Nursing and Midwifery Sciences

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    Accessibility to and utilization of maternal, neonatal and child health (MNCH) services by rural women: A case study of health centres in Mutare district based on the 3 delays model
    (Academic Journals, 2022) Ndhlovu-Ncube, N.P.; Mavondo, G.A.; Moyo, O.; Chikuse F. F.; Ndhlovu, T.C.; Mavondo, J.; Mkhwanazi, B. N.; Musarurwa, C.; Chaibva, C.N.
    High maternal, neonatal and child mortality rate constituting about 70% of the population in Zimbabwe. Zimbabwean rural women have faced challenges in accessing and utilizing Maternal, Neonatal and Child Health (MNCH) services. Rural areas in Zimbabwe have had high prevalence of home deliveries and pregnancy related complications associated with lack of access to and utilization of MNCH services, resulting in high maternal, stillbirths, new-born, neonatal and infant mortality rates. Access to and utilisation of MNCH services and facilities by rural based pregnant women has been limited by several issues that have been explored and assessed in the Primary Health Care clinics. However, the 3 delays (seek, access and receive health service) effects on the factors affecting health care and outcomes remain largely unclear in rural settings. Qualitative and quantitative methods research was conducted in Mutare district, Manicaland Province, Zimbabwe. Data collection tools including interviews questionnaires and focus group discussion guides were used to show how the three delays affected health service access in the district. GraphPad InStat Software and Statistical Package for Social Science were used for data analysis. Religious and cultural beliefs contributed to patient delays in seeking healthcare. With long distances and lack of transport attributed to Delays 1 and 2 with, drug unavailability, up-to date equipment and delay causing Delay 3. The patient, the provider and health systems were critical in accessibility, utilization and linkages of MNCH with other health services being crucial for achieving 4th and 5th Millennium Development Goals the targets.
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    Midwife led maternity care models: A scoping review
    (2023) Danda, G.; Chaibva, C.N.; Chauraya, Y.; Gwatiringa, C.; Chamisa, J.A.; Dabengwa, I.M.; Moyo, H.; Mantula, F.; Sibanda, E.
    Introduction: Midwife led maternity care models focus on normality, continuity of care and being cared for by trusted midwives from preconception throughout pregnancy, labour and the postnatal period. The aim of this model is to provide care either in community or hospital settings, normally to healthy women with uncomplicated pregnancies. Methods: The scoping review used search terms for the PICO components with synonyms, related terms and specialist terms were harvested from the Medical Subject Headings (MeSH)© and Embase© using Rayyan. Database searches were from PubMed, EBSCO-CINAHL, Dimensions, Web of Science, SCOPUS, and the Cochrane Library of Systematic reviews and African Journals Online (AJOL). A total of 17 058 citations were identified and 69 remained for analysis after removing duplicates and others which did not meet the criteria. Results: Of the 69 included studies, 14 were qualitative, 34 were quantitative, 19 were RCTs and 2 were mixed methods. Only 13% of the studies were from Africa and the rest were from the developed world. Six themes emerged as follows: reduced interventions in labour; positive birth outcomes; satisfaction with care; cost effectiveness of services; autonomous practice and quality midwifery services; good woman–midwife relationship and several subthemes. Discussion: Midwife-led care had a significant positive effect on physiological outcomes for women when compared to physician-led care, had reduced surgical interventions and augmentation, as well as less usage of pharmacological analgesia. This may also assist in acceptability, accessibility and availability of such a model in all maternity care units and community settings in LMICs.
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    RoadMApp: a feasibility study for a smart travel application to improve maternal health delivery in a low resource setting in Zimbabwe
    (2020) Nyati-Jokomo, Z.; Dabengwa, I.M.; Makacha, L.; Nyapwere, N.; Dube, Y.P.; Chikoko, L.; Vidler, M.; Makanga, P.T.
    Background: Travel time and healthcare financing are critical determinants of the provision of quality maternal health care in low resource settings. Despite the availability of pregnancy-related mHealth and smart travel applications, there is a lack of evidence on their usage to travel to health facilities for routine antenatal care and emergencies. There is a shortage of information about the feasibility of using a custom-made mobile technology that integrates smart travel and mHealth. This paper explores the feasibility of implementing a custom-made geographically enabled mobile technology-based tool (RoadMApp) to counter the adverse effects of long travel times for maternal care in Kwekwe District, Zimbabwe. Methods: We frame the paper using the first two steps (listen & plan) of the Spiral Technology Action Research (STAR model). The paper uses an exploratory case study design and Participatory Learning Approaches (PLA) with stakeholders (community members) and in-depth interviews with key informants (health care service providers, pregnant women, transport operators). One hundred ninety-three participants took part in the study. We conducted focus group discussions with pregnant women, women of childbearing age, men (household heads), and elderly women. The discussion questions centered on travel time, availability of transport, cellular network coverage, and perceptions of the RoadMApp application. Data were analysed thematically using Nvivo Pro 12. Results: Most parts of rural Kwekwe are far from health facilities and have an inefficient road and telecommunications network. Hence, it is hard to predict if RoadMApp will integrate into the lives of the community - especially those in rural areas. Since these issues are pillars of the design of the RoadMApp mHealth, the implementation will probably be a challenge.