Traditional Reproductive Health and Family Planning Practices among the Dagomba

This paper is a qualitative descriptive study of traditional reproductive health (RH) and family planning practices among Ghana's Dagomba. The purpose of the study was to examine the Dagomba traditional knowledge of RH practices and beliefs, and their relevance in the context of modern health practices. Data for this study was gathered through qualitative methods, including individual in-depth interviews, focus group discussions, and the use of a qualitative questionnaire among 37 participants. Thematic analysis was undertaken. In examining the Dagomba traditional knowledge of RH practices, it was recognized that the concept of RH extends across the life continuum, reaching beyond the sexually active adult population. The RH practices are based on the Dagomba health beliefs and value systems regarding sexuality and the body's functioning. The Dagomba’s health philosophies and practices regarding pregnancy, delivery, breastfeeding, and sexuality have public and preventive health functions, including conflicting positions. The typical traditional RH and FP practices include abstinence, rhythm, prolonged breastfeeding, and postpartum abstinence. Conclusion: We posit that when traditional knowledge of RH is examined critically by modern health experts, it could help us understand why people from different cultures have varying interpretations and uptake of modern RH practices. Thus, we invite biomedical practitioners to be culturally sensitive and incorporate relevant knowledge of traditional RH practices into their current health education efforts

Smoking cessation interventions in south Asian countries: Protocol for scoping review

Introduction: Unfortunately, like many other health risks, smoking rate has been on the rise in developing countries. Half of current smokers in the world reside in only three countries of Asia that include India. Many smoking cessation interventions that were developed and successfully implemented in the context of developed countries have not been equally successful in South Asia. Hence, there is a dire need of culturally relevant smoking cessation interventions. We propose a scoping review with objectives to explore the extent and nature of interventions for smoking cessation and its associated factors in South Asian Region by systematically reviewing the available published and unpublished literature.Methods and analysis: The review has been registered in Joanna Briggs Institute (JBI) systematic reviews register and details are given in the Methodology section. The updated framework of JBI for scoping review methodology will be used as guide for conduct of this scoping review. Electronic databases (PubMed, CINAHL plus, Proquest Theses and Dissertations, EBSCO Dentistry and Oral Sciences, and Wiley Cochrane Library), reference lists of selected studies and grey literature will be considered for inclusion in this review. The literature search is anticipated to be carried out in December-January 2020. Initially, two reviewers in consultation with a librarian will develop search syntax followed by search from the selected sources. Consequently, the reviewers will screen all the titles, abstracts and full articles to establish relevance of each study for inclusion. Factors associated with smoking cessation will be coded and categorised applying qualitative content analysis, while interventions extracted from the literature will be described with the stated level of effectiveness

Knowledge and Dietary Practices on Vitamin A and Iron Among Maasai Pregnant Women: A Mixed-Method Study, Ngorongoro, Tanzania

This research article was published by Dovepress in 2020Background: Provision of micronutrients knowledge is important during pregnancy as it informs mothers what to eat and avoid, to ensure sufficient micronutrient absorption by the mothers and fetuses. Most studies focus on general nutrition knowledge and dietary prac tices, but there is minimal known about micronutrient knowledge especially in pastoral societies. Therefore, the aim of this study was to explain the current micronutrient knowl edge and dietary practices of pregnant women in this unique pastoral society. Methods: This is a mixed-method study that involves focus group discussions and question naires in assessing the micronutrient knowledge and frequency micronutrients dietary practices of Maasai pregnant women from one week to thirty-six weeks pregnant. Chi-square test and descriptive statistics, such as percentages, frequency distribution and measures of central tendency, were used to assess socio-demographic data, micronutrients knowledge and frequency of micronutrients dietary practices and the comparison between knowledge and dietary practices, while inductive thematic content analysis was used to analyze qualitative data. Results: In total, 140 questionnaires were completed with a response rate of 100% and 32 participants drawn from this group attended one of four focus group discussions. The study found that most participants had good knowledge of dietary iron, while less than a quarter (24.3%) had good knowledge of vitamin A. Moreover, there was a statistical significance difference (P=0.043) between knowledge and dietary practices. Low dietary micronutrient intake was primarily due to cultural restrictions, prohibition in cultivating and unavailability of micronutrients rich foods in this geographical area. Conclusion: The majority of the study participants had good knowledge of iron compared to vitamin A; however, they do not translate the knowledge in dietary practices. Therefore, the Government of Tanzania through Ministry of Education and Health should introduce different interventions to increase micronutrients knowledge and practices in pastoral societies

Integration of health promotion into nursing practice: a case study in Pakistan.

The purpose of this study was to understand the concept of health promotion and perceptions related to the integration of health promotion in nursing practice in Pakistan. The study utilized the qualitative single case study approach to explore and describe the concept of health promotion, its significance and ways to integrate health promotion strategies in nursing practice. The data were collected from three different sources; focus group discussion among final year Post-RN BScN students, key informant interviews of practicing nurses, faculty, and MScN students, as well as a document review of the Post-RN BScN curriculum. Data analysis included a content and thematic analysis, yielding four major themes—”Health Promotion as Diverse”, “Health Promotion as Necessary”, “Health Promotion as Nursing Role”, and “Health Promotion as a Strategic Imperative”. Further, the findings highlighted the competencies, support mechanisms, and barriers which select nurses faced while integrating the health promotion strategies in practice

The COVID-19 pandemic: A catalyst for creativity and collaboration for online learning and work-based higher education systems and processes

The purpose of this research is to focus on work-based problems catalysed by the COVID-19 global pandemic, based on a case study of a multi-continental, multi-campus university distributed across Kenya, Tanzania, Uganda and Pakistan. Higher education institutions (HEIs) in developing countries lacked pre-existing infrastructure to support online education and/or policy and regulatory frameworks during the pandemic. The university\u27s programmes in Pakistan and East Africa provide lessons to other developing countries\u27 HEIs. The university\u27s focus on teaching and learning and staff development has had a transformational organisational effect

Levels and predictors of self-care among patients with hypertension in Pakistan

Background: Globally, hypertension is the leading non-communicable disease and strongest predictor of cardiovascular diseases. To mitigate and prevent hypertension-related complications, self-care behavior adaptation has proven to be vital. In this study, we examined the six clinically prescribed levels of self-care as prescribed by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure and its predictors among a select sample of hypertensive individuals in Karachi, Pakistan.Methods: This study reports the cross-sectional survey of a sequential mixed method study which assessed the levels of self-care of hypertensive individuals residing in an urban cosmopolitan setting within Karachi Pakistan. Four hundred and two patients were screened using the H-SCALE questionnaire, while socio-demographic predictors of self-care and level of knowledge of hypertension were identified using a study-specific checklist. Self-care was assessed against six clinical domains including medication adherence, diet, weight management, physical activity, and abstinence from alcohol.Results: Participants were recruited from the two largest tertiary care hospitals in Karachi. Good knowledge about hypertension, including its causes, management, and complications was reported by 4.47% of the participants. Highest levels of self-care adherence were found for abstinence from alcohol (100%), smoking cessation (83.33%), and medication compliance (71.89%), whereas lowest levels were found for diet (27.11%), and physical activity (24.88%). In terms of predictors for self-care, age, male gender, and self-checking of blood pressure at home, followed by the level of education were the most common predictors for each self-care behavior in the given population.Conclusion: Overall knowledge of self-care for hypertension is sub-optimal among hypertensive patients in Pakistan which is reflected in their behaviors. There is a need to introduce healthcare educational programs in Pakistan which can improve self-care behaviors of hypertensive individuals and potentially reduce the prevalence of associated cardiovascular diseases and its complications

Knowledge and Attitudes of Select Ugandan Nurses towards Documentation of Patient Care

Ideally through documentation, nurses track changes in a patient’s condition, make decisions about needs, and ensure continuity of care. However, nursing documentation has often not met these objectives. In Uganda, the systematic nursing specific approach is not reflected in documentation of nursing care. A mixed methods intervention study was conducted to determine knowledge and attitudes of nurses towards documentation, including an evaluation of nurses’ response to a designed nursing documentation form. Forty participants were selected through convenience sampling from six wards of a Ugandan health institution. The study intervention involved teaching nurses the importance of documentation and using of the trial documentation tool. Pre and post testing and open-ended questionnaires were used in data collection. On both pre and post-tests, most participants strongly agreed that nursing notes were meaningful and necessary for legal protection, as well as a nursing priority. Most participants strongly disagreed that there was familiarity with policies on nursing documentation, and that an uninterrupted environment for care documentation existed. Although participants’ knowledge about documentation improved by 20% following the intervention, there was no significant change in attitudes toward documentation. Participants consistently reflected on documentation as an important practice, but highlighted contextual constraints limiting implementation and quality of documentation. The study findings have implications for pre and post-service training, documentation policies, and organizational supports for nursing documentation

Smoking cessation interventions in south Asian region: A systematic scoping review

Background: Cigarette smoking is one of the most preventable causes of morbidities and mortalities. Since 2005, the World Health Organization Framework Convention for Tobacco Control (WHO-FCTC) provides an efficient strategic plan for tobacco control across the world. Many countries in the world have successfully reduced the prevalence of cigarette smoking. However, in developing countries, the prevalence of cigarette smoking is mounting which signifies a need of prompt attention. This scoping review aims to explore the extent and nature of Smoking Cessation (SmC) interventions and associated factors in South Asian Region (SAR) by systematically reviewing available recently published and unpublished literature.Methods: The Joanna Briggs Institute (JBI) framework frames the conduct of this scoping review. PubMed, EBSCO CINAHL Complete, Cochrane Library, ProQuest Dissertation and Theses, and local websites as well as other sources of grey literature were searched for relevant literature. In total, 573 literature sources were screened. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram, finally, 48 data sources were included for data extraction and analysis. We analyzed the extracted SmC interventions through the FCTC. Factors that affect smoking cessation interventions will be extracted through manual content analysis.Results: Regarding FCTC recommended smoking cessation strategies (articles), most of the articles were either neglected or addressed in a discordant way by various anti-smoking groups in SAR. Key barriers that hamper the effectiveness of smoking cessation interventions included lack of awareness, poor implementation of anti-smoking laws, and socio-cultural acceptance of tobacco use. Conversely, increased levels of awareness, through different mediums, related to smoking harms and benefits of quitting, effective implementation of anti-smoking laws, smoking cessation trained healthcare professionals, support systems, and reluctance in the community to cigarette smoking were identified as facilitators to smoking cessation interventions.Conclusion: The ignored or uncoordinated FCTC\u27s directions on smoking cessation strategies have resulted in continued increasing prevalence of cigarette smoking in developing countries, especially SAR. The findings of this review highlight the need for refocusing the smoking cessation strategies in SAR.Strengths: The review was conducted by a team of expert comprising information specialists, and senior professors bringing rich experience in systematic and scoping reviews. Every effort was made to include all available literature sources addressing cigarette SmC and associated factors in SAR. The review findings signal the need and direction for more SmC efforts in SAR which may contribute to development of effective policies and guidelines for the control of smoking prevalence.Limitations: Despite efforts, potentially relevant records may have been missed due to unpublished or inaccessible articles, unintended selection bias, or those published in local languages, etc. Moreover, the exclusion of literature on under 18 participants and mentally ill smokers may limit the generalizability of findings

The Nursing Documentation Dilemma in Uganda: Neglected but Necessary. A Case Study at Mulago National Referral Hospital

In Uganda, nursing documentation still remains a challenge, in most of the government hospitals and some private hospitals, it remains at a manual (non-technology driven) level and omissions have been observed. Nurses continue to capture standard elements in their documentation. A mixed methods intervention study was conducted to determine knowledge and attitudes of nurses towards documentation, including an evaluation of nurses’ response to a designed nursing documentation form. Forty participants were selected through convenience sampling from six wards of a Ugandan health institution. The study intervention involved teaching nurses the importance of documentation and using of the trial documentation tool. Pre- and post-testing and open-ended questionnaires were used in data collection. The results from the close-ended questions were presented in the previous publication; the responses from the open-ended questions would then be presented. The open-ended questions regarding comments about the nursing documentation process and suggestions about the process of implementing the nursing documentation system in the ward units were considered. All participants were provided the opportunity to provide personal comments, reflections, or stories of their experiences with documentation in patient care. A thematic analysis approach was used during data analysis. The results showed that the participants had positive attitude towards documentation of patient care, but they had constraints limiting them to document, they reflected issues concerning the perceived pressure from the administrations and support to document. The study findings have implication that there is need for organizational support and to have multisite studies and extension of the documentation tool

Reducing early neonatal heat loss in low resourced context an Indian exemplar

Background: Although there has been a favorable trend in the Infant Mortality Rate in India in the last decade, the country is still unlikely to meet the Millennium Development Goal #4. Of significance, there has been minimal improvement in the early neonatal mortality rate, which is an indicator of quality of perinatal care. In the efforts to address this aspect, a range of efforts and interventions have been considered. One such effort is in addressing and reducing hypothermia in neonates. Two low tech strategies, professional mummying/swaddling (PM/S) and ‘Kangaroo mother care’ (KMC), are seen as critical in the continuum of neonatal care. Objective: This study compared the effects of KMC and professional mummying/swaddling (PM/S) on select neonatal outcomes (temperature and weight) in a postnatal hospital unit in Chennai India. Methodology: This quasi-experimental study used a repeat measures time series approach monitoring weight and temperatures for neonates across the two interventions. Results: Significant findings were found in the retention of temperature which indicated that the KMC intervention aligned with higher neonatal temperatures than the PM/S interventions. Further, neither maternal or neonate indicators were found to impact significantly on weight or temperature changes in either group. Conclusions: KMC was found to provide a viable and meritous alternative to PM/S as a thermoregulatory strategy for full term neonates in a low resource setting. The study suggest that ongoing research will be necessary to ascertain the optimal approaches and potentials in both methods with such culturally diverse populations