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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)000465053200005 ()30658269 (PubMedID)2-s2.0-85060336294 (Scopus ID)
Available from: 2019-01-21 Created: 2019-01-21 Last updated: 2019-05-09Bibliographically 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
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.
Open this publication in new window or tab >>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 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 12, no 1, article id 1652022Article in journal (Refereed) 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.

Keywords
Bangladesh, Midwifery education, South Asia, capacity building, web-based education
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-30616 (URN)10.1080/16549716.2019.1652022 (DOI)31411128 (PubMedID)
Available from: 2019-08-16 Created: 2019-08-16 Last updated: 2019-08-16Bibliographically approved
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.
Open this publication in new window or tab >>Midwives realities in Bangladesh: A focus group enquiry with midwifery students and educators
2019 (English)Conference paper, Oral presentation only (Refereed)
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-30430 (URN)
Conference
The 21st Congress of the Nordic Federation of Midwives, 2-4 May 2019, Reykjavik, Iceland
Available from: 2019-06-26 Created: 2019-06-26 Last updated: 2019-06-26Bibliographically 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)000470192400003 ()31084822 (PubMedID)2-s2.0-85060759440 (Scopus ID)
Available from: 2019-02-11 Created: 2019-02-11 Last updated: 2019-06-20Bibliographically approved
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.
Open this publication in new window or tab >>Risk Factors for Stillbirth and Beliefs: Findings from a Pilot near Miss Questionnaire Study in Somaliland Focusing the Mother-Baby Dyad
2019 (English)In: The 21st congress of the Nordic Federation of Midwives 2-4 may 2019, 2019Conference paper, Oral presentation with published abstract (Refereed)
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-30044 (URN)
Conference
The 21st congress of the Nordic Federation of Midwives Island, Reykjavik 2-4 may 2019
Available from: 2019-05-16 Created: 2019-05-16 Last updated: 2019-05-20Bibliographically approved
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
Open this publication in new window or tab >>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 (English)In: Evidence Based Midwifery., ISSN 1479-4489, Vol. 17, no 1, p. 19-26Article in journal (Refereed) 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.

National Category
Health Sciences
Identifiers
urn:nbn:se:du-30424 (URN)
Available from: 2019-06-26 Created: 2019-06-26 Last updated: 2019-06-26Bibliographically 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)000470192400006 ()31084814 (PubMedID)2-s2.0-85061449485 (Scopus ID)
Note

Open Access APC beslut 6/2019

Available from: 2019-02-25 Created: 2019-02-25 Last updated: 2019-06-20Bibliographically approved
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
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-6910-7047

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