Perspectives of nursing students on challenges of e-learning during early stages of the COVID-19 pandemic

Background: E-learning is becoming an important approach to teaching and learning in higher education institutions, including nursing training. Despite that, there are students who were never introduced to e-learning prior to the coronavirus disease 2019 (COVID-19) pandemic. Their challenges in relation to e-learning could differ from those of other students who had experienced the platform before, especially against the backdrop of the COVID-19 pandemic that brought an abrupt change in the approach to teaching, learning and assessment. Objectives: This study explored and described university nursing students' challenges in relation to e-learning during the early stages of the COVID-19 pandemic in a resource-constrained setting. Method: Qualitative exploratory and contextual design was used. The sample consisted of 17 participants who were conveniently selected, and data were collected by means of two focus groups and five individual interviews. Data analysis followed a qualitative content analysis process. Results: The five categories emanated from analysis are e-learning mode not suitable for practical components, challenges related to assessment of learning, connectivity issues, e-learning is a lonely journey and computer illiteracy and limited skills for the use of e-learning. Conclusion: Nursing students' challenges regarding e-learning during the early stages of the COVID-19 pandemic related to the learning of practical components, assessment, connectivity, a lack of interaction with peers and a lack of the skills required to operate e-learning tools.

Blended learning during and beyond the COVID-19 pandemic: Attitudes of nurse educators in Gauteng

Background: The use of blended learning (BL) pedagogy has become inevitable due to contemporary technological innovations in the nursing education sector. As of late, the need to use BL pedagogy has resulted by the sudden occurrence of the COVID-19 pandemic. However, several nurse educators still experience uncertainties in using BL due to technological, psychological, infrastructure and equipment readiness barriers. Aim: To report the attitudes of nurse educators towards the use of BL pedagogy as a new norm of teaching and learning in public nursing education institutions (NEIs) in the Gauteng Province (GP), South Africa, during and beyond the COVID-19 pandemic period. Setting: The study was conducted in five Gauteng public NEIs. Methods: A descriptive non-experimental quantitative design was conducted with 144 nurse educators. Data was collected through a questionnaire. Statistical Analysis Software (SAS) was used to analyse data with the help of a biostatistician. Results: Technologically, only 50% (N = 72) found BL easy to use while 48% (n = 69) were ready and willing to use the BL Psychologically, more than half, that is, 65% (n = 94) lacked the confidence to use BL pedagogy. About 55% (n = 79) reported having inadequate BL infrastructure, while 32% (n = 46) seemed to be satisfied with the availability of effective equipment to support BL pedagogy. Conclusion: Based on the results, it is apparent that nurse educators in Gauteng are not technologically and psychologically ready, since the infrastructure and equipment to support the BL are not adequately provided.

Lessons from COVID-19 pandemic: teaching midwifery at the national level in Sierra Leone in the pandemic and post pandemic

The contents of this article are drawn from personal experiences and National response by the Ministry of Health and Sanitation during the COVID-19 pandemic in the midst of teaching in a midwifery training school. Teaching Midwifery in COVID-19 Pandemic and Post Pandemic periods impacted on the way student midwives were taught. Contextual issues are highlighted during the COVID-19 Pandemic in the Midwifery Education profession. But more speciacally, the impact of Covid-19 on midwifery education basically around the way students were taught, classroom spacing rearrangement and institutionalizing national protocols and guidelines on prevention of COVID-19 spread among staff and students.

Evaluation des connaissances théoriques des étudiants en médecine sur les gestes de premiers secours en République Démocratique du Congo / Theoretical knowledge assessment of medical students on first aid in the Democratic Republic of Congo

Introduction: La République Démocratique du Congo fait régulièrement face à plusieurs urgences sanitaires. La présence des médecins en première ligne dans la riposte y est un phénomène spontané. Des lacunes ont été identifiées dans la connaissance des premiers secours au sein de la population; d'où la nécessité de formation. Les étudiants en médecine y joueraient un rôle crucial. Cette étude évalue les connaissances théoriques en premiers secours chez ceux-ci. Méthodologie: Notre étude est de type descriptif et transversal. Elle a été conduite du 01 Juin au 30 Août 2021 à la Faculté de médecine de l'Université Catholique du Graben. Notre échantillon était constitué de 279 étudiants. La collecte des données a été faite par un questionnaire d'enquête couvrant divers aspects des premiers secours. Les données ont été traitées par le logiciel Epi Info version 3.4.5. Résultats: Aucun participant n'a démontré un niveau satisfaisant de connaissances théoriques en premiers secours tandis que 38,7% et 61,3 % ont démontré un niveau intermédiaire et bas respectivement. Une corrélation positive a été notée entre la promotion d'étude, une formation antérieure en premiers secours et le niveau de connaissance. Le média est la principale source d'information. Près de la moitié des étudiants ont affirmé n'avoir jamais posé un geste de premier secours à cause du manque de connaissance (47,7%). La quasi-totalité a montré une attitude positive en rapport avec l'introduction d'une formation en premiers secours en milieu universitaire. Conclusion: Cette étude a démontré un faible niveau de connaissances des gestes de premiers secours parmi les étudiants en médicine, mais une volonté d'apprendre. Il y a nécessité d'intégrer la formation en gestes de premiers secours dans tous les curriculums de l'enseignement en RDC

Introduction: The Democratic Republic of Congo regularly faces several health emergencies. The presence of medical doctors in the first line of the response is a spontaneous phenomenon. Gaps in first aid knowledge have been identified in the population; hence the need for training. Medical students could play a crucial role in this context. This study assesses the theoretical knowledge of first aid among them. Methods: Our study is descriptive and transversal. It was conducted from June 01 to August 30, 2021 in the Faculty of Medicine of the Catholic University of Graben. Our sample consisted of 279 students. Data collection was done through a survey questionnaire covering various aspects of first aid. Data were processed using Epi Info software. The chi-square test was used to estimate the association of variables with knowledge and a p-value. Results: No participant demonstrated a satisfactory level of theoretical knowledge of first aid while 38.7% and 61.3% demonstrated an intermediate and low level respectively. A positive association was noted between the study level, a previous training in first aid and the level of knowledge. The media is the main source of information. Nearly half of the students said they had never taken a rescue action because of lack of knowledge (47.7%). The vast majority (98%) had a positive attitude regarding the introduction of first aid in school's curriculum. Conclusion: Our study showed a poor level of first aid knowledge among medical students, but a great willingness to learn. There is a great need to incorporate first aid trainings in all training curricula in the DRC.

The impact of the responsibility of teachers regarding reproductive healthcare to teenage learners

The Life Orientation subject at school is meant to equip learners with important life skills and prepare them to be responsible adults that will contribute positively to the economy of the country. One of such skills is to avoid pregnancy while being a learner and therefore needs information about sex and sexuality. The school curriculum should thus include the subject Reproductive Health Care and the teachers be allowed the responsibility to teach the subject. Teenage girls who become pregnant as learners are in many times compelled to drop out of school to raise the child as it becomes challenging to cope with studies and looking after the baby. The study used a qualitative exploratory research design aimed to determine the impact of the responsibility of teachers regarding reproductive healthcare to teenage learners. The objectives were to, explore the knowledge of school teachers with regard to reproductive healthcare. To explore and describe the views of the teachers with regard to their responsibility to teach the reproductive healthcare topic to teenage girls. Lastly, to develop guidelines for schools to assist teachers regarding their responsibility to teach the reproductive healthcare topic to teenage girls. The article will report on the first two objectives only. Indepth focus group interviews were conducted with twenty willing participants and a narrative questionnaire was completed. The data analysis method used was the spiral method which follows the process of coding and categorising transcribed data. The processallows data to be organised and setting it for several times so as to get a sense of the whole. identifying general categories and themes of the data is the next step followed by integrating and summarising the data to get a response to the research question. Data analysis results were teachers who felt burdened with the responsibility. Some had a positive opinion of the subject as part of the school curriculum and thus the need for stakeholder collaboration for their assistance. In conclusion, teachers are in need of empowerment for the responsibility to teach reproductive healthcare. (Afr J Reprod Health 2022; 26[4]: 82-91).

Mastering Your Fellowship: Part 4, 2022

The 'Mastering Your Fellowship' series provides examples of the question format encountered in the written and clinical examinations, Part A of the Fellowship of the College of Family Physicians of South Africa examination. The series is aimed at helping family medicine registrars prepare for this examination.

Radiology residents' perception of working and training from home during covid-19 pandemic

Introduction: The spread of coronavirus disease 2019 (COVID-19) pandemic disrupted the personal and profes-sional lives of many throughout the world. To mitigate the spread of the virus, Addis Ababa University introduced an online teaching/learning method which minimized the physical engagement of faculty members and residents. Online teaching is a major shift in the history of the country's oldest and largest university. Objectives: This study aimed to investigate how trainees managed to cope up with the sudden changes in the teach-ing/learning system, and assess the ensuing satisfaction with the new method of teaching/learning. Methods: Descriptive research design was implemented and analysis of variance (ANOVA) and T-tests were used to test hypotheses. Analysis of data collected from 58 radiology residents found that, the residents appreciated the participatory nature of the newly introduced online learning method. Results: The results showed that residents have accepted the new teaching/learning method and are satisfied with it. Furthermore, tests of hypotheses revealed that there is no significant difference in level of satisfaction between female and male residents as well as throughout the three years of radiology residency training. Conclusion: The new method of teaching/learning has a positive acceptance among trainees and there was high level of satisfaction with the new method. Poor internet network, reduced in-person mentoring, failure to make engaging discussions due to large number of participants were the common challenges to online teaching in the setting.

Students' prior knowledge and skills in computer and internet use: An exploration of incoming first year undergraduate health sciences students at Gulu University, Uganda

Internet has provided infrastructure that enables access to a variety of information resources for use by medical students at Gulu University in Northern Uganda. However, little attention has been put to explore prior internet knowledge of undergraduate medical students in Uganda. Cross-sectional research design was used. Fifty-six first year undergraduate health sciences students participated in the study. Self-administered structured questionnaire was used for data collection and analysis was done using SPSS version 16. Results shows that a majority of the participants had prior knowledge of computer 48 (86.0%) and internet 44 (79.0%). 38 (68.0%) participants had access to internet and 34 (61.0%) owned computer before joining the University. Majority owned mobile phones 41 (73.0%) and used it for internet access 43 (84.0%). Use of internet was high in social media 46 (86.8) and searching general information 44 (84.6%). Participants expected easy access to teaching materials 52 (94.5%) and communication 49 (90.7%) via internet. These findings suggest need for healthcare librarians to train incoming medical students on use of ICTs; including social media platforms and mobile phones to improve their ICT literacy skills to enable them access the best academic information resources to enhance medical education.

The influence of language of instruction in the facilitation of academic activities: Nurse educators' experiences

Background: Learners in most South African higher education institutions are taught mainly through English for most of their academic lives, yet many of them enter these institutions with poor proficiency in this language of instruction (LOI). Aims: The purpose of this article was to describe the experiences of nurse educators teaching in a 4-year comprehensive nursing diploma programme regarding the use of English as the LOI during academic activities. Setting: The nursing college under study offers a 4-year comprehensive nursing diploma programme as well as post-basic diploma qualifications such as Primary Health and Midwifery Nursing Science and is situated in Gauteng, South Africa. Methods: Twenty nurse educators were purposively sampled for in-depth individual interviews until data saturation and were requested to participate in the study. Tesch's protocol of qualitative data analysis was used and the themes that emerged were confirmed by an independent coder. Trustworthiness was ensured, and ethical considerations were adhered to. Results: It emerged that English language incompetence (1) undermines learners' self-esteem; (2) hinders critical, reflective and creative thinking; (3) renders understanding difficult and that (4) nurse educators' incompetence in LOI hinders meaningful teaching. Conclusions: Recommendations were made to improve the use of the LOI because through language interdisciplinary knowledge and understanding are integrated, thus ultimately providing patients with comprehensive, holistic and transcultural healthcare

Medication Adherence among Outpatients at the Jos University Teaching Hospital

Background: For every 100 prescriptions written; 25 to 30 are taken properly. Non adherence to medication is a reality to be addressed by detecting the barriers in order to make interventions aimed at improving medication adherence among patients. The aim of this study is to assess the level of medication non adherence among outpatients at the Jos University Teaching Hospital in Nigeria and to identify the factors and barriers to medication adherence among the patients; alongside educating and counseling the patients in an effort to promote adherence. Methods: A cross-sectional prospective study was carried out for 2 months from June 2013 to July 2013 at 6 outpatient departments of the Jos University Teaching Hospital in Plateau State; Northern Nigeria. Patients visiting the departments were involved in the study after taking their consent and completing a structured questionnaire. Statistical analysis was done using Microsoft Excel and Statistical Package for Social Sciences (SPSS) version 17.Results: Out of 324 patients; 72 (22%) were non adherent to medication. The common cause of non-adherent behavior was forgetfulness (32%). Chi square test was conducted for categorical variables and adherence to medication was positively associated with psychiatry clinic recruits; male gender; higher educational level; absence of health insurance; fewer comorbidities; longer duration of condition and therapy; asking questions and satisfactory knowledge of medicines (p 0.05). The result showed that 40% (25) of the 62 non adherent patients that needed interventions were educated and counseled on the need to link frequency of administration with routine activities so as to promote adherence.Conclusion: This study reiterates the need for a systematic assessment of adherence to medication among patients alongside proffering adequate interventions to promote adherence to medication

Antiretrovirals and Co-Prescribed Drugs for People Living with HIV/AIDS (PLWHA) in a University Teaching Hospital; South West Nigeria

Background: Lifelong usage of antiretroviral drugs (ARVs) put them among the most therapeutically risky drugs for clinically significant drug interactions (CSDIs). It is; therefore; essential to document the types of antiretroviral (ARV) and non-ARV drugs co-prescribed (CPD) for PLWHA in order to facilitate the assessment of clinical significance of their interactions. Objectives: To document the most commonly prescribed ARV drugs and CPD among PLWHA and to assess the frequency of prescriptions of the first; second and third lines ART regimen. Methods: All the prescriptions received between January 2009 and June 2014 totaling 22;458 from 500 patients registered in APIN clinic in 2009; were reviewed with a view to documenting the most and the least prescribed CPD and ARV drugs. Results: Zidovudine/lamivudine/nevirapine (AZT/3TC/NVP) (4996/9302; 53.71%) was the most commonly prescribed ART regimen followed by tenofovir/emtricitabine/efavirenz (TDF/FTC/EFV) (1468/9302; 15.78%)and zidovudine/lamivudine/efavirenz (AZT/3TC/EFV) (683/9302; 7.34%). Abacavir/lamivudine/saquinavir/ritonavir (ABC/3TC (SQV/RTV) (1/9302; 0.01%) was the least prescribed ART regimen. The first line ART regimens (8574/9302; 92.17%) were mostly prescribed; followed by the second line (698/9302; 9.5%). Cotrimoxazole (7546/9302; 81.12%) was the most common non-ARV drug co-prescribed with ART regimen; followed by multivitamin (433/9302; 4.65%) and rifampin (316/9302; 3.40%). Conclusion: Co-trimoxazole was the most commonly co-prescribed non-ARV drug. Zidovudine/ lamivudine/nevirapine was the most commonly prescribed ART regimen. Considering the wide range of non- ARV drugs co-prescribed with ART regimens in this study; evaluation of their potential interactions is hereby suggested

Exploring the relationship between demographic factors; performance and fortitude in a group of diverse 1st-year medical students

Background. The majority of 1st-year students are ill-equipped for university life. This heightens stress levels; which are accentuated by a lack of resilience and impact negatively on academic performance and personal wellbeing.Objectives. To explore; within the paradigm of positive psychology; the relationship between the self; family and support constructs of fortitude; and academic performance of 1st-year medical students.Method. First-year medical students completed a fortitude questionnaire and their academic performances in two academic modules were collated. Mann-Whitney and Kruskal-Wallis tests were employed for statistical analysis of the variables. Pearson correlation coefficients were calculated to assess the relationship between academic performance and fortitude subscales; as well as the fortitude composite score.Results. The student population was multicultural; multilingual and had different educational and residential backgrounds. The fortitude instrument was found to be reliable and correlated significantly with student academic performance. Male students had significantly higher fortitude scores than female students. Students who had attended state/government schools had significantly lower fortitude than those who had attended private and ex-Model C schools. Students with prior degrees had higher fortitude than matriculants.Conclusion. The significant; albeit moderate; positive correlation between fortitude and academic performance highlights the need for further exploration of wellbeing and holistic development of medical students. Support programmes are recommended to bridge the gap related to gender and educational background. Low and fair levels of fortitude indicate a need for corrective measures. These could include consulting relevant support networks such as student counsellors; mentors and academic development personnel

Motivated strategies for learning and their association with academic performance of a diverse group of 1st-year medical students

Background. Most instruments; including the well-known Motivated Strategies for Learning Questionnaire (MSLQ); have been designed in western homogeneous settings. Use of the MSLQ in health professions education is limited. Objective. To assess the MSLQ and its association with the academic performance of a heterogeneous group of 1st-year medical students.Methods. Eighty-three percent of 1st-year medical students consented to participate in this quantitative study. The MSLQ consisted of a motivation strategies component with six subscales; while the learning strategies component had nine subscales. Demographic and academic achievement information of the students was also collected. Stata version 13 (StataCorp LP; USA) was used for the statistical analyses of all data.Results. Female students displayed significantly higher motivational scores. Students with prior educational experience and those who attended peer-mentoring sessions had significantly higher learning strategy scores. Significant but moderate relationships were found between academic performance and the motivation strategies subsumed within the categories 'task value' and 'self-efficacy for learning performance'. In terms of the 'learning strategy component'; 'critical thinking'; and 'time and study environment'; the composite score was significantly but poorly correlated to academic performance. Conclusion. Overall; limited correlations were found between the MSLQ scores and academic performance. Further investigation of the use of the MSLQ and its association with academic achievement is recommended; with greater focus on specific learning events than on course outcomes. This study highlights the importance of evaluating an instrument in a specific context before accepting the findings of others with regard to the use of the instrument and its correlation with academic performance

Medical students' views on the use of video technology in the teaching of isizulu communication; language skills and cultural competence

The role of communicator has been included as a key competency for health science students in South Africa. Owing to the population's diverse language and cultural backgrounds; communication between patients and healthcare professionals is challenging. In this study; the Attention; generation; Emotion and Spacing (AGES) neurocognitive model of learning was used as a framework to create videos for language teaching for the vocational needs of students. Objectives. To explore students' views on the use of videos of simulated clinical scenarios for isiZulu communication and language teaching and the development of cultural awareness. Methods. Videos were developed using first- and second-language isiZulu speakers with scripts (verified by the university's Language Board) based on authentic clinical settings. Videos were shown to a target group of students; who were then interviewed in focus group discussions. Audio recordings from the discussions were transcribed and analysed thematically in three categories; i.e. communication; language skills; and cultural awareness; using deductive coding based on the objectives of the research. Results. Students affirmed numerous benefits of the videos and commented on their use and further development. Benefits described related well to the AGES model of learning and fulfilled the learning requirements of communication teaching; language acquisition and cultural awareness. Conclusion. The videos represent an innovative teaching method for the resource-constrained environment in which we work and are relevant to the 21st century learner. Further evaluation and development of the tool using different scenarios and African languages is recommended

Perceptions of undergraduate dental students at maker ere college of health sciences; Kampala; Uganda towards patient record keeping

Background. The creating; maintenance and storage of patients' medical records is an important competence for the professional training of a dental student. Objective. Owing to the unsatisfactory state of dental records at the students' clinic; the objective of this study was to obtain information from undergraduate dental students on the factors that affect this process and elicit recommendations for improvement. Methods. This qualitative cross-sectional study used focus group discussions with 4th- and 5th-year dental students for data collection. Data were captured through a written transcript and an audio recorder. The data were transcribed and analysed manually through developing themes; which were compared with the literature and interpreted. Results. Three themes emerged: (i) Poorly designed clerking forms. The clerking forms were deemed to have a poor design with inadequate space for clinical notes. It was recommended that they be redesigned. (ii) Inadequate storage space. Space for storing patient records was deemed inadequate and a referencing system for file retrieval was lacking. It was recommended that more space be allocated for storage; with a referencing system for easy file retrieval. (iii) Poor maintenance of records. Patients' records; especially radiographs; were not well labelled and stored. It was recommended that drug envelopes be utilised to store radiographs. An electronic system was deemed the ultimate solution to this problem. Conclusion. The general perception was that the current paper-based record system at the clinic was unsatisfactory. Therefore; there is a need to improve the maintenance and storage of records; and to change to a more efficient electronic system. The students' attitude towards record keeping was found to be questionable; with a need to be addressed as part of teaching and learning in the curriculum. Lecturers were deemed to have a bigger role to play in the record-keeping process

An exploration into the awareness and perceptions of medical students of the psychosociocultural factors which influence the consultation: implications for teaching and learning of health professionals

Background. South African society is undergoing rapid changes; and includes people from different cultures; beliefs and social backgrounds. Research suggests that these contextual influences have an important bearing on how patients present and relate to healthcare providers. Medical students; too; have a life-world based on their own backgrounds and cultures; and may find relating to a patient with a different life-world challenging. Objectives. To explore students' awareness and perceptions of how psychosociocultural factors in a multicultural society influence the consultation; and to suggest adaptations for teaching. Methods. Focus group discussions were conducted with final-year medical students in the Family Medicine rotation. Some of the students had viewed a video of a consultation with an isiZulu-speaking patient; and completed a self-reflection learning task. Audio recordings were transcribed and analysed thematically. Results. Exposure to patients in the clinical years had made students aware of the challenges of cultural diversity; although they felt under-prepared to deal with this. Students alluded to the influences of their own cultures; of cultural similarities as well as differences; the roles and behaviours of doctors and patients in cross-cultural consultations; the potential knowledge and experience gap that exists across cultures; and an awareness of the need for patient-centredness. Conclusion. Students should be assisted to improve their cultural competence. Recommendations are made for using various methods; including critical incidents and visual learning to provide opportunities for reflexive practice and transformative learning. Educators must be equipped to address learning objectives relating to cultural competence

The forensic autopsy as a teaching tool: attitudes and perceptions of undergraduate medical students at the University of Pretoria, South Africa

Background. Numerous articles have been published on the use of autopsies in training medical students in anatomy and different branches of pathology. Some authors have described the emotional response of students who attend such postmortem sessions. Forensic pathology is an important subdivision of pathology. In some countries undergraduate medical students are expected to attend postmortem examinations on persons who died from traumatic causes. Objective. To determine the attitudes and perceptions of 5th-year medical students with regard to forensic postmortem examinations at the University of Pretoria; South Africa. Methods. A questionnaire was voluntarily completed by medical students on the last day of the practical rotation.Results. The overall rating of the practical rotation was 82%. The strengths; weaknesses; opportunities and threats (SWOT) analysis indicated the following as strengths: record keeping; legislation review and traumatology description; as weaknesses: emotional trauma and nightmares; as opportunities: the attendance of autopsies; and as threats: physical dangers. Conclusion. The current study was similar to international studies with regard to students' emotional response to attending autopsies. The autopsy remains a valuable teaching tool for undergraduate students. Emotional support is currently available for all students to assist them in overcoming their fear of attending forensic autopsy sessions

Client Confidentiality: Perspectives of Students in a Healthcare Training Programme

Background. Confidentiality is an important ethical principle for all health professionals and also has a legal bearing on duty. One of the most difficult issues health professionals face in their daily fieldwork practice is a conflict between their professional duties; as illustrated in keeping a patient's medical information confidential; and having empathy with a family member's need to know. This moral dilemma is difficult for students to circumvent and therefore this paper presents healthcare students' perspectives of confidentiality.Methods. We aimed to explore healthcare students' views and experiences of confidentiality as an ethical principle by adopting a qualitative explorative approach. Purposeful sampling was undertaken where specific individuals with specific experiences were identified. Data were collected by means of written responses from two open-ended questions and analysed thematically. Two themes emerged.Conclusion. Confidentiality; as with other ethical principles; is an important obligation of a good client-therapist relationship as identified by students. However; the students' responses illustrate that it cannot be absolute; and cognisance must be taken as to when it is acceptable; and even desirable; to override confidentiality because of conflicting; greater duties

A Review of Chronic Lung Disease in Neonates at Charlotte Maxeke Johannesburg Academic Hospital from 1 January 2013 to 31 December 2014

Background. Chronic lung disease (CLD) remains a significant morbidity in preterm babies despite advances in neonatal care. The use of postnatal corticosteroids (PNCSs) to treat CLD remains controversial.Objectives. To describe the clinical characteristics of babies with CLD at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) and to explore the use of PNCSs for the prevention and treatment of CLD.Methods. This was a 2-year retrospective review of neonates admitted to CMJAH. Neonates who were in hospital for =28 days were included. Comparisons were made between neonates with evolving CLD and those with no CLD.Results. A total of 485 neonates were analysed: 237 had evolving CLD and 245 did not have CLD. Overall incidence of evolving CLD was 5%. More neonates with CLD than those without CLD needed resuscitation at birth (48.5% v. 39.8%; p=0.02) and had low 5-minute Apgar scores (17.2% v. 10.6%; p=0.001). Neonates with CLD had increased prevalence of patent ductus arteriosus (30.4% v. 7.7%; p=0.001) and late-onset sepsis (56.5% v. 23.6%; p=0.001). The mortality rate was also higher in CLD babies (10.2 v. 2.4%; p=0.001). Necrotising enterocolitis (NEC) (29.2% v. 8%; p=0.005) and sepsis (83.3% v. 53.8%; p=0.008) were associated with increased mortality. The use of PNCSs was associated with less NEC (3.5% v. 17.2%; p=0.001) and improved survival (95.6% v. 81.7%; p=0.001).Conclusions. CLD remains a common morbidity in neonates despite advances in neonatal care. The use of PNCSs was shown to have short-term benefits. To get the most out of PNCS use for CLD; further studies need to be conducted to determine the safest type of steroid; safe doses and the duration of treatment

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