Tanaka Nao, Horiuchi Shigeko, Shimpuku Yoko, Leshabari Sebalda
St. Luke's International University, Tokyo, Japan.
Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
BMC Nurs. 2015 May 8;14:27. doi: 10.1186/s12912-015-0081-y. eCollection 2015.
Approaches to addressing the shortage of midwives are a great need especially in Sub-Saharan Africa including Tanzania. The midwifery shortage in Tanzania consists of two major causes; the first is the shortage of pre-service nursing training and the second is the low rate of retention as it is difficult to sustain midwives' career motivations. Lack of opportunities for career development, is one of the most related problems to keep midwives motivated. Continuing education as an approach to career development can heighten midwives' motivation and cultivate more skilled midwives who can educate other midwives or students and who could raise the status of midwives. Effective continuing education is ongoing, interactive, contextually relevant and based on needs assessment, however there is very limited research that describes Tanzanian midwives perspective of expectations for career development; hence this research is significant for revealing important and meaningful professional desires of midwives in Tanzania.
This was a preliminary qualitative study, using snowball sampling to recruit 16 midwives in Tanzania. The researchers used a semi-structured interview including probing questions with both a focus group and several individuals. The data were collected from July to December 2013 and coded into categories and sub-categories.
There were 14 midwives in the focus group interview and two midwives in the individual interviews. Through data analysis, four major categories (with subcategories) emerged: (1) motivation for learning (to achieve the MDGs, and to raise reproductive health), (2) knowledge is power (to provide good practice based on knowledge, to be a role model, knowledge gives higher position and courage, and knowledge enables one to approach to the government), (3) there is no end to learning (hunger for learning, and ripple effect).
From findings, four major categories plainly showed midwives' desire for learning, however they experienced a number of barriers to access further education. Continuing education is one of the most important and effective ways to cultivate and retain midwives. In order to respond to the midwives expectations and challenges to overcome the barriers inherent in providing more continuing education, it will be necessary to increase accessible opportunities for career development in Tanzania.
解决助产士短缺问题的方法极为必要，特别是在包括坦桑尼亚在内的撒哈拉以南非洲地区。坦桑尼亚助产士短缺主要有两大原因：一是岗前护理培训不足，二是留用率低，因为难以维持助产士的职业动力。缺乏职业发展机会是影响助产士积极性的最相关问题之一。继续教育作为职业发展的一种途径，可以提高助产士的积极性，并培养出更多有技能的助产士，这些助产士能够培训其他助产士或学生，提升助产士的地位。有效的继续教育应该是持续的、互动的、与实际情况相关且基于需求评估的，然而，描述坦桑尼亚助产士职业发展期望的研究非常有限；因此，这项研究对于揭示坦桑尼亚助产士重要且有意义的职业愿望具有重要意义。
这是一项初步的定性研究，采用滚雪球抽样法在坦桑尼亚招募了16名助产士。研究人员使用了半结构化访谈，包括焦点小组和个人的深入问题。数据收集于2013年7月至12月，并编码为类别和子类别。
焦点小组访谈中有14名助产士，个人访谈中有2名助产士。通过数据分析，出现了四个主要类别（及子类别）：（1）学习动机（实现千年发展目标，提高生殖健康水平），（2）知识就是力量（基于知识提供良好实践，成为榜样，知识赋予更高地位和勇气，知识使人能够接触政府），（3）学无止境（求知欲，涟漪效应）。
从研究结果来看，四个主要类别清楚地表明了助产士的学习愿望，然而他们在接受进一步教育方面遇到了一些障碍。继续教育是培养和留住助产士的最重要、最有效的方法之一。为了回应助产士的期望并应对克服提供更多继续教育所固有的障碍的挑战，有必要在坦桑尼亚增加可获得的职业发展机会。
