JA - Health Sciences

Promoting childbirth in a rural health facility: A quasiexperimental study in western Kenya

2023-10-05T00:00:00Z

Promoting childbirth in a rural health facility: A quasiexperimental study in western Kenya Mwanzia, Lydia The high maternal and neonatal mortality rate in sub-Saharan Africa could be reduced by using navigation by means of mobile devices to increase the number of women who choose to give birth in a health center (HC) with a skilled healthcare practitioner. Methods: A quasi-experimental design was used to test a midwife-delivered navigation by means of mobile phone. A total of 208 women were randomized to two groups (intervention and control). Women in the intervention group received up to three navigation calls from midwives. Women in the control group received usual antenatal education during prenatal visits. Data were collected using semistructured questionnaires. Childbirth location was determined through medical records. Results: Overall, 180 (87%) women gave birth in a HC with a 3% advantage for the intervention group. A total of 86% (88/102) of the control group gave birth in a HC versus 89% (92/103) for the intervention group (Χ2=0.44, p-value=0.51), with an unadjusted odds ratio of 1.33 (95% CI: 0.57, 3.09). Among those with personal phones, 91% (138/152) had a birth in a HC versus 79% (42/53) in those without a personal phone (Χ2=4.89, p-value=0.03). Conclusions: The results of this study indicate that it is feasible to deliver phonebased navigation to support birth in a HC; personal phone ownership may be a factor in the success of this strategy.

Pregnancy and childbirth: male partner involvement in Uasin Gishu, Kenya

2022-12-03T00:00:00Z

Pregnancy and childbirth: male partner involvement in Uasin Gishu, Kenya Mwanzia, Lydia In many African countries, pregnancy and childbirth has traditionally been regarded as a woman’s affair. As a result, male partner involvement and participation in pregnancy and childbirth has been minimal, which is thought to have contributed to the high rate of maternal and neonatal morbidities and mortalities. Male partners are often key decision-makers in African households for cultural reasons, yet their role in pregnancy and childbirth is not clearly defined. The aim of this study was to examine and document male partner involvement in maternal healthcare in Kenya. Methods A health facility-based cross-sectional descriptive study design was used. Systematic random sampling was used to select 384 women seeking maternal and child healthcare at Uasin Gishu County Hospital. The participants were interviewed using structured interviewer-administered questionnaires. Results Almost a third of participants (32%) reported never being accompanied by their partners to maternity clinic visits, while 41% were accompanied only for HIV counselling and testing. Over half of respondents reported that their partners provided a fare or transport to the antenatal clinic (55%) and that they were supported when taking iron and folic acid supplements (58%). Just over a third of participants reported their partners took them to the hospital during labour (37%). Only 8% of male partners were present during labour and birth, 55% provided money to travel home after the birth and less than a fifth (19%) accompanied their wives home after birth. Conclusions Male partner involvement in maternal care is very low in Uasin Gishu county. Male partner involvement needs to be recognised and addressed in health education because of the potential benefits to both maternal and child health outcomes. Health systems should focus on providing couple-friendly antenatal care services. Maternal health intervention strategies and policies that inadvertently isolate men from active engagement in antenatal and postnatal health programmes should be reviewed.

Evaluation of the feasibility of a midwifery educator continuous professional development (CPD) programme in Kenya and Nigeria: a mixed methods study

2024-05-14T00:00:00Z

Evaluation of the feasibility of a midwifery educator continuous professional development (CPD) programme in Kenya and Nigeria: a mixed methods study Mwanzia, Lydia Background Midwifery education is under-invested in developing countries with limited opportunities for midwifery educators to improve/maintain their core professional competencies. To improve the quality of midwifery education and capacity for educators to update their competencies, a blended midwifery educator-specific continuous professional development (CPD) programme was designed with key stakeholders. This study evaluated the feasibility of this programme in Kenya and Nigeria. Methods This was a mixed methods intervention study using a concurrent nested design. 120 randomly selected midwifery educators from 81 pre-service training institutions were recruited. Educators completed four self-directed online learning (SDL) modules and three-day practical training of the blended CPD programme on teaching methods (theory and clinical skills), assessments, effective feedback and digital innovations in teaching and learning. Pre- and post-training knowledge using multiple choice questions in SDL; confidence (on a 0–4 Likert scale) and practical skills in preparing a teaching a plan and microteaching (against a checklist) were measured. Differences in knowledge, confidence and skills were analysed. Participants’ reaction to the programme (relevance and satisfaction assessed on a 0–4 Likert scale, what they liked and challenges) were collected. Key informant interviews with nursing and midwifery councils and institutions’ managers were conducted. Thematic framework analysis was conducted for qualitative data. Results 116 (96.7%) and 108 (90%) educators completed the SDL and practical components respectively. Mean knowledge scores in SDL modules improved from 52.4% (± 10.4) to 80.4% (± 8.1), preparing teaching plan median scores improved from 63.6% (IQR 45.5) to 81.8% (IQR 27.3), and confidence in applying selected pedagogy skills improved from 2.7 to 3.7, p < 0.001. Participants rated the SDL and practical components of the programme high for relevance and satisfaction (median, 4 out of 4 for both). After training, 51.4% and 57.9% of the participants scored 75% or higher in preparing teaching plans and microteaching assessments. Country, training institution type or educator characteristics had no significant associations with overall competence in preparing teaching plans and microteaching (p > 0.05). Qualitatively, educators found the programme educative, flexible, convenient, motivating, and interactive for learning. Internet connectivity, computer technology, costs and time constraints were potential challenges to completing the programme. Conclusion The programme was feasible and effective in improving the knowledge and skills of educators for effective teaching/learning. For successful roll-out, policy framework for mandatory midwifery educator specific CPD programme is needed.

Bioinformatic Identification of Endemic Coronaviruses’ Epitopes in SARS-CoV-2 Genomes Isolated in Kenya.

2024-05-23T00:00:00Z

Bioinformatic Identification of Endemic Coronaviruses’ Epitopes in SARS-CoV-2 Genomes Isolated in Kenya. Musyoki, Stanslaus; Biegon, Richard; Patel, Kirtika Identification of SARS-CoV-2 genome regions with similarity to epitopes for endemic coronaviruses is crucial for understanding cross-immunity and designing broad-spectrum vaccines. Research has highlighted that several epitopes exhibit homology or cross-reactivity between SARS-CoV-2 and various endemic coronaviruses. To identify these shared epitopes, annotated proteins from SARS-CoV-2 genomes isolated in Moi Teaching and Referral Hospital, Kenya were aligned with Epitopes for four endemic coronaviruses using BlastP. Additionally, the overlapping epitopes were aligned with SARS-CoV2 immunodominant epitopes. 321 epitopes from HCoV-OC43, 206 epitopes from HCoV-HKU1, 136 epitopes from HCoV-NL63, and 182 epitopes from HCoV-229E exhibited similarities with regions on SARS-CoV-2 genomes. Of these, ten HCoV-OC43 epitopes; thirteen HCoV-HKU1 epitopes; one HCoVNL63 epitope; and three HCoV-229E spike epitopes exhibited similarity with the SARS-CoV-2 genomes. Seven immunodominant epitopes had notable similarities with the epitopes from endemic coronaviruses. This discovery holds great importance as it implies the existence of potential cross reactivity and shared immune responses among these coronaviruses, thereby potentially impacting the comprehension of immunity and the development of vaccines against SARS-CoV-2.