Dataset Information

Effectiveness of simulation-based cesarean section education on improving non-physician clinician midwife's competency in performing cesarean section in Ethiopia: a quasi-experimental study.

ABSTRACT:

Background

Simulation-based education enhances fundamental and clinical knowledge, procedural abilities, teamwork, and communication skills, as well as quality of care and patient safety. Due to excessive clinical loads and a lack of physicians, even classic teaching methods like bedside instruction are constrained in low-income settings. Thus, this study aimed to ascertain if simulation-based cesarean section education successfully raises non-physician clinician midwives' competency in Ethiopia.

Methods

A quasi-experimental study design triangulated with a qualitative design was implemented. Sixty Masters Clinical Midwifery students (29 intervention and 31 control) were taken in 5 universities. Three questionnaires (knowledge, confidence levels, and skills) were used. Qualitative data was also collected from 14 participants. The data were analyzed using SPSS version 25. Descriptive and inferential analyses were conducted. P < 0.05 was used for statistical significance. A difference-in-difference with a 95% confidence level was employed to control the potential confounders for knowledge and self-confidence. Multiple linear regression was fitted to identify the independent effect of simulation-based education interventions while controlling for other variables. Thematic analysis was performed using MAXQDA 2020.

Result

The age of the respondents varies from 24 to 34 years, with the control group's mean age being 28.8 (± 2.3) years and the intervention group's mean age being 27.2 (± 2.01) years. The intervention and control groups' pre-intervention and post-intervention knowledge scores showed a statistically significant difference. There was a substantial increase in self-confidence mean scores in both the intervention and control groups and between the pre-intervention and post-intervention periods in both the intervention and control groups. Furthermore, there was a substantial improvement in cesarean section skills in the intervention group as compared to the control group (59.6 (3.3) vs. 51.5 (4.8). The qualitative findings supported these.

Conclusions

The study showed that simulation-based education improved students' procedural knowledge, self-confidence, and skills. As a result, professional care teams can create simulation-based teaching packages to help students prepare for their residency.

SUBMITTER: Alemu FM

PROVIDER: S-EPMC10722683 | biostudies-literature | 2023 Dec

REPOSITORIES: biostudies-literature

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Publications

Effectiveness of simulation-based cesarean section education on improving non-physician clinician midwife's competency in performing cesarean section in Ethiopia: a quasi-experimental study.

Alemu Fekadu Mazengia FM Yimer Nigus Bililgn NB Kasegn Belete Belgu BB Kassie Belayneh Ayanaw BA Ibrahim Ibrahim Yimer IY Abdo Abdella Amano AA Worke Mulugeta Dile MD

BMC medical education 20231214 1

<h4>Background</h4>Simulation-based education enhances fundamental and clinical knowledge, procedural abilities, teamwork, and communication skills, as well as quality of care and patient safety. Due to excessive clinical loads and a lack of physicians, even classic teaching methods like bedside instruction are constrained in low-income settings. Thus, this study aimed to ascertain if simulation-based cesarean section education successfully raises non-physician clinician midwives' competency in ...[more]

PMID: 38098058

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Project description:BackgroundBreech deliveries are a significant public health concern in developing countries. The World Health Organization (WHO) declared that the cesarean section rate should not be higher than 10%-15%. As unnecessary C-sections may be associated with an increased risk of maternal and neonatal mortality, this meta-analysis was aimed at determining the rate of caesarean sections among breech deliveries in Ethiopia.MethodsAll published and unpublished articles were obtained from legitimate databases and websites. The PRISMA guidelines were used to conduct this systematic review and meta-analysis. The meta-analysis of the primary and secondary outcomes was performed using STATA version 18. The overall effect size with a 95% CI was estimated using the random effect model with the Der Simonian Liard method. A sensitivity analysis using a leave-one-out meta-analysis was computed.ResultsThis meta-analysis included a total of 57,236 mothers who had breech deliveries. The pooled prevalence of breech deliveries among women in Ethiopia was 5% [95% CI: 4, 6]. The overall pooled cesarean section rate among breech deliveries in Ethiopia was 41% (95% CI: 29-54).ConclusionsIn this review, the pooled prevalence of breech deliveries among women in Ethiopia was 5%, and the overall rate of caesarian section among the breech deliveries was 41%. This finding pointed out that two out of every five pregnant women with breech presentation gave birth by cesarean section in Ethiopia. Therefore, the finding implies that both the government and all the concerned stakeholders shall be given particular emphasis made on strengthening antenatal care services and ensure more women have access to skilled healthcare professionals during childbirth. This can help in providing appropriate interventions, support to women and reducing the need for emergency and unnecessary breech deliveries. The result of this research are a baseline data for future researchers to conduct further studies to better understand the reasons behind the high rates and identify potential interventions and solutions specific to the African context.

Project description:BackgroundThe world health organization considers cesarean section (CS) prevalence of less than 5% suggests an unmet need. On the other hand, a prevalence of more than 15% may pose to risk to mother and child, however, access to CS in a resource-limited country like Ethiopia was much lower than the aforementioned level, Therefore, this was the first study to determine the trend of CS, and factors that influence it.MethodsThis was done based on the five Ethiopia Demographic and Health Surveys. Trend analysis was done separately for rural and urban. The significance of the trend was assessed using the Extended Mantel-Haenszel chi-square test. The factors on CS delivery were identified based on DHS 2016 data. A multi-level logistic regression analysis technique was used to identify the factors associated with cesarean section delivery. The analysis was adjusted for the different individual- and community-level factors affecting cesarean section delivery. Data analysis was conducted using STATA 14.1 software.ResultThe rate of cesarean section increased from 5.1% in 1995 to 16% in 2019 in an urban area and 0.001 in 1995 to 3% in a rural area, the overall increment of CS rate was 0.7% in 1995 to 2019 at 6%. The odds of cesarean section were higher among 25-34 years (AOR = 2.79; 95% CI: 1.92, 4.07) and 34-49 years (AOR = 5.23;95% CI: 2.85,9.59), among those educated at primary school level (AOR = 1.94; 95% CI: 1.23,3.11), secondary education (AOR = 2.01; 95% CI: 1.17, 3.56) and higher education (AOR = 4.12; 95% CI: 2.33-7.29)with multiple pregnancies (AOR = 11.12; 95% CI: 5.37, 23.), with obesity (AOR = 1.73; 95% CI: 1.22, 2.45), living in an urban area (AOR = 2.28; /95% CI: 1.35-3.88), and increased with the number of ANC visit of 1-3 and 4th(AOR = 2.26; 95% CI: 1.12, 4.58), (AOR = 3.34; 95% CI: 1.12, 4.58), respectively. The odds of cesarean section are lower among parity of 2-4 children (AOR = 0.54; 95% CI: 0 .37, 0.80) and greater than four birth order (AOR = 0.42;95% CI: 0.21,0.84).ConclusionIn Ethiopia, the CS rate is below the WHO recommended level in both urban and rural areas, thus, intervention efforts need to be prioritized for women living in a rural area, empowering women's education, encouraging co-services such as ANC usage could all help to address the current problem.

Project description:BackgroundJenny dystocia occurs very rarely and is associated mainly with postural defects due to long fetal extremities. However, the management of dystocia in equines is relatively difficult compared with that in other large animals. Owing to the absence of well-described published papers on cesarean section in donkeys, this condition remain life-threatening after unsuccessful surgical intervention.Patient presentationA 4-year-old Jenny with a difficult birth due to a previous car accident presented for 3 consecutive years at different stages of labor onset. Upon early presentation, there was straining and frequent aggressive rolling. Further examination also revealed a fully dilated cervix and narrow pelvic cavity due to the downward bending of the iliac wing. Surgical sites (lower flank, ventral midline, and paramedian) were used for each cesarean section. General anesthesia was used in all three procedures. Additionally, local infiltration of 2% lidocaine along with light general anesthesia was used when the patient presented with a live fetus. In all approaches, surgical sites were prepared for cesarean section, and dead fetuses were removed at the first and third parity due to delayed presentation. However, in the second parity, a live female foal was delivered. In all the approaches, the first layer of uterine closure was made by using a simple continuous suture pattern (biting all the layers of the uterine wall). The sutures were then oversewed with a Cushing suture pattern using # 0 polyglycolic acid. The skin was closed in different suture patterns during each technique using nonabsorbable suture material # 1 silk. Postoperative subcutaneous swelling was observed and regressed gradually in all surgical approaches. The duration of skin suture removal was determined based on the extent of wound healing and the site of the incision.ConclusionThis is the first ever report describing 3 consecutive cesarean sections in the same donkey with pelvic deformity. Thus, this study was able to indicate different approaches for cesarean section in equines. Moreover, owing to the bleeding nature of the equine uterus, simple continuous suturing was the pattern of choice for 1st layer uterine closure. It was also concluded that subcutaneous edema is unavoidable in donkeys.

Dataset Information

Effectiveness of simulation-based cesarean section education on improving non-physician clinician midwife's competency in performing cesarean section in Ethiopia: a quasi-experimental study.

Background

Methods

Result

Conclusions

Publications

Effectiveness of simulation-based cesarean section education on improving non-physician clinician midwife's competency in performing cesarean section in Ethiopia: a quasi-experimental study.

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