A Cross-Sectional Study of Community-Based Maternal and Child Health Interventions Involving Women's Health Volunteer Groups in Rural Myanmar.

OBJECTIVE: This study identified the relationship between interventions with women's health volunteer groups in two Myanmar villages and maternal and child health outcomes. DESIGN AND SAMPLE: This cross-sectional study included 188 women aged 15-49 years old with at least one ≤5-year-old child. The women were randomly selected from two control and two experimental villages. MEASURES: Data were collected via structured interview with a questionnaire based on the UNICEF Multiple Indicator Cluster Survey. RESULTS: Logistic regression analyses confirmed that women's health volunteer group intervention was related to the participants' receiving any antenatal care (OR: 6.99, p < .01) and having knowledge regarding danger signs during the perinatal period (OR: 15.08, p < .001), modern contraceptive methods (OR: 44.52, p < .001), acceptable first aid (OR: 14.04, p < .001), and malaria prevention (OR: 40.30, p < .001). A skilled midwife had the most significant relationship with patients' receiving any antenatal care (OR: 65.18, p < .001). Distance from urban area negatively related to appropriate disposal of the child's stool (i.e., flushed in a latrine; OR: 7.51, p < .05). CONCLUSIONS: This study shows that women's health volunteer groups may positively affect the diffusion of the need to seek antenatal care and health knowledge in rural Myanmar. The importance of skilled midwives is also highlighted, especially in resource-limited settings.

Complementary and alternative medicine use by pregnant women in Japan: a pilot survey.

BACKGROUND: Complementary and alternative medicine (CAM) are popular among women, and are used during their pregnancy in Japan. This study aimed to survey the prevalence of CAM use by healthy pregnant women as a health-care prescribed therapy or self-care and to investigate the factors associated with CAM use in Japan. METHODS: In this cross-sectional study, pregnant women after 34 weeks of gestation were asked to respond to a questionnaire at the clinic or online. The questionnaire comprised questions on the participants' characteristics and their use of CAM for therapy and self-care. Descriptive statistics were calculated in the analyses, and bivariate and multivariate logistic analyses were performed to evaluate the associations between factors and CAM use. RESULTS: A total of 394 women responded from three hospitals, two clinics, and two midwifery birth centers. CAM was received as treatment by practitioners during pregnancy by 75 women (19.0%). The following therapies were used: traditional Chinese medicine (7.9%), chiropractic (6.9%), moxibustion (6.4%), and acupuncture (5.3%). One or more types of therapy were used as self-care by 348 women (88.3%). Highly used CAM for self-care were: folic acid supplementation (75.4%), other supplements (51.5%), herbs (20.8%), and yoga (19.0%). Multiple logistic regression analyses revealed that the factors associated with CAM use as a therapy were midwifery birth centers for planned childbirth settings (adjusted odds ratio [AOR] 3.64, 95% confidence interval [CI] [1.69-7.83]) and pregnancy complications diagnosed (AOR 2.46, 95%CI [1.38-4.39]). The factors associated with CAM use for self-care were age 30-39 years (AOR 4.48, 95%CI [2.14-9.73]) and over 40 years (AOR 3.92, 95%CI [1.10-13.91]), junior college education or above (AOR 2.30, 95%CI [1.18-4.51]), and primiparas (AOR 3.82, 95%CI [1.86-7.86]). The most common source of information was the "Internet" (43.8%). CONCLUSIONS: Approximately 20% of Japanese pregnant women received CAM as therapy by practitioners, and the related factors were: tended to have baby at midwifery birth center and pregnancy complications. Almost 90% of respondents used CAM as self-care and the related factors were: older, had a higher educational level and tended to be primiparas. They used the Internet as their main source of information about CAM. Health care providers need to provide evidenced-based information on CAM and to help decision making to ensure safe and effective CAM utilization by pregnant women.

Evaluation of knowledge related to competency of nurse educators after participating in international outreach seminar for continuing nursing education in Myanmar.

Background and aims: With the drastic changes brought about by the Fourth Industrial Revolution (Industry 4.0) to nursing science and education, public-private collaboration efforts have been crucial in improving skills using technology. Nurse educators are expected to expand their knowledge and develop skills both in clinical and educational institutions to be able to implement evidence-based practice and develop professional competency. This study aimed to evaluate the knowledge related to competency of nurse educators before and after participating in an international outreach seminar for continuing nursing education in Myanmar. Methods: We conducted an evaluation study to clarify the outcomes of an international outreach seminar before and after its implementation in Myanmar. The seminar focused on the development and improvement of nursing education, as well as research skills and knowledge of nurses. The two-day seminar was conducted at the University of Nursing, Mandalay in Myanmar on September 30, 2019 and October 1, 2019. Pre- and post-questionnaires were distributed before and after the seminar. Results: The seminar was attended by 60 participants who were affiliated with a university (41.7%), nursing school (8.3%), hospital (33.3%), and other institutions (16.7%). All the participants had 12.57 years of clinical experience on average. There was a significant increase in the total average score of knowledge from 31.08 (SD = 19.95) before the seminar to 44.15 (SD = 22.19) after the seminar (p = 0.002). Over 90% of the participants recognized changes in their self-efficacy as educators. Conclusions: The participants acquired valuable up-to-date knowledge related to competency of nurse educators after attending the two-day international outreach seminar. They became keenly aware of the changes in their self-efficacy as educators. To our knowledge, this is the first study in Myanmar to evaluate knowledge related to competency of nurse educators who attended this seminar for continuing nursing education. This seminar was conducted as a mutual collaborative undertaking based on a long academic relationship built on trust and years of partnership between our universities. The findings imply that it is important for low- and middle-income countries to maintain a continuous international collaboration to be able to promote and support professional growth, knowledge, competency, and self-efficacy of their nursing educators. Tweetable abstract: A two-day international outreach seminar on continuing education for clinical nurses and faculty members in Myanmar improved their knowledge related to competency and enhanced their recognition of changes in their self-efficacy as educators.

Professional learning using storytelling videos of childbirth experiences: A qualitative pilot study of student midwives' perceptions in Myanmar.

AIMS: To explore and describe Myanmar student midwives' perceptions of professional learning using storytelling videos of women's childbirth experiences by conducting a qualitative study and to assess potential pedagogical uses of storytelling videos in midwifery education. METHODS: This pilot study used a qualitative content analysis study design implemented as part of the Diversity and commonalities of birth from women's voice sharing project of the Toyota Foundation. Storytelling videos of the childbirth experiences of seven Asian women (three Myanmar, three Lao, and one Japanese women) were viewed by the students. Thereafter, a semistructured interview with focus group discussion was conducted to explore and assess the students' perceptions. SETTING: Kyaing Tong township, Shan State, Myanmar. PARTICIPANTS: Five second-year midwifery students from a single midwifery training school in Myanmar. RESULTS: Data analysis of their perceptions yielded four major categories: (1) deep reverence for women/mothers;; (2) respectful attitude as a midwife to support mothers; (3) wish for a safe and secure birth environment; and (4) importance of learning from the mother's voice. CONCLUSIONS: The student midwives realized the importance of listening to the mothers' voices regardless of the nationalities or cultural background. The findings indicated that the storytelling videos broadened the students' perspectives of pregnancy and childbirth, and motivated them to provide better maternity care. Storytelling videos of childbirth experiences can be powerful educational materials for enhancing professional learning of student midwives.

Voices from undergraduate students and faculty members regarding the status and challenges of baccalaureate nursing education in Myanmar: A qualitative study.

OBJECTIVES: To clarify the present status and challenges of nursing education in a baccalaureate degree program in Myanmar. DESIGN: A qualitative descriptive design using focus group interviews. PARTICIPANTS: Undergraduate nursing students and faculty members from the University of Nursing in Myanmar. METHODS: Focus group interviews were separately conducted for each group of undergraduate students, and junior and senior faculty members. The interview guide for the students was about their perceptions and requests regarding their nursing education. For the faculty members, the interview guide was about their current perceptions and challenges regarding nursing education. Each group interview took about 60 min. RESULTS: Eight undergraduate students, eight junior faculty members, and six senior faculty members were eligible to participate. The undergraduate students voiced their requests for improvement in teaching methods. They described their struggles and learning process from their clinical placement experiences, as well as their distress under the present educational environment. The faculty members described their perceptions and challenges regarding inventiveness in teaching methods, challenges in conducting clinical placements, lack of educational devices and facilities, and innovation requirements in the faculty organization and system. CONCLUSION: The present status of nursing education in a baccalaureate degree program in Myanmar reflects ongoing serious challenges in undergraduate nursing education as expressed by both undergraduate students and faculty members. Their voices echo a pressing need to implement alternative methods of nursing education for better academic outcome. Moreover, continuing education is realized as crucial for capacity building and professional development of faculty members.

Learning experiences and identity development of Japanese nursing students through study abroad: a qualitative analysis.

OBJECTIVES: This study aimed to qualitatively analyze the experiences and perceptions of students at a nursing college in Japan who studied abroad in Asia and North America, thereby identifying the full range of benefits of study abroad programs for Japanese nursing students. METHODS: We conducted a qualitative analysis of the reflection papers and free-response questionnaire items completed by 50 Japanese undergraduate nursing students who participated in 9 study abroad programs in Asia and North America. Content analysis of the data proceeded from typological and deductive to data-driven and inductive, recursively and collaboratively. RESULTS: The results reveal perceived benefits in the areas of English language proficiency and motivation; knowledge of nursing practices, healthcare systems, and global health; cultural awareness and sensitivity; and various types of identity development (second-language motivation and identity, national/ethnic identity, professional identity, identity as a global citizen, and personal growth). It was also shown that students' perceptions of what they learned or gained varied according to the specific characteristics of each study abroad program. CONCLUSIONS: Study abroad experiences are often critical turning points that enhance nursing students' identity formation in the context of multiple and overlapping communities of practice. They also enhance core elements of the educational mission of a nursing college, particularly relating to liberal arts and internationalization. These findings can inform the development of assessment tools to be used in conjunction with study abroad programs at nursing colleges.