Experiences of caregivers of infants who have been on bubble continuous positive airway pressure at Queen Elizabeth Central Hospital, Malawi: A descriptive qualitative study

Background: An innovative, low-cost bubble continuous positive airway pressure (bCPAP) device has recently been introduced in Malawi for the treatment of respiratory distress in infants. While this novel bCPAP system has been shown to be safe and effective in reducing infant mortality, caregivers’ experiences have not been investigated. The purpose of this study was to explore experiences of parents and guardians of infants who had been on bCPAP at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi.Methods: This was a descriptive phenomenological study that was carried out at the Chatinkha nursery unit and the paediatric nursery ward at QECH, from January to February 2015. Purposive sampling was used to select participants for in-depth interviews. Data saturation was reached with 12 caregivers. Data were analysed using Colaizzi’s framework.Results: Caregivers received inadequate, inconsistent, and sporadic information about bCPAP. Student nurses and doctors were best able to answer caregivers’ questions and concerns. When their infants were on bCPAP, caregivers felt anxious and fearful. However, upon implementation of bCPAP treatment for their children, the caregivers were satisfied with it. The main sources of psychological stress were limited parent–child interaction and the constraints of prescribed visiting hours. Family, friends, and caregiver involvement in the care of infants provided some psychological comfort.Conclusions: The results show gaps in the information and psychological support that mothers of infants on bCPAP receive in hospital. We recommend that psychological support be given to the mothers of infants on bCPAP at QEC

Nursing And Midwifery Students’ Lived Experiences Of Faculty Caring And Uncaring Behaviours On Their Learning: A Phenomenology Study

Background: A caring environment in nursing education is one of the most essential factors for empowering students, which is achieved through trust and open academic communication.Aim: To explore the experiences of faculty caring and uncaring behaviours on students learning from the perspective of university nursing and midwifery students. Methods: Descriptive phenomenology was used to collect data from 10 nursing and midwifery students who were purposively selected at a baccalaureate nursing and midwifery school at a public university in Malawi. Data were collected through semi-structured interviews from August 24th, 2015 to September 30th, 2015 and analysed using Colaizzi’s (1978) method. Ethical considerations were followed. European Scientific Journal, ESJ ISSN: 1857-7881 (Print) e - ISSN 1857-7431 January 2021 edition Vol.17, No.3 www.eujournal.org 206 Results: Two sub-themes which emerged under the main theme of experiences of faculty caring behaviours which were: (1) Increased motivation (2) Increased confidence and Competence, whilst three sub-themes which emerged under the main theme of experiences of faculty uncaring behaviours were: (1) Poor performance (2) A risk to patients (3) Feeling helpless and embarrassed. Conclusion: Experiences of students with caring and uncaring faculty had an influence on students learning, personal well-being and on their ability to effectively care for their patients. The study recommends that faculty members should critically analyse their actions and embrace those caring behaviours that facilitate the process of creating a conducive learning environment. In addition, there is need to develop a clear policy stipulating the role of student personal advisors and how students can engage them

Sources of Information on HIV and Sexual and Reproductive Health for Couples Living with HIV in Rural Southern Malawi

With wider access to antiretroviral therapy, people living with HIV are reconsidering their reproductive decisions: remarrying and having children. The purpose of the paper is to explore sources of information for reproductive decision used by couples living with HIV in patrilineal and matrilineal districts of Malawi. Data were collected from forty couples from July to December 2010. Our results illuminate five specific issues: some of the informants (1) remarry after divorce/death of a spouse, (2) establish new marriage relationship with spouses living with HIV, and (3) have children hence the need for information to base their decisions. There are (4) shared and interactive couple decisions, and (5) informal networks of people living with HIV are the main sources of information. In addition, in matrilineal community, cultural practices about remarriage set up structures that constrained information availability unlike in patrilineal community where information on sexual and reproductive health, HIV, and AIDS was disseminated during remarriage counselling. However, both sources are not able to provide comprehensive information due to complexity and lack of up to date information. Therefore, health workers should, offer people living with HIV comprehensive information that takes into consideration the cultural specificity of groups, and empower already existing and accepted local structures with sexual and reproductive health, HIV, and AIDS knowledge

Guidelines for short-term medical missions: perspectives from host countries

Abstract Background In the past decade, there has been increasing guideline development for short-term medical missions (STMMs) traveling from high-income to low- and middle-income countries for the purpose of supporting health care services. The ethics of STMMs is criticized in the literature and there is frequently a lack of host country collaboration. This typically results in guidelines which are developed through the lens of the sending (high-income) countries’ staff and organizations. The aim of this paper is to evaluate an existing best practice guideline document from the perspective of host country participants with knowledge of STMMs from Honduras, Malawi, and the Philippines. Methods The guideline used for the evaluation consisted of nine best practice elements that were discerned based on literature and the experience of those working within the field. Semi-structured interviews were conducted in a cross-sectional study with participants (n = 118) from the host countries. Thematic analysis was conducted by two researchers and the results were assessed by working group members to confirm interpretations of the data. Results Overall, participants expressed a strong interest in having more structured guidance surrounding STMM practices. There was a positive response to and general acceptance of the proposed STMM guidelines, although participants found the 24-page document onerous to use; a companion checklist was developed. The key themes that emerged from the interviews included collaboration and coordination, care for hard-to-reach communities, capacity building, critical products and essential medical supplies, and opportunity and feasibility. Conclusions Host input suggests that the guidelines provide structured regulation and coordination of the medical mission process and have the potential to improve the way STMMs are carried out. The guidelines have also proven to be a useful tool for the actual implementation of STMMs and can be a tool to strengthen links and trust between mission teams and local health staff. However, local contexts vary considerably, and guidelines must be adapted for local use. It is recommended that STMM teams work in conjunction with host partners to ensure they meet local needs, increase capacity development of local health workers, and provide continuity of care for patients into the local system

Primary health care preparedness to integrate diabetes care in Blantyre, Malawi: A mixed methods study.

BackgroundThere is limited access to diabetes care services at primary care facilities in Malawi. Assessing the capacity of facilities to provide diabetes care is an initial step to integrating services at primary care.AimTo assess the preparedness for delivering diabetes services at primary care level within the Blantyre District Health Office (DHO) to support the response to NCD epidemic in Malawi.SettingBlantyre DHO primary care facilities.Materials and methodsA mixed methods approach nested in a national needs assessment for NCD response in Malawi was used. Fourteen primary healthcare facilities from Blantyre DHO were assessed. A tool adapted from the WHO rapid assessment questionnaire was used to identify human resource, equipment, supplies, and medication needed for comprehensive diabetes care. Descriptive statistics were done to analyze the quantitative data. Fisher's exact test was used to assess if there was a statistically significant difference between urban and rural facilities. Seventeen health care workers from the selected facilities participated in key informant interviews. Framework analysis method guided the qualitative data analysis. The quantitative and qualitative data were merged and displayed jointly.ResultsThe quantitative assessment showed that none of the facilities assessed had capacity to provide all the interventions recommended by WHO for diabetes care at primary level. Eight (57%) of the facilities had the capacity to diagnose diabetes, monitor glucose, prevent limb amputations and manage hypoglycemia and hyperglycemia. Four themes emerged from the qualitative data: differences in level of preparedness and implementation of diabetes care; disparities in resources between urban and rural facilities; low utilization of diabetes services; and strategy and policy recommendations for improvement of diabetes care.ConclusionInadequate health financing resulted in significant disparities in the available resources between the rural and urban facilities to offer diabetes care services. There is need to develop national policies and guidelines for diabetes care to strengthen the capacity of primary care facilities to facilitate achievement of universal health coverage

Increasing human resource capacity in African countries: A nursing and midwifery Research Summit

Background: As global efforts to increase the nursing and midwifery workforce intensify to improve access and quality of healthcare, clinical nursing and midwifery research must increase concomitantly to provide a solid evidence base for these clinicians. To maximize research resources in resource-poor regions, the research team collaborated with regional experts in southern and eastern African countries to convene a Research Summit in Nairobi, Kenya. Objectives were to: build a network of midwifery and nurse scientists, identify regional gaps in knowledge and priorities for their research, develop strategies that address these gaps, and initiate a mentorship plan. Purpose: To review methods leading up to organizing and convening as well as the evaluation of the aforementioned Research Summit. Methods: A two-day regional Summit was convened; appropriate experts from 12 countries participated. In a year-long collaborative process, regional experts and research priorities were identified; during the Summit, a fluid agenda incorporated findings from workgroups. Summative evaluations were completed by participants and planners. Results: Through the Summit, a network of regional research experts was established; peer mentoring was initiated; research priorities were confirmed; regional action plans to address clinical nursing and midwifery research priorities were developed; and technical task forces and a steering committee were formed. Evaluations from participants, planners and core collaborators were collected. Follow up reports have been submitted by technical working groups. Conclusions: Evaluations provided favorable feedback regarding the process leading up to as well as the content of the Research Summit. While further long-term evaluations will be needed to determine the sustainability of this initiative, the Summit format afforded the opportunity for regional experts to meet, examine research priorities, and develop strategic action and mentorship plans. This paper describes a replicable method that could be utilized in other regions using available resources to minimize costs and modest grant funding