Adolescent pregnancy is a serious reproductive health problem in Tanzania. However, the risk factors for multidimensional attitudes and behaviors of reproductive health toward pregnancy in Tanzanian ...adolescents remain unexplored.
We collected baseline characteristics and information on attitudes and behaviors of reproductive health from 4161 Tanzanian adolescents in all 54 primary and secondary schools in the Korogwe district. We applied mixed effect multiple regression analyses stratified by sex to find the factors related to reproductive health attitudes and behaviors toward pregnancy.
In female students, regarding the attitudes of reproductive health, higher age, hope for marriage in the future, a talk with a parent about sex or pregnancy, and a higher hope score were significantly associated with a lower score. For the behaviors of reproductive health, higher age, a talk with a parent about sex or pregnancy, time to talk with a parent about daily life, and a higher hope score were significantly associated with a lower score. In male students, regarding the attitudes of reproductive health, a higher hope score was significantly associated with a lower score. For the behaviors of reproductive health, higher age, time to talk with a parent about daily life, and a higher hope score was significantly associated with a lower score.
The heterogeneous factor-outcomes association between female and male students suggested that sex-specialized interventions may be required to change their risky attitudes or behaviors of reproductive health. Although we cannot conclude as points of intervention, our study suggested that it may be practical to improve parent-adolescents communication about sex or reproductive health and change adolescents' views of pregnancy or marriage for gaining financial or social status.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Aim: The aim of this concept analysis was to describe attributes, antecedents, and consequences of reflection in nursing professional development, as well as surrogate terms and a model case to ...inform nursing educators, students, and nurses about developing reflective skills.
Methods: Rodgers' evolutionary cycle for concept analysis was used. The published work search was conducted using five databases: Education Resources Information Center (ERIC), Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Ichushi, and British Nursing Index. The inclusion criteria were: (i) academic articles; (ii) written in English or Japanese; and (iii) including descriptions about reflection. From the pool of extant published work, 50 articles were selected for the thematic analysis.
Results: For the concept of reflection in nursing professional development, four antecedents were identified: (i) theory and practice gap; (ii) expansion of the role and competency in nursing; (iii) educational and learning needs; and (iv) educational responsibility. The major attribute was the process of learning from experience, and the circular process included emotional reaction, description, internal examination, critical analysis, evaluation, and planning new action. The consequences were transforming new perspective, enhanced communication, professional development, and quality of care.
Conclusion: Reflection is used as a method or tool that connects knowledge and experiences. Through the process of reflection, students/nurses become aware of themselves, which helps them review and improve clinical skills. They also become more able to communicate with patients and colleagues. Reflection enhances self‐directed learning and professional maturity. Nurses who use reflection can be better positioned to provide excellent patient care.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK, VSZLJ
BackgroundAdequate community-based or societal collaboration and cooperation are considerably important for the overall welfare of women and adolescent girls with disabilities. “The Multidimensional ...Scale of Perceived Social Support (MSPSS)” has not been evaluated for reliability and validity amid women and adolescent girls with disabilities in the Bangladeshi context.MethodsA Bangla-translated form of the MSPSS was constructed, and the survey was conducted among 152 women and adolescent girls with disabilities who were purposefully recruited from Bogura Sadar and Chapainawabganj Sadar sub-districts of Bangladesh.ResultsThe Cronbach's alpha of the entire scale was 0.868, indicating high internal consistency. Cronbach’s alpha for the family sub-scale was 0.763, the friends sub-scale was 0.820, and the significant others scale was 0.776. The composite reliability for the family sub-scale was 0.849677, the friends sub-scale was 0.881248, and the significant others sub-scale was 0.859668. Convergence reliability was established following sub-scale-wise scores. It affirms the consistency of measurements. The content validity score was >0.62, following the Lawshe approach. The three-factor model was adopted during confirmatory factor analysis when the three-factor model run in SPSS Amos (version 21) CFI (comparative fit index) was 0.919.ConclusionsIn Bangladesh, to the best of our knowledge, our study is initially to calculate the perceived societal assistance of women and adolescent girls with disabilities. We validated the Bangla-translated form of the MSPSS from the Bangladeshi perspective. Researchers and clinicians may rely on our accurate and validated MSPSS translation into Bangla when working with this group. Based on our findings, this study endorses implementing the MSPSS for assessing professed community-based collaboration using the three-factor model, especially among women and adolescent girls with disabilities.
The Western Pacific region constitutes one-quarter of the world's population and has diverse health needs. While dialogue on and promotion of advanced practice nurses are ongoing, this study ...investigated the current responsibilities of nurses in advanced roles, future healthcare needs, and the implications of these components for nurses' professional development within the Western Pacific region.
This study employed three phases, a descriptive survey on the current status of nurses in advanced roles in the Western Pacific region, followed by a Delphi survey, and exploratory interviews. A total of 55 national experts with clinical, academic, and/or government-related backgrounds from 18 countries participated from December 2017 - December 2018. The descriptive survey via email to identify the status of nurses in advanced roles and a working definition was developed. This formed the basis for the Delphi survey, which identified key barriers and challenges for enhancing the development of nurses in advanced roles within the country (round 1) and for the region (rounds 2 and 3). Lastly, semi-structured individual interviews were conducted to identify strategies for establishing nurses in advanced roles to improve equitable access to healthcare.
Thirty-seven roles and characteristics were identified and categorized for nurses performing advanced roles. Emergency care, critical care, elderly health, child health, and rural/remote communities were identified as fields with particular need for nurses in advanced roles in the Western Pacific region. Providing effective services, influencing government leadership, and advocating for health system sustainability were deemed necessary to improve equitable healthcare access. We found that nurses in advanced roles are not limited to clinical tasks within the hospital but are poised for active participation in primary healthcare, education/teaching, professional leadership, quality management, and research.
Demand for nurses in advanced roles is high in the Western Pacific region and 15 items were identified across five core strategic areas to enhance development of nurses in advanced roles. Governmental-level recommendations include establishing legislative protection, improving systems for remuneration, strengthening supportive channels, and conducting national needs assessments.
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In the United Republic of Tanzania, the maternal mortality ratio, and neonatal mortality rate have remained high for the last 10 years. It is well documented that many complications of pregnancy are ...avoidable by providing skilled midwifery care during and immediately after childbirth. However, there have been delays in providing timely and necessary obstetric interventions, most likely due to lack of proper monitoring during labor. Yet, there has been little research concerning how midwives monitor the process of childbirth. Therefore, this study aimed to describe how midwives monitored and managed the process of childbirth to achieve early consulting and timely referral to obstetricians.
The design was qualitative and descriptive, using data from comprehensive semi-structured interviews of midwives. The interviews were conducted at one hospital and one health center in Dar es Salaam, Tanzania's largest city. Eleven participants were purposively recruited and interviewed about their experiences managing complicated intrapartum cases. After the interviews, data were analyzed using content analysis.
Derived from the data were three activity phases: initial encounter, monitoring, and acting. During these phases, midwives noticed danger signs, identified problems, revised and confirmed initial problem identification, and organized for medical intervention or referral. The timing of taking action was different for each midwife and depended on the nature of the prolonged and obstructed labor case.
For the majority of midwives, the processing of assessments and judgments was brief and without reflection, and only a few midwives took time to continue to monitor the labor after the initial identification of problems and before taking actions. To make a final judgment that the labor was becoming prolonged or obstructed, midwives should consider taking time to review and synthesize all their findings.
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Adolescent girls are highly vulnerable to developing anemia due to reproductive immaturity, poor personal hygiene, and lack of nutritional intake and health education in rural Bangladesh. Digital ...health technology is a promising tool to overcome barriers and provide appropriate health guidelines. We aim to evaluate eHealth education's impact and changes in adolescent girls' knowledge, attitude, and practice regarding anemia. A 1:1 parallel randomized control trial was conducted among school-going adolescent girls in rural Bangladesh. A total of 138 anemic (mild and moderate) participants were enrolled. We randomized schools to reduce the health education bias through a simple coin toss technique, then allocated participants to the intervention group (n = 69) and control group (n = 69) by stratified random sampling technique. The intervention group received two online counseling sessions and 8-month eHealth education through mobile phone calls and short message service regarding anemia. The control group received the usual care. The primary endpoint changes the anemic level through changing knowledge, healthy lifestyle behavior, and an iron-rich food dietary plan. Per-protocol analysis will utilize to compare the control and intervention groups using SPSS software. Descriptive statistics (frequencies, percentages, mean, SD) will be employed, and continuous variables will be compared using the t-test/Mann-Whitney test. Two-way analysis of variance will assess outcome variables at baseline, 4 months, and 8 months. The 8-month intervention is designed from May 2022 to February 2023. Participants' age range of 10-14 years was 60.9% in the intervention group and 56.5% in the control group. Among the participants, 89.9% and 88.4% were mild anemic; 11.11 (SD ± 0.80) and 11.06 (SD ± 0.96) were mean hemoglobin in the intervention and control groups, respectively. eHealth education is expected to be an effective way to increase knowledge and healthy behavioral change, which can reduce the anemia burden among adolescent girls.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Menstruation is a normal physiological process for women during their reproductive cycle, typically beginning during adolescence. During this stage, lack of knowledge, social taboos, and shyness act ...as barriers to proper menstrual hygiene management, rendering adolescent girls more vulnerable. This issue is highly prevalent in low- and middle-income countries. In rural areas of Bangladesh, there is a deficiency in menstrual hygiene management due to inadequate information and knowledge among adolescent girls. Therefore, this study aims to assess the effect of mHealth education on the knowledge and practices of menstrual hygiene management among school-going adolescent girls in rural Bangladesh.
This is a quasi-experimental study conducted from early June to December 2023 at a secondary high school in Chandpur, Bangladesh. Participants' data will be collected through face-to-face interviews using a structured questionnaire covering socioeconomics, knowledge of menstrual hygiene management, and practices. Pre-test data will be collected at baseline, followed by a 6-month mHealth education intervention. Afterward, post-test data will be collected using the same questionnaire. The data will be analyzed as frequency and percentage for descriptive statistics, and a paired t-test will be used to compare the pre-and post-test data.
In the study, 172 participants were enrolled at baseline. Among them, 69.8% were aged 10-14 years. The outcome of this study will be published in a peer-reviewed journal. The findings will provide evidence-based information for the government, researchers, and policymakers on menstrual hygiene management using mobile health technology.
mHealth education can be posited as a significant tool for increasing knowledge and practices related to menstrual hygiene management in rural regions of Bangladesh.
In Tanzania, the information on Birth Preparedness and Complication Readiness is insufficiently provided to pregnant women and their families. The aim of this study was to evaluate the maternal and ...infant outcomes of a family-oriented antenatal group education program that promotes Birth Preparedness and Complication Readiness in rural Tanzania.
Pregnant women and families were enrolled in a program about nutrition and exercise, danger signs, and birth preparedness. The cross sectional survey was conducted one year later to evaluate if the participants of the program (intervention group) were different from those who did not participate (control group) with respect to birth-preparedness and maternal and infant outcomes.
A total of 194 participants (intervention group, 50; control group, 144) were analyzed. For Birth Preparedness and Complication Readiness, the intervention group participants knew a health facility in case of emergency (OR: 3.11, 95% CI: 1.39-6.97); arranged accompaniment to go to a health facility for birth (OR: 2.56, 95% CI: 1.17-5.60); decided the birthplace with or by the pregnant women (OR: 3.11, 95% CI: 1.44-6.70); and attended antenatal clinic more than four times (OR: 2.39, 95% CI: 1.20-4.78). For birth outcomes, the intervention group had less bleeding or seizure during labour and birth (OR: 0.28, 95%CI: 0.13-0.58); fewer Caesarean sections (OR: 0.16, 95% CI: 0.07-0.36); and less neonatal complications (OR: 0.28, 95% CI: 0.13-0.60).
The four variables were significantly better in the intervention group, i.e., identifying a health facility for emergencies, family accompaniment for facility birth, antenatal visits, and involvement of women in decision-making, which may be key factors for improving birth outcome variables. Having identified these key factors, male involvement and healthy pregnant lives should be emphasized in antenatal education to reduce pregnancy and childbirth complications.
No.2013-273-NA-2013-101 . Registered 12 August 2013.
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The purpose of the workshop was to introduce the Medical ZAIRAICHI Network, which we are establishing as an international interdisciplinary collaboration to understand how local people prevent, ...treat, and take care of patients with diseases, and maintain health while embracing both modern biomedical and local practices that encompass knowledge, resources (healing, treating, and caring) and skills. The keynote speakers and oral presenters spoke about their perspectives on medical ZAIRAICHI and their research studies in Ethiopia, Tanzania, Uganda, and Malawi. Discussions included Medical ZAIRAICHI's multiple aspects in health care, such as biomedical sciences, interaction with animals and the environment, health-care systems and ethical issues, and socio-cultural environment. In each research field, we need to make sure that we consider the question of how people perceive the body and the causes of health problems, prevention, and caring modalities. Based on this knowledge and resources, we can create a balanced knowledge base for safe, feasible, and sustainable health options through interdisciplinary collaboration. We need to remain open to consultation and feedback from local perspectives. Only then can we develop health education content for communities, schools, and patients and consider the effective distribution of health education using Information and Communication Technology (ICT).
women are more likely to give birth at a health facility when their families agree with the birthplace. However, in rural areas of Tanzania, women are often marginalized from decision-making. This ...study predicted birthplace intention and identified factors to reduce perceptional gaps among pregnant women, husbands and family members.
explanatory cross-sectional survey was conducted in three villages in North Eastern Tanzania. Participants were 138 pregnant women and their families who answered the Birth Intention Questionnaire (BIQ), measuring knowledge, attitude, perceived behavioral control, subjective norms and intention for birthplace. Descriptive analysis, ANOVA, Chi-square, and multiple linear regression was used to analyze the data.
the regression model showed that knowledge, perceived behavioral control, and subjective norms predicted intention for birthplace (R2 = .28). While 81% of pregnant women thought their husbands were decision-makers for their birth, only 38% of husbands and 37% of family members agreed. Pregnant women had significantly lower scores on the item "I will prepare for childbirth with my family" compared with husbands (p < .01) and other family members (p < .001).
providing evidence-based birth preparation and reducing the identified perceptual gaps may enhance women's intention to deliver at health facilities.
as mulheres são mais propensas a dar à luz em um centro de saúde quando suas famílias estão de acordo com o local de nascimento. No entanto, nas áreas rurais da Tanzânia, as mulheres são muitas vezes marginalizadas do processo de decisão. Este estudo fez previsoes de intenção para o local do parto e fatores para reduzir as lacunas de percepção entre as mulheres grávidas, seus maridos e familiares identificados.
estudo transversal explicativo realizado em três aldeias no nordeste da Tanzânia. Os participantes foram 138 mulheres grávidas e suas famílias que responderam ao Questionário de Intenção sobre Parto (BIQ), medindo o conhecimento, atitude, percepcão de controle comportamental, normas subjetivas e intenção para lugar de parto. Análise descritivas, ANOVA, Qui-quadrado e regressão linear múltipla foram utilizados para analisar os dados.
o modelo de regressão mostrou que o conhecimento, percepcão de controle comportamental e normas subjetivas previram intenção de lugar de parto (R2 = 0,28). Enquanto 81% das mulheres grávidas pensavam que seus maridos eram os decisores para seu parto, apenas 38% dos maridos e 37% dos membros da família concordaram. As mulheres grávidas tiveram escores significativamente mais baixos sobre o item "Vou me preparar para o parto com a minha família", em comparação com os maridos (p < 0,01) e outros membros da família (p < 0,001).
Proporcionar preparação para o parto baseada em evidencias e a redução das lacunas de percepção identificadas podem melhorar a intenção das mulheres para dar à luz em unidades de saúde.
las mujeres son más propensas a dar a luz en un centro de salud cuando sus familias están de acuerdo con el lugar de parto. Sin embargo, en las zonas rurales de Tanzania, las mujeres son a menudo marginadas de la toma de decisiones. Este estudio predijo la intención del lugar de parto y los factores identificados para reducir la brecha de percepción entre las mujeres embarazadas, esposos y miembros de la familia.
encuesta transversal explicativa llevada a cabo en tres aldeas en el noreste de Tanzania. Los participantes fueron 138 mujeres embarazadas y sus familias, que respondieron al Cuestionario sobre Intención del Parto (BIQ), que mide el conocimiento, la actitud, percepción de control del comportamiento, las normas subjetivas y la intención de lugar de parto. Se utilizaron análisis descriptivo, ANOVA, Chi-cuadrado y regresión lineal múltiple para analizar los datos.
el modelo de regresión mostró que el conocimiento, la percepción de control del comportamiento, y las normas subjetivas predijeron la intencion del lugar de parto (R2 = 0,28). Mientras que el 81% de las mujeres embarazadas pensaba que sus maridos estaban encargados de tomar decisiones para el nacimiento, sólo el 38% de los esposos y el 37% de los miembros de la familia estuvieron de acuerdo. Las mujeres embarazadas tenían puntuaciones significativamente más bajas en el tema "Me prepararé para el parto con mi familia", en comparación con los maridos (p < 0,01) y otros miembros de la familia (p < 0,001).
proporcionar la preparación al parto basada en la evidencia y reducir las brechas de percepción identificadas pueden mejorar intención de las mujeres a dar a luz en centros de salud.
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