Nursing Sciences

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    Experiences, needs and coping strategies of pregnant and parenting teenagers: A perspective from Lusaka and North Western Provinces of Zambia
    (Journal of Research in Nursing and Midwifery, 2017-12) Mukwato, Patricia Katowa; Maimbolwa, Margaret.C.; Mwape, Lonia; Muleya, Mutinta Crecious
    Pregnant and parenting teenagers have needs that are unique to the developmental stages of adolescence in addition to the needs common to all pregnant women. The study investigated the experiences, needs and coping strategies of pregnant and parenting teenagers. The study utilized a phenomenological approach, where in-depth interviews with pregnant and parenting teenagers were conducted to get an insight into their experiences, needs and coping strategies. Participants were purposively selected. A sample size was 27 participants which was determined using data saturation principle. Three themes emerged on the experiences of teenage pregnancy and parenting including, abandonment and rejection, loss of parental support and burden of being pregnant or being a parent, while three broad needs were identified; information about HIV status, physical materials for the unborn or new born baby and mother, and the desire to go back to school for those who fall pregnant while schooling. Both adaptive and maladaptive strategies were identified as a means for coping including, avoidance of negativity, support from parents, relatives and partner, repentance and dependence on God, focusing on own and the child’s future, and denial of pregnancy or motherhood. It was concluded that pregnant and parenting teenagers undergo diverse negative experiences, while negotiating the transition from teenage hood to adulthood and motherhood amidst unmet teenage and pregnancy related needs. As a means to cope with the negativity and live within circumstances of unmet teenage and motherhood needs, coping strategies are required. Keywords: Experiences, Needs, Coping Strategies, Teenage Pregnancy, Parenting.
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    Evaluation of quality of antenatal care services in selected healthcare centres of Mumbwa and Lusaka districts of Zambia: pregnant women’s perspectives
    (International Journal of Nursing and Midwifery, 2019-05) Mukwato, Patricia Katowa; Mwiinga, Kalusopa Victoria; Emmanuel, Musenge; Banda, Yolan; Muleya, Mutinta Crecious; Maimbolwa, Margaret C
    Antenatal care (ANC) has been recommended as a service that can reduce both maternal and newborn mortalities. However, even in areas recording high ANC attendance, there are unevenly high levels of maternal and new born mortalities. Evidence of a weak relationship between ANC use and maternal and newborn survival has motivated recent calls to focus on content and quality of care provided rather than mere ANC attendance. This was a descriptive cross sectional study which was designed to evaluate the quality of antenatal care services in two health facilities in Lusaka and two in Mumbwa districts of Zambia. The health facilities were selected purposively based on poor maternal outcomes such as high maternal mortality ratio. Women attending antenatal clinics were selected using simple random sampling. Data was collected using a client exist interview schedule designed by World Health Organization for assessing quality of antenatal care. Data was analyzed using Statistical Package for Social Scientist (SPSS) version 24.0. The study revealed a lot of variations in the care provided at the four sites. None of the women had all the blood tests for haemoglobin, grouping and X-match, HIV and syphilis conducted from three out of the four health facilities, while at the fourth, only 30% of women had all the blood tests conducted. Furthermore, less than 20% of women had a full head to toe examination. While less than 10% of women from each of the facility reported that the health providers met the requirements for provision of privacy. Despite not meeting the minimum standards of care, only less than 5% of women categorized the care as poor. All the four health facilities recorded low quality of care on all domains of antenatal care. Therefore, if antenatal care has to achieve its intended purpose of reducing adverse maternal and new born outcomes, then quality of care delivered during pregnancy should be the focus as opposed mere attendance. Key words:Quality, antenatal care services, evaluation.
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    Psychological Distress during the Perinatal Period: Using Edinburgh Postnatal Depression Scale (EPDS) General Health Questionnaire (GHQ-12) and the Study Specific Measure of Perinatal Distress (SSMPD) on a Zambian Cohort
    (2016) Mwape, Lonia; Mukwato, Patricia Katowa; Mweemba, Prudencia
    Background: Psychological distress during the perinatal period affects the woman experiencing it, her baby, and the family a whole. It presents a challenge during this exciting and special time in woman’s life. Various screening instruments have been established to identify psychological distress. This paper reports results of the data collected to determine the prevalence of psychological distress using the EPDS, GHQ-12, and the Study Specific Measure of Psychological Distress. Aim: The study investigates the prevalence of psychological distress during the perinatal period in a Zambian cohort. Methods: A longitudinal descriptive study was conducted on a Zambian cohort consisting of 300 women during their antenatal and postnatal periods. The participants were accessed through antenatal and postnatal clinics in primary health care facilities. Findings: The study revealed high prevalence of psychological distress in the cohort under study in comparison to global estimations. This is as detected by the EPDS and GHQ-12, including the study specific measure of psychological distress. Conclusion: The prevalence of psychological distress during the perinatal period in Zambia is high. Therefore, the psychological well-being of a woman during the perinatal period needs to be given the attention that it deserves in order to safeguard the well-being of the baby and all the people around her. Recommendations: Screening women for the presence of psychological distress during the antenatal and postnatal periods should be mandatory. Appropriate referral should then be made depending on the outcome of the screening. Key words: Psychological distress, Perinatral period, Edinburgh Postnatal Depression Scale, General Health
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    Use of research evidence in policy and decision-making: views, attitudes and practices of health policy makers in Lusaka province of Zambia
    (Scientific research publishing, 2018-04) Mukwato, Patricia Katowa; Mwape, Lonia; Siwale, Mwaba Chileshe; Musenge, Emmanuel Mwila; Maimbolwa, Margaret
    Background: The integration of relevant high-quality research evidence into the health decision and policy formulation process is a key strategy for improving health systems especially in developing countries such as Zambia. However, the lack of capacity to understand and value research evidence by policy and decision makers makes it difficult for them to find and use research evidence in a timely manner even when motivated to do so. This study aimed to establish the views, attitudes and practices of policy makers on the use of research evidence in policy and decision-making process in Zambia. Methodology: This descriptive cross-sectional study was conducted in Lusaka, Zambia among selected public health decision and policy making institutions. A purposive sample of 21 consenting policy makers who were working in different positions in the Ministry of Health Headquarters, Provincial and District Health Offices, Health Professions Regulatory Bodies, United Nations Agencies, International Non-Governmental Organizations and University Deans from the University of Zambia participated in the study. A self-administered questionnaire was used to collect data. The IBM? SPSS? Statistics for Windows Version 20.0 was used for data analysis. Results: The concept of Evidence Informed Health Policy was not well understood such that only less than half (47.5%) of the participants reported having heard specifically about Evidence Informed Health Policy meanwhile almost two thirds (61.9%) reported that they used research evidence in decision making and policy formulation. Similar discrepancy was expressed in the understanding of and use of rapid response mechanisms such that although (47.6%) of the participants reported having heard about it, (57%) had never used rapid response mechanisms for deci-sion-making. With regard to the sources of information, about half (52.3) of the participants reported scholarly articles as their main source of evidence. Con-clusion and Recommendations: There is need for more sensitization and ca-pacity building among the decision and policy makers on the importance of using research evidence in decision and policy making process as incorporation of relevant high-quality research evidence into the health policy making pro-cess is a key strategy for improving health systems. Keywords Evidence-Informed Health Policy, Rapid Response Mechanisms, Decision-Making