Article

Competencies and skills for remote and rural maternity care: a review of the literature.

School of Nursing & Midwifery, The Robert Gordon University, Aberdeen, UK.
Journal of Advanced Nursing (Impact Factor: 1.53). 05/2007; 58(2):105-15. DOI: 10.1111/j.1365-2648.2007.04246.x
Source: PubMed

ABSTRACT This paper reports a review of the literature on skills, competencies and continuing professional development necessary for sustainable remote and rural maternity care.
There is a general sense that maternity care providers in rural areas need specific skills and competencies. However, how these differ from generic skills and competencies is often unclear.
Approaches used to access the research studies included a comprehensive search in relevant electronic databases using relevant keywords (e.g. 'remote', 'midwifery', 'obstetrics', 'nurse-midwives', education', 'hospitals', 'skills', 'competencies', etc.). Experts were approached for (un-)published literature, and books and journals known to the authors were also used. Key journals were hand searched and references were followed up. The original search was conducted in 2004 and updated in 2006.
Little published literature exists on professional education, training or continuous professional development in maternity care in remote and rural settings. Although we found a large literature on competency, little was specific to competencies for rural practice or for maternity care. 'Hands-on' skills courses such as Advanced Life Support in Obstetrics and the Neonatal Resuscitation Programme increase confidence in practice, but no published evidence of effectiveness of such courses exists.
Educators need to be aware of the barriers facing rural practitioners, and there is potential for increasing distant learning facilitated by videoconferencing or Internet access. They should also consider other assessment methods than portfolios. More research is needed on the levels of skills and competencies required for maternity care professionals practising in remote and rural areas.

3 Bookmarks
 · 
168 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Achieving the Millennium Development Goal (MDG) of improving maternal health has become a focus in recent times for the majority of countries in sub-Saharan Africa. Ghana's maternal mortality is still high indicating that there are challenges in the provision of quality maternal health care at the facility level. This study examined the implementation challenges of maternal health care services in the Tamale Metropolis of Ghana. Purposive sampling was used to select study participants and qualitative strategies, including in-depth interviews, focus group discussions and review of documents employed for data collection. The study participants included midwives (24) and health managers (4) at the facility level. The study revealed inadequate in-service training, limited knowledge of health policies by midwives, increased workload, risks of infection, low motivation, inadequate labour wards, problems with transportation, and difficulties in following the procurement act, among others as some of the challenges confronting the successful implementation of the MDGs targeting maternal and child health in the Tamale Metropolis. Implementation of maternal health interventions should take into consideration the environment or the context under which the interventions are implemented by health care providers to ensure they are successful. The study recommends involving midwives in the health policy development process to secure their support and commitment towards successful implementation of maternal health interventions.
    BMC Health Services Research 01/2014; 14(1):7. · 1.77 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This paper discussed a recent study of elemental mercury removal by gaseous hydrogen chloride over novel CeO2–WO3/TiO2 catalysts under bench scale conditions. The performances of mercury removal over the catalysts were tested in simulated flue gas with 80–100μgm−3 Hg0, 8% O2, 10ppm HCl, 8% H2O, 800ppm SO2 and balanced with N2. Results indicated that about 95% of the Hg0 could be removed by hydrogen chloride over the CeO2–WO3/TiO2 catalysts in the presence of O2, and the HgO that formed was effectively converted to mercury chloride when hydrogen chloride was added to the system. The Hg0 removal efficiency was found to be slightly but significantly affected by H2O and SO2 addition. Water vapor slightly inhibited the Hg0 removal efficiency, due to the competitive adsorption. By contrast, SO2 promoted the oxidation reactions, resulting in higher Hg0 removal efficiencies. The Hg-TPD and SO2-TPD results indicated that less negative effect of Hg adsorption with/without water vapor and less adsorption mass of SO2 might be responsible for the tolerance of the catalysts to H2O and SO2. From the characterization results, the BET surface areas had no significant influence on the catalytic performance. The XRD pattern indicated that cubic CeO2 crystallite was the crystalline form on the surface. The XPS and H2-TPR results suggested that Ce4+ oxide was the main form of Ce on the catalysts surfaces, which was beneficial for the Hg0 removal reactions.
    Chemical Engineering Journal - CHEM ENG J. 01/2011; 170(2):512-517.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to assess the possible mismatch of obstetrical skills between the training offered in Ecuadorian medical schools and the tasks required for compulsory rural service.
    BMJ Open 01/2014; 4(7):e005759. · 2.06 Impact Factor