Nurse-midwives knowledge and utilization of partograph in monitoring of labour in tertiary hospitals in Enugu, South-Nigeria

It is not clear whether knowledge of partograph has influence the management of women in labour by nurse-midwives working in tertiary hospitals, Enugu, Nigeria. Many women in labour do not benefit from the use of partograph in monitoring of normal proceedings of labour despite its importance in reducing maternal and infant mortality. This study examined nurse-midwife's knowledge and utilization of partograph in monitoring of labour in tertiary hospitals in Enugu, Nigeria. A cross sectional descriptive study with a sample of 96 nurse-midwives working in the reproductive health units of two tertiary hospitals in Enugu metropolis were used for the study. Data were collected using semi-structured questionnaire. Descriptive statistics was used for data analysis. All analyses were performed using IBM SPSS version 20.0 at a 5% level of significance. Result showed that all the respondents at tertiary hospitals had heard about partograph. Few 40(80%) of the nurse-midwives in UNTH and 32(69.6%) in ESUTH utilized partograph during labour management. Factors that hindered use of partograph were lack of intermittent training of nurse-midwives and non-availability of partograph charts with mean score of 1.19 respectively. The association between the years of working experience and the use of partograph failed to be statistically significant (P = 0.90). There is need for improvement in knowledge and use of partograph during labour management through continuing education for nurse-midwives, periodic workshops and mandatory hospital policy on use of partograph during management of labour

Training-of-Trainers of Nurses and Midwives as a Strategy for the Reduction of Eclampsia-Related Maternal Mortality in Nigeria

Background: Preeclampsia and eclampsia (PE/E) are major contributors to maternal and perinatal mortality in Nigeria. Despite the availability of current curriculum at Nigerian schools of nursing and midwifery; the knowledge on the management of PE/E among the students has remained poor. In order to reduce maternal and perinatal mortality in developing countries; targeted training and supportive supervision of frontline health care providers have been recommended. Methodology: A total of 292 tutors from 171 schools of nursing and midwifery participated in the training of the trainers' workshops on current management of PE/E across the country. Pre- and post-test assessments were administered. Six months after the training; 29 schools and 84 tutors were randomly selected for follow-up to evaluate the impact of the training. Results: Significant knowledge transfer occurred among the participants as the pretest/posttest analysis showed knowledge transmission across all the 13 knowledge items assessed. The follow-up evaluation also showed that the trained tutors conducted 19 step-down trainings and trained 157 other tutors in their respective schools. Subsequently; 2382 nursing and midwifery students were properly trained. However; six of the monitored schools (24.2) lacked all the essential kits for teaching on PE/E. Conclusion: Updating the knowledge of tutors leads to improved preservice training of the future generation of nurses and midwives. This will likely result in higher quality of care to patients and reduce PE/E-related maternal and perinatal mortality. However; there is need to provide essential training kits for teaching of student nurses and midwives

The Expectations of Fathers Concerning Care Provided by Midwives to the Mothers during Labour

Midwives have been criticised for neglecting the expectations and needs of fathers. They either ignore the fathers or pressure them into becoming more involved than they would choose; if allowed to provide support to the mothers during labour. Whilst midwives are providing woman-centred care; it is important that they remember to involve the fathers in decision-making and to acknowledge their role; expectations and needs; because the birth of a child is one of the most important events in a person's lifetime. This study focused on fathers' expectations of the care provided to mothers by the midwives during labour. A qualitative; explorative; descriptive and contextual study design was utilised. In-depth qualitative interviews were conducted with fathers about the care provided to their partners or wives by midwives. Data were then analysed with an open descriptive method of coding that is appropriate for qualitative research. The results of the interviews were subsequently positioned within a holistic health-promotive nursing theory that encompassed body; mind and spirit. The results revealed that fathers saw the provision of comfort and support as the two main aspects for mothers in labour that they expected from midwives. The findings were that midwives should improve their communication skills with the mothers; as well as with the fathers if they are available. Fathers expected midwives to encourage them to accompany the mother during labour and to facilitate bonding between father; mother and baby. The results of this study should assist midwives to provide holistic quality care to mothers and fathers during labour

Caring as a Core Concept in Educating Midwifery Learners: A qualitative Study

Caring is the core business of nursing and midwifery; involving a relationship in which the carer is committed to the needs of the one being cared for (Mason-Whitehead; Mcintosh; Bryan et Mason). Caring is the emotion which drives a midwife to care; the motive aimed at assisting someone to grow and self-actualise (Watson). The concern in midwifery is that irrespective of caring being central to the midwifery profession; caring taught in theoretical learning does not always translate into caring behaviour in practice. A qualitative exploratory study examined how midwifery educators impart the skill of caring during theoretical learning and clinical accompaniment; in order to respond to the general complaint made both locally and internationally that midwives are uncaring. The aim was to explore caring during theoretical learning and clinical accompaniment from the perspective of midwifery educators. Participants in the study were midwifery educators teaching midwifery in institutions of learning in Tshwane; South Africa. The naive sketch was used to gather data; wherein one central question was asked and the educators were invited to narrate and respond. Three themes emerged: the meaning of caring; how caring was conveyed during theoretical learning; and how it was conveyed during clinical accompaniment. Although the midwifery educators expressed how they conveyed caring to the learner midwives; it was not evident how caring competencies were assessed in order to ensure caring midwives at the end of training