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Papers by Ireen Chola Mwape Musonda

International Journal of Women's Health, 2018

Access to skilled care and facilities with capacity to provide emergency obstetric and newborn ca... more Access to skilled care and facilities with capacity to provide emergency obstetric and newborn care is critical to reducing maternal mortality. In rural areas of Zambia, 42% of women deliver at home, suggesting persistent challenges for women in seeking, reaching, and receiving quality maternity care. This study assessed the determinants of home delivery among remote women in rural Zambia. Methods: A household survey was administered to a random selection of recently delivered women living 10 km or more from their catchment area health facility in 40 sites. A subset of respondents completed an in-depth interview. Multiple regression and content analysis were used to analyze the data. Results: The final sample included 2,381 women, of which 240 also completed an interview. Households were a median of 12.8 km (interquartile range 10.9, 16.2) from their catchment area health facility. Although 1% of respondents intended to deliver at home, 15.3% of respondents actually delivered at home and 3.2% delivered en route to a facility. Respondents cited shorter than expected labor, limited availability and high costs of transport, distance, and costs of required supplies as reasons for not delivering at a health facility. After adjusting for confounders, women with a first pregnancy (adjusted OR [aOR]: 0.1, 95% CI: 0.1, 0.2) and who stayed at a maternity waiting home (MWH) while awaiting delivery were associated with reduced odds of home delivery (aOR 0.1, 95% CI: 0.1, 0.2). Being over 35 (aOR 1.3, 95% CI: 0.9, 1.9), never married (aOR 2.1, 95% CI: 1.2, 3.7), not completing the recommended four or more antenatal visits (aOR 2.0, 95% CI: 1.5, 2.5), and not living in districts exposed to a large-scale maternal health program (aOR 3.2, 95% CI: 2.3, 4.5) were significant predictors of home delivery. After adjusting for confounders, living nearer to the facility (9.5-10 km) was not associated with reduced odds of home delivery, though the CIs suggest a trend toward significance (aOR 0.7, 95% CI: 0.4, 1.1). Conclusion: Findings highlight persistent challenges facing women living in remote areas when it comes to realizing their intentions regarding delivery location. Interventions to reduce home deliveries should potentially target not only those residing farthest away, but multigravida women, those who attend fewer antenatal visits, and those who do not utilize MWHs.

TEXILA INTERNATIONAL JOURNAL OF NURSING, 2019

The aim of the study was to profile the epidemiology and different determinants of needle stick i... more The aim of the study was to profile the epidemiology and different determinants of needle stick injury among health care workers at St. Pauls Mission Hospital which could be used to develop/foster needle stick infection control measures. A cross sectional quantitative survey-based design was used in this study. A sample of 143 nurses instead was enlisted in this study from an expected sample size. In the last ten years, the incidence of NSIs was 139 episodes with an annual mean occurrence of 11 episodes per year. Within the sample of those who had NSIs, there are more health workers who are proactive and take up preventive actions than those who do not. Infection control measures appear not to be emphasised. There are more than half of respondents who indicated ''No'' than those who indicated ''Yes'' for the infection control prevention strategies. The least adhered to infection control strategy is the non-insistence of wearing of eye goggles when conducting minor or major surgery. The determinants of NSIs were; not wearing gloves before touching anything wetbroken skin, mucous membranes, blood, body fluids, secretion, or excretion or before touching soiled instruments and other items, not using barriers-Personal Protective Equipment (PPE) such as protective goggles, face mask and aprons if splashes or spills of blood or body fluids secretions or excretions are anticipated, lack of training at the workplace, long working hours and lack of supplies: disposable syringes, safer needle devices, and sharps-disposal containers. In conclusion, NSIs were observed in all categories of HCWs. There is a scope for improvement in safety protocols. Preventive strategies have to be devised and reporting of NSI need to be made mandatory. Issues requiring attention include use of safety engineered devices (SED), recording and reporting of incidents, training of all HCWs in handling and disposal of sharps, establishing a staff student health service and inculcating a responsible attitude among HCWs. The solutions are easy ones as they do need substantial resources.

Texila International Journal of Nursing, 2021

Luapula Province has the highest maternal mortality and one of the lowest facility-based births i... more Luapula Province has the highest maternal mortality and one of the lowest facility-based births in Zambia. The distance to facilities limits facility-based births for women in rural areas. In 2013, the government incorporated maternity homes into the health system at the community level to increase facility-based births and reduce maternal mortality. Despite the policy to stopping traditional birth attendants from conducting deliveries at home and encouraging all women to give birth at the health facility under skilled care, many women still give birth at home. An exploratory cross section survey was used to gather data by conducting structured interviews with 50 women of childbearing age who had a recent or previous home delivery. The following factors were found to be associated with home deliveries in surrounding villages in kashikishi; abrupt onset/precipitate labor, long distance/transport difficulties to reach the nearest health facility, having had successful HD, poverty/low ...

Texila International Journal of Nursing, 2019

The aim of the study was to profile the epidemiology and different determinants of needle stick i... more The aim of the study was to profile the epidemiology and different determinants of needle stick injury among health care workers at St. Pauls Mission Hospital which could be used to develop/foster needle stick infection control measures. A cross sectional quantitative survey-based design was used in this study. A sample of 143 nurses instead was enlisted in this study from an expected sample size. In the last ten years, the incidence of NSIs was 139 episodes with an annual mean occurrence of 11 episodes per year. Within the sample of those who had NSIs, there are more health workers who are proactive and take up preventive actions than those who do not. Infection control measures appear not to be emphasised. There are more than half of respondents who indicated ''No'' than those who indicated ''Yes'' for the infection control prevention strategies. The least adhered to infection control strategy is the non-insistence of wearing of eye goggles when conducting minor or major surgery. The determinants of NSIs were; not wearing gloves before touching anything wet-broken skin, mucous membranes, blood, body fluids, secretion, or excretion or before touching soiled instruments and other items, not using barriers-Personal Protective Equipment (PPE) such as protective goggles, face mask and aprons if splashes or spills of blood or body fluids secretions or excretions are anticipated, lack of training at the workplace, long working hours and lack of supplies: disposable syringes, safer needle devices, and sharps-disposal containers. In conclusion, NSIs were observed in all categories of HCWs. There is a scope for improvement in safety protocols. Preventive strategies have to be devised and reporting of NSI need to be made mandatory. Issues requiring attention include use of safety engineered devices (SED), recording and reporting of incidents, training of all HCWs in handling and disposal of sharps, establishing a staff student health service and inculcating a responsible attitude among HCWs. The solutions are easy ones as they do need substantial resources.

International Journal of Women's Health, 2018

Access to skilled care and facilities with capacity to provide emergency obstetric and newborn ca... more Access to skilled care and facilities with capacity to provide emergency obstetric and newborn care is critical to reducing maternal mortality. In rural areas of Zambia, 42% of women deliver at home, suggesting persistent challenges for women in seeking, reaching, and receiving quality maternity care. This study assessed the determinants of home delivery among remote women in rural Zambia. Methods: A household survey was administered to a random selection of recently delivered women living 10 km or more from their catchment area health facility in 40 sites. A subset of respondents completed an in-depth interview. Multiple regression and content analysis were used to analyze the data. Results: The final sample included 2,381 women, of which 240 also completed an interview. Households were a median of 12.8 km (interquartile range 10.9, 16.2) from their catchment area health facility. Although 1% of respondents intended to deliver at home, 15.3% of respondents actually delivered at home and 3.2% delivered en route to a facility. Respondents cited shorter than expected labor, limited availability and high costs of transport, distance, and costs of required supplies as reasons for not delivering at a health facility. After adjusting for confounders, women with a first pregnancy (adjusted OR [aOR]: 0.1, 95% CI: 0.1, 0.2) and who stayed at a maternity waiting home (MWH) while awaiting delivery were associated with reduced odds of home delivery (aOR 0.1, 95% CI: 0.1, 0.2). Being over 35 (aOR 1.3, 95% CI: 0.9, 1.9), never married (aOR 2.1, 95% CI: 1.2, 3.7), not completing the recommended four or more antenatal visits (aOR 2.0, 95% CI: 1.5, 2.5), and not living in districts exposed to a large-scale maternal health program (aOR 3.2, 95% CI: 2.3, 4.5) were significant predictors of home delivery. After adjusting for confounders, living nearer to the facility (9.5-10 km) was not associated with reduced odds of home delivery, though the CIs suggest a trend toward significance (aOR 0.7, 95% CI: 0.4, 1.1). Conclusion: Findings highlight persistent challenges facing women living in remote areas when it comes to realizing their intentions regarding delivery location. Interventions to reduce home deliveries should potentially target not only those residing farthest away, but multigravida women, those who attend fewer antenatal visits, and those who do not utilize MWHs.

TEXILA INTERNATIONAL JOURNAL OF NURSING, 2019

The aim of the study was to profile the epidemiology and different determinants of needle stick i... more The aim of the study was to profile the epidemiology and different determinants of needle stick injury among health care workers at St. Pauls Mission Hospital which could be used to develop/foster needle stick infection control measures. A cross sectional quantitative survey-based design was used in this study. A sample of 143 nurses instead was enlisted in this study from an expected sample size. In the last ten years, the incidence of NSIs was 139 episodes with an annual mean occurrence of 11 episodes per year. Within the sample of those who had NSIs, there are more health workers who are proactive and take up preventive actions than those who do not. Infection control measures appear not to be emphasised. There are more than half of respondents who indicated ''No'' than those who indicated ''Yes'' for the infection control prevention strategies. The least adhered to infection control strategy is the non-insistence of wearing of eye goggles when conducting minor or major surgery. The determinants of NSIs were; not wearing gloves before touching anything wetbroken skin, mucous membranes, blood, body fluids, secretion, or excretion or before touching soiled instruments and other items, not using barriers-Personal Protective Equipment (PPE) such as protective goggles, face mask and aprons if splashes or spills of blood or body fluids secretions or excretions are anticipated, lack of training at the workplace, long working hours and lack of supplies: disposable syringes, safer needle devices, and sharps-disposal containers. In conclusion, NSIs were observed in all categories of HCWs. There is a scope for improvement in safety protocols. Preventive strategies have to be devised and reporting of NSI need to be made mandatory. Issues requiring attention include use of safety engineered devices (SED), recording and reporting of incidents, training of all HCWs in handling and disposal of sharps, establishing a staff student health service and inculcating a responsible attitude among HCWs. The solutions are easy ones as they do need substantial resources.

Texila International Journal of Nursing, 2021

Luapula Province has the highest maternal mortality and one of the lowest facility-based births i... more Luapula Province has the highest maternal mortality and one of the lowest facility-based births in Zambia. The distance to facilities limits facility-based births for women in rural areas. In 2013, the government incorporated maternity homes into the health system at the community level to increase facility-based births and reduce maternal mortality. Despite the policy to stopping traditional birth attendants from conducting deliveries at home and encouraging all women to give birth at the health facility under skilled care, many women still give birth at home. An exploratory cross section survey was used to gather data by conducting structured interviews with 50 women of childbearing age who had a recent or previous home delivery. The following factors were found to be associated with home deliveries in surrounding villages in kashikishi; abrupt onset/precipitate labor, long distance/transport difficulties to reach the nearest health facility, having had successful HD, poverty/low ...

Texila International Journal of Nursing, 2019

The aim of the study was to profile the epidemiology and different determinants of needle stick i... more The aim of the study was to profile the epidemiology and different determinants of needle stick injury among health care workers at St. Pauls Mission Hospital which could be used to develop/foster needle stick infection control measures. A cross sectional quantitative survey-based design was used in this study. A sample of 143 nurses instead was enlisted in this study from an expected sample size. In the last ten years, the incidence of NSIs was 139 episodes with an annual mean occurrence of 11 episodes per year. Within the sample of those who had NSIs, there are more health workers who are proactive and take up preventive actions than those who do not. Infection control measures appear not to be emphasised. There are more than half of respondents who indicated ''No'' than those who indicated ''Yes'' for the infection control prevention strategies. The least adhered to infection control strategy is the non-insistence of wearing of eye goggles when conducting minor or major surgery. The determinants of NSIs were; not wearing gloves before touching anything wet-broken skin, mucous membranes, blood, body fluids, secretion, or excretion or before touching soiled instruments and other items, not using barriers-Personal Protective Equipment (PPE) such as protective goggles, face mask and aprons if splashes or spills of blood or body fluids secretions or excretions are anticipated, lack of training at the workplace, long working hours and lack of supplies: disposable syringes, safer needle devices, and sharps-disposal containers. In conclusion, NSIs were observed in all categories of HCWs. There is a scope for improvement in safety protocols. Preventive strategies have to be devised and reporting of NSI need to be made mandatory. Issues requiring attention include use of safety engineered devices (SED), recording and reporting of incidents, training of all HCWs in handling and disposal of sharps, establishing a staff student health service and inculcating a responsible attitude among HCWs. The solutions are easy ones as they do need substantial resources.