31^st Global Experts Meeting on Neonatal Nursing and Maternal Healthcare May 08-09, 2019 Tokyo, Japan

Biography:

Dr. Shu Wen Chen is an Assistant Professor in the Department of Nursing at National Taipei University of Nursing and Health Science, Taiwan. Dr. Chen received her master degree from Taiwan University in 1996 and PhD degree from Deakin University Australia in 2015. Dr. Chen is a scholar in Nursing and Midwifery, she has published over 10 maternal care books and articles and delivered over 10 professional presentations at international conferences. She is an active member of several professional associations, journal editorial boards. Dr. Chen’ specializes in birth choice following previous cesarean section and shared decision-making and decision aids.

Abstract:

Vaginal birth after caesarean (VBAC) is an alternative option for women who have had a previous caesarean section (CS); however, uptake is limited because of concern about the risks of uterine rupture. The aim of this study was to explore women’s decision-making processes and the influences on their mode of birth following a previous CS. Methods: A qualitative approach was used. The research comprised three stages. Stage I consisted of naturalistic observation at 33-34 weeks’ gestation. Stage II involved interviews with pregnant women at 35-37 weeks’ gestation. Stage III consisted of interviews with the same women who were interviewed postnatally, 1 month after birth. The research was conducted in a private medical centre in northern Taiwan. Using a purposive sampling, 21 women and 9 obstetricians were recruited. Data collection involved in-depth interviews, observation and field notes. Constant comparative analysis was employed for data analysis. Results: Ensuring the safety of mother and baby was the focus of women’s decisions. Women’s decisions-making influences included previous birth experience, concern about the risks of vaginal birth, evaluation of mode of birth, current pregnancy situation, information resources and health insurance. In communicating with obstetricians, some women complied with obstetricians’ recommendations for repeat caesarean section (RCS) without being informed of alternatives. Others used four step decision-making processes that included searching for information, listening to obstetricians’ professional judgement, evaluating alternatives, and making a decision regarding mode of birth. After birth, women reflected on their decisions in three aspects: reflection on birth choices; reflection on factors influencing decisions; and reflection on outcomes of decisions. Conclusions: The health and wellbeing of mother and baby were the major concerns for women. In response to the decision-making influences, women’s interactions with obstetricians regarding birth choices varied from passive decision-making to shared decision-making. All women have the right to be informed of alternative birthing options. Routine provision of explanations by obstetricians regarding risks associated with alternative birth options, in addition to financial coverage for RCS from National Health Insurance, would assist women’s decision-making. Establishment of a website to provide women with reliable information about birthing options may also assist women’s decision-making. 

Biography:

Jane Namasasu, retired civil servant in the Ministry of Health, is an expert in qualitative research using focus group discussions, in-depth interviews and observations. Her passion is in improving lives in Sexual and Reproductive Health (SRH) especially maternal and neonatal health, adoloscent health and Family planning. She has vast experience in programming of SRH. This includes designing & planning of SRH services, coordination of partners and guiding the implementation of SRH services, Policy development and training service providers in SRH in Ministry of Health. Her expertise has earned her awards in Leardiship in Health, A woman of distinction in maternal health and best family planning proposal. She has played an instrumental role in co-founding the centre for reproductive health (CRH) at College of Medicine  in Malawi, planning and conducting the  National Basic Emergency Obstetric Care in 2005 which led to the development of  the Malawi Roadmap to Accelerate the Reduction of Maternal and Neonatal Mortality and Morbidity by 2015, the first of its kind in Malawi. She establishing Reproductive Health Unit (RHU) where all the SRHcomponents were developed and are housed. This unit is now called the Reproductive Health Directorate.

Abstract:

Neonatal mortality in Malawi is very high at 27/1000 live births. These deaths occur within first 28 days of life meaning that 1 in 37 neonates die in the 28 days of life.The leading causes are asphyixia,prematurity,sepsis,pneumonia and many other causes. The majority of these deaths can be prevented by initiating low-cost interventions that health care workers, family members and community can implement. These intervention include skilled birth attendant during delivery (SBA) helping babies breathe (HBB) and kangaroo mother care (KMC). Helping babies breathe is a low-cost intervention which prepares health workers  with proper training to act at birth to help babies who cannot breathe immediately to breathe. On the other hand, kangaroo mother care is according to WHO, a care of premature and or lowbirth weight infants carried skin to skin by the mother or guardian. Available evidence indicates that KMC contributes to humanization of neonatal care bonding between mother and baby in low-income and high income countries.

In this paper, I present maternal death reviews in five district hospitals in Malawi,causes and contributing factors to neonatal deaths, identify quality of care problems, avoidable and remedial factors to improving neonatal care in the future, challenges and responses. Additionally, increasing institutional deliveries and offering quality of service around  delivery is an important factor in reducing neonatal mortality.

Biography:

Chukwudebelu Victor S. RN from Virgen Milagrosa University Foundation, San Carlos City, 2420 Pangasinan, Philippines.

Abstract:

Immunization is a way of creating immunity to certain diseases by using a small amount of a killed or weakened microorganism that causes the particular disease. Child immunization is designed to protect infants and children in the early life, when they are most vulnerable and before they are exposed to potentially life-threatening diseases. In order to improve immunization coverage, factors such as mothers’/care-takes’ practices are known to contribute to the success or failure of the immunization program.

            A qualitative phenomenological type of research design was employed in the study. The study was carried out in Carlatan, City of San Fernando, La Union. The researchers made use of an interview guide questions and a small group discussion as a method of accurate data collection tool on 15 participants. The participants were mothers who had children under 1 year old.

The study showed that mothers engage in several practices before, during and after immunization such as observing daily routine, relaxation, massage and hot compresses. With regard to practices for their children, mothers’ practices include breast feeding, cooling, use of anti-pyretic and hot compresses. This helped the researchers to draw a conclusion that the participants have good immunization practices.

The researchers recommend that mothers should continue to breastfeed their infants before, during and after immunization, mothers should use warm compress instead of hot or cold compress so as to avoid reducing the immunization potency; and that researchers should conduct further studies on the health benefits of these practices.

Biography:

Linos Muvhu is the founder and Chief Talent Team Leader of Society for Pre and Post Natal Services’ (SPANS) Maternal, child and family mental health programme in Zimbabwe. SPANS promotes good mental health across the life course starting in the perinatal period. It is a national evidence based family focused program. Linos trained as a family therapist with Connect (Zimbabwe Institute of Systemic family Therapy). He is passionate about the rights of all people to enjoy good mental health, in particular the right for good family mental health and in 2016, he initiated the first ever International Conference on Maternal Mental Health in Africa (ICAMMHA.) 

Abstract:

Statement of the Problem: By 2020, maternal depression will be the leading cause of disability among women globally (WHO, 2018).  Advances in research on how mental health across the life course is influenced by parental mental health and the parent/carer – neonatal, infants and children relationship has led to perinatal and infant mental health being a global health priority (WHO, 2018; UNICEF, 2017). The purpose of this study is to support long-term emotional wellbeing for neonatal, infants and children to promote good sound family mental health and well-being across the life course in a rural setting in Zimbabwe. Methodology & Theoretical Orientation: The Mashonaland east province under Goromonzi district is a pre-urban and a rural setting in Zimbabwe.  SPANS was set up to address the following: Identify parental, neonatal, infants and children mental health problems early via screening families in the first 28 days and 3 months of booking their pregnancy;  improved access to perinatal mental health support and treatment, and increased community awareness of perinatal mental health issues and perinatal loss and bereavement peer support. Findings: The Early Childhood Program aims to improve the mental health of families in a rural setting in Zimbabwe through empowering families and communities to understand the importance of good family mental health alongside delivering a public health approach to good mental health through; raising awareness, offering acceptable and accessible support.

Conclusion & Significance: There is a lack of funded services to support good family mental health in Zimbabwe and our work with families in a resource poor country may have important lessons for other communities facing these challenges.