Men's perspectives on HIV self-testing in sub-Saharan Africa: a systematic review and meta-synthesis.

BACKGROUND: Despite the many HIV testing models implemented in Africa, the level of HIV testing uptake remains relatively poor, especially among men. The HIV self-testing (HIVST) model offers an additional approach for encouraging men to get tested. This study aimed to synthesise evidence on men's perspectives regarding HIVST in sub-Saharan Africa (SSA). METHODS: The databases searched included PubMed/MEDLINE, American Doctoral Dissertations via EBSCO host; Union Catalogue of Theses and Dissertations; SA ePublications via SABINET Online; World Cat Dissertations; Theses via OCLC; ERIC; CINAH; PsychInfo; Embase, Sociological Abstract, Scopus; and Google Scholar. The World Health Organization (WHO) and The Joint United Nations' Programme on HIV and AIDS (UNAIDS) websites were further searched. We only extracted qualitative information from the included studies, despite the research method used (qualitative or mixed methods). The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), as well as the Mixed Method Appraisal Tool (MMAT) version 2018, were used to determine the methodological quality of the included studies. NVivo version 11 was used for thematic analysis. RESULTS: A total of 21,184 articles were identified by the initial search criteria, but only 16 articles were included in the data extraction and quality assessment stage. The following key themes emerged: knowledge of HIVST; acceptability of HIVST; need for HIVST counselling; confidentiality of HIVST; convenience of HIVST; and accuracy of HIVST. The study shows that while HIVST provides men with an alternative, confidential and convenient testing model, the potential for psychological and physical harm remains a challenge. CONCLUSION: The introduction of the HIVST strategy has the potential of improving men's uptake in HIV testing services, thereby contributing towards addressing the first cascade of the 90-90-90 strategy. While HIVST has a potential for addressing men's barriers to attending clinic settings, such as confidentiality and convenience, it barely addresses the HIVST counselling and accuracy concerns.

Issues and challenges of curriculum reform to competency-based curricula in Africa: A meta-synthesis.

Although in recent decades reforms to undergraduate nursing and midwifery education have increasingly been guided by the concept of competency-based curriculum in a drive to produce competent graduates in the African context, the topic remains poorly researched in-depth. The related issues and challenges need to be explored in the interest of evidence-based practice. This article stems from a systematic review of qualitative literature on the design and implementation of competency-based curriculum. Data was inductively analyzed using constant comparison. The two categories that emerged were: (i) the need for a paradigm shift to competency-based curriculum; and (ii) the associated issues and challenges, such as a shift from informative to transformative learning, lack or limited of involvement of key stakeholders in curriculum development, focus on hospital-oriented education, lack of preparation of educators, and inappropriate resources. While ongoing reform of nursing and midwifery education continues, much still needs to be done - in particular, extensive financial investment to increase the capacity of educators, mentors and infrastructure, and the development of collaborative frameworks between nursing and midwifery and higher educational councils.

Planning reform to competency based curricula in undergraduate nursing and midwifery education: A qualitative study.

BACKGROUND: Reform to Competency-based curricula, a standard for training health professionals of the 21st century, requires rigorous planning for successful implementation. However, although the reform defines the direction of the schools and quality of their products, it lacks in planning and prominence which could lead to the failure and waste of resources. OBJECTIVE: To explore the processes of planning reform to Competency-based curricula in undergraduate nursing and midwifery education in Rwanda. DESIGN: This study adopted a qualitative approach to give detailed descriptions and explanations of the phenomenon. Ethics approval and permissions were obtained before data collection. SETTINGS: The data was collected on two campuses of the University of Rwanda offering undergraduate nursing and midwifery programs. PARTICIPANTS: 17 staff participated in this study. METHODS: The data was collected through in-depth individual interviews of staff including four administrators and leaders, seven people occupying both academic management and teaching posts, and six educators. The data was analysed by the researchers following Corbin and Strauss' grounded theory through open coding, axial coding, and selective coding. RESULTS: Emerged categories were: (a) Establishment of a curriculum development team, (b) sourcing of curriculum development experts, (c) situational analysis, (d) curriculum development, and (e) preparation of stakeholders. CONCLUSION: Well-planned reform to Competency-based curricula leads to successful implementation through the involvement of different stakeholders from the beginning.

Analyzing Evidence on Interventions to Strengthen the Clinical Support for Midwifery Students in Clinical Placements: Protocol for a Systematic Scoping Review.

BACKGROUND: The benefits of clinical support are evident in various mentorship, preceptorship, or clinical supervision models. Poor collaboration between lecturers and clinical staff, lack of confidence about student support, large student intakes coupled with core demands create negative attitudes toward student supervision, and this poses a huge challenge to midwifery students who are expected to become competent in the process. OBJECTIVE: This study aims to identify and analyze interventions, strategies, and/or mechanisms in order to strengthen the clinical support for midwifery students in clinical practice areas from a global perspective. METHODS: This review will follow the Arksey and O'Malley framework (2005). The search strategy will include primary studies searched for in electronic databases such as EBSCOhost (CINAHL, MEDLINE, and Health Source: Nursing/Academic edition), PubMed, Google, and Google Scholar. Keywords such as "midwifery students," "midwifery education," and "clinical support" will be used to search for related articles. The search will include articles from the cited by search, as well as citations from the reference list of included articles. All title-screened articles will be exported to an EndNote library, and duplicate studies will be removed. Two independent reviewers will concurrently carry out the abstract and full-text article screening according to the eligibility criteria. Extracted data will highlight the aims, geographical setting, and level of training; intervention outcomes; and the most relevant and most significant findings. This review will also include a mixed methods quality appraisal check. A narrative summary of data extracted will be analyzed using content analysis. RESULTS: Interventions to strengthen the clinical support for midwifery students in practice will be extracted from this review, and data will be analyzed and extracted to develop a comprehensive guide or framework for clinical mentorship. As of August 2021, the electronic search, the data extraction, and the analysis have been completed. The results paper is expected to be published within the next 6 months. CONCLUSIONS: It is expected that this review will contribute to midwifery education by identifying quality evidence on clinical support interventions available to midwifery students globally, as well as best practice methods, procedures, or interventions that can be used to develop a midwifery mentorship training program. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/29707.

Challenges in postgraduate research supervision in nursing education: Integrative review.

AIM: The aim of this study was to investigate challenges associated with postgraduate research supervision in nursing education and possible implications for improvement efforts. BACKGROUND: Postgraduate research-based programs in nursing education are particularly new compared to other professions. Anecdotal notes from nursing education stakeholders indicate that postgraduate research supervision encounters numerous challenges, with negative consequences for the nursing profession and for society. METHOD: Integrative review that combines empirical and theoretical evidence was used to obtain a comprehensive picture of challenges in the supervision of postgraduate research. DATA SOURCES: EBSCOhost; Science Direct; Google Scholar. REVIEW METHODS: The quality of included studies was appraised using the Mixed Method Appraisal Tool for quantitative, qualitative and mixed-method studies. Two reviewers extracted data and did quality appraisal. ANALYSIS: Inductive content analysis was used to analyse extracted data from included studies. RESULTS: Seven studies were included. Three main categories of challenges associated with (a) institutional context, (b) research supervisors, and (c) postgraduate students. DISCUSSION: Institutional context challenges were lack of clear guidelines for nursing schools, limited pool of appropriate research supervisors, and recruitment of many postgraduate students leading to mismatch, confusion and limited support. Research supervisors are insufficiently prepared, predominantly use traditional face-to-face method, and provide inconsistent feedback. Postgraduate students are inadequately prepared and are mostly full-time employed. CONCLUSION: Many challenges continue to beset postgraduate research supervision in nursing discipline, with negative consequences for the quality of graduates and the quality of their research output. THE IMPLICATION FOR NURSING POLICY: To generate useful knowledge and increase the number of motivated nursing scholars, challenges associated with postgraduate research supervision need to be addressed, with emphasis on formal training for research supervisors and development of clear guidelines for postgraduate research supervision and for recruitment of postgraduate students.

Conceptualization of competency based curricula in pre-service nursing and midwifery education: A grounded theory approach.

In health professional education, the competency-based curriculum concept has been an important driver of reform in the training of competent graduates for the 21st century. In African countries, although there has been implementing it in pre-service nursing and midwifery education and the literature reports a lack of understanding of what is it on the part of the implementers. This article explores the meaning of competency based curriculum in pre-service nursing and midwifery education in Rwanda. A grounded theory approach, following Corbin and Strauss, was used. Following ethical clearance by the university ethical committee, data was collected from 17 participants through in-depth individual interviews of staff. Four categories emerged: (a) transformation, (b) tool for primary health care philosophy, (c) technological approach to education, (d) and modular system. Competency-based curriculum is confirmed as an appropriate educational tool in producing competent graduates for today and the future.