Fear in childbirth: are the media responsible?

This is the second year that the Centre for Midwifery, Maternal and Perinatal Health convened a debate as part of the Festival of Learning at Bournemouth University (BU). The debate encourages members of the public and service users to get involved in our research and education and ensures that what we do at BU is relevant and current. Last year the team debated the pros and cons of allowing women free choice with regard to major medical interventions, such as caesarean section (Hundley et al. 2013). This year the focus was on the role of the media in childbirth. Social perceptions and beliefs about childbirth can increase women’s requests for interventions, such as caesarean section, with long-term health implications for mothers and babies. The debate was planned to explore the role of the mass media in shaping these beliefs and identify whether media portrayals are responsible for rising rates of intervention. Attendees were given the opportunity to voice their views and to vote for or against the motion. The motion for debate was: This house believes that: The media is responsible for creating fear in childbirth

Sexual and reproductive health of adolescents in rural Nepal: Knowledge, attitudes and behavior

Background: Nepal has a relatively young and growing population, like most low-income countries. Recently, Nepal has accelerated its commitment to the International Conference on Population and Development (ICPD) Programme of Action by introducing a programme focusing on the sexual and reproductive health of adolescents. This paper aims to report the sexual health knowledge, attitudes and behaviour of adolescents in rural Nepal. Methods: A survey was conducted in four districts of Nepal with representative sample among adolescents aged 15–19 years using pre-tested structured questionnaire in 2011. Questionnaire contents socio-demographic questions including knowledge, attitudes and behaviours related to reproductive and sexual health. The study was approved by the Nepal Health Research Council. Results: A total 3041 adolescents (mean age 16.4 years, 49.4% male and 50.6% female) completed the questionnaire. The data indicated that HIV/AIDS and other reproductive and sexual health knowledge among the respondents was moderate. Male respondents have better knowledge on HIV/AIDS compare to female respondents. Similarly, male have better access to modern means of communications. Both male and female were equally likely to say that they had used a condom the last time they had sex. A small proportion of all respondents (9.3%) had acquired emergency contraception, two thirds of those were male (65%) and among total users of emergency contraceptives, 85% were unmarried. Conclusions: Both education and youth-friendly services, targeting to female adolescents are required to improve the sexual health status of adolescents. The findings have important implications for the (re-)development sexual health interventions for adolescents in Nepal

Study on Nutritional Problems in Preschool Aged Children of Kaski District of Nepal

Undernutrition remains a key public health burden in Nepal. This study aimed to measure knowledge, attitudes, and beliefs about nutritious food amongst mothers of 3 – 5-year-olds from rural and urban areas. A cross-sectional mixed-methods approach comprised a quantitative survey and qualitative focus groups. The community-based survey included 524 mothers of children who are no longer breastfed. Open-ended and structured questions investigated knowledge, beliefs and attitudes about nutritious food, child feeding patterns, and major barriers, food insecurity, and health-seeking behaviours. Focus groups were held with key informants, a thematic analysis was applied to the qualitative data. Results: Major barriers to recommending nutritious foods included: lack of knowledge (19%); cost (21%); and culture/beliefs (7%). Nearly 55% children were given fruit once a week. Almost 37% of mothers never gave meat, fish and egg regularly to their children and 34% did not choose healthy food from stores, and 12% lacked food. Most children (57%) had been taken at least once to a spiritual healer and 16% had been taken more than once. The qualitative analysis suggested that important factors of knowledge, attitudes, and beliefs about healthy diet are poverty, education, strong cultural beliefs, family size, household income, time and a growing preference for fast food. Conclusion: Knowledge of and attitudes towards nutritious food is still poor. Beliefs about food practice are strongly embedded in Nepal. Thus, this study shows that policymakers should consider a public health intervention and approach based around changing these largely cultural beliefs and behaviours

Guide to the design and application of online questionnaire surveys

Collecting research data through traditional approaches (face-to-face, postal or telephone survey) can be costly and time consuming. The emerging data collection approach based on internet/e-based technologies (e.g. online platforms and email), is a relatively cost effective survey alternative. These novel data collection strategies can collect large amounts of data from participants in a short time frame. Similarly, they also seem to be feasible and effective in collecting data on sensitive issues or with samples they are generally hard to reach, for example, men who have sex with men (MSM) or migrants. As a significant proportion of the population currently in the world are digitally connected, the shift from postal (paper-pencil) or telephone towards online survey use in research is in the interests of researchers in academia as well as in the commercial world. However, compared to designing and executing paper version of the questionnaire, there is limited literature to help a starting researcher with the design and a use of online questionnaires. This short paper highlights issues around: a) methodological aspect of online questionnaire survey; b) online survey planning and management; and c) ethical concerns that may arise while using this option. We believe that this paper will be useful for researchers who want to gain knowledge or apply this approach in their research

Avoidance as a strategy of (not) coping: qualitative interviews with carers of Huntington's Disease patients

Peer reviewedPublisher PD

Facilitators and barriers to condom use in Middle East and North Africa: a systematic review

Background: The Middle East and North Africa (MENA) region continues to have the lowest prevalence of HIV (human immunodeficiency virus) in the world, less than 0.1%, yet new transmissions are increasing. Consistent condom use can reduce the probability of transmission by 90–95%, and its use remains as the staple prevention method; however, this isn’t the case for the MENA region, where condom use, knowledge of proper use, and accessibility are limited. Aims: To conduct a systematic review on condom use, its use across different population groups, and its barriers and facilitators in countries that fall under the UNAIDS regional classification of MENA. Methods: This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The search included electronic databases: PubMed/MEDLINE, Academic Search Ultimate, COCHRANE, APA PsycINFO, ScienceDirect, CINAHL Complete, Scopus. There was no date restriction. Results: Of the 471 records retrieved, 45 articles were appraised and included in the analysis. The reported barriers and facilitators are sub-divided into personal, social, and structural factors. Condom accessibility, partner objection, and their perceived ineffectiveness were key barriers, whereas availability, cost, and lack of awareness were rarely mentioned. Concerns of personal health and future financial security, as well as positive peer influence and delayed sexual experience, were identified as motivators. Conclusion: Condom promotion in the region needs to incorporate gender-based power in relationships and the influence of religion, as well as the legal and structural factors. More investment and research are needed for women-initiated contraceptive and digital healthcare initiatives

Health Promotion opportunities for Auxiliary Nurse Midwives in Nepal

Health promotion moves beyond changing the health-related knowledge, attitudes and behaviour of individuals and covers a wide range of social and environmental interventions. Nepal has also introduced health promotion policies targeting health education, information and communication. Auxiliary Nurse Midwives (ANMs), who are responsible for delivering primary care maternity services, especially in birthing centres located in rural areas of Nepal, also have an important role to play in the promotion of women’s health during pregnancy, intra-partum and post-partum. However, in the present context, health promotion provided by ANMs in Nepal is confined mostly to health education and behavioural-change communication. There are a range of health promotion activities relevant to maternity care and midwifery that ANMs can practice even in low-technology rural birthing centres. Such health promotion offers an opportunity to move away from a very medical and behavioural model to a more empowering one in order to prevent health problems in a cost-effective way