Perceptions of student accoucheurs regarding gender inequality in midwifery training at Free State maternal healthcare institutions (original) (raw)
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International Journal of Africa Nursing Sciences, 2020
Worldwide midwifery has been regarded as a female domain until recently where female and male student nurses are trained to become midwives/accoucheurs. Most women are still reluctant to receive maternal healthcare from student accoucheurs. The purpose of the study was to explore and describe the perceptions of women regarding student accoucheurs' involvement in maternal health care in the Free State Province. A descriptive, exploratory, qualitative research design was undertaken. The study was conducted in the Free State Province. Three regional hospitals, two district hospitals and five Primary Health Care clinics were purposefully selected to make a total of 10 maternal health care institutions that were used as data collection sites. Data was collected using one on one semi-structured interviews with 30 women in the post-partum period, 18 years of age and above, attending for post-natal health care services at the Free State maternal health care institutions. Data was organised and stored using ATLAS.ti program and analysed using Tesch's open coding approach. The majority of the participants did not approve of student accoucheurs' involvement in maternal health care. The perceptions of the participants were influenced by cultural beliefs, values, socioeconomic factors and social interactions. The study findings cannot be generalized to the other provinces because the study was contextualized to the Free State Province. This study highlights the importance of understanding and consideration of cultural diversity in the provision of health care services.
Guidelines for student accoucheurs' acceptance in maternal healthcare
2021
Purpose The quality of maternal healthcare training is the most optimal degree of health in the delivery of effective, efficient and quality healthcare in midwifery discipline. Student accoucheurs studying at the Free State School of Nursing are faced with resistance, discrimination, rejection and unacceptability by pregnant women during their clinical placement at the Free State maternal healthcare institutions. This results in poor quality of training of student accoucheurs in maternal healthcare. Considerable studies have been conducted on males in midwifery nursing, but no guidelines have been developed to facilitate student accoucheurs' acceptance and improvement of the quality of training in maternal healthcare, hence the purpose of this study. Design/methodology/approach A descriptive, explorative qualitative design was used in this study. Qualitative focused group discussions ( n = 32) were conducted through purposeful sampling method. Data was analysed thematically. Fin...
African Health Sciences
Background: Anecdotal evidence suggests that student accoucheurs studying at the Free State School of Nursing in South Africa are faced with resistance, discrimination, rejection and unacceptability by pregnant women during their clinical placement at the Free State maternal health care institutions. Objective: The aim of the study was to explore and describe the challenges faced by student accoucheurs regarding the maternal health care services they render to women. Methods: An explorative, descriptive, and qualitative research design was employed to conduct the study. Purposive sampling was used to select student accoucheurs who met the inclusion criteria. Focus group discussion was used to collect data from the selected student accoucheurs. Data were analysed thematically, and the findings were triangulated with the integration of Peplau's Theory of Interpersonal Relations as a theoretical framework that guided the study. Results: The findings in relation to the research question were synthesised under four themes: transcultural diversity, socioeconomic factors, social interactions and relations, and gender inequality in the work place. Conclusion: The study is a contribution to the emerging education and training of student accoucheurs body of knowledge in the Free State Province and to the global existing body of knowledge regarding the phenomena.
Background In South Africa, the South African Nursing Council (SANC) introduced a four-year comprehensive programme leading to registration as a Nurse (General, Psychiatric and Community) and Midwife, Regulation R425 of 22 February 1985 as amended. This regulation requires student nurses to be trained in all disciplines irrespective of their gender. Student accoucheurs studying at the Free State School of Nursing are faced with resistance, discrimination, rejection and unacceptability by pregnant women during their clinical placement at the Free State maternal health care institutions. Considerable studies have been conducted on males in nursing, but no guidelines have been developed to facilitate student accoucheurs’ acceptance in maternal health care. Aim of the study The aim of the study was to explore and describe the views of student accoucheurs and women regarding the maternal health care services rendered by student accoucheurs, and ultimately to develop guidelines to facilit...
Journal of Research in Medical Sciences, 2016
services to pregnant mothers. [3] Mortality of mother will be followed by adverse consequences for family and community. Moreover, many women, who have rescued and survived after the given severe traumas during their pregnancy and delivery period, may suffer from physical, mental, and social destructive effects of this process that may influence the quality of their life. [4,5] To improve health status in mothers and newborns, the presence of skilled birth attendant as well as in sustainable development plan after 2015 is also included in the international accepted goals. [6,7] Surveillance on maternal death occurred at Azerbaijan Province, Iran during years from 2002 to 2011 indicates medial errors and substandard care at all levels, especially hospitals are the most important Background: The organizational environment and its existing context may deeply affect on empowerment of individuals. In educational institutions as well as other organizations, students are going to be powerful when opportunities for growth and achievement of power are provided for them in learning and educational environments. This study has been carried out to explain the facilitators and impediment factors of midwifery student's empowerment in pregnancy and delivery care. Materials and Methods: The current qualitative study has been conducted with participation of 15 midwifery senior students, 10 midwifery academic teachers, and 2 employed midwives in educational hospitals. The given data were collected through individual and group semi-structured interviews, and there were analyzed using directed content analysis method. Results: Three main categories of opportunity for acquisition of knowledge, opportunity for acquisition of clinical skills and opportunity for acquisition of clinical experiences formed structure of access to opportunity in the course of an explanation of facilitators and impediment factors for midwifery student's empowerment in pregnancy and delivery care. Conclusion: To prepare and train the skilled midwives for giving care services to mothers during pregnancy and on delivery and after this period, the academic teachers and clinical instructors should pay due attention to providing the needed opportunities to acquire the applied knowledge and proficiency in the required skills for clinical work and the necessary clinical experiences in these individuals during college period.
Gender differences in women’s health and maternity care training: A scoping review
MedEdPublish, 2018
Women's health and maternity care is a core component of the practice of comprehensive family medicine in Canada. The College of Family Physicians of Canada (CFPC) requires that all learners achieve clinical competencies in these skills prior to starting independent practice. Through our integrated women's health program at the University of Alberta, Canada, we aim to train all learners in these required skills. However, despite our intentions, general program evaluation reveals differences in clinical experiences based on a learner's gender. The objective of the present scoping review of published literature was to examine the prevalence of gender differences in women's health and maternity care training, and to identify educational opportunities to ensure that the clinical curriculum provides equitable exposures to learners of all genders. Several publications in our review revealed that male learners had fewer clinical encounters than female learners, while others demonstrated that male learners felt a bias against them during their women's health and maternity care rotations. It was suggested that these differences may result from patient refusal or discrimination against the learner by training staff, and may lead the learner to perform less well on clinical assessments and have decreased comfort and interest in this area of practice. Suggested approaches to minimize these differences included encouraging patients to consent to care by a learner, supporting learners while on these clinical experiences, and providing faculty development to clinical educators. Further research into strategies to narrow the gap in gender differences in clinical experience in women's health and maternity care is warranted.
Expecting mothers’ preferences of midwife gender: implication for midwifery deployment
International Journal of Advanced Research in Management and Social Sciences, 2015
The purpose of this study was to gather expecting mothers’ preference of midwife gender. This was motivated by the fact that, catering for expecting mothers’ preferences in midwife deployment is a strategy to promote client centered service delivery in hospitals. It is also expected to reduce home deliveries by woman who fear exposing their bodies to males who are not their husbands. A combination of a descriptive survey and historical research design was applied in this study. Data was collected from a purposive sample of 100 expecting mothers through a self reporting questionnaire and focus group discussions. The study found that, male midwives were only allowed to train and practice as midwives when the Sex Discrimination Act of 1975 was implemented. Otherwise midwifery was a female to female affair. The majority of expecting mothers prefer female midwifes. There was an association between midwife preference and location. The majority of mothers in rural areas prefer female midwi...
The Perspective of Pregnant Women of Male Student Nurses in Obstetrics and Women's Health Nursing
ACIBADEM ÜNİVERSİTESİ SAĞLIK BİLİMLERİ DERGİSİ, 2019
Purpose: It is seen that male student nurses encounter gender-based barriers during their professional experiences. Our aim was to evaluate the perspective of pregnant women of male students in the maternity clinic. The sociodemographic characteristics of the pregnant women were recorded. In order to evaluate the perspectives of the pregnant women of male student nurses, 30 questions consisting of three parts were asked. Results: When asked whether male nurses should work in maternity wards, 61.99% of the pregnant women answered 'no.' When asked whether male students should participate in active maternal and neonatal care in maternity wards, 60.09% of pregnant women said 'No.' Three-quarters (77.67%) of the pregnant women thought that male student nurses could communicate easily with their husbands, and 71.49% believed their husbands would feel more comfortable with male nurses outside the delivery room. Conclusion: Our study contributed to a better understanding of the approach to male student nurses in obstetrics clinics. As a result of Turkey's cultural structure, male students face gender-based prejudices. Changing the social environment in nursing is a difficult process to influence the value judgments of society. We may not have enough time to change the perspective of societies, it may take many years. Students should be encouraged to become nurses who are professionals. Socioculturally equipping student nurses and making them resistant to psychological attrition will encourage them to perform their profession through ownership. Keywords: Male student nurses, pregnant women, gender discrimination GEBELERİN PERSPEKTİFİNDEN, KADIN SAĞLIĞI VE HASTALIKLARI HEMŞİRELİĞİ'NDE, ERKEK ÖĞRENCİLERE BAKIŞ ÖZET Amaç: Erkek hemşirelik öğrencilerinin, mesleki deneyimleri sırasında cinsiyete dayalı engellerle karşılaştıkları görülmektedir. Amacımız, doğum kliniğinde erkek öğrencilere gebelerin bakış açısını değerlendirmektir. Yöntem: Çalışmamız Mart 2019-Ağustos 2019'da, Trakya Üniversitesi Hastanesi Perinatoloji kliniğinde interne edilen 421 gönül-lü gebeyle yapıldı. Gebelere sosyodemografik özellikleri ve erkek hemşirelik öğrencilerine bakış açılarını değerlendirmek üzere, üç bölümden oluşan 30 soru soruldu. Bulgular: Erkek hemşireler doğum servislerinde çalışmalı mı sorusuna; gebelerin %61.99'u hayır cevabını verdi. Doğum servis-lerinde aktif maternal ve yenidoğan bakımlarına katılmalı mı sorularının cevaplarıysa %60.09 ''hayır''dı. Erkek öğrencilerin; do-ğum servislerinde, diğer gebelerden tepki alacağını düşünenlerin oranı %78.14, gebelerin eşlerinden tepki alacağını belirtenler %77.90'dı. Gebelerin %77.67'si eşlerinin; erkek hemşirelik öğrencilerine, babalara düşen maternal ve yenidoğan bakımıyla ilgili sorularda, daha kolay iletişim kurduklarını belirttiler. Gebelerin 71.49%'u doğum sırasında, doğumhane dışında bekleyecek babaların, yanlarında erkek hemşireler olursa, kendilerini güvende hissedeceklerini belirtti. Sonuçlar: Bu çalışma, doğum kliniklerindeki erkek hemşirelik öğrencilerine yaklaşımın daha iyi anlaşılmasına ve karşılaştıkları en-gelleri gebelerin bakış açısıyla görebilmemize katkı sağladı. Türkiye'nin sosyokültürel yapısının sonucu olarak; erkek öğrencilerin cinsiyete dayalı önyargılarla karşılaşıldığını gösterdi. Kadın sağlığı ve hastalıkları hemşireliği bakım hizmetleri için kadın hemşireler tercih edilmektedir. Toplumda, sosyal ortamın değiştirilmesi, toplumun değer yargılarına etki edilebilmesi zor bir süreçtir. Toplum-ların bakış açısının değişmesi için sürecek uzun yıllar için, yeterli zamanımız olmayabilir. Hemşirelik öğrencilerini; sosyokültürel donanımlı, manevi yıpranmalara dayanıklı; mesleği sahiplenen hemşireler olarak yetişmelerine destek olunmalıdır. Anahtar sözcükler: Erkek hemşirelik öğrencileri, doğum klinikleri, gebe, cinsiyet ayrımcılığı
Midwifery scope of practice among staff nurses: A grounded theory study in Gujarat, India
Midwifery, 2013
One key strategy to achieve reduction in maternal and neonatal mortality is to scale up the availability of skilled birth attendants (SBAs). The staff nurses (i.e., registered nurse and midwives) are skilled birth attendants recognized by the government of India. Aim and objectives: This thesis studied women's choices, perceptions, and practices related to childbirth, and how these were affected by modernity in general and modernity brought in by maternal health policies (Paper-I). The midwifery scope of practice of staff nurses was studied in government facilities (Paper-II). The confidence of the final-year students on selected midwifery skills, from the diploma and bachelor's programmes, was assessed against the list of competencies of the International Confederation of Midwives (ICM) (Paper-III). The teaching and learning approaches associated with confidence were also studied (Paper-IV). Methods: The grounded theory approach was used to develop models for describing the transition in childbirth practices amongst tribal women (Paper-I) and to describe the scope of midwifery practice of staff nurses (Paper-II). Data used for Paper-I included eight focus groups with women and five in-depth interviews with traditional birth attendants and staff nurses. For Paper-II, 28 service providers and teachers from schools of nursing were interviewed in depth. A cross sectional survey design was used to assess the confidence of final-year students from 25 randomly selected educational institutions stratified by type of programme (diploma/bachelor's) and ownership (private/government) (Paper-III & IV). Students assessed their confidence using a 4-point Likert scale in the competency domains of antepartum, intrapartum, postpartum, and newborn care. Explorative factor analysis using principal component analysis (PCA) was used to reduce skill statements into subscales for each domain. Crude and adjusted odds ratios with 95% CI were calculated to compare students with high confidence (≤75 th percentile of scores) and those without high confidence (> 75 th percentile) to compare diploma and bachelor students (Paper-III) and to study the association of teaching-learning methods and high and not high confidence for each subscale (Paper-IV). Results: A transition in childbirth practices was noted amongst women-a shift from home to hospital births seen as a ‗trade-off between desirables (i.e., secure surroundings) and essentials (i.e., reduced risk of mortality)' (Paper-I). General development, increased access to western medical care, and international/national maternal health policies socialized women into western childbirth practices. The communities increasingly relied on hospitals as a consequence of role redefinition and deskilling of the Traditional Birth Attendants. Existing cultural beliefs facilitated the acceptance of medical interventions. The midwifery practice of staff nurses was ‗circumstance-driven' and ranged from extended to marginal because the legal right to practice was unclear Paper-II). Their restricted practice led to deskilling, and extended practice was perceived as risky. The clinical midwifery education of students was marginalized. Because of dual registration as nurse and midwife, the identity of a nurse was predominant. From 633 students, 25-40% scored above the 75 th percentile and 38-50% below the 50 th percentile of confidence in all subscales Paper-III). A majority had not attended the required number of births prescribed by the Indian Nursing Council. The diploma students were 2-4 times more likely to have high confidence in all subscales compared to the bachelor students. High confidence was associated with number of births attended, practice on manikins, and being satisfied with supervision during clinical practice (Paper-IV). Conclusions: Access to hospitals increases women's choices for childbirth in the context of high mortality. Inequitable distribution of health facilities requires region specific strategies. The women are dissatisfied with the psychosocial aspects of hospital care. India has a national regulatory body, but midwifery specific regulation is lacking. In this situation, the midwifery scope of practice of staff nurses is undefined. The pre-service midwifery education does not develop student's confidence to provide first level care for childbirth, as expected by the governments. Short-term and long-term measures to professionalize midwives in India are suggested.