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1.
Front Health Serv ; 2: 792909, 2022.
Article in English | MEDLINE | ID: mdl-36925824

ABSTRACT

Introduction: There is increasing evidence suggesting that clinical mentorship (CM) involving on-the-job training is one of the critical resources-friendly entry points for strengthening the knowledge and skills of healthcare providers (HCPs), which in turn facilitate the delivery of effective reproductive, maternal, and newborn health (RMNH) care. The article explores the experiences of HCPs following participation in the CM program for RMNH in eight districts of Mwanza Region in Tanzania. Materials and Methods: A qualitative descriptive design employing data from midterm project review meetings and Key Informant Interviews (KIIs) with purposefully selected HCPs (mentors and mentees) and District Medical Officers (DMOs) during endline evaluation were employed. Interview data were managed using Nvivo Software and analyzed thematically. Results: A total of 42 clinical mentors and master mentors responded to a questionnaire during the midterm review meeting. Then, a total of 17 KIIs were conducted with Mentees (8), Mentors (5), and DMOs (4) during endline evaluation. Five key themes emerged from participants' accounts: (i) the topics covered during CM visits; (ii) the benefits of CM; (iii) the challenges of CM; (iv) the drivers of CM sustainability; and (iv) suggestions for CM improvement. The topics of CM covered during visits included antenatal care, neonatal resuscitation, pregnancy monitoring, management of delivery complications, and infection control and prevention. The benefits of CM included increased knowledge, skills, confidence, and change in HCP's attitude and increased client service uptake, quality, and efficiency. The challenges of CM included inadequate equipment for learning and practice, the limited financial incentive to mentees, shortage of staff and time constraints, and weaker support from management. The drivers of CM sustainability included the willingness of mentees to continue with clinical practice, ongoing peer-to-peer mentorship, and integration of the mentorship program into district health plans. Finally, the suggestions for CM improvement included refresher training for mentors, engagement of more senior mentors, and extending mentorship beyond IMPACT catchment facilities. Conclusion: CM program appears to be a promising entry point to improving competence among HCPs and the quality and efficiency of RMNH services potentially contributing to the reduction of maternal and neonatal deaths. Addressing the challenges cited by participants, particularly the equipment for peer learning and practice, may increase the success of the CM program.

2.
BMC Health Serv Res ; 21(1): 735, 2021 Jul 24.
Article in English | MEDLINE | ID: mdl-34303368

ABSTRACT

BACKGROUND: Continuous professional development (CPD) has been reported to enhance healthcare workers' knowledge and skills, improve retention and recruitment, improve the quality of patient care, and reduce patient mortality. Therefore, validated training needs assessment tools are important to facilitate the design of effective CPD programs. METHODS: A cross-sectional survey was conducted using self-administered questionnaires. Participants were healthcare workers in reproductive, maternal, and neonatal health (RMNH) from seven hospitals, 12 health centers, and 17 dispensaries in eight districts of Mwanza Region, Tanzania. The training needs analysis (TNA) tool that was used for data collection was adapted and translated into Kiswahili from English version of the Hennessy-Hicks' Training Need Analysis Questionnaire (TNAQ). RESULTS: In total, 153 healthcare workers participated in this study. Most participants were female 83 % (n = 127), and 76 % (n = 115) were nurses. The average age was 39 years, and the mean duration working in RMNH was 7.9 years. The reliability of the adapted TNAQ was 0.954. Assessment of construct validity indicated that the comparative fit index was equal to 1. CONCLUSIONS: The adapted TNAQ appears to be reliable and valid for identifying professional training needs among healthcare workers in RMNH settings in Mwanza Region, Tanzania. Further studies with larger sample sizes are needed to test the use of the TNAQ in broader healthcare systems and settings.


Subject(s)
Health Personnel , Infant Health , Adult , Cross-Sectional Studies , Female , Humans , Infant, Newborn , Reproducibility of Results , Surveys and Questionnaires , Tanzania/epidemiology
3.
BMC Pregnancy Childbirth ; 20(1): 636, 2020 Oct 19.
Article in English | MEDLINE | ID: mdl-33076869

ABSTRACT

BACKGROUND: Delayed health-seeking continues to contribute to preventable maternal and neonatal deaths in low resource countries. Some of the strategies to avoid the delay include early preparation for the birth and detection of danger signs. We aimed to assess the level of practice and factors associated with birth preparedness and complication readiness (BPCR) in Kenya and Tanzania. METHODS: We conducted community-based multi-stage cross-sectional surveys in Kilifi and Kisii counties in Kenya and Mwanza region in Tanzania and included women who delivered two years preceding the survey (2016-2017). A woman who mentioned at least three out of five BPCR components was considered well-prepared. Bivariate and multivariable proportional odds model were used to determine the factors associated with the BPCR. The STROBE guidelines for cross-sectional studies informed the design and reporting of this study. RESULTS: Only 11.4% (59/519) and 7.6% (31/409) of women were well-prepared for birth and its complications in Kenya and Tanzania, respectively, while 39.7 and 30.6% were unprepared, respectively. Level of education (primary: adjusted odds ratio (aOR): 1.59, 95% CI: 1.14-2.20, secondary: aOR: 2.24, 95% CI: 1.39-3.59), delivery within health facility (aOR: 1.63, 95% CI: 1.15-2.29), good knowledge of danger signs during pregnancy (aOR: 1.28, 95% CI: 0.80-2.04), labour and childbirth (aOR: 1.57, 95% CI: 0.93-2.67), postpartum (aOR: 2.69, 95% CI: 1.24-5.79), and antenatal care were associated with BPCR (aOR: 1.42, 95% CI: 1.13-1.78). CONCLUSION: Overall, most pregnant women were not prepared for birth and its complications in Kilifi, Kisii and Mwanza region. Improving level of education, creating awareness on danger signs during preconception, pregnancy, childbirth, and postpartum period, and encouraging antenatal care and skilled birth care among women and their male partners/families are recommended strategies to promote BPCR practices and contribute to improved pregnancy outcomes in women and newborns.


Subject(s)
Health Knowledge, Attitudes, Practice , Mothers/statistics & numerical data , Obstetric Labor Complications/prevention & control , Parturition/psychology , Prenatal Care/statistics & numerical data , Adolescent , Adult , Age Factors , Community-Based Participatory Research , Cross-Sectional Studies , Educational Status , Female , Humans , Kenya/epidemiology , Maternal Age , Maternal Mortality , Middle Aged , Mothers/psychology , Obstetric Labor Complications/epidemiology , Obstetric Labor Complications/psychology , Patient Acceptance of Health Care/psychology , Patient Acceptance of Health Care/statistics & numerical data , Pregnancy , Prenatal Care/psychology , Surveys and Questionnaires/statistics & numerical data , Tanzania/epidemiology , Young Adult
4.
BMC Pregnancy Childbirth ; 19(1): 474, 2019 Dec 05.
Article in English | MEDLINE | ID: mdl-31805887

ABSTRACT

BACKGROUND: Improving maternal health by reducing maternal mortality/morbidity relates to Goal 3 of the Sustainable Development Goals. Achieving this goal is supported by antenatal care (ANC), health facility delivery, and postpartum care. This study aimed to understand levels of use and correlates of uptake of maternal healthcare services among women of reproductive age (15-49 years) in Mwanza Region, Tanzania. METHODS: A cross-sectional multi-stage sampling household survey was conducted to obtain data from 1476 households in six districts of Mwanza Region. Data for the 409 women who delivered in the 2 years before the survey were analyzed for three outcomes: four or more ANC visits (ANC4+), health facility delivery, and postpartum visits. Factors associated with the three outcomes were determined using generalized estimating equations to account for clustering at the district level while adjusting for all variables. RESULTS: Of the 409 eligible women, 58.2% attended ANC4+, 76.8% delivered in a health facility, and 43.5% attended a postpartum clinic. Women from peri-urban, island, and rural regions were less likely to have completed ANC4+ or health facility delivery compared with urban women. Education and early first antenatal visit were associated with ANC4+ and health facility delivery. Mothers from peri-urban areas and those who with health facility delivery were more likely to attend postpartum check-ups. CONCLUSION: Use of ANC services in early pregnancy influences the number of ANC visits, leading to higher uptake of ANC4+ and health facility delivery. Postpartum check-ups for mothers and newborns are associated with health facility delivery. Encouraging early initiation of ANC visits may increase the uptake of maternal healthcare services.


Subject(s)
Delivery, Obstetric/statistics & numerical data , Maternal Health Services/statistics & numerical data , Postnatal Care/statistics & numerical data , Prenatal Care/statistics & numerical data , Adolescent , Adult , Cross-Sectional Studies , Female , Health Facilities/statistics & numerical data , Humans , Infant, Newborn , Middle Aged , Pregnancy , Prevalence , Rural Population/statistics & numerical data , Socioeconomic Factors , Surveys and Questionnaires , Tanzania/epidemiology , Urban Population/statistics & numerical data , Young Adult
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