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Open Access
Perceptions of Diploma Nursing and Midwifery Students on Simulation-Based Education at Haydom Institute of Health Sciences in Northern Tanzania
(2025-04-15) Wilson Saimon Eliamini
Traditional teaching approaches are not very effective in enhancing students' knowledge, abilities, and attitudes. Simulation-Based Education has been shown to be successful in boosting students' learning. Nevertheless, many nursing and midwifery schools in Lowand Middle-Income Countries, notably those in Sub-Saharan Africa, continue to be dominated by traditional didactic methods. In Tanzania, the adoption of SimulationBased Education as a teaching method in nursing and midwifery programmes is still low and Haydom Institute of Health Sciences in Northern Tanzania implements it since 2017. Although anecdotal evidence suggests that simulation continues to be used, there is a scarcity of literature on students' perceptions on simulation-based education since its inauguration. To explore the perceptions of nursing and midwifery students on simulation-based education in Haydom Institute of Health Sciences. This study used an exploratory-descriptive qualitative study design. The study was conducted at Haydom Institute of Health Sciences among population third year nursing and midwifery students. A purposive sampling technique was used to select 31 participants in five focus group discussions. Thematic analysis according to Braun & Clarke (2006) was used. The study was approved by KCMU CRERC and COMREC. Participants' human rights were maintained throughout the study. The analysis of qualitative data resulted into four themes and thirteen subthemes. The identified themes were: Experiences of simulationbased education among the nursing students; Perceived benefits of simulation-based education among the nursing students; Perceived challenges faced by nursing students during simulation-based education and Perspectives on how to improve simulation-based education. Perceptions of diploma in nursing and midwifery students indicate that Simulation-Based Education is a highly effective teaching method even in limited resource settings. Although nursing and midwifery students had limited access to Simulation-Based Education, it stands to be a valuable teaching approach for developing practical skills. This positive feedback highlights the role of Simulation-Based Education in enhancing learning and preparation for real clinical situations.
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Open Access
Exploring Midwives’ Experiences Regarding Implementation of Maternal Death Surveillance and Response at Mwanza District Hospital, Malawi
(2025-04-15) Wakhonderachi Temweka Nyirenda Likha
Despite the Malawi government's implementation of the Maternal Death Surveillance and Response initiative in 2002, preventable maternal deaths persist. Data from Mwanza District Hospital revealed 9 maternal deaths in 2023 alone. This demonstrated that Malawi, like many other low- and middle-income countries, is still far from attaining the Sustainable Development Goals (SDGs) for reducing maternal mortality. Midwives play a pivotal role as members of the MDSR team, and there is potential for midwives to indirectly experience trauma from such role. However, little is known about their experiences during implementation of the MDSR. The main objective of the study was to explore the experiences of midwives regarding the implementation of maternal death surveillance and response. We employed a qualitative explorative descriptive design. In-depth interviews with 18 purposively selected individuals were used to collect qualitative data using a semistructured interview guide. Data analysis was carried out in accordance with Braun and Clarke's six phases of theme analysis, with Nvivo 12 software. The study highlighted three themes based on midwives' experiences with MDSR: maternal death identification, notification, and reporting. Experiences with the maternal death review and audit processes, as well as the implementation and follow-up of action plans. These themes illustrate the complexities of MDSR, such as emotional impact, protocol obstacles, and implementation barriers. The possible recommendation that emerged was the need for more research and development of national policy to identify high quality interventions to support midwives through the MDSR.
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Open Access
ASSESSING NURSE AND MIDWIFE EDUCATORS’ READINESS FOR THE USE OF SIMULATION BASED EDUCATION IN HEALTH TRAINING INSTITUTIONS IN KILIMANJARO TANZANIA
(2025-03-15) Sakanda Linus
Simulation-based education (SBE) improves students' critical thinking, clinical reasoning, and decision-making skills. However, in Tanzania, its implementation is hampered by a lack of organizational support and unprepared staff, with 97% of nurses and midwifery educators using traditional didactic methods that are ineffective in developing relevant healthcare skills. Currently, little is known about readiness for the use of SBE in health teaching institutions in Tanzania. This study aimed to assess the readiness of nurse/midwife educators to incorporate simulation-based education in health training institutions in Tanzania. A quantitative descriptive cross-sectional study design was employed, and it adopted a validated Simulation Culture Organization Readiness Survey (SCORS) questionnaire with 24 items and a 5-point Likert scale. Consecutive sampling was used to recruit 99 participants from selected nurses and midwifery training institutions in Kilimanjaro. Data were collected using a selfadministered questionnaire and analyzed using the Statistical Package for Social Sciences (SPSS) version 26. The study discovered that institutional readiness for simulation-based education was significantly low. This was primarily due to a lack of a clear strategic vision for simulation-based education (mean=2.79), the absence of a written commitment to SBE (mean=2.62), and insufficient resources to support SBE (mean=2.72). Organizations were perceived as "ready but not acting," with participants scoring both the current state and the previous six months similarly on a scale of "73- 108": 40 (40.4%) vs. 38 (38.4%). The low levels of readiness to implement simulationbased education (SBE) in Tanzania highlight the need for a clear strategic vision by nursing and midwifery institutions. Additionally, institutional support is required to develop policies and allocate resources to enhance the effective adoption of SBE.
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Open Access
EXPLORATION OF YOUNG PEOPLE’S HIV SELF-TESTING AND LINKAGE TO CARE EXPERIENCES AT NDIRANDE HEALTH CENTRE IN BLANTYRE CITY, MALAWI
(2025-03-14) CHISOMO MALANGO KUMWENDA
Understanding the experiences of recipients of HIV self-testing (HIVST) can significantly enhance its uptake by young people. However, few studies have focused on young people's perspectives, particularly those of Malawi. This study aimed to explore the experiences of young people related to HIVST and its linkage to care at the Ndirande Health Centre in Blantyre City, Malawi, in order to improve testing rates, linkage to care, and treatment outcomes.This study used a qualitative research approach. Young people aged 18-24, who received HIVST, regardless of their HIV status, were purposively sampled from the Ndirande Health Centre. In terms of sample size, 15 were purposively selected for in-depth interviews (IDIs), while 18 participants, 15 of whom participated in the IDIs, were purposively selected to participate in three focus group discussions (FGDs). Data from both IDIs and FGDs were analyzed using thematic analysis, where patterns and themes were identified, coded, and interpreted to capture insights into young people's experiences with HIVST. The findings of the study were organized into four key themes that emerged from the data: : Motivating Factors for HIVST Engagement, Perspectives on HIVST Process and Linkage to Care, Support Needs During and After HIVST, and Facilitators and Barriers to HIVST and Linkage to Care. The study revealed that media influence, health worker recommendations, peer pressure, educational input, and personal curiosity were significant factors that influenced young people's intention to engage in HIVST. While many respondents appreciated the convenience and autonomy of HIVST, the process and linkage to care were emotionally taxing, with fear of an HIV-positive result, stigma, and discrimination. Support needs during and after HIVST and linkage to care were also highlighted as being important. These include emotional support, practical guidance, reassurance from health workers, and support from family and friends.
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Open Access
Antibiotic medicine-related problems: pharmaceutical quality, availability, adherence to treatment guidelines and associated adverse drug reactions in Southern Malawi
(Kamuzu University of Health Sciences, 2024-11-16) Chiumia, Francis Kachidza
Globally, there are concerns of increasing incidence of antimicrobial resistance (AMR). However, there is limited literature on antibiotic medicine-related problems that may exacerbate the risk of AMR. The aim of this research was to assess the pharmaceutical quality, availability and use of antibiotic medicines and the associated adverse drug reactions in Southern Malawi. We tested the quality of 293 medicine samples from Zomba, Machinga and Nsanje districts and retrospectively reviewed 304 patient files to evaluate the clinical outcomes. Data on medicine availability was collected from stock cards. The prevalence of substandard medicines among antibiotics was 25.4% and were associated with local manufacturing and plastic primary packaging, p<0.01. Over six months, the antibiotic stock outs were 12.5%, 64.3% and 85.7% for Zomba, Machinga and Nsanje respectively. Adherence to treatment guidelines was lower for antibiotics that were stocked out than those that were not stocked out, p< 0.002. About 75% of prescribed antibiotics were from the watch class. The ADR prevalence was 24% of which 27% were serious events. The ADR occurrence was associated with age, polypharmacy and length of hospital stay, p<0.005. Patients who received antibiotics with optimal content of the active pharmaceutical ingredient (API) had higher rates of both ADR occurrence and patient recovery as compared to the patients who received antibiotics with lower than the required API content. However, the differences were not statistically significant. In summary, the study revealed that high prevalence of SF antibiotic medicines, overuse of watch antibiotics, poor adherence to standard treatment guidelines and occurrence of ADRs are serious problems affecting antibiotic therapy. These problems need to be tackled as part of antimicrobial stewardship and pharmacovigilance strategies in Malawi.