Global collaboration between Tanzania and Japan to advance midwifery profession: A case report of a partnership model

The global health agenda to reduce maternal mortality is delayed in Sub-Saharan Africa. The shortage of skilled birth attendants in Tanzania hinders the improvement of midwifery care to prevent maternal mortality and morbidity. It is urgently neccesary to develop midwifery leaders capable of working as educators, researchers, administrators, and advanced practitioners, contributing to the improvement of midwifery care and maternal child health in their own country. This report describes the process of establishing the first midwifery master’s program in Tanzania through the efforts of two academic institutions, one in Tanzania and one in Japan. The collaboration developed a sustainable partnership model for the advancement of midwifery education. This partnership model was based upon the professional relationships corresponding with our values of humanized childbirth and people-centered care. The key elements for the project success included: (1) spending adequate time for in-person communication with the collaborative partner; (2) sharing the same goals and concepts; (3) understanding different values and norms for working and living; (4) learning ways of communication and project implementation in the partner’s culture and (5) confirming the feasibility, which could increase team members’ motivation and commitment. Midwives from the two institutions both gained knowledge and research outcomes as well as the satisfaction of establishing the midwifery master’s program. To improve the remaining global maternal health issues, this win-win collaboration should be considered as the 21st century’s partnership model for the global health community

Evaluation of a family-oriented antenatal group educational program in rural Tanzania: a pre-test/post-test study

Abstract Background To increase births attended by skilled birth attendants in Tanzania, studies have identified the need for involvement of the whole family in pregnancy and childbirth education. This study aimed to develop, implement, and evaluate a family-oriented antenatal group educational program to promote healthy pregnancy and family involvement in rural Tanzania. Methods This was a quasi-experimental 1 group pre-test/post-test study with antenatal education provided to pregnant women and their families in rural Tanzania. Before and after the educational program, the pre-test/post-test study was conducted using a 34-item Birth Preparedness Questionnaire. Acceptability of the educational program was qualitatively assessed. Results One-hundred and thirty-eight participants (42 pregnant women, 96 family members) attended the educational program, answered the questionnaire, and participated in the feasibility inquiry. The mean knowledge scores significantly increased between the pre-test and the post-test, 7.92 and 8.33, respectively (p = 0.001). For both pregnant women and family members, the educational program improved Family Support (p = 0.001 and p = 0.000) and Preparation of Money and Food (p = 0.000 and p = 0.000). For family members, the scores for Birth Preparedness (p = 0.006) and Avoidance of Medical Intervention (reversed item) (p = 0.002) significantly increased. Despite the educational program, the score for Home-based Value (reversed item) (p = 0.022) and References of SBA (p = 0.049) decreased in pregnant women. Through group discussions, favorable comments about the program and materials were received. The comments of the husbands reflected their better understanding and appreciation of their role in supporting their wives during the antenatal period. Conclusions The family-oriented antenatal group educational program has potential to increase knowledge, birth preparedness, and awareness of the need for family support among pregnant women and their families in rural Tanzania. As the contents of the program can be taught easily by reading the picture drama, lay personnel, such as community health workers or traditional birth attendants, can use it in villages. Further development of the Birth Preparedness Questionnaire is necessary to strengthen the involved factors. A larger scale study with a more robust Birth Preparedness Questionnaire and documentation of skilled care use is needed for the next step. Trial registration No.2013–273-NA-2013-101. Registered 12 August 2013

A family-oriented antenatal education program to improve birth preparedness and maternal-infant birth outcomes: A cross sectional evaluation study

Background: In Tanzania, the information on Birth Preparedness and Complication Readiness is insufficiently provided to pregnant women and their families. The aim of this study was to evaluate the maternal and infant outcomes of a family-oriented antenatal group education program that promotes Birth Preparedness and Complication Readiness in rural Tanzania. Methods: Pregnant women and families were enrolled in a program about nutrition and exercise, danger signs, and birth preparedness. The cross sectional survey was conducted one year later to evaluate if the participants of the program (intervention group) were different from those who did not participate (control group) with respect to birth-preparedness and maternal and infant outcomes. Results: A total of 194 participants (intervention group, 50; control group, 144) were analyzed. For Birth Preparedness and Complication Readiness, the intervention group participants knew a health facility in case of emergency (OR: 3.11, 95% CI: 1.39–6.97); arranged accompaniment to go to a health facility for birth (OR: 2.56, 95% CI: 1.17–5.60); decided the birthplace with or by the pregnant women (OR: 3.11, 95% CI: 1.44–6.70); and attended antenatal clinic more than four times (OR: 2.39, 95% CI: 1.20–4.78). For birth outcomes, the intervention group had less bleeding or seizure during labour and birth (OR: 0.28, 95%CI: 0.13–0.58); fewer Caesarean sections (OR: 0.16, 95% CI: 0.07–0.36); and less neonatal complications (OR: 0.28, 95% CI: 0.13–0.60). Conclusions: The four variables were significantly better in the intervention group, i.e., identifying a health facility for emergencies, family accompaniment for facility birth, antenatal visits, and involvement of women in decision-making, which may be key factors for improving birth outcome variables. Having identified these key factors, male involvement and healthy pregnant lives should be emphasized in antenatal education to reduce pregnancy and childbirth complications

A bibliometric analysis of the global research trend in child maltreatment

Child maltreatment remains a major health threat globally that requires the understanding of socioeconomic and cultural contexts to craft effective interventions. However, little is known about research agendas globally and the development of knowledge-producing networks in this field of study. This study aims to explore the bibliometric overview on child maltreatment publications to understand their growth from 1916 to 2018. Data from the Web of Science Core Collection were collected in May 2018. Only research articles and reviews written in the English language were included, with no restrictions by publication date. We analyzed publication years, number of papers, journals, authors, keywords and countries, and presented the countries collaboration and co-occurrence keywords analysis. From 1916 to 2018, 47,090 papers (53.0% in 2010–2018) were published in 9442 journals. Child Abuse & Neglect (2576 papers; 5.5%); Children and Youth Services Review (1130 papers; 2.4%) and Pediatrics (793 papers, 1.7%) published the most papers. The most common research areas were Psychology (16,049 papers, 34.1%), Family Studies (8225 papers, 17.5%), and Social Work (7367 papers, 15.6%). Among 192 countries with research publications, the most prolific countries were the United States (26,367 papers), England (4676 papers), Canada (3282 papers) and Australia (2664 papers). We identified 17 authors who had more than 60 scientific items. The most cited papers (with at least 600 citations) were published in 29 journals, headed by the Journal of the American Medical Association (JAMA) (7 papers) and the Lancet (5 papers). This overview of global research in child maltreatment indicated an increasing trend in this topic, with the world’s leading centers located in the Western countries led by the United States. We called for interdisciplinary research approaches to evaluating and intervening on child maltreatment, with a focus on low-middle income countries (LMICs) settings and specific contexts