Midwifery最新文献

Problem: In remote Papua New Guinea there are few midwives or functioning health facilities, and high perinatal mortality. Indigenous traditional birth attendants carry the burden of caring for women and newborns.

Background: Midwives training and developing traditional birth attendants rely on ad-hoc approaches to the education they provide, drawing from their own knowledge and skills.

Aim: Develop a culturally sensitive conceptual educational framework as a guide for midwives to train and supervise traditional birth attendants in low-resource settings.

Methods: Seven-step approach: 1) Establish trust and respect; 2) Identification of the need; 3) Ethical considerations; 4) Needs analysis; 5) Contextual considerations; 6) Theoretical framework; 7) Practice standards.

Findings: The Yamen Traditional Birth Attendant Conceptual Educational Framework guides midwives to train and supervise traditional birth attendants to strengthen maternal and newborn healthcare in low-resource settings through pre-service education and community development. Four adult, cross-cultural learning principles were identified: cultural sensitivity, strategic issues, previous experience, evidence-based practice. Expected outcomes include increased knowledge, skills, attitudes, and critical thinking of traditional birth attendants.

Discussion: Training and supervision of traditional birth attendants by midwives is recommended for low-resource settings of Papua New Guinea to foster strong partnerships between communities and health facilities and improve perinatal safety.

Conclusion: A co-designed, culturally sensitive education framework is presented with the potential to strengthen maternal and newborn services in low-resource settings by linking traditional birth attendants to midwives in formal health services. Further research is needed to articulate the role, scope of work and key learning competencies.

Background: Breastfeeding is essential health behavior for the health of the mother and child. The duration of breastfeeding often affects the likelihood of overlapping between breastfeeding and subsequent pregnancies.

Aim: This meta-analysis evaluated the effects of breastfeeding during pregnancy on maternal and newborn health outcomes and the composition of breast milk based on previous studies.

Methods: The study protocol was developed, and the article was written following the PRISMA guidelines. The screening was conducted in September 2024, and the study was registered with PROSPERO. A comprehensive search was performed using PubMed, Google Scholar, the Cochrane Library, EBSCO, Embase, the National Thesis Center, and the TR Index. The methodological quality of the included studies was assessed using the JBI quality assessment tools. Data were pooled through meta-analysis, and a GRADE evidence profile was generated.

Findings: The meta-analysis revealed that breastfeeding during pregnancy did not significantly affect birth weight, the incidence of miscarriage, preterm labor, or pregnancy complications. However, it was associated with an increased incidence of low birth weight and intrauterine growth retardation. Regarding breast milk composition, breastfeeding during pregnancy did not change the total protein or lactose content but resulted in a reduction in fat content. Subgroup analyses indicated that the effects of breastfeeding during pregnancy on maternal and newborn health were influenced by the level of development of the country in which the studies were conducted.

Key conclusions: Breastfeeding during pregnancy may impact breast milk composition and maternal and neonatal health.