An Analysis of Bachelor of Science Nursing Students’ Attitudes on Nursing Profession at the end of their Basic Training: Case of Public Universities, Kenyan.

Background information: Attitudes are learned predispositions to respond in a consistently favorable or unfavorable manner with respect to a given object. Thus they cannot be observed directly.  Their dimension on a particular aspect determines the end result of that activity.  Nurses are responsible for caring for patients and are directly involved in decisions regarding a patient’s care. Nurse’s attitudes are also influential on other health care providers. Today’s nursing students and future nurses make up the backbone of the health care forces in every country and a positive attitude is essential in provision of health care services. Methodology and objective This study investigated the attitude of BScN as they finish their training. Study subjects involved 46 final year Bachelor of Science in Nursing (BScN) students, randomly selected from purposefully selected Kenyan public universities which included, Kenyatta University, Moi University and University of Nairobi. Data was collected using self administered questionnaire and attitude scales. Statistical package of social studies version 17 was used for data analysis. Results and discussions: Most respondents had a positive attitude toward the nursing profession because their main reason for joining nurse training was to help and care for the sick (70%). This was supported by the fact that 45.7 % of them viewed nursing as a noble profession. However, 52.2% of the respondents had not made a definite choice to remain in the nursing profession. This was mainly associated to lack of recognition for the work performed by nurses and poor financial motivation. Conclusions and recommendations: Majority of the nursing students have a positive attitude toward the nursing profession but certain aspects in this noble profession tend to diminish the proportion of those who would like to take it up as a lifelong career. Therefore, effort to motivate nurses financially, improve the working schedules and recognize the work done by the nurses should be encouraged in order to increase the number of the students who would prefer to remain in the nursing profession in future. Key words: Bachelor of Science Nursing Students,               Attitudes on Nursing Profession, Public Universities in Kenya

A Delphi survey to determine midwifery research priorities among midwives in sub-Saharan Africa

Objective: In sub-Saharan Africa, midwifery input into the generation of important research questions is limited. The authors aimed to address this issue by enabling midwives to set their own research priorities with the intention of developing a research strategy to conduct studies relevant to clinical practice. Methods: A survey was carried out in six countries (Kenya, Malawi, Uganda, Zambia, Zimbabwe and Tanzania). The Delphi method was used with six panels of midwives (n=118) to attain a convergence of opinion on midwifery research priorities. Consensus-building was achieved by using a series of questionnaires delivered using multiple iterations to collect data. Data were analysed using ranked means and proportions. Findings: Consensus was reached on 11 research questions which were considered regional priorities. These covered three key areas: midwifery training, clinical care and organisational issues. Conclusions: Midwives prioritised areas of research that had direct applicability to their own practice. All questions were at the applied end of the research spectrum. Priorities tended to cover broad areas within reproductive health, as opposed to being disease-focused. This is likely to reflect the desire to provide quality care that embraces the social aspects of health. Some of these research priorities are being taken forward by midwives in the group. </jats:sec

Parents’ experiences of care and support after stillbirth in rural and urban maternity facilities:A qualitative study in Kenya and Uganda

Objective To explore parents' lived experiences of care and support following stillbirth in urban and rural health facilities. Design Qualitative, interpretative, guided by Heideggerian phenomenology. Setting Nairobi and Western Kenya, Kampala and Central Uganda. Sample A purposive sample of 75 women and 59 men who had experienced the stillbirth of their baby (≤1 year previously) and received care in the included facilities. Methods In-depth interviews, analysed using Van Manen's reflexive approach. Results Three main themes were identified; parents described devastating impacts and profound responses to their baby's death. Interactions with health workers were a key influence, but poor communication, environmental barriers and unsupportive facility policies/practices meant that needs were often unmet. After discharge, women and partners sought support in communities to help them cope with the death of their baby but frequently encountered stigma engendering feelings of blame and increasing isolation. Conclusions Parents in Kenya and Uganda were not always treated with compassion and lacked the care or support they needed after the death of their baby. Health workers in Kenya and Uganda, in common with other settings, have a key role in supporting bereaved parents. There is an urgent need for context and culturally appropriate interventions to improve communication, health system and community support for African parents

African midwifery students’ self-assessed confidence in antenatal care : a multi-country study

Background: Evidence-based antenatal care is one cornerstone in Safe Motherhood and educated and confident midwives remain to be optimal caregivers in Africa. Confidence in antenatal midwifery skills is important and could differ depending on the provision of education among the training institutions across Africa. Objective: The aim of the study was to describe and compare midwifery students’ confidence in basic antenatal skills, in relation to age, sex, program type and level of program. Methods: A survey in seven sub-Saharan African countries was conducted. Enrolled midwifery students from selected midwifery institutions in each country presented selfreported data on confidence to provide antenatal care. Data were collected using a selfadministered questionnaire. The questionnaire consisted of 22 antenatal skills based on the competency framework from the International Confederation of Midwives. The skills were grouped into three domains; Identify fetal and maternal risk factors and educate parents; Manage and document emergent complications and Physical assessment and nutrition. Results: In total, 1407 midwifery students from seven Sub-Saharan countries responded. Almost one third (25-32%) of the students reported high levels of confidence in all three domains. Direct entry programs were associated with higher levels of confidence in all three domains, compared to post-nursing and double degree programs. Students enrolled at education with diploma level presented with high levels of confidence in two out of three domains. Conclusions: A significant proportion of student midwives rated themselves low on confidence to provide ANC. Midwifery students enrolled in direct entry programs reported higher levels of confidence in all domains. It is important that local governments develop education standards, based on recommendations from the International Confederation of midwives. Further research is needed for the evaluation of actual competence