ABSTRACT
E-learning has gained popularity in Uganda. Midwifery institutions have invested in it to manage the increasing demand for education. However, its adoption is low, which is likely to hinder the enhancement of numbers, competencies, and skill mix of midwives. The study intended to ascertain if technology leadership practices were significant to e-learning adoption and sketch core practices. Ten midwifery institutions and 167 end users participated in the study. Two phases of data collection and analysis were executed. Technology leadership practices had substantial effect on adoption of e-learning (n = 167, r = 0.691, & p = 0.000), and was responsible for 47.5% of the change. Core technology leadership practices were; commitment to provide e-learning facilities; encouragement of learners to use e-learning facilities; appreciating those who excel at using e-learning facilities; grooming of e-learning champions; supportive environment for technological use; and institutionalising technological use in school activities. Midwifery institutions can focus on technology leadership core practices to improve e-learning adoption.
ABSTRACT
Objective To analyze the service demand and capacity for preventing mother-to-child transmission(MTCT) of acquired immune deficiency syndrome in Guangdong, as well as to find the weakness in the work. Methods The relevant data of service demands and intervention capacity of human acquired immunodeficiency virus(HIV)-infected maternal and their babies from 2014 to 2017 was collected, and SPSS 21.0 software was employed to analyze the differences among the pearl river delta area, western area, mountainous area and eastern area, and to explore the correlation between regional midwifery institutions or personnel numbers and the rate of HIV MTCT. Results The education of HIV-infected maternal wasn’t high, generally, mainly in middle school (54.49%). The service demand of HIV-infected maternal was different in each area. The ethnic minorities outside the pearl river delta region (12.96%) and non-local living maternal in mountainous area (43.75%) were high. The proportion of maternal in the eastern area who didn’t know the route of HIV infection was also high (77.78%). The service capacity varies in each area, and the proportion (mountainous area: 41.67%, eastern area: 44.44%) of the confirmation time in intrapartum /postpartum was high among those from the mountains and eastern areas, which lead to poor intervention (the proportions of starting to antiretroviral treatment time later than 36 weeks or untreated in mountainous and eastern areas were 43.75% and 55.56%, respectively), as well as a high proportion of untreated maternal and exposed-infant (mountainous area: 2.08%, eastern area: 33.33%), and a higher percentage (11.11%) of breastfeeding in eastern area. There was no significant correlation between the number of midwifery institutions or healthcare personnel and the rate of HIV MTCT in different regions. Conclusions The mountainous and eastern areas are the weak of HIV MTCT in Guangdong Province, and later detection, less-standard intervention, and lower quality of information management are the weak steps in those areas. Targeted measures should be urgently developed to strengthen the training of the key areas to eliminate the regional differences of service capacity, which is essential to achieve the elimination of HIV MTCT in Guangdong.
ABSTRACT
Objective To learn the current obstetric beds allocation,obstetric service delivery and access in midwifery institutions at various levels in the localities and nationwide as well as the trends,and assess the equity of obstetric beds allocation,for the purpose of recommending on a reasonable adjustment of obstetric beds allocation in these institutions.Methods Random sampling made in 44 cities in China for questionnaire survey on obstetric beds allocation,service delivery and utilization in 2008～2010 at all midwifery institutions in these cities.Interview of health administrators and medical workers at obstetric of midwifery institutions in 6 counties.Results Every thousand square kilometers in China average 5.9 midwifery institutions,and every thousand people average 0.24 obstetric beds.During 2008 ～ 2010,the number of beds and midwifery service delivery kept a growing trend while in townships obstetric service deliveries maintain a falling trend.The fairness index of maternity beds layout nationwide is 0.021283.Obstetric beds supply and demand ratio in different regions ranges among 0.97～ 1.41.The number of deliveries made in county level hospitals is 54.1％,but the beds in such hospitals account for but 48.1％.Conclusion The equity of obstetric beds allocation is good in terms of population layout.The quantity of obstetric beds meets the current needs nationwide,while the allocation of obstetric beds is less than reasonable among obstetric institutions of various levels in the country.The authors recommend a better control and adjustment of midwifery institutions layout,especially more such hospitals at the township level to meet the need of women delivery in hospital in remote areas.
