaching the 3-year diploma midwifery education programme.

FINDINGS: this study provides insight into the development of a context-specific accreditation assessment tool for Bangladesh. Important components to be included in this accreditation tool are presented under the following categories and domains: 'organization and administration', 'midwifery faculty', 'student body', 'curriculum content', 'resources, facilities and services' and 'assessment strategies'. The identified components were a prerequisite to ensure that midwifery students achieve the intended learning outcomes of the midwifery curriculum, and hence contribute to a strong midwifery workforce. The components further ensure well-prepared teachers and a standardized curriculum supported at policy level to enable effective deployment of professional midwives in the existing health system.

KEY CONCLUSIONS: as part of developing an accreditation assessment tool, it is imperative to build ownership and capacity when translating the ICM Global Standards for Midwifery Education into the national context.

IMPLICATIONS FOR PRACTICE: this initiative can be used as lessons learned from Bangladesh to develop a context-specific accreditation assessment tool in line with national priorities, supporting the development of national policies.

Keywords
Accreditation/standards, Bangladesh, Instrument development, Midwifery/education, Quality assessment, South Asia nurses and midwives’
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-27423 (URN)10.1016/j.midw.2018.02.021 (DOI)000430726400014 ()29554606 (PubMedID)2-s2.0-85044165958 (Scopus ID)
Available from: 2018-03-22 Created: 2018-03-22 Last updated: 2018-05-15Bibliographically approved
Bogren, M. & Erlandsson, K. (2018). Opportunities, challenges and strategies when building a midwifery profession. Findings from a qualitative study in Bangladesh and Nepal. Sexual & Reproductive HealthCare, 16, 45-49
Open this publication in new window or tab >>Opportunities, challenges and strategies when building a midwifery profession. Findings from a qualitative study in Bangladesh and Nepal
2018 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 16, p. 45-49Article in journal (Refereed) Published
Abstract [en]

Objective

The aim of this paper was to identify opportunities and challenges when building a midwifery profession in Bangladesh and Nepal.

Methods

Data were collected through 33 semi-structured interviews with government officials, policy-makers, donors, and individuals from academia and non-government organizations with an influence in building a midwifery profession in their respective countries. Data were analyzed using content analysis.

Findings

The opportunities and challenges found in Bangladesh and Nepal when building a midwifery profession emerged the theme “A comprehensive collaborative approach, with a political desire, can build a midwifery profession while competing views, interest, priorities and unawareness hamper the process”. Several factors were found to facilitate the establishment of a midwifery profession in both countries. For example, global and national standards brought together midwifery professionals and stakeholders, and helped in the establishment of midwifery associations. The challenges for both countries were national commitments without a full set of supporting policy documents, lack of professional recognition, and competing views, interests and priorities.

Conclusion and clinical application

This study demonstrated that building a midwifery profession requires a political comprehensive collaborative approach supported by a political commitment. Through bringing professionals together in a professional association will bring a professional status. Global standards and guidelines need to be contextualized into national policies and plans where midwives are included as part of the national health workforce. This is a key for creating recognized midwives with a protected title to autonomously practice midwifery, to upholding the sexual and reproductive health and rights for women and girls.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Midwifery professionMidwifery strategyHealth workforceSouth AsiaBangladeshNepal
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-27312 (URN)10.1016/j.srhc.2018.02.003 (DOI)29804774 (PubMedID)2-s2.0-85041839398 (Scopus ID)
Available from: 2018-02-26 Created: 2018-02-26 Last updated: 2018-06-05Bibliographically approved
Byrskog, U., Hussein, I. H., Yusuf, F. M., Egal, J. A. & Erlandsson, K. (2018). The situation for female survivors of non-partner sexual violence: A focused enquiry of Somali young women's views, knowledge and opinions. Sexual & Reproductive HealthCare, 16, 39-44
Open this publication in new window or tab >>The situation for female survivors of non-partner sexual violence: A focused enquiry of Somali young women's views, knowledge and opinions
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2018 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 16, p. 39-44Article in journal (Refereed) Published
Abstract [en]

Objective

The aim of the study is to elucidate young women’s perceptions of the situation for female survivors of non-partner sexual violence in Somaliland.

Methods

Young Somali women with diverse backgrounds (n = 25) shared views, knowledge and opinions about non partner sexual violence in focus group discussions held in urban settings. Data was analysed using content analysis.

Results

A main category “Bound by culture and community perceptions” with four subcategories comprises the informants’ perceptions of non-partner sexual violence among young women in Somaliland. Illuminated is the importance of protecting oneself and the family dignity, a fear of being rejected and mistrusted, how the juridical system exists in the shadow of tradition and potential keys to healthcare support.

Conclusion

The study raises awareness of the dilemmas which may be faced by young women subjected to non-partner sexual violence and healthcare providers in the intersection between state and traditional norms. Education is a key when it comes to a young woman considering the use of the services available in a society where traditional problem-solving is relied on parallel to state-based support. State-based functions, communities and families need to work together to provide comprehensive support to young female survivors of non-partner sexual violence in Somaliland.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Content analysis; Healthcare; Non-partner sexual violence; Perceptions; Somalia; Somaliland; Young women
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-27313 (URN)10.1016/j.srhc.2018.01.006 (DOI)000440877700007 ()2-s2.0-85041821320 (Scopus ID)
Available from: 2018-02-26 Created: 2018-02-26 Last updated: 2018-08-23Bibliographically approved
Bogren, M., Erlandsson, K. & Byrskog, U. (2018). What prevents midwifery quality care in Bangladesh? A focus group enquiry with midwifery students. BMC Health Services Research, 18(1), Article ID 639.
Open this publication in new window or tab >>What prevents midwifery quality care in Bangladesh? A focus group enquiry with midwifery students
2018 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 18, no 1, article id 639Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: With professional midwives being introduced in Bangladesh in 2013, the aim of this study was to describe midwifery students perceptions on midwives' realities in Bangladesh, based on their own experiences.

METHOD: Data were collected through 14 focus group discussions that included a total of 67 third-year diploma midwifery students at public nursing institutes/colleges in different parts of Bangladesh. Data were analyzed deductively using an analytical framework identifying social, professional and economical barriers to the provision of quality care by midwifery personnel.

RESULTS: The social barriers preventing midwifery quality care falls outside the parameters of Bangladeshi cultural norms that have been shaped by beliefs associated with religion, society, and gender norms. This puts midwives in a vulnerable position due to cultural prejudice. Professional barriers include heavy workloads with a shortage of staff who were not utilized to their full capacity within the health system. The reason for this was a lack of recognition in the medical hierarchy, leaving midwives with low levels of autonomy. Economical barriers were reflected by lack of supplies and hospital beds, midwives earning only low and/or irregular salaries, a lack of opportunities for recreation, and personal insecurity related to lack of housing and transportation.

CONCLUSION: Without adequate support for midwives, to strengthen their self-confidence through education and through continuous professional and economic development, little can be achieved in terms of improving quality care of women during the period around early and late pregnancy including childbirth.The findings can be used for discussions aimed to mobilize a midwifery workforce across the continuum of care to deliver quality reproductive health care services. No matter how much adequate support is provided to midwives, to strengthen their self-confidence through education, continuous professional and economic development, addressing the social barriers is a prerequisite for provision of quality care.

National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-28364 (URN)10.1186/s12913-018-3447-5 (DOI)000441829700002 ()30111324 (PubMedID)2-s2.0-85051661540 (Scopus ID)
Available from: 2018-08-21 Created: 2018-08-21 Last updated: 2018-09-03Bibliographically approved
Faysal Badal, N., Alo Yusuf, U., Egal, J., Pedersen, C., Erlandsson, K., Osman, F. & Byrskog, U. (2018). With knowledge and support women can attend antenatal care: the views of women in IDP camps in Somaliland. African Journal of Midwifery and Womens' Health, 12(3)
Open this publication in new window or tab >>With knowledge and support women can attend antenatal care: the views of women in IDP camps in Somaliland
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2018 (English)In: African Journal of Midwifery and Womens' Health, ISSN 1759-7374, Vol. 12, no 3Article in journal (Refereed) Published
Abstract [en]

In Somaliland, women’s perceptions of barriers to accessing antenatal care is sparsely described, particularly with regard to marginalized women. The aim was to investigate perceptions of barriers to accessing antenatal care from the perspective of pregnant women living in Internal Displaced Persons camps. Individual semi-structured interviews with fifteen women were conducted and analysed using content analysis. The overriding theme was “With knowledge and support, women can attend antenatal care”.  The findings highlighted that to obtain antenatal care, it is crucial for women to have knowledge and trust regarding antenatal services, a supporting environment, and ways to overcome practical barriers, such as patient fees and long waiting hours. If women and families received relevant information about the structure and benefits of ANC, they would probably prioritize ANC, given that the care is tailored to each woman’s needs. For this, community awareness and trust between women, families and ANC providers are central.

Keywords
Antenatal care, Content analysis, Somaliland
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-26593 (URN)10.12968/ajmw.2018.12.3.138 (DOI)
Available from: 2017-11-21 Created: 2017-11-21 Last updated: 2018-11-13Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-6910-7047

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