Going viral - capacity strengthening in the context of pandemic(s).

Strengthening the capacity of midwives and nurses in low- and middle-income countries to lead research is an urgent priority in embedding and sustaining evidence-based practice and better outcomes for women and newborns during childbearing. International and local travel restrictions, and physical distancing resulting from the COVID-19 pandemic have compromised the delivery of many existing programmes and challenged international partnerships working in maternal and newborn health to adapt rapidly. In this paper, we share the experiences of a midwife-led research partnership between Kenya, Malawi, Tanzania, Uganda, the UK, Zambia and Zimbabwe in sustaining and enhancing capacity strengthening activities remotely in this period. Whilst considerable challenges arose, and not all were overcome, collectively, we gained new insights and important learning which have shifted perspectives and will impact future design and delivery of learning programmes.

Evaluation of an educational board game to improve use of the partograph in sub-Saharan Africa: A quasi-experimental study.

BACKGROUND: The partograph is a tool used to record labour observations and support decision-making. Although used globally, it has not reached its full potential. We aimed to determine whether an educational board game can improve labour-monitoring skills and influence practice. STUDY DESIGN: A quasi-experimental study, underpinned by Kirkpatrick's evaluation model, was used. Midwives and student midwives from Malawi, Kenya and Tanzania were given an identical hypothetical case-scenario of a woman in labour pre-and post-implementation of a game, to assess recording and interpretation abilities. This was supplemented by qualitative inquiry 3 months post-game-playing using semi-structured interviews (n = 24) and expert case-record reviews (n = 24). Quantitative data were analysed using the paired t-test and qualitative data were subjected to framework analysis. RESULTS: 95 midwives and 97 students participated. In each country the mean test scores improved; Kenya from 86.5 (6.7) to 95.5 (3.7) (paired t = 11.82, p < 0.001), Malawi from 83.6 (6.7) to 94.6 (4.1) (paired t = 13.35, p < 0.001), and Tanzania from 83.8 (6.2) to 94.9 (4.1) (paired t = 15.27, p < 0.001). Qualitative findings revealed six themes: 'an enjoyable way of practicing,' 'learning and re-learning,' 'improved clinical decision-making', 'promoting team-work', 'a catalyst for additional learning' and 'barriers to transference of learning'. Expert case-record review demonstrated good adherence to recommendations. CONCLUSION: Board games have the ability to improve labour-monitoring knowledge. Retention of information was apparent and application of learning into practice was encouraging. Health-system barriers need to be resolved for midwives to apply theory to practice. Whether such application results in improved clinical outcomes is uncertain and requires further evaluation.

'Moving with the times' taking a glocal approach: a qualitative study of African student nurse views of e learning.

BACKGROUND: Information technology is a rapidly increasing means of communication in education and healthcare. This is also true in low resource settings, where electronic communication provides an opportunity for sharing information about health and wellbeing and enhancing learning for healthcare professionals. METHODS: A qualitative study whereby 51 year 3 and 4 student nurses at the University of Nairobi participated in 5 focus group discussions. Data were recorded, transcribed verbatim and analyzed using a framework approach. RESULTS: Four main themes were identified, 'moving with the times', 'global networking', 'inequity as a barrier' and 'transfer of internet learning into practice'. CONCLUSIONS: Information technology is already integral to students' lives both personally and professionally and the students had a strong desire to find out what is happening globally. The familiarity of the internet contributes to the acceptance of e-learning programs as part of educational curricula. Students felt that e-learning 'is here to stay' and wanted to 'embrace the concept.' E-learning was generally welcomed however students suggested that it should be 'supplementary' to face-to-face learning. In order to incorporate e-learning ethically in low resource settings, resources should be sustainable, for example CDROMs and DVDs which are not dependant on internet access. Researching the views of qualified midwives might be the next step in promoting this valuable teaching method.