1,721,140 research outputs found
Influencing midwifery education - internationally
No full textInternational consultancy in developing countries is not uncommon especially within in the field of health care and professional practice. Large universities, Non-government organisations and global agencies are all commonly found within this environment (Stubbs 2003) whereas small teams of practitioners and academics have less experience in this arena. This paper focuses on a personal journey to influence the strengthening of midwifery in India. The literature available is often on two levels, that of the broad overview or the very personal account (Stubbs 2003, Woods 2004), which do not give much instruction for primary interactivities. International working requires new ways of thinking as many of us are not used to working with political figures in political systems which are complex, unfamiliar and often frustrating. Consideration of many interconnecting factors is required for a successful outcome. Attention to four key areas of a complex jigsaw is required before embarking on this new territory of working practice. 1. Personal - critical evaluation2. Political system which includes a country analysis3. Professional4. PeoplePersonal - critical evaluation: The need to understand the new role and how personal attributes may increase or decrease the effectiveness of the relationships (MacClean 2000). MacClean outlines the need for self awareness as our belief and value system will be very different to those we are asked to work with. Personal motivation needs exploring in depth as this could cause a barrier in that we have an agenda which is not compatible with working internationally. Clearly working in partnership requires skills which we may not have or we have not considered. We could, by not valuing or respecting those we are working with, cause the project to fail. Personal experience has shown that the need for flexibility is paramount, as the need to adapt to systems which we find oppressive or legalistic. Transcultural awareness enables working on the positive aspects (Papadopoulos 2006) and lays the foundation for the more difficult issues. Professional understanding and ways of working may also pose different issues which need to be addressed from within rather than imposing a solution from outside the system and because they are not the same does not make them wrong. Political system: Understanding the politics of the country helps to identify any possible barriers to success. This includes researching the country’s population, geography, financial system and the area from which the identified problem is embedded. Gaining as much insight into these will save time in the long term but remember you will only get what has been presented in the media and there will be issues which are not apparent through this type of preparation. Talking to others, who have worked in the country, will help, but caution should be used when forming assumptions and preconceived ideas, as later experience could prove these wrong. Knowing yourself is therefore very important as you can identify the potential of this happening prior to any misunderstanding and addressing the issues before any barriers occur.Professional: Look at all factors which influence the solution to the problem but always consider what is expressed by users of the system, those giving care and the policy makers. This list may appear to be in reverse but policy makers are political people looking for possible short term gain whilst users require long term sustainability. Any solution should be sustainable, which requires time and commitment, as many countries have tried to change the ways they are providing care but are left without support too quickly to see the changes through and they fail. Importing western ideas to other countries is not always the best solution, as the systems are often incompatible and other problems arise, which were not there previously. People: We are working on a personal level with politicians, partners and client groups. Our understanding of all these areas will enable us to understand and therefore problem solve the situation ( Foss 2004). Women do not access antenatal care as in this country and for the same reasons. They need to know what they are going to get out of it but there is evidence to show that women who access other types of health care are more likely to access maternity care (Pallikadavath et al 2004). The status of women is a major consideration as it pervades all aspects of our interactions as well as access to maternity care which is often dictated by a senior member of the famil
Development and testing of a distance learning package used to improve the knowledge of trained Auxiliary Nurse/Midwives (ANM) in normal midwifery practice in Central India
No full textBackground: This study is set in the Indian State of Madhya Pradesh (MP) where maternal health is poor and women’s social status is low. In the majority of cases women’s autonomy and decision making within the family is limited and their ability to seek medical treatment is through their husband or father-in-law. The State government identified a need to strengthen midwifery care given by Auxiliary Nurse/Midwives (ANMs) in the hope of improving maternal and neonatal health. This study formed part of one Non-Governmental Organisation’s response to this need.Design: This cross-cultural, two phase study was designed in partnership with an Indian Non-Government Organisation, utilising Elliot’s Action Research model within the paradigm of critical theory. The first phase investigated the then current situation and established a potential solution to strengthening midwifery practice within MP. This solution comprised an educational approach using a specifically designed self-directed distance learning programme (DLP) focussing on normal pregnancy and childbirth. The DLP consisted of a hard copy workbook supported by a multimedia resource. The second phase was the use and evaluation of the DLP with a sample of 28 ANMs in MP. Their knowledge was tested using a pre- and post-test multiple-choice question paper. Data were analysed using Wilcoxon signed rank. Participants then negotiated a three day workshop to cover aspects they had not been able to address. A further 19 participants joined these three days.Outcomes: The MCQ test results indicated that the first group had poor knowledge of the normal process of pregnancy and childbirth. This group did not improve their personal performance scores significantly after the three day workshop. However, the second group demonstrated a significant change which suggests that coupling self-directed guided study material with an enabling, face-to-face environment can be successful.Conclusion: Distance learning may be more effective if coupled with face-to-face workshops. Partnership working was a crucial component of this cross cultural Action Research study which required attention to detail in all stages for a successful conclusion. Both of these points have relevance for others undertaking similar studies.Recommendations: Improved interface between global organisations and the Indian Government to improve midwifery education and status
Chapter 8: Role of obstetric care practitioner in the management of obstetric emergencies. Obstetric Care in Central India
No full textChapter 4: Antenatal care in rural Madya Pradesh: provision and inequality. Obstetric Care in Central India
No full textSafer pregnancies for all in rural India
No full textA mother's access to antenatal care, between conception and birth, is crucial to a healthy birth. In parts of India, many women are not using antenatal services despite government and NGO efforts to improve services. Extending the role of nurses and midwives, and providing more care within communities are key to increasing access to care and limiting pressure on local services.Researchers from ‘Opportunities and Choices’ programme at the University of Southampton, UK, drew on data on 11,369 women of reproductive age from the Indian states of Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh in the 1998-99 Indian National Family Health Survey. The researchers examined the factors associated with the use of antenatal care facilities in rural areas, and with access to specific components of antenatal care. They also looked for differences in the pattern of use between health clinics and home visits. The study uses data on antenatal check-ups for women during their last pregnancy. The variables included were: education level, socio-economic status, demographic characteristics, including age and parity, and level of exposure to the media, such as regular television viewing. The researchers considered the following components of antenatal care: urine testing, taking of blood pressure, blood testing, abdomen examination, internal examination, tetanus vaccination and being given iron and folic acid supplements.Research findings include:Overall, 3 out of every 5 women (62.8 percent) did not receive any antenatal check-up during their last pregnancy. Among those women who did attend a clinic, the average number of visits was two. In Uttar Pradesh and Bihar more women were seen by a doctor than by a nurse or midwife. Overall 55 percent of women attending antenatal check-ups were seen by a doctor. The most commonly received services were tetanus vaccination and iron and folic acid supplements. Women visited at home by health workers received fewer services. Women who married at an older age and watched television each week were more likely to use antenatal services, whereas the association between a woman’s religion or caste and access to services varied between states. In all states, women and their husbands who had a higher standard of living and education levels were more likely to visit a health clinic and receive a more specific type of care Women from poor and uneducated backgrounds with at least one child were least likely to receive antenatal care. To overcome the socio-economic and cultural barriers that prevent women in rural India accessing antenatal services, policy-makers should:take into account the diverse social conditions between states and between communities within each state consider whether the uptake of services for second and subsequent pregnancies may be due to a reduced perception of need, or practical difficulties associated with caring for young children plan health policies that take into account that decisions to access antenatal care are based on an individual's or a community's perception of need, and the cost and quality of different health care providers provide further training and supervision for health workers to ensure all the components of antenatal care are provided increase the role of nurses and midwives so that specialised clinical staff can treat those with complications expand the provision of iron or folic acid supplements in communities to reduce dependence on the health service for these simple interventions. Contributor(s): Saseendran Pallikadavath, Mary Foss, R. William StonesSource(s): ‘Antenatal care: provision and inequality in rural north India’, Social Science and Medicine 59: 1147-1158, by S. Pallikadavath, M. Foss and R.W. Stones, 2004 More information.'Obstetric care in central India', Southampton: University of Southampton Press, A. Ranjan and R.W. Stones (eds.), 2004 'A framework for the evaluation of quality of care in maternity services', Southampton: University of Southampton Press, L.A. Hulton, Z. Matthews and R.W. Stones (eds.), 2004Funded by: UK Department for International Development id21 Research Highlight: 16 February 2005Further Information:R William Stones Level F (815) Princess Anne Hospital SouthamptonSO16 5YAUKTel: +44 (0) 23 8079 6033Fax: +44 (0) 23 8078 6933Email: [email protected]
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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