Nurses and midwives’ experience in providing fertility awareness-based methods, including natural family planning methods in Rwanda

  • International Journal of Africa Nursing Sciences, Volume 18, Year 2023

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Study Justification:
– Access to effective and acceptable family planning services is crucial in developing countries to reduce maternal deaths and prevent unwanted pregnancies.
– This study aims to understand the experiences of nurses and midwives in providing information on fertility awareness-based methods, including natural family planning, in Rwanda.
– The findings can help identify barriers and facilitators in the provision of these methods and inform improvements in family planning education and service delivery.
Study Highlights:
– Ten nurses and midwives from six health centers in the Kicukiro district in Rwanda were interviewed.
– Three main themes emerged from the analysis: facilitators and barriers to fertility awareness-based methods, advantages of these methods, and the attitude and teaching of nurses and midwives.
– Limited pre-service education and lack of in-service training contribute to limited knowledge and skills of healthcare providers in fertility awareness-based methods.
– Nursing and midwifery schools should improve the teaching of these methods, and health centers should provide ongoing in-service education to healthcare providers.
– The findings have implications for other developing countries and can guide positive changes in family planning education and service delivery.
Recommendations for Lay Readers:
– Improve pre-service education and in-service training for nurses and midwives on fertility awareness-based methods, including natural family planning.
– Enhance the teaching of these methods in nursing and midwifery schools.
– Provide ongoing extensive in-service education to healthcare providers in health centers.
– Increase content related to family planning in nursing and midwifery education.
Recommendations for Policy Makers:
– Allocate resources to improve pre-service education and in-service training for healthcare providers on fertility awareness-based methods.
– Support nursing and midwifery schools in enhancing the teaching of these methods.
– Provide funding for ongoing extensive in-service education programs in health centers.
– Advocate for increased content related to family planning in nursing and midwifery education curricula.
Key Role Players:
– Ministry of Health
– Nursing and midwifery schools
– Health center administrators
– Professional nursing and midwifery associations
– International organizations supporting reproductive health
Cost Items for Planning Recommendations:
– Development and implementation of pre-service education programs
– Training materials and resources
– Hiring of trainers and facilitators
– Coordination and administration of in-service education programs
– Monitoring and evaluation of education initiatives
– Curriculum development and revision in nursing and midwifery schools
– Support for research and evidence-based practice in family planning education

The strength of evidence for this abstract is 7 out of 10.
The evidence in the abstract is moderately strong. The study utilized qualitative descriptive methods and conducted face-to-face interviews with ten nurses and midwives in Rwanda. The data was analyzed using inductive content analysis, which helps in gaining an in-depth understanding of the participants’ experiences. The study identified three themes related to the facilitators, barriers, advantages, attitudes, and teaching of fertility awareness-based methods. The findings suggest that limited education and training contribute to healthcare providers’ limited knowledge and impact their attitudes and skills. The study provides actionable steps to improve the situation, such as improving how fertility awareness-based methods are taught in nursing and midwifery schools and providing ongoing in-service education to healthcare providers. However, the evidence could be strengthened by including a larger sample size and conducting quantitative research to validate the findings.

Access to effective and acceptable family planning services in developing countries is an essential reproductive health intervention to reduce maternal deaths and prevent unwanted pregnancies. The purpose of this qualitative descriptive study was to gain an in-depth understanding of nurses’ and midwives’ experiences in providing information related to fertility awareness-based methods, including natural family planning, to clients in Rwanda. Face-to-face individual interviews were conducted with ten nurses and midwives who provide family planning services at six health centers in the Kicukiro district in Rwanda. The interviews were audio-recorded, transcribed verbatim into Kinyarwanda and then translated into English. Inductive content analysis was used for data analysis. Three themes were identified: 1) Fertility Awareness-Based Methods, including Natural Family Planning Method Facilitators and Barriers, 2) Advantages of Fertility Awareness-Based Methods, including Natural Family Planning Methods; and 3) Nurses’ and Midwives’ Attitude and Teaching of Fertility Awareness-Based Methods, including Natural Family Planning Methods. Study findings suggest that limited pre-service education and lack of in-service training about family planning contributes to nurses’ and midwives’ limited knowledge of Fertility Awareness-Based Methods, including Natural Family Planning Methods, and impacts their attitudes and skill level toward counselling clients. Nursing and midwifery schools need to improve how they teach Fertility Awareness-Based Methods, including Natural Family Planning, and health centers need to provide ongoing extensive in-service education to healthcare providers. There is a need to increase content related to family planning in nursing and midwifery education. These findings may also pertain to other developing countries like Rwanda and guide a positive change in family planning education for healthcare providers and FP services delivery.

N/A

Innovations for the above recommendations could include:

1. Integration of comprehensive family planning education into nursing and midwifery curricula: Nursing and midwifery schools can revise their curricula to include comprehensive education on fertility awareness-based methods and natural family planning. This can be achieved by incorporating dedicated courses or modules that cover the principles, methods, and counseling techniques related to these family planning methods.

2. Development of training programs for nurses and midwives: Health centers can establish training programs that provide ongoing in-service education to nurses and midwives. These programs can be designed to update their knowledge and enhance their skills in delivering family planning services, with a specific focus on fertility awareness-based methods and natural family planning.

3. Collaboration with international organizations and experts: Nursing and midwifery schools, as well as health centers, can collaborate with international organizations and experts in the field of family planning. This collaboration can involve knowledge sharing, training workshops, and mentorship programs to ensure that healthcare providers receive the most up-to-date and evidence-based education and training in fertility awareness-based methods and natural family planning.

4. Utilization of technology and e-learning platforms: Nursing and midwifery schools can leverage technology and e-learning platforms to enhance the education and training of healthcare providers. Online courses, webinars, and interactive modules can be developed to provide accessible and flexible learning opportunities for nurses and midwives, regardless of their geographical location.

5. Strengthening of supervision and mentorship programs: Health centers can establish robust supervision and mentorship programs for nurses and midwives providing family planning services. This can involve regular monitoring, feedback, and support from experienced healthcare providers or supervisors who have expertise in fertility awareness-based methods and natural family planning.

These innovations aim to improve the education and training of nurses and midwives in Rwanda, ultimately enhancing their knowledge and skills in providing fertility awareness-based methods, including natural family planning, and improving access to maternal health services.
AI Innovations Description
The recommendation from the study is to improve access to maternal health by enhancing the education and training of nurses and midwives in Rwanda. The study found that limited pre-service education and lack of in-service training about family planning contribute to healthcare providers’ limited knowledge and skills in providing fertility awareness-based methods, including natural family planning.

To address this, nursing and midwifery schools should improve their curriculum to include comprehensive education on fertility awareness-based methods and natural family planning. This will ensure that future healthcare providers are equipped with the necessary knowledge and skills to effectively counsel and provide these services to clients.

Additionally, health centers should provide ongoing extensive in-service education to nurses and midwives. This will help update their knowledge and enhance their skills in delivering family planning services.

The findings of this study can also be applied to other developing countries, suggesting the need for a positive change in family planning education for healthcare providers and the delivery of family planning services.
AI Innovations Methodology
To simulate the impact of the main recommendations mentioned in the abstract on improving access to maternal health, the following methodology can be employed:

1. Study Design: A mixed-methods approach can be used to gather both quantitative and qualitative data. This can include surveys, interviews, and observations.

2. Sample Selection: A representative sample of nurses and midwives from various healthcare facilities in Rwanda can be selected. This can include both rural and urban areas to capture a diverse range of experiences.

3. Pre-Intervention Assessment: Before implementing the recommendations, a baseline assessment should be conducted to measure the current knowledge, attitudes, and skills of nurses and midwives regarding fertility awareness-based methods and natural family planning. This can be done through surveys and interviews.

4. Intervention Implementation: The recommendations from the study can be implemented, including enhancing the curriculum of nursing and midwifery schools to include comprehensive education on fertility awareness-based methods and natural family planning. In-service training programs can also be developed and provided to healthcare providers in health centers.

5. Post-Intervention Assessment: After the intervention, a follow-up assessment should be conducted to measure the impact of the recommendations. This can include surveys, interviews, and observations to evaluate changes in knowledge, attitudes, and skills of nurses and midwives.

6. Data Analysis: The collected data should be analyzed using appropriate statistical methods for quantitative data and thematic analysis for qualitative data. This will help identify any significant changes in the knowledge, attitudes, and skills of healthcare providers.

7. Evaluation and Recommendations: Based on the findings, an evaluation should be conducted to assess the effectiveness of the recommendations in improving access to maternal health. Recommendations can be made for further improvements or adjustments to the interventions.

8. Dissemination: The results of the study should be disseminated through publications, conferences, and workshops to raise awareness and promote the adoption of these recommendations in other developing countries.

By following this methodology, researchers can assess the impact of enhancing education and training of nurses and midwives on improving access to maternal health in Rwanda and potentially replicate these findings in other similar contexts.

Statistics:
Authors: 7
Identifiers:
DOI: 10.1016/j.ijans.2023.100537
ISSN: 22141391
Research Areas:
Community Interventions, Health System and Policy, Maternal Access, Maternal and Child Health, Quality of Care, Sexual and Reproductive Health, Social Determinants, Workforce
Study Countries:
Rwanda
Study Design:
Cross Sectional Study, Exploratory Study, randomised-control-trial
Study Approach:
Qualitative
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