Rafat Jan

The first competency-based higher education programme for midwives in the South Asian region – Pakistan

Midwives in Pakistan and the South Asian region who complete a diploma program face many challenges for career growth and development. The absence of higher education in professional midwifery in the region has contributed to general non-acceptance and invisibility of midwifery. In response to the interest, Aga Khan University (AKU) developed bachelors program in midwifery based on the Global Standards for Midwifery Education developed by the International Confederation of Midwives (ICM) with the vision to equip midwives to provide full-scope practice, develop confidence to practice midwifery independently, become clinical leaders and contribute to the future of midwifery. The final curriculum had a balance of theory and clinical practice in order to develop a high level of clinical competence that would meet the ICM standards and guidelines. The two year bachelors program is currently in progress. The first cohort of 21 midwives graduated in 2014 and a second cohort was enrolled in 2015. There is a planning for a future graduate program in midwifery to prepare individuals for leadership roles in practice, teaching, maternal-child health provision and policy making through a masters degree in midwifery.

We need higher education: Voice of nursing administration from Kabul, Afghanistan

To explore the educational profile of nursing managers and head nurses at public hospitals in Kabul, Afghanistan.

Exploring the Experiences and Perceptions of Women About Childbirth at Birthing Centers in Karachi, Pakistan

Objective: The purpose of this study was to explore the perceptions of women about childbirth experiences at the birthing centers (BCs) in Karachi, Pakistan. Design: A qualitative descriptive exploratory approach was employed using semistructured interviews. Participants: A purposive sample of eight women who had used BCs was enrolled from each site. Findings: Five themes emerged from content analysis including: (a) satisfaction with BC, (b) provision of homely environment, (c) promotion of normalcy, (d) facilitation of family support, and (e) protection of privacy. Key Conclusions: Overall, the findings of the study revealed that women who used BCs were satisfied with the services and the environment provided to them by the midwives during the antenatal, intranatal, and postnatal periods. Most of the women appreciated the privacy offered at the BCs. They considered BCs as a safe, accessible, and affordable option for childbirth and encouraged others in the community to opt for it. Implications for Practice: The findings of this study may help to advocate for births at BCs and provide women-friendly maternity care, by giving choice and control to women during childbirth, providing comfort to women by using fewer medical interventions, and promoting normalcy by attending spontaneous vaginal delivery.

Recurrent Miscarriages: Causes, Management and Impact by Applying the Transactional Model of Stress

The term recurrent miscarriage includes all pregnancy losses from the time of conception until 24 weeks of gestation. 1 Miscarriage is a multifaceted biologic and psychological experience, affecting 1% of couples trying to conceive. The purpose of this paper is to discuss about the causes, impact, and management of recurrent miscarriage by using the transactional model of stress. The exact cause of miscarriage is unknown; but, increased anticardiolipin antibodies, increased maternal age translocation of parental chromosomes, anatomical variation such as septate uterus, and presence of genital tract infections can lead to miscarriage. It is a stressful event; and, women respond to it in a variety of ways. Some woman may end up in having altered marital relationships, and others may suffer from psychological problems such as sadness, anger, guilt, anxiety, and lack of interest. Thus, this puts the burden on the health care providers to identify and address medical and psychological issues; and encourage for follow-up counseling that is required to minimize discomfort and enhance coping strategies for living a happy life.