Midwives’ experience of participating in the Advanced Life Support in Obstetrics® educational program in Rwanda

Abstract

High maternal and newborn mortality rates remain a global health issue. Ninety-nine percent of maternal deaths occur in low and middle income countries and many could be prevented by having more qualified health providers. In 2013, 62% of maternal deaths took place in Sub-Saharan Africa. The Advanced Life Support in Obstetrics (ALSO R ) Educational Program is an internationally recognized continuous professional development course aimed at increasing the knowledge, skills, competence, and confidence of health professionals to manage obstetric emergencies. The purpose of this qualitative descriptive study was to explore midwives' experiences of translating the knowledge and skills acquired from participating in the ALSO R program into their professional practice in Rwanda. A purposive sample of nine midwives participated in one-to-one interviews directed at understanding their experience of implementing their new knowledge and skills into practice. All interviews were audio-recorded and transcribed verbatim. Content analysis was used to illuminate five themes: 1) Improved midwifery practice, 2) Availability of resources, 3) Inter-professional collaboration, 4) Job (dis)satisfaction, and 5) Autonomy for midwifery practice. The findings revealed that although midwives reported increased knowledge, skills and confidence in management of obstetric emergencies, their ability to change practice was often hampered by non-conducive work environments, a shortage of health care providers, and insufficient equipment and materials. These findings can serve to inform ALSO R course module development, midwifery education development, and health human resources policy that can address obstetrical and newborn education needs and health service delivery in Rwanda.

Benefits of a Mentorship Program on Interprofessional Collaboration in Obstetric and Neonatal Care in Rwanda: A Qualitative Descriptive Case Study

“…A study conducted in Rwanda to understand midwives and nurses' experience in participating in continuous professional development (CPD) workshops demonstrated improvement in collaborative practice as a result of participating in the trainings, suggesting the need for CPD either in the form of mentorship or other kind of trainings. [33] However, the study focused only on two categories of professionals including nurses and midwives while the present study focused on three categories of healthcare professionals: medical doctors, anesthesia providers who were non-physician anesthetists, nurses, and midwives. Furthermore, the CPD was organized in the form of training delivered in a classroom session, which is different for mentorship, where mentors work with their mentees in a clinical setting.…”

“…Twelve participants were female while thirteen were male, and most were between [27][28][29][30][31][32][33][34][35]…”

Child health nursing in the Solomon Islands: A qualitative evaluation of the impact of the ‘Bachelor of nursing ‐ Child health’

“…Participants working in remote locations stated that such limitations had substantial consequences, as the isolation prevents them from easily communicating with their support network and easily referring patients. Many studies in low‐income contexts document the lack of human and material resources as a barrier to best practice (Martinez et al., 2012; Uwajeneza et al., 2015).…”

‘No other alternative than to compromise’: Experiences of midwives/nurses providing care in the context of scarce resources

“…Staffing shortages and inadequately trained healthcare personnel have led to increased workload, prolonged working hours, decreased contact hours with many labouring women and interfered with the implementation of the advanced life‐saving skills (Beltman et al, 2013; Bremnes et al,2018; Chimwaza et al, 2014; Filby et al, 2016; Macdonald et al, 2019; Mothiba et al, 2019; Mselle et al, 2013; Uwajeneza et al, 2015). Narrative of frequent shortages of delivery kits, oxygen, intravenous fluid, oxytocic agents, blood products, resuscitation kits, beds, and malfunctioning equipment was reported to significantly constrained the delivery of care to childbearing women (Adolphson et al, 2016; Boakye et al, 2021; Macdonald et al, 2019; Mothiba et al, 2019; Mselle et al, 2013; Munabi‐Babigumira et al, 2019; Nabirye et al, 2014; Uwajeneza et al, 2015). Others described inadequate spacing and poor infrastructure created precarious working conditions and overcrowding, thereby compromising the delivery of humanized care (Macdonald et al, 2019; Mselle, Kohi, & Dol, 2018; Munabi‐Babigumira et al, 2019; Narchi et al, 2017; Nunes et al, 2016).…”

“…2013; Bremnes et al,2018;Chimwaza et al, 2014;Filby et al, 2016;Macdonald et al, 2019;Mothiba et al, 2019;Mselle et al, 2013;Uwajeneza et al, 2015). Narrative of frequent shortages of delivery kits, oxygen, intravenous fluid, oxytocic agents, blood products, resuscitation kits, beds, and malfunctioning equipment was reported to significantly constrained the delivery of care to childbearing women (Adolphson et al, 2016;Boakye et al, 2021;Macdonald et al, 2019;Mothiba et al, 2019;Mselle et al, 2013;Munabi-Babigumira et al, 2019;Nabirye et al, 2014;Uwajeneza et al, 2015).…”