Recherche Collaborative Entre le Canada et la République Démocratique du Congo. Sages-Femmes et l'Aspiration IntraUtérine Manuelle suite aux Avortements Incomplets dans la Ville de Kinshasa

Kirsty Bourret; Amélie Hien; Sylvie Larocque; Carol Hogue; Kalum Muray; Aurélie Thethe Lukusa; Abel Minani Ngabo

doi:10.19044/esj.2024.v20n12p1

Kirsty Bourret McMaster University, Canada
Amélie Hien Université du Québec à Trois-Rivières, Canada
Sylvie Larocque Université Laurentienne, Canada
Carol Hogue Emory University, United States
Kalum Muray Université Laurentienne, Canada
Aurélie Thethe Lukusa Société Congolaise de la Pratique Sage-femme, République démocratique du Congo
Abel Minani Ngabo Institut Supérieur des Sciences Infirmières, République démocratique du Congo

DOI: https://doi.org/10.19044/esj.2024.v20n12p1

Keywords: Collaboration, Pratique, Sages-femmes, AMIU, Kinshasa

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 à la suite de leur formation lors d’un avortement incomplet. Les sagesfemmes 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. Discussion :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. Conclusion : Les programmes ultérieurs peuvent collaborer avec des sagesfemmes déviantes positives en tant que vulgarisateurs et 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 postabortion 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. Positive deviant midwives used strategies during emergencies to safely practice MVA and increased the credibility of midwives while disseminating evidence-based practices. Conclusion: 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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References

1. Atuhairwe, S., Byamugisha, J., Kakaire, O., Hanson, C., Cleeve, A., Klingberg-Allvin, M., . . . Gemzell-Danielsson, K. (2022). Comparison of the effectiveness and safety of treatment of incomplete second trimester abortion with misoprostol provided by midwives and physicians: a randomised, controlled, equivalence trial in Uganda. The Lancet Global Health, 10(10), e1505-e1513. https://doi.org/https://dx.doi.org/10.1016/S2214-109X%2822%2900312-6
2. Boum Ii, Y., Burns, B. F., Siedner, M., Mburu, Y., Bukusi, E., & Haberer, J. E. (2018). Advancing equitable global health research partnerships in Africa. BMJ Global Health, 3(4), e000868. https://doi.org/10.1136/bmjgh-2018-000868
3. Bourret, K. (2017). États de Lieux pour le renforcement des capacités visant l’amélioration des pratiques cliniques des sages-femmes dans les structures de santé pour la ville/province de Kinshasa. Société Congolaise de la Pratique Sage-Femme. Kinshasa, RDC .
4. Bourret, K. M., Larocque, S., Hien, A., Hogue, C., Muray, K., Lukusa, A. T., & Ngabo, A. M. (2020). Midwives' integration of post abortion manual vacuum aspiration in the Democratic Republic of Congo: a mixed methods case study & positive deviance assessment. BMC Health Services Research, 20(1), 1136.
5. Clark, K. A., Mitchell, E. H., & Aboagye, P. K. (2010). Return on investment for essential obstetric care training in Ghana: do trained public sector midwives deliver postabortion care? Journal of Midwifery & Women's Health, 55(2), 153-161.
6. Creswell, J. W., & Clark, V. L. P. (2017). Designing and Conducting Mixed Methods Research. SAGE Publications.
7. DRC, P. (2018). Office of the President of the Republic, special issue. Democratic Republic of Congo Retrieved from https://www.ilo.org/dyn/natlex/docs/SERIAL/84846/94671/F861828376/ratification%20protocole%20droits%20de%20la%20femme.pdf.
8. Fullerton, J., Butler, M. M., Aman, C., Reid, T., & Dowler, M. (2018). Abortion-related care and the role of the midwife: a global perspective. International Journal of Women's Health, 10, 751-762.
9. Fullerton, J. T., Thompson, J. B., Severino, R., & International Confederation of, M. (2011). The International Confederation of Midwives essential competencies for basic midwifery practice. an update study: 2009-2010 [Practice Guideline]. Midwifery, 27(4), 399-408.
10. Gipson, J. D., Becker, D., Mishtal, J. Z., & Norris, A. H. (2011). Conducting Collaborative Abortion Research in International Settings. Women's Health Issues, 21(3), S58-S62. https://doi.org/10.1016/j.whi.2011.01.005
11. Glover, Kayembe, Kaba, & Babakazo. (2020). Assessing Readiness to Provide Comprehensive Abortion Care in the Democratic Republic of the Congo After Passage of the Maputo Protocol. International Perspectives on Sexual and Reproductive Health, 46(Supplement 1), 3. https://doi.org/10.1363/46e0420
12. Glover, A. L., Mulunda, J.-C., Akilimali, P., Kayembe, D., & Bertrand, J. T. (2023). Expanding access to safe abortion in DRC: charting the path from decriminalisation to accessible care. Sexual and Reproductive Health Matters, 31(1). https://doi.org/10.1080/26410397.2023.2273893
13. Homer, C. S., Turkmani, S., Wilson, A. N., Vogel, J. P., Shah, M. G., Fogstad, H., & Langlois, E. V. (2022). Enhancing quality midwifery care in humanitarian and fragile settings: a systematic review of interventions, support systems and enabling environments. BMJ Global Health, 7(1), e006872. https://doi.org/10.1136/bmjgh-2021-006872
14. Ishoso, D. K., Tshefu, A. K., Delvaux, T., & Coppieters, Y. (2019). Extent of induced abortions and occurrence of complications in Kinshasa, Democratic Republic of the Congo. Reproductive Health, 16(1). https://doi.org/10.1186/s12978-019-0727-4
15. Lince-Deroche, N., Kayembe, P., Blades, N., Williams, P., London, S., Mabika, C., Bankole, A. (2019). Grossesses non planifiées et avortements à Kinshasa (République Démocratique du Congo) : Défis et progrès. https://dx.doi.org/10.1363/2019.30887
16. Mainey, L., O'Mullan, C., Reid-Searl, K., Taylor, A., & Baird, K. (2020). The role of nurses and midwives in the provision of abortion care: A scoping review [Review]. Journal of Clinical Nursing, 29(9-10), 1513-1526.
17. Mattison, C., Ateva, E., Bernis, L., Binfa, L., Kaufman, K., Klingberg-Allvin, M., ….Sharma, S. (2023). Whose voice counts? Achieving better outcomes in global sexual and reproductive health and rights research. BMJ Global Health, 8(10), e012680. https://doi.org/10.1136/bmjgh-2023-012680
18. Mattison, C., Bourret, K., Hebert, E., Leshabari, S., Kabeya, A., Achiga, P., . . . Darling, E. (2021). Health systems factors impacting the integration of midwifery: an evidence-informed framework on strengthening midwifery associations. BMJ Glob Health, 6(6), e004850. https://doi.org/10.1136/bmjgh-2020-004850
19. Mertens, D. M. (2021). Transformative Research Methods to Increase Social Impact for Vulnerable Groups and Cultural Minorities. International Journal of Qualitative Methods, 20, 160940692110515. https://doi.org/10.1177/16094069211051563
20. Mertens, W., Recker, J., Kohlborn, T., & Kummer, T.-F. (2016). A Framework for the Study of Positive Deviance in Organizations. Deviant Behavior, 37(11), 1288-1307. https://doi.org/10.1080/01639625.2016.1174519
21. Miller, S., Billings, D. L., & Clifford, B. (2002). Midwives and postabortion care: experiences, opinions, and attitudes among participants at the 25th Triennial Congress of the International Confederation of Midwives [Research Support, Non-U.S. Gov't]. Journal of Midwifery & Women's Health, 47(4), 247-255.
22. Ministère de la Santé Publique. (2014). Enquête Démographique et de Santé en République Démocratique du Congo 2013-2014. http://dhsprogram.com/pubs/pdf/FR300/FR300.pdf
23. Mulyumba, M., Ilumbulumbu, M., Kitamwivirirwa, T., & Ketha, J. (2018). Prevalence, Complications and Outcome of Clandestine Abortion in Rural Eastern Area of Democratic Republic of the Congo (D.R.C). Archives of Current Research International, 14(1), 1-7. https://doi.org/10.9734/acri/2018/41321
24. Murphy, J., Hatfield, J., Afsana, K., & Neufeld, V. (2015). Making a commitment to ethics in global health research partnerships: a practical tool to support ethical practice. J Bioeth Inq, 12(1), 137-146. https://doi.org/10.1007/s11673-014-9604-6
25. Nabirye, R. C., Kinengyere, A. A., & Edwards, G. (2018). Nursing and Midwifery Research Output in Africa: A Review of the Literature. International Journal of Childbirth, 8(4), 236-241. https://doi.org/10.1891/2156-5287.8.4.236
26. Norton, T. C., Rodriguez, D. C., Howell, C., Reynolds, C., & Willems, S. (2021). ‘Maybe we can turn the tide’: an explanatory mixed-methods study to understand how knowledge brokers mobilise health evidence in low- and middle-income countries. Evidence & Policy, 17(1), 9-28. https://doi.org/10.1332/174426419x15679622689515
27. Ouedraogo, R., Senderowicz, L., & Ngbichi, C. (2020). “I wasn’t ready”: abortion decision-making pathways in Ouagadougou, Burkina Faso. International Journal of Public Health, 65(4), 477-486. https://doi.org/10.1007/s00038-020-01359-6
28. Rogers, E. (2003). Diffusion of Innovations (5th ed.). Simon & Schuster, Inc.
29. Rose, A. J., & McCullough, M. B. (2017). A Practical Guide to Using the Positive Deviance Method in Health Services Research. Health Services Research, 52(3), 1207-1222. https://doi.org/10.1111/1475-6773.12524
30. Santé, M. d. l. (2018). Guide de suivi, supervision et évaluation de la formation en soins obstétricaux et néonatals d’urgence (SONU) Sage-Femme. Kinshasa, RDC
31. Sun, C., Dohrn, J., Omoni, G., Malata, A., Klopper, H., & Larson, E. (2016). Clinical nursing and midwifery research: grey literature in African countries. International Nursing Review, 63(1), 104-110. https://doi.org/10.1111/inr.12231
32. Turner, K. L., Pearson, E., George, A., & Andersen, K. L. (2018). Values clarification workshops to improve abortion knowledge, attitudes and intentions: a pre-post assessment in 12 countries. Reproductive Health, 15(1). https://doi.org/10.1186/s12978-018-0480-0
33. WHO. (2022). Abortion Care Guideline.