A qualitative study of healthcare professionals' experiences of providing maternity care for Muslim women in the UK.

BACKGROUND: A growing Muslim population in the UK suggests the need for healthcare professionals (HCPs) to gain a better understanding of how the Islamic faith influences health related perceptions and healthcare seeking behaviour. Although some researchers have explored the experiences of Muslim women as recipients of healthcare, little attention has been paid to the challenges HCPs face as service providers on a day-to-day basis whilst caring for Muslim women. The aim of this study was to investigate HPCs lived experiences of providing maternity care for Muslim women. METHOD: Data was collected through twelve semi-structured one-to-one qualitative interviews with HCPs in a large National Health Service (NHS) maternity unit located in the North West of England. Interview participants included Community and specialist clinic (e.g. clinic for non-English speakers), Midwives in a variety of specialist roles (7), Gynaecology Nurses (2), Breastfeeding Support Workers (2) and a Sonographer (1). The audio-recorded interviews were transcribed and analysed thematically. RESULTS: The majority of participants expressed an understanding of some religious values and practices related to Muslim women, such as fasting the month of Ramadhan and that pregnant and breastfeeding women are exempt from this. However, HCPs articulated the challenges they faced when dealing with certain religious values and practices, and how they tried to respond to Muslim women's specific needs. Emerging themes included: 1) HCPs perceptions about Muslim women; 2) HCPs understanding and awareness of religious practices; 3) HCPs approaches in addressing and supporting Muslim women's religious needs; 4) Importance of training in providing culturally and religiously appropriate woman-centred care. CONCLUSION: Through this study we gained insight into the day-to-day experiences of HCPs providing care provision for Muslim women. HCPs showed an understanding of the importance of religious and cultural practices in addressing the needs of Muslim women as part of their role as maternity care providers. However, they also identified a need to develop training programmes that focus on cultural and religious practices and their impact on women's health care needs. This will help support HCPs in overcoming the challenges faced when dealing with needs of women from different backgrounds

Human resources requirements for highly active antiretroviral therapy scale-up in Malawi

<p>Abstract</p> <p>Background</p> <p>Twelve percent of the adult population in Malawi is estimated to be HIV infected. About 15% to 20% of these are in need of life saving antiretroviral therapy. The country has a public sector-led antiretroviral treatment program both in the private and public health sectors. Estimation of the clinical human resources needs is required to inform the planning and distribution of health professionals.</p> <p>Methods</p> <p>We obtained data on the total number of patients on highly active antiretroviral treatment program from the Malawi National AIDS Commission and Ministry of Health, HIV Unit, and the number of registered health professionals from the relevant regulatory bodies. We also estimated number of health professionals required to deliver highly active antiretroviral therapy (HAART) using estimates of human resources from the literature. We also obtained data from the Ministry of Health on the actual number of nurses, clinical officers and medical doctors providing services in HAART clinics. We then made comparisons between the human resources situation on the ground and the theoretical estimates based on explicit assumptions.</p> <p>Results</p> <p>There were 610 clinicians (396 clinical officers and 214 physicians), 44 pharmacists and 98 pharmacy technicians and 7264 nurses registered in Malawi. At the end of March 2007 there were 85 clinical officer and physician full-time equivalents (FTEs) and 91 nurse FTEs providing HAART to 95,674 patients. The human resources used for the delivery of HAART comprised 13.9% of all clinical officers and physicians and 1.1% of all nurses. Using the estimated numbers of health professionals from the literature required 15.7–31.4% of all physicians and clinical officers, 66.5–199.3% of all pharmacists and pharmacy technicians and 2.6 to 9.2% of all the available nurses. To provide HAART to all the 170,000 HIV infected persons estimated as clinically eligible would require 4.7% to 16.4% of the total number of nurses, 118.1% to 354.2% of all the available pharmacists and pharmacy technicians and 27.9% to 55.7% of all clinical officers and physicians. The actual number of health professionals working in the delivery of HAART in the clinics represented 44% to 88.8% (for clinical officers and medical doctors) and 13.6% and 47.6% (for nurses), of what would have been needed based on the literature estimation.</p> <p>Conclusion</p> <p>HAART provision is a labour intensive exercise. Although these data are insufficient to determine whether HAART scale-up has resulted in the weakening or strengthening of the health systems in Malawi, the human resources requirements for HAART scale-up are significant. Malawi is using far less human resources than would be estimated based on the literature from other settings. The impact of HAART scale-up on the overall delivery of health services should be assessed.</p

Medicinal plants used by women in Mecca: urban, Muslim and gendered knowledge

Background: This study explores medicinal plant knowledge and use among Muslim women in the city of Mecca, Saudi Arabia. Ethnobotanical research in the region has focused on rural populations and male herbal healers in cities, and based on these few studies, it is suggested that medicinal plant knowledge may be eroding. Here, we document lay, female knowledge of medicinal plants in an urban centre, interpreting findings in the light of the growing field of urban ethnobotany and gendered knowledge and in an Islamic context. Methods: Free-listing, structured and semi-structured interviews were used to document the extent of medicinal plant knowledge among 32 Meccan women. Vernacular names, modes of preparation and application, intended therapeutic use and emic toxicological remarks were recorded. Women were asked where they learnt about medicinal plants and if and when they preferred using medicinal plants over biomedical resources. Prior informed consent was always obtained. We compared the list of medicinal plants used by these Meccan women with medicinal plants previously documented in published literature. Results: One hundred eighteen vernacular names were collected, corresponding to approximately 110 plants, including one algae. Of these, 95 were identified at the species level and 39 (41%) had not been previously cited in Saudi Arabian medicinal plant literature. Almost one half of the plants cited are food and flavouring plants. Meccan women interviewed learn about medicinal plants from their social network, mass media and written sources, and combine biomedical and medicinal plant health care. However, younger women more often prefer biomedical resources and learn from written sources and mass media. Conclusions: The fairly small number of interviews conducted in this study was sufficient to reveal the singular body of medicinal plant knowledge held by women in Mecca and applied to treat common ailments. Plant availability in local shops and markets and inclusion in religious texts seem to shape the botanical diversity used by the Meccan women interviewed, and the use of foods and spices medicinally could be a global feature of urban ethnobotany. Ethnobotanical knowledge among women in Islamic communities may be changing due to access to mass media and biomedicine. We recognise the lack of documentation of the diversity of medicinal plant knowledge in the Arabian Peninsula and an opportunity to better understand gendered urban and rural knowledge

Atitudes de estudantes de enfermagem frente questões relacionadas ao álcool, alcoolismo e alcoolista Actitudes de estudiantes de enfermería frente a cuestiones relacionadas al álcool, alcoolismo e alcoolista Attitudes of nursing students facing questions related to alcohol, alcoholism and the alcoholic

OBJETIVO: Examinar as atitudes de uma amostra de estudantes de enfermagem frente ao álcool, alcoolismo e alcoolista. MÉTODOS: Estudo exploratório realizado com 144 estudantes do último ano de graduação em enfermagem de duas escolas do setor privado da cidade de Ribeirão Preto - SP. Para a coleta de dados, utilizou-se a Escala de atitudes frente álcool, alcoolismo e alcoolista. RESULTADOS: as atitudes frente ao alcoolista foram mais negativas do que aquelas que vêm sendo reportadas na literatura. A maioria dos participantes considerou o alcoolista culpado por seus problemas de saúde e preferiu não trabalhar com esse tipo de paciente. CONCLUSÃO: As atitudes dos estudantes frente às questões relacionadas ao álcool e alcoolismo tendem à ambivalência e à negatividade, o que pode ser atribuído à falta de preparo recebida durante a graduação. Apesar das recomendações feitas pelos especialistas no País pouco tem sido investido na formação do enfermeiro em álcool e outras drogas sobretudo nas escolas privadas.<br>OBJETIVO: Examinar las actitudes de una muestra de estudiantes de enfermería frente al alcohol, alcoholismo y al alcohólico. MÉTODOS: Estudio exploratorio realizado con 144 estudiantes del último año del pregrado en enfermería de dos escuelas del sector privado de la ciudad de Ribeirão Preto - SP. Para la recolección de datos, se utilizó la Escala de Actitudes frente al alcohol, alcoholismo y alcohólico. RESULTADOS: las actitudes frente al alcoholismo fueron más negativas que aquellas que vienen siendo reportadas en la literatura. La mayoría de los participantes consideró al alcohólico culpable por sus problemas de salud y prefirió no trabajar con este tipo de paciente. CONCLUSIÓN: Las actitudes de los estudiantes frente a las cuestiones relacionadas al alcohol y alcoholismo tienden a la ambivalencia y a la negatividad, el que puede ser atribuído a la falta de preparación recibida durante el pregrado. A pesar de las recomendaciones realizadas por los especialistas en el País poco ha sido invertido en la formación del enfermero en alcohol y otras drogas sobre todo en las escuelas privadas.<br>OBJECTIVE: To examine the attitudes of a sample of nursing students toward alcohol, alcoholism and the alcoholic. METHODS: An exploratory study conducted with 144 students in their final year of undergraduate nursing in two private schools in the city of Ribeirão Preto - SP. For data collection, we used the scale of attitudes towards alcohol, alcoholism and the alcoholic. RESULTS: Attitudes toward alcohol were more negative than those that have been reported in the literature. The majority of participants considered the alcoholic to blame for his health problems and preferred not to work with this type of patient. CONCLUSION: The students' attitudes to questions related to alcohol and alcoholism tended toward ambivalence and negativity, which can be attributed to lack of preparation received during their education. Despite recommendations made by specialists in the country, little has been invested in nursing education on alcohol and other drugs, especially in private schools

The factor structure of the spiritual well-being scale in veterans experiencing chemical weapon exposure

This is the author accepted manuscript. The final version is available from Springer Verlag via the DOI in this record.This study aimed to determine the factor structure of the spiritual well-being among a sample of the Iranian veterans. In this methodological research, 211 male veterans of Iran–Iraq warfare completed the Paloutzian and Ellison spiritual well-being scale. Maximum likelihood (ML) with oblique rotation was used to assess domain structure of the spiritual well-being. The construct validity of the scale was assessed using confirmatory factor analysis (CFA), convergent validity, and discriminant validity. Reliability was evaluated with Cronbach’s alpha, Theta (θ), and McDonald Omega (Ω) coefficients, intra-class correlation coefficient (ICC), and construct reliability (CR). Results of ML and CFA suggested three factors which were labeled “relationship with God,” “belief in fate and destiny,” and “life optimism.” The ICC, coefficients of the internal consistency, and CR were >.7 for the factors of the scale. Convergent validity and discriminant validity did not fulfill the requirements. The Persian version of spiritual well-being scale demonstrated suitable validity and reliability among the veterans of Iran–Iraq warfare