florence west

Background: Pressing issues, like financial concerns, may outweigh the importance people attach to health. This study tested whether health, compared to other life domains, was considered more important by people in high versus low socioeconomic positions, with future focus and financial strain as potential explanatory factors. Methods: A cross-sectional survey was conducted in 2019 among N=1,330 Dutch adults. Participants rated the importance of two health-related domains (not being ill, living a long life) and seven other life domains (e.g., work, family) on a five-point scale. A latent class analysis grouped participants in classes with similar patterns of importance ratings. Differences in class membership according to socioeconomic position (indicated by income and education) were examined using structural equation modelling, with future focus and financial strain as mediators. Results: Three classes were identified, which were defined as: neutralists, who found all domains neutral or unimportant (3.5% of the sample); hedonists, who found most domains important except living a long life, work, and religion (36.2%); and maximalists, who found nearly all domains important, including both health domains (60.3%). Of the neutralists, 38% considered not being ill important, and 30% considered living a long life important. For hedonists, this was 92% and 39%, respectively, and for maximalists this was 99% and 87%, respectively. Compared to belonging to the maximalists class, a low income predicted belonging to the neutralists, and a higher educational level and unemployment predicted belonging to the hedonists. No mediation pathways via future focus or financial strain were found. Conclusions: Lower income groups were less likely to consider not being ill important. Those without paid employment and those with a higher educational level were less likely to consider living a long life important. Neither future focus nor financial strain explained these inequalities. Future research should investigate socioeconomic differences in conceptualisations of health, and if inequalities in the perceived importance of health are associated with inequalities in health. To support individuals dealing with challenging circumstances in daily life, health-promoting interventions could align to the life domains perceived important to reach their target group and to prevent widening socioeconomic health inequalities.

[Background] Midwifery educators play a critical role in strengthening the midwifery workforce in low and lower-middle income countries (LMIC) to ensure that women receive quality midwifery care. The most effective approach to building midwifery educator capacity is not always clear. Partnering international and national midwifery educators in education institutions is one strategy to improve the quality of midwifery teaching and learning. [Aim] The aim of this study was to explore how midwifery educator capacity in learning and teaching in LMIC can be strengthened and improved. This research was conducted in two phases. Phase 1 aimed to determine whether one approach – the Papua New Guinea Maternal and Child Health Initiative – contributed to capacity building that was designed to improve midwifery teaching and learning. Phase 2 explored how capacity building using international partnerships is conducted in other LMICs. [Methods] This study used a sequential exploratory mixed method design. During Phase 1, an exploratory qualitative case study design was used. Data were collected from 26 semi-structured interviews conducted with both national and international midwifery educators. A thematic analysis was undertaken. In Phase 2, a descriptive quantitative design was used with data collected from a survey of 18 international and nine national midwifery educators working in 13 different LMICs. Descriptive statistics and content analysis were undertaken. [Findings] In Phase 1, seven themes were identified. The first three provided insights into enabling factors: knowing your own capabilities, being able to build relationships and being motivated to improve the health status of women. The next four themes explored constraining factors: having a mutual understanding of the capacity building project, preparing stakeholders for working together, knowing how to adapt to a different culture, and needing an environment which supports improved midwifery education. Phase 2 confirmed that midwifery educators working in other LMICs experience similar enabling and constraining factors. An individual’s knowledge, skills and attitude influenced the quality of the international partnership. Social norms, institutional support and context also shaped the capacity of midwifery educators to improve teaching and learning. [Discussion and Implications] Individual, partnership and environmental factors influenced midwifery educators to improve teaching and learning in LMIC. Monitoring and evaluation of individual performance, using national and international guidelines may help to provide feedback and build educator confidence. Specific individual preparation for the capacity building partnership would help to ensure that all stakeholders have a mutual understanding, are culturally competent and maintain relevance to the context. Strengthening institutional leadership and infrastructure to provide a supportive working environment would also enable educators to access contemporary teaching resources and research evidence. Supporting…

Introduction: Midwives in Papua New Guinea have a vital role to play in addressing the high maternal and neonatal mortality rate. Attracting applicants in sufficient numbers and quality to study midwifery has been challenging in some countries. Aim: The aim of this study was to explore the motivation of students to study midwifery in Papua New Guinea. Findings from this study will assist in midwifery workforce recruitment and retention. Methods: Between 2012-2014, midwifery students (n=298) from the four midwifery schools in Papua New Guinea were surveyed and interviewed on their perceptions regarding their midwifery studies. One part of the data collection process asked the students to describe their motivation to become a midwife with the question: Why did you choose to study midwifery ? A content and thematic analysis was undertaken. Results: 194 (65% response rate) students provided between 1-3 different responses to the question, making a total of 246 responses. Three main them...

Background:Midwifery educators play a critical role in strengthening the midwifery workforce in low and lower-middle income countries to ensure that women receive quality midwifery care. However, the most effective approach to building midwifery educator capacity is not always clear. Objective:This paper reports the findings from a study that aimed to determine how a capacity building initiative enabled the midwifery educators to improve the teaching and learning to ensure quality graduates. Methods:A qualitative study using an explanatory case study design was used to explore how the capacity of midwifery educators in low and lower-middle income countries can be strengthened. Data were collected from 26 semi-structured interviews conducted with both the national and international midwifery educators. The interviews explored the educator's perceptions of working together in teaching institutions and clinical practice sites to strengthen teaching capacity. A thematic analysis was undertaken. Results:There were seven themes identified. The first three provide insights into enabling factors for strengthening midwifery educator capacity: knowing your own capabilities, being able to build relationships and being motivated to improve the health status of women. The next four themes explored aspects perceived to constrain the individual's ability to improve midwifery educator capacity: having a mutual understanding of the capacity building project, preparing stakeholders for working together, knowing how to adapt to a different culture, needing an environment which supports improved midwifery education. Conclusion:The study provides evidence to support a capacity-building approach where international and national midwifery educators work closely together to strengthen teaching and learning skills. An individual's personal and professional attributes play a role in determining the success of working in such a partnership. Cultural competence, adapting to the context and a supportive environment were also identified as key aspects of a capacity building initiative.

Midwifery educators play a critical role in strengthening the midwifery workforce globally, including in low and lower-middle income countries (LMIC) to ensure that midwives are adequately prepared to deliver quality midwifery care. The most effective approach to building midwifery educator capacity is not always clear. The aim of this study was to determine how one capacity building approach in Papua New Guinea (PNG) used international partnerships to improve teaching and learning. A qualitative exploratory case study design was used to explore the perspectives of 26 midwifery educators working in midwifery education institutions in PNG. Seven themes were identified which provide insights into the factors that enable and constrain midwifery educator capacity building. The study provides insights into strategies which may aid institutions and individuals better plan and implement international midwifery partnerships to strengthen context-specific knowledge and skills in teaching. Fu...

midwifery educators play a critical role in strengthening the midwifery workforce in low and lower-middle income countries (LMIC) to ensure that women receive quality midwifery care. However, the most effective approach to building midwifery educator capacity is not always clear. This paper will explore approaches used to build midwifery educator capacity in LMIC and identify evidence to inform improved outcomes for midwifery education. a structured search of bibliographic electronic databases (CINAHL, OVID, MEDLINE, PubMed) and the search engine Google Scholar was performed. It was decided to also review peer reviewed research, grey literature and descriptive papers. Papers were included in the review if they were written in English, published between 2000 and 2014 and addressed building knowledge and/or skills in teaching and/or clinical practice in midwifery educators who work in training institutions in LMIC. The Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) was used to guide the reporting process. The quality of papers was appraised in discussion with all authors. The findings sections of the research papers were analysed to identify successful elements of capacity building approaches. eighteen (six research and 12 discursive) papers were identified as related to the topic, meeting the inclusion criteria and of sufficient quality. The findings were themed according to the key approaches used to build capacity for midwifery education. These approaches are: skill and knowledge updates associated with curriculum review, involvement in leadership, management and research training and, participation in a community of practice within regions to share resources. the study provides evidence to support the benefits of building capacity for midwifery educators. Multilevel approaches that engaged individuals and institutions in building capacity alongside an enabling environment for midwifery educators are needed but more research specific to midwifery is required. these findings provide insight into strategies that can be used by individuals, faculties and institutions providing development assistance to build midwifery educator capacity in LMIC.