Context specific realities and experiences of nurses and midwives in basic emergency obstetric and newborn care services in two district hospitals in Rwanda: a qualitative study
Abstract Background In low and middle-income countries, nurses and midwives are the frontline healthcare workers in obstetric care. Insights into experiences of these healthcare workers in managing obstetric emergencies are critical for improving the quality of care. This article presents such insig...
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| Format: | Article |
| Language: | English |
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BMC
2022-01-01
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| Series: | BMC Nursing |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12912-021-00793-y |
| _version_ | 1818753019477491712 |
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| author | Aurore Nishimwe Daphney Nozizwe Conco Marc Nyssen Latifat Ibisomi |
| author_facet | Aurore Nishimwe Daphney Nozizwe Conco Marc Nyssen Latifat Ibisomi |
| author_sort | Aurore Nishimwe |
| collection | DOAJ |
| description | Abstract Background In low and middle-income countries, nurses and midwives are the frontline healthcare workers in obstetric care. Insights into experiences of these healthcare workers in managing obstetric emergencies are critical for improving the quality of care. This article presents such insights, from the nurses and midwives working in Rwandan district hospitals, who reflected on their experiences of managing the most common birth-related complications; postpartum hemorrhage (PPH) and newborn asphyxia. Rwanda has made remarkable progress in obstetric care. However, challenges remain in the provision of high-quality basic emergency obstetric and newborn care (BEmONC). This study is a qualitative part of a broader research project about implementation of an mLearning and mHealth decision support tool in BEmONC services in Rwanda. Methods In this exploratory qualitative aspect of the research, four focus group discussions (FGDs) with 26 nurses and midwives from two district hospitals in Rwanda were conducted. Each FGD was made up of two parts. The first part focused on the participants’ reflections on the research results (from the previous study), while the second part explored their experiences of delivering obstetric care services. The research results included: survey results reflecting their knowledge and skills of PPH management and of neonatal resuscitation (NR); and findings from a six-month record review of PPH management and NR outcomes, from the district hospitals under study. Data were analyzed using hybrid thematic analysis. Results The analysis revealed three main themes: (1) reflections to the baseline research results, (2) self-reflection on the current practices, and (3) contextual factors influencing the delivery of BEmONC services. Nurses and midwives felt that the presented findings were a true reflection of the reality and offered diverse explanations for the results. The participants’ narratives of lived experiences of providing BEmONC services are also presented. Conclusion The insights of nurses and midwives regarding the management of birth-related complications revealed multi-faceted factors that influence the quality of their obstetric care. Even though the study was focused on PPH management and NR, the resulting recommendations to improve quality of care could benefit the broader field of maternal and child health, particularly in low and middle-income countries. |
| first_indexed | 2024-12-18T05:00:42Z |
| format | Article |
| id | doaj.art-1555e53a3ed14af7945e8a5789352024 |
| institution | Directory Open Access Journal |
| issn | 1472-6955 |
| language | English |
| last_indexed | 2024-12-18T05:00:42Z |
| publishDate | 2022-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nursing |
| spelling | doaj.art-1555e53a3ed14af7945e8a57893520242022-12-21T21:20:09ZengBMCBMC Nursing1472-69552022-01-0121111610.1186/s12912-021-00793-yContext specific realities and experiences of nurses and midwives in basic emergency obstetric and newborn care services in two district hospitals in Rwanda: a qualitative studyAurore Nishimwe0Daphney Nozizwe Conco1Marc Nyssen2Latifat Ibisomi3School of Public Health, Faculty of Health Sciences, University of the WitwatersrandSchool of Public Health, Faculty of Health Sciences, University of the WitwatersrandDepartment of Biomedical Statistics and Informatics, Vrije UniversiteitSchool of Public Health, Faculty of Health Sciences, University of the WitwatersrandAbstract Background In low and middle-income countries, nurses and midwives are the frontline healthcare workers in obstetric care. Insights into experiences of these healthcare workers in managing obstetric emergencies are critical for improving the quality of care. This article presents such insights, from the nurses and midwives working in Rwandan district hospitals, who reflected on their experiences of managing the most common birth-related complications; postpartum hemorrhage (PPH) and newborn asphyxia. Rwanda has made remarkable progress in obstetric care. However, challenges remain in the provision of high-quality basic emergency obstetric and newborn care (BEmONC). This study is a qualitative part of a broader research project about implementation of an mLearning and mHealth decision support tool in BEmONC services in Rwanda. Methods In this exploratory qualitative aspect of the research, four focus group discussions (FGDs) with 26 nurses and midwives from two district hospitals in Rwanda were conducted. Each FGD was made up of two parts. The first part focused on the participants’ reflections on the research results (from the previous study), while the second part explored their experiences of delivering obstetric care services. The research results included: survey results reflecting their knowledge and skills of PPH management and of neonatal resuscitation (NR); and findings from a six-month record review of PPH management and NR outcomes, from the district hospitals under study. Data were analyzed using hybrid thematic analysis. Results The analysis revealed three main themes: (1) reflections to the baseline research results, (2) self-reflection on the current practices, and (3) contextual factors influencing the delivery of BEmONC services. Nurses and midwives felt that the presented findings were a true reflection of the reality and offered diverse explanations for the results. The participants’ narratives of lived experiences of providing BEmONC services are also presented. Conclusion The insights of nurses and midwives regarding the management of birth-related complications revealed multi-faceted factors that influence the quality of their obstetric care. Even though the study was focused on PPH management and NR, the resulting recommendations to improve quality of care could benefit the broader field of maternal and child health, particularly in low and middle-income countries.https://doi.org/10.1186/s12912-021-00793-yBasic emergency obstetric and newborn carePost-partum haemorrhageNeonatal resuscitationNurseMidwifeRwanda |
| spellingShingle | Aurore Nishimwe Daphney Nozizwe Conco Marc Nyssen Latifat Ibisomi Context specific realities and experiences of nurses and midwives in basic emergency obstetric and newborn care services in two district hospitals in Rwanda: a qualitative study BMC Nursing Basic emergency obstetric and newborn care Post-partum haemorrhage Neonatal resuscitation Nurse Midwife Rwanda |
| title | Context specific realities and experiences of nurses and midwives in basic emergency obstetric and newborn care services in two district hospitals in Rwanda: a qualitative study |
| title_full | Context specific realities and experiences of nurses and midwives in basic emergency obstetric and newborn care services in two district hospitals in Rwanda: a qualitative study |
| title_fullStr | Context specific realities and experiences of nurses and midwives in basic emergency obstetric and newborn care services in two district hospitals in Rwanda: a qualitative study |
| title_full_unstemmed | Context specific realities and experiences of nurses and midwives in basic emergency obstetric and newborn care services in two district hospitals in Rwanda: a qualitative study |
| title_short | Context specific realities and experiences of nurses and midwives in basic emergency obstetric and newborn care services in two district hospitals in Rwanda: a qualitative study |
| title_sort | context specific realities and experiences of nurses and midwives in basic emergency obstetric and newborn care services in two district hospitals in rwanda a qualitative study |
| topic | Basic emergency obstetric and newborn care Post-partum haemorrhage Neonatal resuscitation Nurse Midwife Rwanda |
| url | https://doi.org/10.1186/s12912-021-00793-y |
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