Collaborations de Recherche Equitables sur la Pratique des Sages-Femmes : Exploration de l'Intégration de l'Aspiration Intra-Utérine Manuelle Réalisée par des Sages-Femmes Lors des Avortements Incomplets dans la Ville de Kinshasa, en République Démocratiq
Abstract
Introduction : Les approches de collaboration transnationale sont un moyen de soutenir la recherche par et pour les sages-femmes. Cet article décrit une approche de recherche équitable de collaboration transnationale avec l'Association des sages-femmes congolaises pour examiner l'intégration de l'aspiration manuelle intra-utérine par les sages-femmes à la suite d'une formation continue.
Méthodes : Un cadre d'équité pour la recherche collaborative a été employé pour le processus de recherche. La recherche a utilisé une approche méthodologique mixte de déviance positive pour identifier les sages-femmes qui ont pratiqué l'aspiration manuelle intra-utérine (AMIU) après la formation et a exploré les facteurs favorables à cette pratique.
Résultats : Parmi les 102 sages-femmes, 34 % ont déclaré avoir pratiqué l'AMIU après leur formation lors d’un avortement incomplet. Les sages-femmes à déviance positive, celles qui pratiquaient l'AMIU, ont démontré et décrit plus de confiance et de compétence dans la pratique et l'enseignement de la procédure. Elles étaient plus disposées à s'identifier comme enseignantes, à surmonter les barrières interprofessionnelles pour enseigner l'AMIU aux autres prestataires, et à se positionner comme expertes dans les situations d'urgence en matière de soins après-avortement.
Conclusion : Les sages-femmes déviantes positives ont utilisé des stratégies au cours des urgences pour pratiquer l'AMIU en toute sécurité et ont augmenté la crédibilité des sages-femmes tout en diffusant des pratiques fondées sur des données probantes. Les programmes ultérieurs peuvent collaborer avec des sages-femmes déviantes positives en tant que vulgarisateurs courtiers de connaissances sur la diffusion de l’AMIU par des sages-femmes, ce qui peut améliorer l'accès à des soins reproductifs sûrs et respectueux.
Introduction: Transnational collaborative approaches are a means of supporting research production by and for midwives. This article describes an equitable research approach to transnational collaboration with the Congolese Midwives‘ Association to examine the integration of manual intrauterine vacuum aspiration by midwives following a continuing education intervention.
Methods: An equity framework for collaborative research was applied throughout the research process (design, operationalisation and dissemination). The research used a positive deviance mixed method approach to identify midwives who practised manual vacuum aspiration (MVA) after training and explored enabling factors.
Results: Of the 102 midwives, 34% reported using MVA after training for incomplete abortion. Positive deviance midwives, those practising MVA, demonstrated and described more confidence and competence in practising and teaching the procedure. They were more willing to identify themselves as teachers, overcome inter-professional barriers in teaching MVA to doctors, medical students, and other midwives, and positioned themselves as experts in post-abortion care emergencies.
Discussion: The results provided important insights into integrating post-abortion care by midwives in Kinshasa. Equity-based research collaborations help support the work of midwifery associations and advance the role of midwives in achieving abortion provision.
Conclusion: Positive deviant midwives used strategies during emergencies to safely practice MVA and increased the credibility of midwives while disseminating evidence-based practices. Future programs can work with positive deviant midwives as knowledge brokers on the diffusion of midwifery-led manual vacuum aspiration, which can improve access to safe and respectful reproductive care.
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