Abstract Background Cervical cancer remains the second most common cause of death in women and poses a growing public health challenge. It is urgent to increase cervical cancer screening rates in ...Kenya as per the 2018 Kenya National Cancer Screening Guidelines. Addressing access to care may serve as a target to achieve this goal; however, how individual dimensions of access to care are associated with the utilization of cervical cancer screening services in low- and middle-income countries, including Kenya, remains unclear. This study aimed to examine how different aspects of access to care (affordability, availability, geographical access, and social influence) were associated with cervical cancer screening among Kenyan women of reproductive age. Methods This cross-sectional study used data from the 2014 Kenya Demographic and Health Survey and the 2010 Kenya Service Provision Assessment. The final sample included 5,563 women aged 25–49 years. Logistic regression models were used to examine the association between different aspects of access to care and the uptake of cervical cancer screening. Results Factors such as being in the poorest wealth quintile, lacking health insurance, having difficulty obtaining funds for treatment (affordability), limited availability of screening services at nearby facilities (availability), living in rural areas (geographical access), and having healthcare decisions made solely by husbands/partners or others (social influence) were associated with a decreased likelihood of the uptake of cervical cancer screening. Conclusions Increasing health insurance coverage, enhancing the availability of screening services at health facilities, expanding mobile screening health facilities in rural areas, and empowering women to make their own healthcare decisions are crucial steps for increasing cervical cancer screening uptake in Kenya.
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CEKLJ, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Improved food availability and a growing economy in Tanzania may insufficiently decrease pre-existing nutritional deficiencies and simultaneously increase overweight within the same individual, ...household or population, causing a double burden of malnutrition (DBM). We investigated economic inequalities in DBM at the household level, expressed as a stunted child with a mother with overweight/obesity, and the moderating role of dietary diversity in these inequalities.
We used cross-sectional data from the 2015-2016 Tanzania Demographic and Health Survey.
A nationally representative survey.
Totally, 2867 children (aged 6-23 months) and their mothers (aged 15-49 years). The mother-child pairs were categorised into two groups based on dietary diversity score: achieving and not achieving minimum dietary diversity.
The prevalence of DBM was 5·6 % (sd = 0·6) and significantly varied by region (ranging from 0·6 % to 12·2 %). Significant interaction was observed between dietary diversity and household wealth index (
< 0·001). The prevalence of DBM monotonically increased with greater household wealth among mother-child pairs who did not achieve minimum dietary diversity (
< 0·001; however, this association was attenuated in those who achieved minimum dietary diversity (
= 0·16), particularly for the richest households (
= 0·44). Analysing household wealth index score as a continuous variable yielded similar results (OR (95 % CI): 2·10 (1·36, 3·25) for non-achievers of minimum dietary diversity, 1·38 (0·76, 2·54) for achievers).
Greater household wealth was associated with higher odds of DBM in Tanzania; however, the negative impact of household economic status on DBM was mitigated by minimum dietary diversity.
Aim To explore the individual factors (such as gender, division of household labor, childcare and elder care) and their impact on research activities in the Japanese nursing research community during ...the early stage of the COVID-19 pandemic from April to June in 2020. Design Cross-sectional study. Methods An online survey with a self-reported questionnaire was conducted on Japan Academy of Nursing Science members to explore the impacts of individual factors among Japanese nursing researchers from April to June 2020. A multivariate logistic regression model was used for data analysis. Results A total of 1,273 participants (90.7% female, 85.8% university faculty) were included in the analysis. This survey showed that no evidence of a significant gender gap was found in research activities in Japanese nursing researchers during the COVID-19 pandemic. Research activities during the pandemic were associated with time and motivation.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
ObjectivesThis study aimed to identify typical patterns and determinants of early-career nurse researchers (ECNRs: age ≤45 years) who reported that their research activities were negatively impacted ...during the COVID-19 pandemic, using a data mining methodology. To gain a deeper understanding of the characteristics of these ECNRs, we compared them with the characteristics of senior nurse researchers (SNRs: age ≥46 years).DesignA cross-sectional study.Participants1532 nurse researchers.Data collection and analysisWe conducted an anonymous online questionnaire survey that assessed individual and professional attributes of nurse researchers and their experiences from April to June 2020. We analysed the association between the impact on research activities and the individual and professional attributes using cross-tabulation, and employed the chi-square automatic interaction detection technique to perform population segmentation.ResultsWe found that difficulties in research management, an increased burden of student education and organisational management, and organisational management position were relatively important factors for determining the negative impact of COVID-19 on the research activities of ECNRs (p<0.05). For both ECNRs and SNRs, the most relevant determinant of disrupted research activities was ‘difficulties in research management’ (χ2=34.7 and 126.5, respectively, p<0.001 for both). However, only ECNRs yielded ‘position in organisational management’ and was extracted only for ECNRs (χ2=7.0, p=0.008).ConclusionsDifficulties in research management and an increased burden of student education and organisational management had an unfavourable impact on the research activities of ECNRs. To ensure quality of nursing care and nursing science development during and after the COVID-19 era, it is important to support ECNRs in their nursing research activities and career development. Our findings could contribute to the prioritisation of interventions and policymaking for ECNRs who are particularly at risk of being negatively affected by the pandemic.
To address Tanzania's high maternal mortality ratio, it is crucial to increase women's access to healthcare. To improve access, the quality of antenatal care needs to be improved. Therefore, we ...conducted a pilot study of a smartphone app for midwives and examined its potential effects on the learning outcomes of midwives and birth preparedness of pregnant women in Tanzania. This mixed-methods, pilot study provided an educational app for midwives in the intervention group, obtained data about the continuous use of the app, measured midwives' learning outcomes, directed focus group discussions on the usability of the app, and conducted surveys among pregnant women about birth preparedness in the intervention and control groups to evaluate if midwives provided proper information to them. The control group received regular antenatal care and answered the same survey. Participants were 23 midwives who participated in the testing and provided learning outcome data. Twenty-one participated in focus group discussions. Results showed that 87.5% of midwives continued to study with the app two months post-intervention. A mini-quiz conducted after using the app showed a significant increase in mean scores (6.9 and 8.4 points, respectively) and a non-significant increase on the questionnaire on women-centered care (98.6 and 102.2 points, respectively). In the focus group discussions, all midwives expressed satisfaction with the app for several reasons, including comprehensive content, feelings of confidence, and reciprocal communication. There were 207 pregnant women included in the analysis. The intervention group had significantly higher knowledge scores and home-based value scores than did controls. The total scores and other subscales did not show statistical significance for group differences. The results indicate the potential impact of the midwifery education app when it is implemented on a larger scale, especially considering that the results show a potential effect on midwives' learning outcomes.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Over the last two decades, facility-based childbirths in Tanzania have only minimally increased by 10% partly because of healthcare providers' disrespect and abuse (D&A) of women during childbirth. ...Although numerous studies have substantiated women's experience of D&A during childbirth by healthcare providers, few have focused on how D&A occurred during the midwives' actual care. This study aimed to describe from actual observations the respectful and disrespectful care received by women from midwives during their labor period in two hospitals in urban Tanzania.
This descriptive qualitative study involved naturalistic observation of two health facilities in urban Tanzania. Fourteen midwives were purposively recruited for the one-on-one shadowing of their care of 24 women in labor from admission to the fourth stage of labor. Observations of their midwifery care were analyzed using content analysis.
All the 14 midwives showed both respectful and disrespectful care and some practices that have not been explicated in previous reports of women's experiences. For respectful care, five categories were identified: 1) positive interactions between midwives and women, 2) respect for women's privacy, 3) provision of safe and timely midwifery care for delivery, 4) active engagement in women's labor process, and 5) encouragement of the mother-baby relationship. For disrespectful care, five categories were recognized: 1) physical abuse, 2) psychological abuse, 3) non-confidential care, 4) non-consented care, and 5) abandonment of care. Two additional categories emerged from the unprioritized and disorganized nursing and midwifery management: 1) lack of accountability and 2) unethical clinical practices.
Both respectful care and disrespectful care of midwives were observed in the two health facilities in urban Tanzania. Several types of physical and psychological abuse that have not been reported were observed. Weak nursing and midwifery management was found to be a contributor to the D&A of women. To promote respectful care of women, pre-service and in-service trainings, improvement of working conditions and environment, empowering pregnant women, and strengthening health policies are crucial.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Aim
To investigate how nursing faculties' perceived time devoted to research changed during the first wave of the pandemic in Japan (April–June 2020) compared to pre‐pandemic.
Methods
This ...cross‐sectional study was conducted online from July 1 to August 10, 2020 and involved 1,023 nursing faculties in Japan. Participants were asked to respond to a questionnaire based on their experiences from April to June 2020. We calculated descriptive statistics for several measures and examined associations between professional/personal demographic factors and declines in overall research time.
Results
Of the 1,023 participants, 71.1% were spending less time on overall research activity; 79.6% spent less time attending academic events/conferences, and 77.4% spent less time conducting experiments/surveys. In contrast, 81.2% spent more time teaching, a much greater proportion than the global scientific community in a previous survey. As for work time allocation during the pandemic, teaching was by far the one activity that participants spent the most time on. Logistic regression analysis revealed that declines in overall research time were associated with several professional demographic factors, such as type of university, current academic position, and acquisition status of Japan's major research grant (KAKENHI) (all p < .05).
Conclusions
Nursing faculties in Japan clearly spent less time on research, and more time on teaching during the first wave of the pandemic compared to pre‐pandemic. The initial impact of the pandemic on nursing faculties revealed through this study is an eye‐opener and a start for addressing the long‐term impact on the nursing scientific community.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK, VSZLJ
In many African countries, cultural norms and values hinder conversations about sexuality among adolescents and their parents. Currently, there are no sex education classes in the curriculum at ...schools in Tanzania. Even when sex education is provided, the content is often abstinence-oriented, and there is a lack of in-depth instruction and exploration on the topic. To help overcome this, peer education is encouraged. After implementing peer-based adolescent education via a non-profit organization, this study aims to (1) identify students' and peer educators' perceptions of adolescent education and (2) identify the changes that occur as a result of adolescent education with peer educators.
This was a qualitative descriptive study using focus group discussions (FGDs). Secondary school students, including peer educators as well as students who received adolescent education, were asked about their perception of peer-based adolescent education. The FGDs were conducted in Swahili with the support of local collaborators. Data were transcribed and translated into English and Japanese. Content analysis was conducted to merge the categories and subcategories.
A total of 92 students (57 girls and 35 boys) were included from three urban and three rural secondary schools where peer education was being implemented. Six FGDs were conducted for girls and four for boys, for a total of 10 FGDs. The students had both positive and negative perceptions of peer-based adolescent education. Both the peer educators and the other students felt that they gained more confidence through the process, based on the conversations they had and the trusting relationship that formed as a result. The peer educators were also successful in eliciting behavioral changes, and the students shared their sex-related knowledge with other peers as well.
The peer education process helped students gain confidence in teaching their peers and elicit behavioral changes. Adult supervision for peer educators is suggested.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
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