Cultural Childbirth Practices and Beliefs in Zambia - Research Paper Example

Qualitative Research Paper Critique: “Cultural childbirth practices and beliefs in Zambia” “Cultural childbirth practices and beliefs in Zambia” Authors/qualifications: “Margaret C. Maimbolwa BSc RNM DNE; Lecturer, School of Nursing, University Teaching Hospital, Lusaka; and Department of Obstetrics and Gynaecology, University Teaching Hospital, School of Medicine, University of Zambia, Lusaka, Zambia Bawa Yamba PhD; Anthropologist, The Nordic Africa Institute, Uppsala, Sweden Vinod Diwan MD PhD; Professor, The Nordic School of Public Health, Gothenburg; and Department of Public Health Sciences, Division of International Health (IHCAR), Karolinska Institutet, Stockholm, Sweden Anna-Berit Ransjo-Arvidson PhD RNM DNE; Senior Lecturer, Department of Public Health Sciences, Division of International Health (IHCAR), Karolinska Institutet, Stockholm; and Department of Women and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institutet, Stockholm, Sweden” (Maimbowla, Yamba, Diwan, & Ransjo-Arvidson, 2003, p. 263) Study Design? 1. How does the investigator identify the study approach? The investigators identified the study approach through explicitly defining the aim and noting that the study would entail conducting interviews, observation and field notes under the portion of data collection (Maimbowla, Yamba, Diwan, & Ransjo-Arvidson, 2003, pp. 265-266). Are the language and concepts consistent with the approach? The authors used a straightforward and comprehensible language that assisted in presenting relevant concepts and expounding on the approach. Likewise, relevant terms were appropriate defined under a heading entitled ‘Definitions’ which came after the Data Collection portion (Maimbowla, Yamba, Diwan, & Ransjo-Arvidson, 2003, p. 266). Are data generation and analysis techniques appropriate? To achieve the aim of exploring “cultural childbirth practices and beliefs in Zambia as related by women accompanying labouring women to maternity units” (Maimbowla, Yamba, Diwan, & Ransjo-Arvidson, 2003, p. 265), the data collection method (use of interviews, observation and field notes, as indicated) and the data analysis techniques (use of EPI-INFO software to interpret quantitative information and the use of content analysis for the qualitative interpretation) (Maimbowla, Yamba, Diwan, & Ransjo-Arvidson, 2003, p. 266) were appropriate. These approaches effectively evaluated the results and the design incorporated screening factors that could adversely affect the outcome. 2. Is the significance/importance of the study explicit? The significant or importance of the study was not explicitly stated but the portion which was presented as ‘What this paper adds’ (Maimbowla, Yamba, Diwan, & Ransjo-Arvidson, 2003, p. 272) as value added information. Does the review of the literature support a need for the study? The review of literature portion, presented in the ‘Background’ section aptly provided the needed support and theoretical framework for the study. What is the study’s potential contribution to nursing? The study’s potential contribution to nursing included illuminating health care practitioners on the role of cultural practices and beliefs during the pregnancy period (from prenatal to antenatal) as influential to the outcome of the delivery. As such, the relevant role accorded to women accompanying laboring women during childbirth provided illuminating information that could assist policy makers in the health care profession in Zambia, or in other rural locations where the same practices prevail, to provide appropriate training, as deemed necessary. 3. Is the sampling strategy clear and guided by study needs? The sampling strategy was clear and effectively conforms to the requirement of the study. This was presented as a separate section under the ‘The Study’ portion (Maimbowla, Yamba, Diwan, & Ransjo-Arvidson, 2003, p. 265) Does the investigator control selection of the sample? One believes that he investigator has some level of control on the selection of the sample since it was stipulated that the participant was selected depending on the set of criteria, also established by the investigator. Participants were therefore selected based on their conformity to the research aim. Thus, one could not contest whether other women accompanying laborers were consistently approached, as alleged. Do sample composition and size reflect study needs? Actually, the sample size was relatively small, at 36 women being interviewed in Zambia. One firmly believes that this is not an effective representative of the whole population of women who delivered on the identified time frame. 4. Are data generation procedures clear? The data generation procedures are clear and straightforward. The study likewise expressly included the contents of the interview questions, as well as the demographic factors that were results of the data gathered. Are sources and means of verifying data explicit? Yes, the sources and means of verifying data were also explicit and a tabular format was presented to highlight the “socio-demographic characteristics of social support women” (Maimbowla, Yamba, Diwan, & Ransjo-Arvidson, 2003, p. 266), to assist in presenting and highlighting the results. 5. Are data analysis procedures described? Yes, data analysis procedures were appropriately described, including ethical considerations which were aptly incorporated (Maimbowla, Yamba, Diwan, & Ransjo-Arvidson, 2003, p. 266). Does the analysis guide direction of sampling and when it ends? Since the data analysis portion was presented in a clear and separate portion, all aspects of study design, including sampling were effectively identified. This portion ends with a section on ‘Results” which explains socio-demographic factors, rule of cultural practices and traditions, up to the summary of results (Maimbowla, Yamba, Diwan, & Ransjo-Arvidson, 2003, p. 269). Are data management processes described? Data management processes are actually deemed described under the ‘Discussion’ portion (Maimbowla, Yamba, Diwan, & Ransjo-Arvidson, 2003, pp. 269-272). 6. How are specific findings presented? The findings were clearly and explicitly presented through the ‘Results’ portion which was likewise effectively followed by the ‘Discussion’ portion (Maimbowla, Yamba, Diwan, & Ransjo-Arvidson, 2003). Is the presentation logical, consistent, and easy to follow? The overall presentation was clear, logical, consistent, easy to follow due to the straightforward structure that divided the discussion into headings and sub-headings. Do quotes fit the findings they are intended to illustrate? Quotes and citations were actually used to provide support to the findings. A total of 49 authoritative sources provided credible and reliable support to the investigators’ contentions. How was trustworthiness assured? Trustworthiness was assured through the provision of reliable sources which could be verified and validated by readers. Likewise, the investigators aptly provided limitations of the study, which is indicative of the acknowledgement that improvements in future research on the subject could still be made. 7. How are overall results represented? The overall results were represented through a discussion of the interpretation of findings gathered from the interview, observation and field notes; in conjunction with support from authoritative secondary sources. Are meanings derived from data described in context? Yes, meanings were derived from the data described in context and were appropriately explained, as required. References were frequently made from the data that were collected and analyzed and categorized in sub-heading for greater clarity and understanding. Does the writing effectively promote understanding? The writing and language used assisted in promoting understanding of the discussions. Likewise, as noted, relevant terms used through the discourse were appropriately defined. 8. Are implications of the research stated? The implications were not explicitly stated but the discussion of ‘What is already known about this topic’ and ‘What this paper adds’ (Maimbowla, Yamba, Diwan, & Ransjo-Arvidson, 2003, p. 272) provide information that would lead practitioners on the relevant implications of the research. May new insights increase sensitivity to others’ needs? Definitely, new insights would provide increased sensitivity to others’ needs. It was clearly advised in the limitations portion that women who delivered at home and were not accompanied by other women were not included in the study. Their views could also increase relevance of the current study. May understanding enhance situational competence? Greater understanding on concepts and contemporary applications of the role of cultural practices, beliefs and traditions would definitely enhance situational competence; especially a more comprehensive understanding on cultural diversity in the health care setting. 9. How are the ethics of the study addressed? There was a section on ‘Ethical Considerations’ (Maimbowla, Yamba, Diwan, & Ransjo-Arvidson, 2003, p. 266) that signified conformity to ethical standards and where approval from ethical committees were duly sought. Is IRB status addressed? There was no mention about the IRB status or if any exemption was secured. Is informed consent discussed? Informed consent was discussed in the sampling portion where the participants’ consent were sought prior to their being considered part of the study sample. What is the risk versus benefit for the participants? There were actually no apparent risk to the participants as women accompanying laboring women. The potential benefits to them would be in terms of future policies that could be enforced regarding providing them with appropriate training to assist them in their respective endeavors. Is/are the investigators qualified? The investigators were appropriately and evidently qualified as noted from their education, experiences and work-related backgrounds, as shown in the authors and qualifications noted above. Is the participants’ anonymity/confidentiality maintained? Yes, the participants’ anonymity and confidentiality were duly maintained as no personal information or identification was disclosed within the study. 10. Identify the strengths and weaknesses of the study. Be objective and realistic when identifying the strengths and weaknesses. The critique should be a balanced assessment of the worth of the research. Strive not to be overly critical or overly flattering. List 5 specific strengths of this research: Clearly structured format; Good, comprehensible and clear language used; Support from extensive authoritative and verifiable sources were effectively provided; Authors clearly established authoritativeness on the subject; Findings were supportive of the study design and methodology used. List 5 specific weaknesses of this research: Selection of sample is within the control of the investigator and could affect the results; Limited sample size which could influence validity of the results; 13 out of 49 references, or 27% were already outdated; exemplifying publication dates of more than 10 years from the publication date of the study (2003) which could affect validity of the results; Limitation was not only due to the composition of sample but also in sample size and applicability of results to other cultural locations; Implications for current and future use of the research findings were not provided; Additional comments: Overall, the study was interesting and beneficial to nurses and other health care practitioners in terms of signifying the role that culture plays in the health care settings. As such, the findings and results that were provided should be used by policy makers in improving the delivery of health care to marginalized members of society to decrease mortality and assist in improving access to health on a more universal and equitable scope. Reference Maimbowla, M., Yamba, B., Diwan, V., & Ransjo-Arvidson, A. (2003). Cultural childbirth practices and beliefs in Zambia. Journal of Advanced Nursing, 43(3), 263–274. Read More