Enhancing nursing student presentation competences using Facilitatory Pecha kucha presentation pedagogy: a quasi-experimental study protocol in Tanzania.

INTRODUCTION: With an increasing number of nursing students in higher education institutions in Tanzania, traditional student presentation pedagogies are insufficient to enhance effective learning. Pecha Kucha presentation is a new promising approach that can improve students' speaking skills, learning process, creativity, and students' engagement in learning. It involves the use of 20 slides where each covers 20 s, thus making a total of 6 min and 40 s. The current study will assess the effect of Pecha Kucha's presentation on presentation knowledge, skills, and learning satisfaction among nursing students in Tanzania. OBJECTIVES: The objectives of this study aimed to determine the baseline and end-line of Pecha Kucha Presentation knowledge, skills, and learning satisfaction among nursing students. METHODS: This study protocol proposes to employ an uncontrolled quasi-experimental study design with a quantitative approach among 230 university nursing students in Dodoma Region using simple and stratified sampling techniques. It proposes to employ the researcher-administered questionnaire to assess study variables that arise as students use the Pecha Kucha presentation format to prepare and present their assignments. The study will involve training of research assistants, pre-assessment of study variables, and training, and demonstration of Pecha Kucha presentations format among study participants. It will also involve assigning topics to study participants, submission and evaluation of the prepared assignments, participants' presentations in the classroom, post-intervention assessment, data analysis, reporting and dissemination of the study findings. CONCLUSION: This study will address and complement the global need to invest in nursing in an attempt to prepare competent nurses who are capable of solving complex health challenges through critical thinking, analysis, collaboration, and effective communication. The study will inform policymakers, health training institutions, and educators about a new engaging, and innovative nursing student presentation approach that enhances students' creativity, critical thinking skills, and meaningful learning. The referred nursing students' presentation approach intends to equip the students with survival and life skills in the 21st century in an attempt to meet the global economy and job opportunities. TRIAL REGISTRATION: It is not applicable as this is not a trial.

Knowledge and Attitude of Healthcare Providers on Managing Pre-Eclampsia and Eclampsia During Antenatal Care in Mwanza Region-Tanzania.

Background: Pre-eclampsia and eclampsia are the second-leading causes of maternal death. Health care providers have a critical role in preventing and managing these conditions. Lack of knowledge among healthcare providers on managing pre-eclampsia and eclampsia has been reported in other parts of Tanzania, but more information is needed in other parts of the country so as to design appropriate targeted interventions. Hence, this study assessed the knowledge and attitude of healthcare providers on the management of pre-eclampsia and eclampsia in the Mwanza region of Tanzania. Method: A facility-based analytical cross-sectional study was conducted from April to May 2022 among 157 health care providers in the Mwanza region. A simple random sampling method was used to select districts and dispensaries, while a census method was used to recruit health care providers. A self-administered questionnaire was used for data collection. A descriptive statistics analysis was used to determine the distribution of background information of healthcare providers. Inferential statistics were used to determine the association between variables by using a chi-square test and logistic regression. A statistically significant variable in the final model was declared with a 95% confidence interval and a p-value of 0.05. Results: The study results showed that only 40 (25%) of healthcare providers had adequate knowledge and 56.69% had positive attitude towards the management of pre-eclampsia and eclampsia. Knowledge was predicted by having more years of working experience (1-5 years) (AOR: 0.12, 95% CI 0.03-0.53, p-value 0.005) and working in a health center (AOR: 4.58, 95% CI 1.14-18.36, p-value 0.023). For attitude, no variable was significantly associated with it. Conclusion: The study showed that the majority of the participants had inadequate knowledge of the management of pre-eclampsia or eclampsia, despite the positive attitude they possessed. This implies that HCP may be struggling to identify the signs and symptoms of the condition in pregnant women, and this could lead to delays in diagnosis despite believing that it is important to early diagnose the condition. To address this issue, it's crucial to invest in continuing medical education and training programs for healthcare providers to update their knowledge.

Perceptions and experiences of diploma nursing students on clinical learning. A descriptive qualitative study in Tanzania.

BACKGROUND: The quality of nursing education depends largely on the experience student receive in the clinical environment. The learning environment is complex with factors that may positively or negatively influence students learning. The current study aimed to explore the experiences and perceptions of diploma nursing students toward their clinical learning in Dodoma-Tanzania. METHODS: A qualitative descriptive study design was employed. The study was conducted in four nursing schools involving 32 nursing students who were purposively selected. Data was collected using focus-group discussions and analyzed using thematic analysis. RESULTS: Three main themes emerged during the discussions: experience on personal and technical support for clinical learning, the importance of the clinical environment in clinical learning, and insufficient clinical educational planning. The majority of students had negative experiences including poor clinical supervision, lack of equipment, congestion of students, and inability to meet clinical objectives. Few students had positive experiences related to exposure to a real clinical environment and great support from staff nurses. CONCLUSION: Students had mixed experiences, both positive and negative on their clinical learning. The majority of students had negative experiences. This may have a serious impact on the student completing their education, the services they will offer to patients when employed, and nursing professional development.

Prevalence of anemia and its associated factors among pregnant women in Ilala Municipality - Tanzania: Analytical cross-sectional study.

Anaemia during pregnancy is still 1 of the leading causes of maternal and neonatal mortality in low and middle-income countries. Initiatives to address this need evidence on trends and their relevant factors, as they vary from 1 area to another. This study determined the prevalence of anemia and its associated factors among pregnant women in Ilala, Tanzania. This community-based, analytical cross-sectional study was conducted in April 2022 involving 367 randomly selected pregnant women. An interviewer-administered questionnaire and a HemoCue analyzer were used for data collection The data was described using descriptive statistics (frequency distributions, percentages, etc) and inferential statistics (Chi-square tests and logistic regression) were used to explore the associations between the study's outcome and its explanatory variables, with a significance level of P < .05. The mean age of participants was 26.2 (standard deviation = 5.2) years, 58.0% had a secondary education level, and 45.2 were prime-para. About half (57.2%) of all participants had low hemoglobin level, among which, 36.2% had moderate anemia. Having a primary education level (adjusted odds ratio [AOR] = 2.3, confidence interval [CI] = 1.1-4.7), having an inter-pregnancy interval of <18 months (AOR = 2.6, CI = 1.2-5.5), being in the third trimester (AOR = 2.4, CI = 1.2-4.7), not taking Intermittent Prophylaxis Treatment (AOR = 3.7, CI = 1.3-10), not taking iron supplement and folic acid (AOR = 3.7, CI = 1.3-10), and having a moderate appetite(AOR = 1.6, CI = 1.0-2.6) were predictors of anemia. Nutritionally related factors were not consuming on a daily basis dairy food (AOR = 3.7, CI = 1.4-9.3), meat/fish (AOR = 6.6, CI = 3-14), dark green and other vegetables (AOR = 6.6, CI = 3.1-14), fruits (AOR = 4.2, CI = 1.4-12) and having a lower dietary diversity score (AOR = 84, CI = 37-188). Approximately half of pregnant women in Ilala municipality were anemic with 1 third of them having moderate anemia. The associated factors varied from nutritional, obstetric, and socio-demographic factors. The targeted interventions should focus on health promotion campaign to sensitize the population on the dangers of anemia in pregnancy and preventive measures that must be adhered to.

Auditing the readiness of healthcare facilities for referral and management of pre-eclampsia cases in Zanzibar- a study protocol.

Hypertensive disorders of pregnancy are reported as the second leading root of maternal morbidity and mortality in Zanzibar. Evidence shows that the majority of pregnant women in Zanzibar are referred late from lower-level healthcare facilities, and majority develop complications of eclampsia. This study's goal is to determine if all public healthcare facilities in Zanzibar are prepared to manage pre-eclampsia cases and if lower-levels public healthcare facilities are ready to refer pre-eclampsia cases. This will be a descriptive cross-sectional study that will involve a total of 54 healthcare facilities and 176 health care providers working in antenatal clinics. All public health care facilities will be stratified into tertiary, secondary, and primary strata. A simple random sampling will be used to select 46 healthcare facilities in the primary stratum while all healthcare facilities within the tertiary and secondary strata will be selected. In each healthcare facility, a physical observation will be performed to assess the availability of equipment and supplies, medications, and lab tests, while a self-administered questionnaire will be used to assess the knowledge level and skills of healthcare providers for the management of pre-eclampsia and eclampsia. Patient's case files in the tertiary and secondary strata will be reviewed to assess the quality of management of pre-eclampsia while the service records of the primary stratum will be assessed for compliance status with referral guidelines. Data will be analyzed using SPSS version 25. Descriptive statistics will be used to describe the frequency distribution of the study variables, and results will be presented in terms of frequency and percentage. The Chi-square test will be used to describe the relationship between variables, and a p-value of < 0.05 will be regarded as a statistically significant difference.

Knowledge and skills of pre-eclampsia management among healthcare providers working in antenatal clinics in Zanzibar.

BACKGROUND: Pre-eclampsia and eclampsia are the leading causes of perinatal morbidity and mortality worldwide. Early detection and treatment of preeclampsia is lifesaving; however, evidence suggests that the majority of women in low and middle income-countries are not routinely screened for high blood pressure during antenatal care, that those with severe and mild pre-eclampsia are not monitored for blood pressure and proteinuria as needed, and the magnesium sulphate is not administered as needed. The purpose of this study was therefore to assess knowledge and skills in pre-eclampsia and eclampsia management and their associated factors among healthcare providers working in antenatal clinics in Zanzibar. METHODS: This was a cross-sectional analytical study conducted in all levels of healthcare facilities in Zanzibar. The study involved 176 healthcare providers (nurses and doctors) who were randomly selected. A self-administered questionnaire was used to collect data and descriptive and inferential statistics were used in the analysis whereby logistic regression models were employed. The Chi-square coefficient, odds ratio, and 95% confidence intervals were reported, and the level of significance was set at p < 0.05. RESULTS: The mean age of healthcare providers was 35.94 (SD ± 7.83) years. The proportion of healthcare providers with adequate knowledge was 49.0%, and 47% had adequate skills. Knowledge level was predicted by working in higher healthcare facility levels (AOR: 3.28, 95% CI: 1.29-8.29), and having attended on-the-job training on pre-eclampsia (AOR: 7.8, 95% CI: 2.74 - 22.75). Skills were predicted by having attended on-job training (AOR: 8.6, 95% CI: 2.45 - 30.16), having working experience of five years or above in antenatal care units (AOR: 27.89, 95% CI: 5.28 - 148.89) and being a medical doctor or assistant medical doctor (AOR: 18.9, 95% CI: 2.1-166). CONCLUSION: Approximately half of Zanzibar's ANC healthcare workers demonstrated inadequate knowledge and skills in preeclampsia care, indicating a critical need for targeted interventions to reduce maternal morbidity and mortality. Knowledge is predicted by attending on-the-job training and working in higher healthcare facility level, while skills is predicted by attending on job training, more years of working experience in antenatal care units and being a medical doctor or assistant medical doctor The study recommends the healthcare facility institutions to provide on-the-job training to for the healthcare providers working in lower healthcare facility levels.

The Influence of Fear During Pregnancy, Labour and Delivery on Birth Outcome Among Post-Delivery Women: A Case Control Study in Zanzibar.

Background: Assessing the influence of fear during pregnancy, labour, and delivery on birth outcomes among women is very important. Normally, women experience happiness during pregnancy, but some may develop fear which may cause maternal and neonatal complications. The aim of this study was to determine the influence of fear during pregnancy, labour and delivery on birth outcome among post-delivery women in Zanzibar. Methodology: This was a matched case-control study involving 204 post-delivery women who were randomly selected from 4 hospitals in Zanzibar. Cases (n=68) were those who experienced a negative birth outcome, whether maternal, fetal, or both. The control group (n=136) had normal birth outcomes. A self-administered questionnaire was used to collect data and was analyzed using SPSS whereby percentages, chi-square test, and odds ratio results were reported. Results: Among cases, 27(39.7%) had high level of fear during pregnancy compared to the control group, 75(40.4%). During labour, 29(42.6%) of cases had high level of fear, and in control, 55(42.4%). And during delivery 35(51.4%) of cases had highest level of fear, while only 47(34.5%) of control had high level of fear. The chi-square test showed only fear during delivery was significantly associated with undesirable birth outcomes. Women who experienced a high level of fear during delivery were 2 times more likely to have undesirable birth outcomes (AOR=1.941, p=.051) after adjusting for other variables. Conclusion: This study established that most women experience high level of fear during pregnancy, labour and delivery. A high level of fear during delivery is associated with having negative birth outcomes, but not during pregnancy and labour. The findings are of clinical importance as they highlight the need to integrate a universal screening intervention into antenatal care services for early management.

Knowledge and practice of umbilical cord care among young mothers of neonates in Tabora region: Analytical cross-sectional study.

Knowledge of cord care influences the choice of cord care practices and has a great impact on neonate health. Poor cord care can lead to infection of the umbilical cord and thus have a bearing on the subsequent growth trajectory of the newborn. A health facility-based analytical cross-sectional study was carried out from January-March 2021 among 315 randomly selected young mothers aged 15 to 25 years with neonates aged between 7 and 28 days. An interviewer-administered structured questionnaire was used to collect data, and a chi-square test and a binary logistic regression model were used during data analysis. The level of significance was set at 5%. More than half of young mothers 196 (62.2%) had adequate knowledge of cord care, although practice of umbilical cord care was exceptionally poor, as only 21% of them had good cord care practice. Predictors of low knowledge were living in rural areas (adjusted odds ratio (AOR) = 2.54, P = .012), having no formal education (AOR = 15.4, P = .038), and delivering at home (AOR = 0.21. P = .001). While the predictors of poor umbilical cord care practices were having no formal education (AOR = 12.15, P = .001), having primary education (AOR = 7.8, P = .003), being a peasant (AOR = 6.6, P = .001), business woman (AOR = 3.6, P = .035), housewife (AOR = 4.2, P = .014) and prime para (AOR = 0.49, P = .004). Living in urban areas, having a higher education level, and having delivered in a health facility were important factors in having knowledge on cord care, while having a higher education level, being employed, and being a multipara were important factors in maintaining cord in a healthy state.

Prevalence and Predictor of Exclusive Breastfeeding among Mothers of 0 to 6 months Infants from Pastoralists and Hunters' Community in Tanzania; A Community Based Cross-Sectional Study.

BACKGROUND: Initiating breastfeeding during the first hour after birth and continuing breastfeeding exclusively for 6 months prevents childhood infections such as diarrhoea. Exclusive breastfeeding (EBF) for the first 6 months of life of the baby is recognised globally as the best and the most effective intervention to ensure the survival of babies. The aim of this study was to determine the prevalence of EBF and its predictors among mothers of 0 to 6 months infants from pastoralists and hunters' community in Manyara region-Tanzania. METHODS: This was a community-based analytical cross-sectional study that involved 342 mothers of 0 to 6 months infants who were randomly selected through 4 stage multistage sampling technique. Data was collected using an interviewer-administered questionnaire. Collected data was analysed using Statistical Package for Social Sciences (SPSS) version 20. Binary Logistic Regression analysis was used to establish factors associated with EBF practices. RESULTS: The prevalence of EBF among postnatal women from hunters and pastoralists societies was 47.1% at 95% CI=41.7%-52.5%. After adjusted for confounders, the predictors of EBF practice were age of infants (0-1 months, AOR = 2.838 at 95% CI = 1.326-6.075, p=.007), age of mothers (26-35 years, AOR=1.851 at 95% CI= 1.059-3.234, p=.031), Level of education of infants' mothers (primary education, AOR= 2.374 at 95% CI= 1.321-4.265, p=.004) and knowledge on exclusive breast feeding, AOR=2.51 at 95% CI= 1.435-4.393, p=.001. CONCLUSION: Majority of mothers from pastoralists' and hunters' societies were not practising EBF. Predictors of EBF practice were; the age of infants, maternal age, level of education of the mother and knowledge on exclusive breastfeeding. Poor EBF practice was mainly contributed to low level of knowledge about the EBF. The low level of knowledge could have been contributed by poor access to maternal services. Nature of living (lack of permanent settlement) of the study population could have contributed to low access to maternal services. An innovative interventional study is highly recommended to come up with strategies that will improve knowledge on EBF and practice of EBF.

Poor level of knowledge on elderly care despite positive attitude among nursing students in Zanzibar Island: findings from a cross-sectional study.

BACKGROUND: It is estimated by the year 2050, 80% of the global elderly population will be from the low-and middle income countries. Elderly care requires health workers with skills associated with an understanding of the biological, psychological, social and cultural theories related to aging. Nurses with better knowledge, skills and positive attitudes towards elderly care are highly needed and critically important for better healthcare and wellbeing of the elderly population. Therefore the objective of this study was to assess the level of knowledge and attitude of nursing students towards elderly care in Zanzibar Island. METHODS: A cross-sectional study was conducted in Zanzibar involving three out of five nursing training institutions. Participants were selected by systematic random sampling. Facts on Aging Quiz 2 and Kogan's Attitudes Toward Old People scale were used to assess the level of knowledge and attitude towards elderly care among the students respectively. Simple and multivariable logistic regressions were applied to determine the predictors of knowledge and attitude among the participants. RESULTS: A total of 393 students participated in this study. Only 17% (69) of the participants had good level of knowledge and about 67.9% (267) had positive attitude towards elderly care. Living in an extended family and with an elderly person at home were both associated with good level of knowledge and positive attitude towards elderly care. Furthermore, living in a rural area (adjusted odds ratio = 2.23; 95% confidence interval: 1.22, 4.10) and studying at public institution (adjusted odds ratio = 2.59; 95% confidence interval: 1.41, 4.63) were associated with positive attitude towards elderly care. CONCLUSION: This study has shown that the majority of nursing students in Zanzibar have positive attitude but poor level of knowledge towards elderly care. The current findings have demonstrated that past experience with an elderly person can help in influencing good knowledge and shaping positive attitudes towards elderly care. Low level of knowledge shown in the study suggests for further research on adequacy of nursing curriculum and/or its implementation.

Sexual and reproductive health communication intervention for caretakers of adolescents: a quasi-experimental study in Unguja- Zanzibar.

BACKGROUND: Caretakers/parents or parents figure need to be trained to promote effective communication about sexual and reproductive health to their adolescents. This study assessed the effect of an intervention aiming to improve caretaker-adolescent communication on sexual and reproductive health matters through improving information, motivation, and behavioral skills related to sexual health communication. The study also evaluated the relationship of information, motivation, and behavioral skills model-constructs with communication practice. Information-Motivation-Behavioural skills model was used as a framework to guide the intervention implementation and evaluation process. METHOD: This is a quasi-experimental non-randomized controlled pre- and post-test study which involved one thousand caretakers of adolescents in all the six districts of Unguja-Zanzibar. All participants completed interviewer-administered structured pre-test questionnaire. The experimental group then received sexual health communication intervention addressing the information, motivation, and behavioral skills related to sexual health communication, while the control group received the sexual health information only. All participants were then reassessed for their information, motivation, behavioral skills and their sexual health communication after 1 month, 6 months and at 1 year following the intervention. To evaluate the effect of intervention at the post-test measures, Univariate Analyses of Covariance was performed whereby the pre-test score and variables on which the groups differed were considered as covariates. Standardized mean difference statistics of Cohen's d was used to calculate the effect size, and the cut-off point for the level of significance was set at two-sided, p-value < 0.05. RESULTS: Results shows that the immediate post-test sexual health communication, motivation and behavioral skills scores were statistically significantly higher in the experimental group compared to control group (p < 0.05). Moreover, sexual health communication score after 6 months and at 1 year were statistically significantly higher in the experimental group compared to control group (p < 0.05). Information construct however did not differ between groups in post-test measures. Furthermore, results revealed that communication practice is statistically significantly associated with information, motivation and behavioural skills in post-test measures. CONCLUSION: The findings provided preliminary evidence for the effectiveness of SRH communication intervention and supported the significance of IMB model-constructs to inform the SRH-communication intervention and to guide the intervention evaluation.

Caretaker-adolescent communication on sexual and reproductive health: a cross-sectional study in Unguja-Tanzania Zanzibar.

BACKGROUND: Caretakers/parents/caregivers/guardians play important roles in improving Sexual and Reproductive Health (SRH) of adolescents. Caretaker-adolescent sexual communication suggested to influence young people's sexual behaviours. Despite this significance, the communication is believed to be low in Unguja due to the increase of risky sexual behaviours among adolescents. This study assessed the pattern of such communication using IMB model as a framework. METHODS: This is a cross-sectional study targeted caretakers of adolescents aged 15-19. One thousand caretakers of adolescents were interviewed using structured questionnaire. Comparison between male and female caretakers on discussing different SRH topics to both sexes of adolescents was made. The mean-score difference of overall communication was examined using Univariate analysis of variance (ANOVA). Bivariate correlation and simple path analysis via regression was conducted to determine the association of IMB variables in relation to communication practice. RESULTS: This study finds 40.7% of caretakers had ever communicated with their adolescents on SRH matters and 9.2% reported to have had communicated in the past 30 days. The weighted topic measure revealed only 26.5% of caretakers communicated with their adolescents. Both caretakers communicated more with their female adolescents. The communication was more common between same sex and between caretakers and their biological adolescents (p < 0.000). Both male and female caretakers mostly discussed sexual abstinence to female adolescents while to male adolescents, HIV/STIs was mostly discussed by female caretakers and pregnancy by male caretakers. The least discussed topics to both sexes are safer sex and other contraceptives use. The bivariate correlations suggested that IMB constructs were inter-related and associated with communication practice. CONCLUSION: Caretakers-adolescents communication on SRH in Unguja is low and it is not comprehensive. Caretakers fail to communicate with their adolescents on sensitive issues but do so on less sensitive ones. The pattern of communication found to vary across gender of caretaker and that of adolescent and depends on the nature of relationship between caretaker and adolescent. There is gender differences in selecting SRH topics of discussion. Interventions programmes have to include strategies that enhance caretaker's information, motivation and skills so as to improve SRH communication between caretakers and adolescent.