Competency of Midwives in Assisting Vaginal Breech Births and associated factors: A Cross-sectional study in Lower Level Health Facilities of Hoima District, Uganda.

Prossy Nandawula; Ayebare  Elizabeth; Mathew  Nyashanu; Michelle  Telfer; Scovia Nalugo  Mbalinda

doi:10.51168/sjhrafrica.v3i9.243

Authors

Prossy Nandawula Department of Nursing, School of Health Sciences, Makerere University.
Ayebare Elizabeth Department of Nursing, School of Health Sciences, Makerere University
Mathew Nyashanu Department of Public Health, Nottingham Trent University UK
Michelle Telfer Midwifery specialist, School of Nursing, Yale University USA.
Scovia Nalugo Mbalinda Department of Nursing, College of Health Sciences, Makerere University

DOI:

https://doi.org/10.51168/sjhrafrica.v3i9.243

Keywords:

Competence, Mal presentation, Breech Presentation, Frank breech, Vaginal breech births

Abstract

Objectives:

To assess midwives’ competencies in the application of the manoeuvers for a vaginal frank breech delivery and identify factors associated with midwives’ competency in delivering a vaginal frank breech.

Methods:

A cross-sectional study was conducted among 143 practicing midwives who were recruited consecutively. A 30-item checklist was used to assess the midwives’ competence in the application of Pinard, Loveset’s, and Mauriceau Smellie Viet manoeuvers. A self-administered questionnaire was used to obtain the associated factors. Descriptive statistics were used to analyze midwives’ competence. Crude Odds Ratios and their 95% confidence intervals measured the association.

Results:

87.4% of midwives knew and mentioned a manoeuvre. Slightly half of 72(50.4%) study participants, with a mean score of 12.3 (SD: 2.7), were competent. Competence scores for Pinard, Loveset’s, and Mauriceau Smelie Viet manoeuvres were 69.2%, 44.1%, and 30.8% respectively. Midwives who could mention any manoeuvre were 11 times more likely to be competent (Adjusted odds ratio [AOR]: 11.79, 95% CI: 2.23-58.35, P: 0.002). Midwives who felt confident were 5 times more likely to be competent (AOR: 5.95, 95% CI: 1. 23-28.80, P: 0.026).

Conclusion:

Overall midwives’ competence was average. The majority were competent with the application of Pinard manoeuvre. Lovset and Mauricea Smelie Viet had below-average scores. The significantly associated factors were being able to mention any type of the manoeuvres, and reporting a feeling of confidence. These findings highlight the need for in-service vaginal breech births training, and a hands-on vaginal breech births practice to improve competence.

Recommendations:

The health care system should standardize the quality of midwifery practice as stated by the global standard of midwifery practice. Standard guidelines and standard operating procedures should be developed to guide the care practices in health units.

Author Biographies

Prossy Nandawula, Department of Nursing, School of Health Sciences, Makerere University.

is a nurse midwife, maternal and child health specialist, and midwifery educator for 8 years. A Nurse/Midwife seeking proficiency in midwifery training and service delivery that promotes development and implementation of evidence-based practice through continuous research, work experience, and respect for patient’s values and preferences. In my profession, I have managed to train over 1,000 Midwives and Nurses with diplomas and a few numbers at a bachelor’s level. I hold a Bachelor of Science in Nursing from Uganda Christian University, a Master of Science in Nursing Midwifery and women’s Health (MSNM) from Makerere University: School of Health Sciences, Department of Nursing, and a Post Graduate Diploma in Medical Education (PGMME) from Makerere University
Health Tutor’s college; Mulago.