ABSTRACT
BACKGROUND: With the recognition of the need for research capacity strengthening for advancing health and development, this research capacity article explores the use of technology enhanced learning in the delivery of a collaborative postgraduate blended Master's degree in Malawi. Two research questions are addressed: (i) Can technology enhanced learning be used to develop health research capacity?, and: (ii) How can learning content be designed that is transferrable across different contexts? METHODS: An explanatory sequential mixed methods design was adopted for the evaluation of technology enhanced learning in the Masters programme. A number of online surveys were administered, student participation in online activities monitored and an independent evaluation of the programme conducted. RESULTS: Remote collaboration and engagement are paramount in the design of a blended learning programme and support was needed for selecting the most appropriate technical tools. Internet access proved problematic despite developing the content around low bandwidth availability and training was required for students and teachers/trainers on the tools used. Varying degrees of engagement with the tools used was recorded, and the support of a learning technologist was needed to navigate through challenges faced. CONCLUSION: Capacity can be built in health research through blended learning programmes. In relation to transferability, the support required institutionally for technology enhanced learning needs to be conceptualised differently from support for face-to-face teaching. Additionally, differences in pedagogical approaches and styles between institutions, as well as existing social norms and values around communication, need to be embedded in the content development if the material is to be used beyond the pilot resource-intensive phase of a project.
Subject(s)
Capacity Building/methods , International Cooperation , Inventions/trends , Learning , Software Design , Humans , Internet , Qualitative Research , Research Support as Topic/methods , Research Support as Topic/standards , Surveys and QuestionnairesABSTRACT
BACKGROUND: Approximately 90% of Malawian women attend antenatal care at least once during their pregnancies; however, most mothers first present during months five and six and do not adhere to the World Health Organization's recommended four visits. The objective of this study was to explore the role the patient-provider relationship has on antenatal care uptake. METHODS: A qualitative study, consisting of interviews with 20 urban pregnant mothers and eight health workers, was conducted from September to December 2014. Two large tertiary care hospitals in the Central and Southern regions of Malawi were selected as study sites. RESULTS: Several factors influenced antenatal care attendance. Significant barriers reported included the patient-provider relationship, clinic wait times, family and friend support, distance from home to the clinic, transportation, cost, and number of visits. The patient-provider relationship appears to have a large impact on antenatal clinic participation. Mothers indicated that health workers often mistreat or demean them during visits. Additionally, health workers revealed that, due to staff shortages, patients often do not receive the care they deserve. CONCLUSIONS: The results of this study suggest that, in addition to other factors, healthcare provider attitudes influence antenatal clinic attendance. Improving the patient-provider relationship may increase antenatal clinic attendance and decrease pregnancy complications during pregnancy. Professional development opportunities and quality improvement programmes are would help improve patient care and health outcomes while the continued staff shortages in the country are addressed.
Subject(s)
Attitude of Health Personnel , Health Knowledge, Attitudes, Practice , Mothers/psychology , Patient Acceptance of Health Care , Prenatal Care/statistics & numerical data , Professional-Patient Relations , Adolescent , Adult , Female , Health Services Accessibility , Humans , Interviews as Topic , Malawi , Middle Aged , Pregnancy , Pregnancy Complications , Qualitative Research , Quality of Health Care , Socioeconomic Factors , Young AdultABSTRACT
Background.Approximately 90% of Malawian women attend antenatal care at least once during their pregnancies; however; most mothers first present during months five and six and do not adhere to the World Health Organization's recommended four visits. The objective of this study was to explore the role the patient-provider relationship has on antenatal care uptake.Methods. A qualitative study; consisting of interviews with 20 urban pregnant mothers and eight health workers; was conducted from September to December 2014. Two large tertiary care hospitals in the Central and Southern regions of Malawi were selected as study sites. Results.Several factors influenced antenatal care attendance. Significant barriers reported included the patient-provider relationship; clinic wait times; family and friend support; distance from home to the clinic; transportation; cost; and number of visits. The patient-provider relationship appears to have a large impact on antenatal clinic participation. Mothers indicated that health workers often mistreat or demean them during visits. Additionally; health workers revealed that; due to staff shortages; patients often do not receive the care they deserve. Conclusions.The results of this study suggest that; in addition to other factors; healthcare provider attitudes influence antenatal clinic attendance. Improving the patient-provider relationship may increase antenatal clinic attendance and decrease complications during pregnancy. Professional development opportunities and quality improvement programmes would help improve patient care and health outcomes while the continued staff shortages in the country are addressed
Subject(s)
Community Health Workers , Prenatal Diagnosis , Referral and ConsultationABSTRACT
In this article I deal with extending the ethical principles of research to include communities through the establishment of Community Advisory Boards (CABs). The aim of the project on which this article is based demonstrates the need for protecting communities that participate in research in order to stimulate ethical conduct in research in Malawi. In the article, I provide an overview on the role and functions of CABs. I discuss the establishment of CABs in Malawi and present descriptions of the processes and challenges involved. I conclude by sharing experiences of some of the key lessons learnt from the establishment of CABs.
