Birthingway College of Midwifery

Diabetes mellitus (DM) is a degenerative disease caused by genetic and environmental factors. Therefore, patients with DM type 2 requires regular control. One of the health facilities that allows a fine control and follow up over patients with DM is telemedicine. This study aimed to estimate the average effectiveness of telemedicine on glycemic management (HbA1C) of patients with DM type 2. The current research employed a systematic review with meta-analysis research design. The subjects of the study were articles published in 2005 - 2021. The article search was conducted for a maximum of 1 month over journal databases: PubMed, ScienceDirect, and Google Scholar. The primary study employed Randomized Controlled Trial with articles search according to the established PICO model, where P (Population), in this sense, patients suffering from DM type 2, I (Intervention) which was Telemedicine, C (Comparison) or non-telemedicine, and O (Outcome), which was glycemic management (HbA1c). A total of 10 primary studies were assessed with Critical Appraisal Center for Evidence-Based Medicine (CEBM). The results demonstrated that telemedicine is effective in glycemic management (HbA1c) of DM type-2 patients with a p-value of <0.05, namely p<0.04 and a standardized mean difference (SMD) value of -0.24 (95% CI, -0.34 to -0.15). The results of this meta-analysis provide strong scientific evidence regarding the benefits of telemedicine in lowering HbA1c levels in patients with type 2 DM.

ObjectiveTo assess the time to initiation of antenatal care (ANC) and its predictors among pregnant women in Ethiopia.DesignRetrospective follow-up study using secondary data from the 2019 Ethiopian Mini-Demographic and Health Survey.Setting and participants2933 women aged 15–49 years who had ANC visits during their current or most recent pregnancy within the 5 years prior to the survey were included in this study. Women who attended prenatal appointments but whose gestational age was unknown at the first prenatal visit were excluded from the study.Outcome measuresParticipants were interviewed about the gestational age in months at which they made the first ANC visit. Multivariable mixed-effects survival regression was fitted to identify factors associated with the time to initiation of ANC.ResultsIn this study, the estimated mean survival time of pregnant women to initiate the first ANC visit in Ethiopia was found to be 6.8 months (95% CI: 6.68, 6.95). Women whose last birth was a caesarean section (adjusted acceleration factor (AAF)=0.75; 95% CI: 0.61, 0.93) and women with higher education (AAF)=0.69; 95% CI: 0.50, 0.95) had a shorter time to initiate ANC early in the first trimester of pregnancy. However, being grand multiparous (AAF=1.31; 95% CI: 1.05, 1.63), being previously in a union (AAF=1.47; 95% CI: 1.07, 2.00), having a home birth (AAF=1.35; 95% CI: 1.13, 1.61) and living in a rural area (AAF=1.25; 95% CI: 1.03, 1.52) were the impediments to early ANC initiation.ConclusionWomen in this study area sought their initial ANC far later than what the WHO recommended. Therefore, healthcare providers should collaborate with community health workers to provide home-based care in order to encourage prompt ANC among hard-to-reach populations, such as rural residents and those giving birth at home.

ObjectiveThis review aims to determine the prevalence of pregnancy termination and its determinant factors in Ethiopia.DesignSystematic review and meta-analysis.Data sourcesRelevant articles were retrieved from databases such as PubMed, EMBASE, Medline and other search engines.Eligibility criteria for selecting studiesThe research design for this study had no restrictions, allowing for the inclusion of cross-sectional and case–control studies that examined the prevalence or determinants of pregnancy termination. However, case reports, case series, reviews, editorials and studies published as abstracts only were excluded from the analysis.Data extraction and synthesisThe review was precisely in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria, and the quality of the review was assessed using the Joanna Briggs Institute critical appraisal checklist. Heterogeneity was indicated by the p value for I2 statistics less than 0.05. Data were entered into Microsoft Excel, and the analysis was conducted by using Stata V.16.ResultsThe pooled prevalence of pregnancy termination in Ethiopia was 21.52% (95% CI 15.01% to 28.03%). Women who had their first sexual initiation before the age of 18 (OR 1.78; 95% CI 1.13 to 2.82, p=0.14), had irregular menstrual bleeding (OR 1.86; 95% CI 1.25 to 2.77, p=0.76), being a student (OR 4.85; 95% CI 1.98 to 11.91, p=0.20) and had multiple sexual partners (OR 4.88; 95% CI 3.43 to 6.93, p=0.33) were significantly associated with pregnancy termination.ConclusionsOne in five women terminated their pregnancies, which is higher than in other sub-Saharan countries. Being a student, irregular menstrual bleeding, early initiation of sexual intercourse and multiple sexual partners were determinants of pregnancy termination. Special attention is needed in avoiding early sexual initiation and in reducing sexual risk behaviours.

This integrative review aims to explore the experiences of newly qualified midwives (NQMs) when caring for women in the maternity setting. An integrative review (IR) method was chosen based on a systematic approach using Cooper's 1984 framework for transparency and rigorousness. A total of 2428 articles were located, duplicate records were removed, leaving 1428 records. All titles and abstracts were reviewed and 91 articles were then retrieved in full text. After applying inclusion and exclusion criteria, 22 studies were ultimately included in this IR. Appraisal tools were used for each study included in this review according to its research approach. Literature demonstrated how NQMs' wellbeing is at stake after registration as they go through a tumultuous period full of psychological stress, fear and other surges of negative emotions. The importance for NQMs to form new and trusting relationships with colleagues and women patients is highly evident in the literature. Transitioning from a student to a midwife brings about stress and tension especially when NQMs take full responsibility for the women under their care, knowing that their decisions might have a direct impact on the outcome for women, newborns, and families. Literature shows that NQMs are a precious entity to healthcare as they are the future of midwifery and hence more research is recommended.

For decades, care for clients after prelabor rupture of membranes (PROM) at term has been guided by results from the 1996 Term Prelabor Rupture of the Membranes (TERMPROM) study.Researchers designed the TERMPROM study to determine whether induction of labor or expectant management was the superior course after term PROM.They randomized 5042 pregnant people with PROM at 72 hospitals in high-income countries to either induction with oxytocin, expectant management up to 96 hours followed by induction with oxytocin, induction with prostaglandin E2, or expectant management up to 96 hours followed by induction with prostaglandin E2.The researchers found no significant differences in occurrence of cesarean birth or neonatal infection.There were more diagnoses of clinical chorioamnionitis and postpartum fever among participants who were randomized to expectant management, and people who were randomized to induction expressed slightly more favorable experiences of labor. 1 Clinicians have used the results of the TERMPROM study to justify both immediate induction of labor after PROM and expectant management.The American College of Nurse-Midwives supports both immediate induction and expectant management, stating that "Management of PROM at term is a complex issue that requires a balanced and individualized approach based on discussion of risks and benefits as well as shared decision-making." 2(p2) It calls for future trials to determine optimal guidelines for expectant management.The American College of Obstetricians and Gynecologists, on the other hand, states that "if spontaneous labor does not occur near the time of presentation in those who do not have

The concept of quality in healthcare is a core issue that gets ever more interesting and important. According to WHO, the definition of quality in care is 'the extent to which healthcare services provided to individuals and patient populations improve desired health outcomes. In order to achieve this, healthcare must be safe, effective, timely, efficient, equitable and people-centred' 1 . Thus, as quality of healthcare for women and newborns, we define the extent to which the provided services, whether individual or not, meet the requirements to achieve the desired outcomes, that are, at the same time, in line with contemporary practices and accommodate the patients' needs and desires 2 .