Professor Angela Dawson is a public health social scientist with expertise in maternal and reproductive health service delivery to priority populations in Australia and low and lower middle-income countries. Angela is an NHMRC Translational research fellow examining approaches to counselling women with FGM at the point of care and the recipient of the Sax prize for research impact. She has undertaken research into to the delivery of reproductive health services in humanitarian emergencies, the management and referral of women who have experienced domestic violence as well as access to abortion and emergency contraceptive pills in Australia and internationally. Angela is the convenor of the Public Health Association of Australian Women’s Health Special Interest group, a member of the Interagency working group of reproductive health in crisis and an Associate Editor of the journal BMC Pregnancy and Childbirth.
Angela has a special interest in Indigenous health and innovative approaches to delivering drug and alcohol services. She has been involved in the evaluation of Aboriginal child health programs across NSW. Angela is a chief investigator on an ARC funded discovery project examining the use of qualitative research to inform policy and practice in Aboriginal health services research. She is also an associate investigator on the Centre for Research Excellence on Indigenous Health and Alcohol at the University of Sydney and an NHMRC Global Alliance for Chronic Diseases grant examining the scaling up of a community based alcohol education program in rural Sri Lankan villages.
Angela has over 100 publications in peer-reviewed journals and written numerous reports and papers for governments and United Nations bodies. She has over 20 years experience in the areas of Indigenous Australian and international health, primary health care services, workforce development, health promotion and health communication. Angela was involved with the National Malaria Control Programme in five African countries, a Gates funded project with the Liverpool School of Tropical Medicine and the London School of Hygiene and Tropical Medicine. She has also designed programmes to develop dialogue and debate between journalists and public health practitioners in Africa, Asia and the Caribbean.
Associate Editor: BMC Pregnancy and Childbirth
Associate Editor: BMC Public Health
Editorial Board: Health Education
Convenor: The Public Health Association of Australia Women's Health Special Interest Group
International Federation of Abortion and Contraception Professionals member
Inter-Agency Working Group (IAWG) on Reproductive Health in Crises member
Pacific Reproductive Health Association member
The Australian Association for Adolescent Health
Australian Research Alliance for Children and Youth member
Project group member: Community Mental Health and Alcohol and Drug Research Network.
Can supervise: YES
- Maternal and reproductive health service delivery
- Adolescent sexual and reproductive health
- Global health
- Sexual and reproductive health in humanitarian settings
- Indigenous Australian primary health care
- Health promotion and communication
Areas of research supervision
- Global health
- Primary health care workforce and service delivery
- Maternal and reproductive health
- Vulnerable and marginalised populations
- Community health
- Health communication
Primary health Care service delivery
Qualitative Research methods
An understanding of alcohol's place in Iraq's history and society can help inform alcohol policy responses in that country and other Muslim majority countries. This article describes the history of alcohol in Iraq from ancient to modern times, with reflection on the challenges facing Iraqi youth today. A search was undertaken to identify peer-reviewed and gray literature that describes alcohol-related practices, norms, and values across the millennia in Iraq. A historical overview is provided of alcohol's use and context, with more detail on recent times. Alcohol was an important commodity in Iraq until the rise of Islam in the seventh century CE. Despite the subsequent Islamic restrictions on alcohol, alcohol remained present in Iraq's society and cultures. Recent studies provide varying descriptions of the prevalence of alcohol consumption, and there are challenges in researching this sensitive topic. External forces shaping alcohol use in Iraq include direct and indirect alcohol promotion, globalized media, and conflict and violence with its associated stress and trauma. Alcohol research and policy development in Iraq must consider the country's unique cultural, religious, historical, and political context. Iraq's youth may be subject to pressures to increase consumption, and thus policies must be informed by an understanding of the complex set of current perspectives and pressures.
Beek, K, McFadden, A & Dawson, A 2019, 'The role and scope of practice of midwives in humanitarian settings: a systematic review and content analysis.', Human resources for health, vol. 17, no. 1.View/Download from: UTS OPUS or Publisher's site
BACKGROUND:Midwives have an essential role to play in preparing for and providing sexual and reproductive health (SRH) services in humanitarian settings due to their unique knowledge and skills, position as frontline providers and geographic and social proximity to the communities they serve. There are considerable gaps in the international guidance that defines the scope of practice of midwives in crises, particularly for the mitigation and preparedness, and recovery phases. We undertook a systematic review to provide further clarification of this scope of practice and insights to optimise midwifery performance. The review aimed to determine what SRH services midwives are involved in delivering across the emergency management cycle in humanitarian contexts, and how they are working with other professionals to deliver health care. METHODS:Four electronic databases and the websites of 33 organisations were searched between January and March 2017. Papers were eligible for inclusion if they were published in English between 2007 and 2017 and reported primary research pertaining to the role of midwives in delivering and performing any component of sexual and/or reproductive health in humanitarian settings. Content analysis was used to map the study findings to the Minimum Initial Service Package (MISP) for SRH across the three phases of the disaster management cycle and identify how midwives work with other members of the health care team. RESULTS:Fourteen studies from ten countries were included. Twelve studies were undertaken in conflict settings, and two were conducted in the context of the aftermath of natural disasters. We found a paucity of evidence from the research literature that examines the activities and roles undertaken by midwives across the disaster management cycle. This lack of evidence was more apparent during the mitigation and preparedness, and recovery phases than the response phase of the disaster management cycle. CONCLUSION:Research-informed g...
Dawson, AJ, Rossiter, C, Doab, A, Romero, B, Fitzpatrick, L & Fry, M 2019, 'The Emergency Department Response to Women Experiencing Intimate Partner Violence: Insights From Interviews With Clinicians in Australia', ACADEMIC EMERGENCY MEDICINE, vol. 26, no. 9, pp. 1052-1062.View/Download from: UTS OPUS or Publisher's site
Dowsett, M, Islam, MM, Ganora, C, Day, C, Lee, KSK, Dawson, A, Joseph, T, White, A, Freeburn, B & Conigrave, KM 2019, 'Asking young Aboriginal people who use illicit drugs about their healthcare preferences using audio‐computer‐assisted self‐interviewing', Drug and Alcohol Review, vol. 38, no. 5, pp. 482-493.View/Download from: UTS OPUS or Publisher's site
Lewis, E, Harrison, R, Hanly, L, Psirides, A, Zammit, A, McFarland, K, Hillman, K, Dawson, A, Barr, M & Cardona, M 2019, 'End-of-life priorities of older adults with terminal illness and caregivers: a qualitative consultation', Health Expectations, vol. 22, no. 3, pp. 405-414.View/Download from: UTS OPUS or Publisher's site
Njue, C, Karumbi, J, Esho, T, Varol, N & Dawson, A 2019, 'Preventing female genital mutilation in high income countries: a systematic review of the evidence.', Reproductive health, vol. 16, no. 1.View/Download from: UTS OPUS or Publisher's site
BACKGROUND:Female genital mutilation (FGM) is prevalent in communities of migration. Given the harmful effects of the practice and its illegal status in many countries, there have been concerted primary, secondary and tertiary prevention efforts to protect girls from FGM. However, there is paucity of evidence concerning useful strategies and approaches to prevent FGM and improve the health and social outcomes of affected women and girls. METHODS:We analysed peer-reviewed and grey literature to extract the evidence for FGM prevention interventions from a public health perspective in high income countries by a systematic search of bibliographic databases and websites using appropriate keywords. Identified publications were screened against selection criteria, following the PRISMA guidelines. We examined the characteristics of prevention interventions, including their programmatic approaches and strategies, target audiences and evaluation findings using an apriori template. FINDINGS:Eleven documents included in this review described primary and secondary prevention activities. High income countries have given attention to legislative action, bureaucratic interventions to address social injustice and protect those at risk of FGM, alongside prevention activities that favour health persuasion, foster engagement with the local community through outreach and the involvement of community champions, healthcare professional training and capacity strengthening. Study types are largely process evaluations that include measures of short-term outcomes (pre- and post-changes in attitude, knowledge and confidence or audits of practices). There is a dearth of evaluative research focused on empowerment-oriented preventative activities that involve individual women and girls who are affected by FGM. Beattie's framework provides a useful way of articulating negotiated and authoritative prevention actions required to address FGM at national and local levels. CONCLUSION:FGM is a comple...
Rossiter, C, Power, T, Fowler, C, Elliott, K & Dawson, A 2019, 'Reflexivity in correctional research: researcher perspectiveson parenthood in a study with incarcerated parents', Qualitative Social Work.View/Download from: UTS OPUS or Publisher's site
Vaughan, G, Dawson, A, Peek, MJ, Carapetis, JR & Sullivan, EA 2019, 'Standardizing clinical care measures of rheumatic heart disease in pregnancy: A qualitative synthesis', Birth.View/Download from: Publisher's site
© 2019 Wiley Periodicals, Inc. Background: Rheumatic heart disease (RHD) is a preventable cardiac condition that escalates risk in pregnancy. Models of care informed by evidence-based clinical guidelines are essential to optimal health outcomes. There are no published reviews that systematically explore approaches to care provision for pregnant women with RHD and examine reported measures. The review objective was to improve understanding of how attributes of care for these women are reported and how they align with guidelines. Methods: A search of 13 databases was supported by hand-searching. Papers that met inclusion criteria were appraised using CASP/JBI checklists. A content analysis of extracted data from the findings sections of included papers was undertaken, informed by attributes of quality care identified previously from existing guidelines. Results: The 43 included studies were predominantly conducted in tertiary care centers of low-income and middle-income countries. Cardiac guidelines were referred to in 25 of 43 studies. Poorer outcomes were associated with higher risk scores (detailed in 36 of 41 quantitative studies). Indicators associated with increased risk include anticoagulation during pregnancy (28 of 41 reported) and late booking (gestation documented in 15 of 41 studies). Limited access to cardiac interventions was discussed (19 of 43) in the context of poorer outcomes. Conversely, early assessment and access to regular multidisciplinary care were emphasized in promoting optimal outcomes for women and their babies. Conclusions: Despite often complex care requirements in challenging environments, pregnancy provides an opportunity to strengthen health system responses and address whole-of-life health for women with RHD. A standard set of core indicators is proposed to more accurately benchmark care pathways, outcomes, and burden.
Turkmani, S, Homer, CSE & Dawson, A 2019, 'Maternity care experiences and health needs of migrant women from female genital mutilation-practicing countries in high-income contexts: A systematic review and meta-synthesis.', Birth, vol. 46, pp. 3-14.View/Download from: UTS OPUS or Publisher's site
Female genital mutilation (FGM) is a cultural practice defined as the partial or total removal of the external female genitalia for nontherapeutic indications. Due to changing patterns of migration, clinicians in high-income countries are seeing more women from countries where the practice is prevalent. This review aims to understand the sociocultural and health needs of these women and identify opportunities to improve the quality of maternity care for women with FGM.We undertook a systematic review and meta-synthesis of peer-reviewed primary qualitative research to explore the experience and needs of migrant women with FGM receiving maternity care. A structured search of nine databases was undertaken, screened papers appraised, and a thematic analysis undertaken on data extracted from the findings and discussion sections of included papers.Sixteen peer-reviewed studies were included in the systematic review. Four major themes were revealed: Living with fear, stigma, and anxiety; Feelings of vulnerability, distrust, and discrimination; Dealing with past and present ways of life after resettlement; and Seeking support and involvement in health care.The findings suggest that future actions for improving maternity care quality should be focused on woman-centered practice, demonstrating cultural safety and developing mutual trust between a woman and her care providers. Meaningful consultation with women affected by FGM in high-income settings requires cultural sensitivity and acknowledgment of their specific circumstances. This can be achieved by engaging women affected by FGM in service design to provide quality care and ensure woman-focused policy is developed and implemented.
Goodhew, MA, Stein-Parbury, MJ & Dawson, A 2019, 'Consumer participation in drug treatment: a systematic review', Drugs and Alcohol Today, vol. 19, no. 2, pp. 97-112.View/Download from: UTS OPUS or Publisher's site
White, MR, Stein-Parbury, J, Orr, F & Dawson, A 2019, 'Working with consumers who hear voices: The experience of early career nurses in mental health services in Australia.', International Journal of Mental Health Nursing, vol. 28, no. 2, pp. 605-615.View/Download from: UTS OPUS or Publisher's site
Mental health consumers who hear voices frequently experience distress and express a desire to discuss their voice-hearing experience. Nurses do not regularly demonstrate a willingness to engage in such discussions. With the introduction of educational strategies that develop empathy and an understanding of voice-hearing experiences, it is anticipated that early career nurses will be able to translate such understanding into their professional nursing practice. To explore early career nurses' understanding of providing care to mental health consumers who hear voices, a qualitative exploratory descriptive study was conducted in which nine early career Registered Nurses were interviewed regarding their experiences of caring for people who hear voices. Thematic analysis was employed to analyse the data and generate themes. Participants reported difficulty in developing relationships with consumers who hear voices, due to a workplace culture that was focussed on risk and lacking professional support. Nurses need specific education to develop the skills necessary to respond to consumers who hear voices and engage in dialogue that assists consumers to relate to the voices in a meaningful way. However, for this to succeed in practice, changes need to be supported by addressing the cultural barriers, such as risk-focussed environments, that prevent nurses implementing best practice.
Akter, T, Dawson, A & Sibbritt, D 2018, 'Changes in neonatal mortality and newborn health-care practices: descriptive data from the Bangladesh Demographic and Health Surveys 2011 and 2014', The WHO South-East Asia Journal of Public Health.View/Download from: UTS OPUS or Publisher's site
Lam, W, Fowler, C & Dawson, A 2018, 'The role of culture in relation to the seasonal influenza prevention practices of Hong Kong Chinese parents with preschool children', International Journal of Health Promotion and Education, vol. 56, no. 1, pp. 3-16.View/Download from: UTS OPUS or Publisher's site
Aims and objectives: To explore the role of culture in the seasonal influenza prevention practices of Hong Kong Chinese parents with a healthy preschool child.
Background: Cultural values and norms significantly influence parents' health preventive practices and related health promotion strategies. Most research is concerned with influenza prevention and focuses on the factors affecting vaccination uptake, the use of facemasks and effective hand hygiene. There is limited research exploring the influence of culture on the seasonal influenza prevention practices of parents with a young child in Hong Kong.
Design: Mixed methods using a multiple-case study approach.
Methods: Purposive intensity sampling was employed to recruit 20 parents with children under five years old. A thematic analysis was employed to examine the qualitative interview data and the quantitative data were analysed descriptively. The data were then integrated to provide a more rigorous comprehension of parents' cultural seasonal influenza preventive practices. Comparisons were conducted across the 20 cases and patterns examined.
Results: Five themes were identified. They were sharing beds; boiling white vinegar to kill air-born germs; diet therapy to enhance health; self-prescribed Chinese medication to manage a child's cold symptoms; and the co-use of Western and traditional Chinese medications to prevent seasonal influenza.
Conclusions: The findings indicate that a pluralistic approach to health promotion should be considered to ensure the likelihood that families accept, support and comply with health advice in seasonal influenza prevention. The delivery of culturally appropriate health promotion requires a close partnership between nurses and parents.
Setiwan, A & Dawson, A 2018, 'Strengthening the primary care workforce to deliver community case management for child health in rural Indonesia', Australian Health Review, vol. 42, pp. 536-541.View/Download from: UTS OPUS or Publisher's site
Objectives The aim of the present study was to report on the implementation of community case management (CCM) to reduce infant mortality in a rural district, namely Kutai Timur, Kalimantan Indonesia.
Methods An interpretive qualitative methodology was used. In-depth interviews were conducted with 18 primary healthcare workers (PHCWs), and PHCWs were observed during a consultation with mothers to gain insight into the delivery of the new protocol and workforce issues. The field notes and interview transcripts were analysed thematically.
Results PHCWs reported that their performance had improved as a result of increased knowledge and confidence. The implementation of CCM had also reportedly enhanced the PHCWs' clinical reasoning. However, the participants noted confusion surrounding their role in prescribing medication.
Conclusions CCM is viewed as a useful model of care in terms of enhancing the capacity of rural PHCWs to provide child health care and improve the uptake of life-saving interventions. However, work is needed to strengthen the workforce and to fully integrate CCM into maternal and child health service delivery across Indonesia.
What is known about the topic? Indonesia has successfully reduced infant mortality in the past 10 years. However, concerns remain regarding issues related to disparities between districts. The number of infant deaths in rural areas tends to be staggeringly high compared with that in the cities. One of the causes is inadequate access to child health care.
What does this paper add? CCM is a model of care that is designed to address childhood illnesses in limited-resource settings. In CCM, PHCWs are trained to deliver life-saving interventions to sick children in rural communities. In the present study, CCM improved the capacity of PHCWs to treat childhood illnesses.
What are the implications for practitioners? CCM can be considered to strengthen PHCWs' competence in addressing infant mortality in areas where access to chi...
© 2018 The Royal Society for Public Health Objectives: In this article, we outline the link between migration, public health and ethics. Study design: Discussing relevant arguments about migration from the perspective of public health and public health ethics. Methods: Critical review of theories and frameworks, case-based analysis and systematic identification and discussion of challenges. Results: Migration is a core issue of public health ethics and must take a case-based approach: seeking to identify the specific ethical dimensions and vulnerabilities in each particular context. Public health as a practice, built upon the core value of justice, requires the protection and promotion of migrants' well-being (even if this produces tension with immigration services). Ethical analysis should take all phases of migration into account: before, during and after transit. We argue that migration policies, at least as they relate to migrants' well-being, should be founded upon a shared humanity, respect for human rights and on the idea that effective public health cannot and should not be confined within the borders and to the citizens of any host country. Conclusions: We make the case for migration to be seen as a core issue of public health ethics.
Fowler, C, Rossiter, C, Dawson, A, Power, T, Jackson, D & Roche, M 2018, 'When parenting doesn't 'come naturally': providers' perspectives on parenting education for incarcerated mothers and fathers', Studies in Continuing Education, vol. 40, no. 1, pp. 98-114.View/Download from: UTS OPUS or Publisher's site
Learning to parent sensitively and safely can be challenging for adults with childhood abuse and neglect experiences. Such childhood experiences are prevalent among incarcerated parents whose ability to parent their own children is also limited by separation from them. Several prisons have developed programs to foster pro-social parenting skills among incarcerated mothers and fathers to assist them on release. This paper reports a qualitative research study that explored the factors affecting the delivery and outcomes of parenting programs in correctional facilities in New South Wales Australia from the perspective of individuals involved in developing and implementing the programs. Thematic analysis of 19 interviews identified two main themes: supporting parents' learning in correctional settings and providers' learning about parent education in correctional settings. Respondents reported the benefits of providing creative learning opportunities enabling parents to build on their strengths and to develop relationships. These factors contributed to changing prisoners' attitudes and supporting them to consider alternative parenting approaches. The co-productive approach to parent education supported enhanced parenting knowledge among parents and greater insights among educators. Parenting education can be successfully delivered in correctional settings and can assist incarcerated parents to build on existing knowledge and adapt it to their own needs.
Brooks, F, Aggleton, P, Dawson, A & Kang, M 2018, 'Youth health and practical justice - Time for renewed conversation', HEALTH EDUCATION JOURNAL, vol. 77, no. 6, pp. 627-630.View/Download from: UTS OPUS or Publisher's site
Turkmani, S, Homer, C, Varol, N & Dawson, A 2018, 'A survey of Australian midwives' knowledge, experience, and training needs in relation to female genital mutilation', Women and Birth, vol. 31, no. 1, pp. 25-30.View/Download from: UTS OPUS or Publisher's site
Female genital mutilation (FGM) involves partial or total removal of the external female genitalia or any other injury for non-medical reasons. Due to international migration patterns, health professionals in high income countries are increasingly caring for women with FGM. Few studies explored the knowledge and skills of midwives in high income countries.
To explore the knowledge, experience and needs of midwives in relation to the care of women with FGM.
An online self-administered descriptive survey was designed and advertised through the Australian College of Midwives' website.
Of the 198 midwives (24%) did not know the correct classification of FGM. Almost half of the respondents (48%) reported they had not received FGM training during their midwifery education. Midwives (8%) had been asked, or knew of others who had been asked to perform FGM in Australia. Many midwives were not clear about the law or health data related to FGM and were not aware of referral paths for affected women.
As frontline providers, midwives must have appropriate up-to-date clinical skills and knowledge to ensure they are able to provide women with FGM the care they need and deserve. Midwives have a critical role to play in the collection of FGM related data to assist with health service planning and to prevent FGM by working closely with women and communities they serve to educate and advocate for its abandonment. Therefore, addressing educational gaps and training needs are key strategies to deliver optimal quality of care.
Dawson, AJ, Krastev, Y, Parsonage, WA, Peek, M, Lust, K & Sullivan, EA 2018, 'Experiences of women with cardiac disease in pregnancy: a systematic review and metasynthesis.', BMJ open, vol. 8, no. 9, pp. e022755-e022755.View/Download from: UTS OPUS or Publisher's site
OBJECTIVE:Cardiac disease in pregnancy is a leading cause of maternal death in high-income countries. Evidence-based guidelines to assist in planning and managing the healthcare of affected women is lacking. The objective of this research was to produce the first qualitative metasynthesis of the experiences of pregnant women with existing or acquired cardiac disease to inform improved healthcare services. METHOD:We conducted a systematic search of peer-reviewed publications in five databases to investigate the decision-making processes, supportive strategies and healthcare experiences of pregnant women with existing or acquired cardiac disease, or of affected women contemplating pregnancy. Identified publications were screened for duplication and eligibility against selection criteria, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We then undertook a thematic analysis of the data relating to women's experiences extracted from each publication to inform new healthcare practices and communication. RESULTS:Eleven studies from six countries were included in our meta-synthesis. Four themes were revealed. Women with congenital and acquired heart disease identified situations where they had either taken charge of decision-making, lacked control or experienced emotional uncertainty when making decisions. Some women were risk aware and determined to take care of themselves in pregnancy while others downplayed the risks. Women with heart disease acknowledged the importance of specific social support measures during pregnancy and after child birth, and reported a spectrum of healthcare experiences. CONCLUSIONS:There is a lack of integrated and tailored healthcare services and information for women with cardiac disease in pregnancy. The experiences of women synthesised in this research has the potential to inform new evidence-based guidelines to support the decision-making needs of women with cardiac disease in pregnancy. Shared dec...
Nguyen, TT, Baggio, S, Dawson, A, O'Moore, É, Williams, B, Bedell, P, Simon, O, Scholten, W, Getaz, L & Wolff, H 2018, 'Words matter: a call for humanizing and respectful language to describe people who experience incarceration', BMC International Health and Human Rights, vol. 18.View/Download from: UTS OPUS or Publisher's site
Akter, T, Dawson, A & Sibbritt, D 2017, 'What impact does antenatal and postnatal care have on neonatal deaths in low- and lower-middle-income countries? Evidence from Bangladesh.', Health Care for Women International, vol. 38, no. 8, pp. 848-860.View/Download from: UTS OPUS or Publisher's site
We investigated the contribution of antenatal and postnatal care in reducing the risk of neonatal deaths in Bangladesh. The effects of these services were examined using adjusted Cox regression models and secondary data with 7,314 live-born infants. We observed that neonatal mortality was significantly decreased for newborns whose mothers' attended antenatal care services but postnatal care did not show any effect. Health promotion programs offering antenatal care in Bangladesh and other low- and lower-middle-income countries may build awareness about these practices. Further research is required to examine the reasons for the lack of impact of postnatal care on mortality.
Beek, K, Whelan, A & Dawson, A 2017, 'A review of factors affecting the transfer of sexual and reproductive health training into practice in low and lower-middle income country humanitarian settings', Conflict and Health, vol. 11, no. 16, pp. 1-12.View/Download from: UTS OPUS or Publisher's site
Background: A lack of access to sexual and reproductive health (SRH) care is the leading cause of morbidity and
mortality among displaced women and girls of reproductive age. Efforts to address this public health emergency
in humanitarian settings have included the widespread delivery of training programmes to address gaps in health
worker capacity for SRH. There remains a lack of data on the factors which may affect the ability of health workers
to apply SRH knowledge and skills gained through training programmes in humanitarian contexts.
Methods: We searched four electronic databases and ten key organizations' websites to locate literature on SRH
training for humanitarian settings in low and lower-middle income countries. Papers were examined using content
analysis to identify factors which contribute to health workers' capacity to transfer SRH knowledge, skills and
attitudes learned in training into practice in humanitarian settings.
Results: Seven studies were included in this review. Six research papers focused on the response stage of
humanitarian crises and five papers featured the disaster context of conflict. A range of SRH components were
addressed including maternal, newborn health and sexual violence. The review identified factors, including
appropriate resourcing, organisational support and confidence in health care workers that were found to facilitate
the transfer of learning. The findings suggest the presence of factors that moderate the transfer of training at the
individual, training, organisational, socio-cultural, political and health system levels.
Conclusion: Supportive strategies are necessary to best assist trainees to apply newly acquired knowledge and
skills in their work settings. These interventions must address factors that moderate the success of learning transfer.
Findings from this review suggest that these are related to the individual trainee, the training program itself and
the workplace as well as the broader environmental cont...
Brett, J, Dawson, A, Ivers, R, Lawrence, L, Barclay, S & Conigrave, K 2017, 'Healing at home: Developing a model for ambulatory alcohol "detox" in an Aboriginal community controlled health service', International Journal of Indigenous Health, vol. 12, no. 1, pp. 24-38.View/Download from: UTS OPUS or Publisher's site
Introduction: Indigenous Peoples who have been colonized face a higher burden of harm from
alcohol and increased risk of alcohol use disorders. Yet they often also have limited access to
alcohol treatment. Limited access to withdrawal management ('detox' in particular) can be a
barrier to recovery. Ambulatory or 'outpatient' alcohol detox can offer improved treatment
access, but no research has examined its feasibility and acceptability in Indigenous populations.
Aim: To develop a model for outpatient detox delivered by an Australian Aboriginal community
controlled health service (ACCHS), and to describe its feasibility and acceptability. Methods:
This report describes a framework for alcohol treatment service development within an ACCHS
through community, staff, and client consultation. Thematic analysis of focus groups and phone
interviews were used to gain insight into the views and experiences of Aboriginal community
stakeholders, service clients, and staff regarding alcohol detox services and the pilot of the
outpatient detox program service model. Results: Individual, family, and community support
was regarded as key to recovery from alcohol dependence. Outpatient detox was seen as a way
of keeping the individual near this support. Reported positive aspects include satisfaction with
the approach to care that was considered accessible, holistic, and integrated. Challenges and
suggested improvements were identified. Discussion: Outpatient detox within an ACCHS was
assessed as feasible and acceptable for carefully selected clients and was reported to aid access to
treatment. More clinical experience is needed to fully delineate effectiveness and safety.
Dawson, A & Varol, N 2017, 'Continuing professional education on Female Genital Mutilation for obstetricians, gynecologists, and midwives in Australia: educational program development', BMC Reproductive Health, vol. 14, no. Supplement 2.View/Download from: UTS OPUS or Publisher's site
Dawson, A, Nicholls, R, Bateson, D, Doab, A, Estoesta, J, Brassil, A & Sullivan, E 2017, 'Medical termination of pregnancy in general practice in Australia: a descriptive-interpretive qualitative study', Reproductive Health, vol. 14, no. 39, pp. 1-13.View/Download from: UTS OPUS or Publisher's site
Dawson, A, Varol, N, Turkmani, S, Hall, J & Black, K 2017, 'Evidence-based policy responses to strengthen health, community and legislative systems to care for women with female genital mutilation in Australia', Reproductive Health, vol. 14, no. 63, pp. 1-8.View/Download from: UTS OPUS or Publisher's site
Lam, W, Dawson, A & Fowler, C 2017, 'Approaches to better engage parent–child in health home-visiting programmes: A content analysis', Journal of Child Health Care, vol. 21, no. 1, pp. 94-102.View/Download from: UTS OPUS or Publisher's site
Home visiting is an evidence-based strategy used to enhance child and family health outcomes. Such primary healthcare endeavours demand the full participation of individual and families. We conducted a review to identify approaches to planning, executing and assessing home-visiting health promotion interventions to determine how parents and children can be best engaged. A structured search (2000–2015) was undertaken using a defined search protocol. The quality of the papers was assessed using standard appraisal tools. Sixteen studies were retrieved. A content analysis of the findings sections of the papers was undertaken and guided by the eight phases of the PRECEDE-PROCEED health promotion planning framework. The analysis found that while all the PRECEDE assessment areas were represented no studies included all phases. Parents and children did not appear to be actively involved in undertaking the assessments and evaluation of the home-visiting health promotion programmes. The findings suggest that there is a need to develop a consistent home-visiting approach that includes comprehensive assessments in the planning phases and parent and child involvement at each step of programme development, implementation and evaluation. This approach enables the development of tailored and sustainable health promotion intervention in order to achieve optimal child health outcomes.
Vaughan, G, Peek, M, Dawson, A & Sullivan, E 2017, 'Rheumatic Heart Disease in Pregnancy: A Health Services Challenge', Heart, Lung and Circulation, vol. 26, no. Supplement 2, pp. S335-S335.View/Download from: UTS OPUS or Publisher's site
Rossiter, C, Power, T, Fowler, C, Jackson, D, Roche, M & Dawson, A 2017, '"Learning to become a better man": Insights from a fathering programme for incarcerated indigenous men', Australian Journal of Social Issues, vol. 52, no. 1, pp. 13-31.View/Download from: UTS OPUS or Publisher's site
Fowler, C, Rossiter, C, Power, T, Dawson, A & Jackson, D 2017, 'Becoming a 'better' father: Supporting the needs of incarcerated fathers', The Prison Journal, vol. 97, no. 6, pp. 692-712.View/Download from: UTS OPUS or Publisher's site
Given the importance of fathering to the well-being and development of children, paternal incarceration has a major impact on children and families. Drawing on interviews with 64 incarcerated fathers in New South Wales, Australia, this article explores their experiences. The men's childhood familial separation and disconnection is frequently repeated in adulthood, with limited contact with their own families even when not in custody. Despite barriers to connection, the interviewees express strong aspirations to be 'good' fathers and to achieve a 'better life' for their children. The absence of stable models of responsive fathering in early life is a common theme that has implications for the development of education and support programs for imprisoned fathers.
Adams, C, Dawson, A & Foureur, M 2017, 'Competing Values Framework: A useful tool to define the predominant culture in a maternity setting in Australia.', Women and Birth, vol. 30, pp. 107-113.View/Download from: UTS OPUS or Publisher's site
To identify the predominant culture of an organisation which could then assess readiness for change.An exploratory design using the Competing Values Framework (CVF) as a self-administered survey tool.The Maternity Unit in one Australian metropolitan tertiary referral hospital.All 120 clinicians (100 midwives and 20 obstetricians) employed in the maternity service were invited to participate; 26% responded.The identification of the predominant culture of an organisation to assess readiness for change prior to the implementation of a new policy.The predominant culture of this maternity unit, as described by those who responded to the survey, was one of hierarchy with a focus on rules and regulations and less focus on innovation, flexibility and teamwork. These results suggest that this unit did not have readiness to change.There is value in undertaking preparatory work to gain a better understanding of the characteristics of an organisation prior to designing and implementing change. This understanding can influence additional preliminary work that may be required to increase the readiness for change and therefore increase the opportunity for successful change. The CVF is a useful tool to identify the predominant culture and characteristics of an organisation that could influence the success of change.
Turkmani, S, Homer, C, Varol, N & Dawson, A 2017, 'A survey of Australian midwives' knowledge, experience, and training needs in relation to female genital mutilation', Women and Birth, vol. 30, no. Supplement 1, pp. 30-30.View/Download from: UTS OPUS or Publisher's site
Introduction: Female genital mutilation (FGM) involves partial or total removal of the external female genitalia or any other injury for non-medical reasons. Due to international migration patterns, health professionals in high-income countries are increasingly caring for women with FGM. Few studies have explored the knowledge and skills of midwives in high-income countries.
Aim: To explore the knowledge, experience and needs of midwives in relation to the care of women with FGM in Australia
Methods: An online self-administrated descriptive survey was designed and advertised through the Australian College of Midwives' website and e-bulletin to explore the perspectives of midwives regarding the care of women with FGM across states and territories of Australia.
Results: The survey revealed gaps in midwives knowledge of FGM. Of the 198 midwives (24%) did not know the correct classification of FGM. Almost half of the respondents (48%) reported they had not received FGM training during their midwifery education. Midwives (8%) had been asked, or knew of others who had been asked to perform FGM in Australia. Many midwives were not clear about the law or collecting FGM related health data and were not aware of referral paths for affected women.
Conclusion: As frontline providers, midwives must have appropriate up-to-date clinical skills and knowledge to ensure they are able to provide women with FGM the care they need and deserve. Midwives have a critical role to play in the collection of FGM related data to assist with health service planning and to prevent FGM by working closely with women, their partners and communities they serve to educate and advocate for its abandonment. Therefore, addressing educational gaps and training needs are key strategies to deliver optimal quality of care.
West, F, Dawson, A & Homer, CSE 2017, 'Building midwifery educator capacity using international partnerships: Findings from a qualitative study.', Nurse Education in Practice, vol. 25, pp. 66-73.View/Download from: UTS OPUS or Publisher's site
Midwifery educators play a critical role in strengthening the midwifery workforce globally, including in low and lower-middle income countries (LMIC) to ensure that midwives are adequately prepared to deliver quality midwifery care. The most effective approach to building midwifery educator capacity is not always clear. The aim of this study was to determine how one capacity building approach in Papua New Guinea (PNG) used international partnerships to improve teaching and learning. A qualitative exploratory case study design was used to explore the perspectives of 26 midwifery educators working in midwifery education institutions in PNG. Seven themes were identified which provide insights into the factors that enable and constrain midwifery educator capacity building. The study provides insights into strategies which may aid institutions and individuals better plan and implement international midwifery partnerships to strengthen context-specific knowledge and skills in teaching. Further research is necessary to assess how these findings can be transferred to other contexts.
OBJECTIVES: To examine the association of sociodemographic, antenatal and delivery care factors with the essential newborn care (ENC) practices of neonates born at home in Bangladesh. STUDY DESIGN: This study analyzed data of a cross-sectional survey-the Bangladesh Demographic and Health Survey, 2011. METHODS: This analysis considered 3190 most recent live-born infants who were delivered at home within three years of the survey. Logistic regression models were used to identify the factors affecting the implementation of six ENC practices, namely using disinfected instruments to cut the umbilical cord, avoidance of application of any substances to the umbilical cord stump, immediate drying and wrapping of newborns, delayed bathing of newborns, and immediate initiation of breastfeeding. RESULTS: Factors affecting ENC practices in Bangladesh are low parental education, low utilization of antenatal care services, the absence of skilled birth attendants, smaller size at birth, higher birth order and mother's age at birth. Regional factors also seem to considerably affect ENC practices. CONCLUSION: There is ample scope to improve the coverage of ENC practices in Bangladesh. Health promotion programmes that target parents with low education and older mothers may help to build awareness of ENC practices. This investigation provides insight into the key determinants of ENC practices, which require consideration when scaling up ENC practices in low-income and lower middle-income countries.
Akter, T, Dawson, A & Sibbritt, D 2016, 'What impact do essential newborn care practices have on neonatal mortality in low and lower-middle income countries? Evidence from Bangladesh.', Journal of Perinatology, vol. 36, pp. 225-230.View/Download from: UTS OPUS or Publisher's site
To assess the impact of essential newborn care (ENC) practices on the mortality of neonates delivered at home in Bangladesh.This study used cross-sectional data from the 2011 Bangladesh Demographic and Health Survey. Adjusted logistic regression model was used to examine the effect of ENC practices on neonatal mortality based on 3190 live-born infants.Delayed bathing (72 h after delivery) significantly contributed to reducing neonatal mortality. A significant but counterintuitive relation was observed between the dry cord care and neonatal deaths.Neonatal mortality may be reduced through emphasizing delayed bathing. Specific guidelines on the cleanliness of the fabric used to dry and wrap newborns, as well as emphasizing the use of clean delivery kits and initiation of immediate and exclusive breastfeeding, may improve neonatal outcomes. Further, the ENC guidelines in Bangladesh should include the application of topical antiseptics to the cord stump.Journal of Perinatology advance online publication, 3 December 2015; doi:10.1038/jp.2015.181.
Akter, T, Dawson, A & Sibbritt, D 2016, 'Workforce Interventions to Deliver Postnatal Care to Improve Neonatal Outcomes in Low- and Lower-Middle-Income Countries: A Narrative Synthesis', Asia-Pacific Journal of Public Health, vol. 28, no. 8, pp. 659-681.View/Download from: UTS OPUS or Publisher's site
Reducing neonatal mortality rates in low- and lower-middle-income countries (LMICs) requires
postnatal interventions to be delivered through an appropriately prepared and supported
workforce. This review examines health workforce interventions that deliver integrated packages
of postnatal care to improve neonatal outcomes in LMICs. We conducted a structured search
of peer-reviewed articles published during 2003-2014 that investigated the delivery of postnatal
interventions by formal and lay health workers. We selected 13 studies and analyzed them using a
narrative synthesis methodology. This review observed a wide divergence among studies regarding
the outcomes as well as the approaches and duration of workforce training and staff supervision.
Except 4, all studies observed a significant reduction in neonatal mortality. On the other hand,
teams of lay health workers appear to be more effective in improving neonatal outcomes. Further
improvement in the performance of health care providers may require emphasis on workforce
interventions such as competency assessment, the acquisition of appropriate skills, and supervisory
guidelines. Nevertheless, the heterogeneity and limited number of studies do not allow us to
arrive at definitive conclusions, and we recommend the need for the harmonization of future
studies, with uniformity of outcome measures and cost analyses.
Bhagavathula, AS, Tegegn, HG, Dawson, A, Elnour, AA & Shehab, A 2016, 'Retention and treatment outcomes of an undernutrition program for HIV patients involving ready-to-use therapeutic food at Gondar university hospital, Ethiopia: A cross-sectional study', Journal of Clinical and Diagnostic Research, vol. 10, no. 8, pp. LC01-LC06.View/Download from: UTS OPUS or Publisher's site
© 2016, Journal of Clinical and Diagnostic Research. All Rights Reserved. Introduction: Despite global efforts to eradicate poverty and hunger, under-nutrition is still a major health problem, especially in Sub-Saharan Africa, where HIV/AIDS prevalence is also a serious burden. Aim: To assess the retention and outcomes of under-nutrition treatment program in Gondar University Hospital, Ethiopia. Settings and Design: A cross-sectional study was conducted in HIV positive children and adults participating in the Ready-to-use Therapeutic Food (RUTF) treatment program at Gondar University Hospital ART clinic for one year from November 2012 to November 2013. Materials and Methods: Six hundred and thirty six patient records were followed-up for one year. Outcome variables were Mid-Upper Arm Circumference (MUAC) values measured as severe, moderate acute malnutrition, normal after treatment, non-respondent, relapsed and lost to follow-up using the hospital records of HIV positive children and adults eligible for the program. Statistical Analysis: Univariate and multivariate analysis were performed to compute Crude Odds Ratio (COR) and Adjusted Odds Ratio (AOR). Statistical significance was set at p-value < 0.05. Results: Among 636 clients, 44.2% achieved MUAC measures ≥ 125 mm for children and ≥ 21 cm for adults at 4 and 6 months. 70.1% of those were children while 29.9% of the 281 were adults. Moreover, a more positive initial response to ready-to-use therapeutic food was found among children as there was significant increase (p < 0.05) in MUAC value after the second month of initiating treatment while adults achieved a significant (p < 0.05, p < 0.01) in MUAC at the 4th and 6th month respectively. There was a significant association between age, nutrition status and treatment outcome, while sex, HIV status, education and residency were not associated with treatment outcome. Conclusion: Recovery and weight gain rates were below 50%. Defaulter rates were higher than the S...
Dawson, A, Bateson, D, Estoesta, J & Sullivan, E 2016, 'Towards comprehensive early abortion service delivery in high income countries: insights for improving universal access to abortion in Australia', BMC Health Services Research, vol. 16, no. 1.View/Download from: UTS OPUS or Publisher's site
lam, Y, Fowler, C & Dawson, A 2016, 'The approaches Hong Kong Chinese mothers adopt to teach their preschool children to prevent influenza: a multiple case study at household level', BMC Nursing, vol. 15.View/Download from: UTS OPUS or Publisher's site
Lee, K, Dawson, A & Conigrave, K 2016, 'Insights into the effective management of support groups for Aboriginal Australian women with substance use disorders', Society, Health and Vulnerability, vol. 7.View/Download from: UTS OPUS or Publisher's site
Aboriginal women with substance use disorders are a vulnerable population. This study examines approaches used to deliver support to Aboriginal women in an outpatient alcohol and other drug treatment service in Australia. A descriptive qualitative study was undertaken using structured interviews to explore staff and client perceptions of current and optimal processes for the management of an Aboriginal women's group. The findings show that approaches to the management of the support group involved personal skills development and therapeutic strategies that were all grounded in the women's social and cultural context. A framework is proposed for the management of support groups that may be transferrable to other culturally distinct and marginalised populations.
Setiwan, A, Dawson, A, Dignam, D & Waters, C 2016, 'Improving access to child health care in Indonesia through community case management', Maternal and Child Health Journal, vol. 20, no. 11, pp. 2254-2260.View/Download from: UTS OPUS or Publisher's site
Objectives In order to reduce infant mortality in Indonesia, community case management (CCM) was introduced. CCM is a community-based service delivery model to improve children's wellness and longevity, involving the delivery of lifesaving, curative interventions to address common childhood illnesses, particularly where there are limited facility-based services. This paper reports the findings of a qualitative study that investigated the implementation of CCM in the Kutai Timur district, East Kalimantan Indonesia from the perspective of mothers who received care. Methods Seven mothers and health workers were observed during a consultation and these mothers were interviewed in their home weeks after delivery. Field notes and the interview transcriptions were analysed thematically. Findings Mothers reported that their access to care had improved, along with an increase in their knowledge of infant danger signs and when to seek care. Family compliance with care plans was also found to have improved. Mothers expressed satisfaction with the care provided under the CCM model. The mothers expressed a need for a nurse or midwife to be posted in each village, preferably someone from that village. However two mothers did not wish their children to receive health interventions as they did not believe these to be culturally appropriate. Conclusion CCM is seen by rural Indonesian mothers to be a helpful model of care in terms of increasing access to health care and the uptake of lifesaving interventions for sick children. However there is a need to modify the program to demonstrate cultural sensitivity and meet cultural needs of the target population. While CCM is a potentially effective model of care, further integrative strategies are required to embed this model into maternal and child health service delivery.
Adams, C, Dawson, A & Foureur, M 2016, 'Exploring a Peer Nomination Process, Attributes, and Responses of Health Professionals Nominated to Facilitate Interprofessional Collaboration', International Journal of Childbirth, vol. 6, no. 4, pp. 234-245.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: When significant changes are required across an organization, a collaborative approach with wide stakeholder engagement may be beneficial. One of the challenges of stakeholder engagement lies with identifying the most appropriate participants who can most effectively facilitate the process of change.
AIM: This article aims to provide insight into a process of identifying individuals, and their attributes, who staff perceive to be effective collaborators, and change agents to decrease intervention in childbirth in one maternity setting in New South Wales, Australia.
METHODS: Midwives and obstetricians were invited to nominate a peer from each discipline who they believed to be an effective collaborator and describe the associated personal attributes of these individuals. The 5 highest scoring midwives and obstetricians were then invited to participate in a collaborative project.
FINDINGS: The attributes that were most recognized in the collaborators were their effective communication and overall positive attitudes. Collaborator's skills and knowledge were described less frequently. The nominees chosen identified that they were not usually selected by management for projects with some respondents feeling visible for the first time among their peers.
CONCLUSION: This method of peer nomination to recruit participants to facilitate collaborative organizational change may offer an effective method of engaging the whole team in such processes.
Dawson, A, Kililo, M, Geita, L, Mola, G, Brodie, P, Rumsey, M, Copeland, F, Neill, A & Homer, C 2016, 'Midwifery capacity building in Papua New Guinea: Key achievements and ways forward', Women and Birth, vol. 29, no. 2, pp. 180-188.View/Download from: UTS OPUS or Publisher's site
Moores, A, Puawe, P, Buasi, N, West, F, Samor, M, Joseph, N, Rumsey, M, Dawson, A & Homer, C 2016, 'Education, employment and practice: Midwifery graduates in Papua New Guinea', Midwifery, vol. 41, pp. 22-29.View/Download from: UTS OPUS or Publisher's site
Moores, A, Puawe, P, Buasi, N, West, F, Samor, MK, Joseph, N, Rumsey, M, Dawson, A & Homer, CSE 2016, 'Continuing professional development and challenges facing newly graduated midwives in Papua New Guinea', Pacific Journal of Reproductive Health, vol. 1, no. 4.View/Download from: UTS OPUS or Publisher's site
Varol, N, Dawson, A, Turkmani, S, Hall, J, Nanayakkara, S, Jenkins, G, Homer, C & McGeechan, K 2016, 'Obstetric outcomes for women with female genital mutilation at an Australian hospital, 2006–2012: a descriptive study', BMC Pregnancy and Childbirth, vol. 16, no. 328, pp. 1-10.View/Download from: UTS OPUS or Publisher's site
Women, who have been subjected to female genital mutilation (FGM), can suffer serious and irreversible physical, psychological and psychosexual complications. They have more adverse obstetric outcomes as compared to women without FGM. Exploratory studies suggest radical change to abandonment of FGM by communities after migration to countries where FGM is not prevalent. Women who had been subjected to FGM as a child in their countries of origin, require specialised healthcare to reduce complications and further suffering. Our study compared obstetric outcomes in women with FGM to women without FGM who gave birth in a metropolitan Australian hospital with expertise in holistic FGM management.
The obstetric outcomes of one hundred and ninety-six women with FGM who gave birth between 2006 and 2012 at a metropolitan Australian hospital were analysed. Comparison was made with 8852 women without FGM who gave birth during the same time period. Data were extracted from a database specifically designed for women with FGM and managed by midwives specialised in care of these women, and a routine obstetric database, ObstetriX. The accuracy of data collection on FGM was determined by comparing these two databases. All women with FGM type 3 were deinfibulated antenatally or during labour. The outcome measures were (1) maternal: accuracy and grade of FGM classification, caesarean section, instrumental birth, episiotomy, genital tract trauma, postpartum blood loss of more than 500 ml; and (2) neonatal: low birth weight, admission to a special care nursery, stillbirth.
The prevalence of FGM in women who gave birth at the metropolitan hospital was 2 to 3 %. Women with FGM had similar obstetric outcomes to women without FGM, except for statistically significant higher risk of first and second degree perineal tears, and caesarean section. However, none of the caesarean sections were performed for FGM indications. The ObstetriX database was only 35 % accur...
West, F, Homer, C & Dawson, A 2016, 'Building midwifery educator capacity in teaching in low and lower-middle income countries. A review of the literature', Midwifery, vol. 33, pp. 12-23.View/Download from: UTS OPUS or Publisher's site
© 2015 Elsevier Ltd. Aim and objective: midwifery educators play a critical role in strengthening the midwifery workforce in low and lower-middle income countries (LMIC) to ensure that women receive quality midwifery care. However, the most effective approach to building midwifery educator capacity is not always clear. This paper will explore approaches used to build midwifery educator capacity in LMIC and identify evidence to inform improved outcomes for midwifery education. Design: a structured search of bibliographic electronic databases (CINAHL, OVID, MEDLINE, PubMed) and the search engine Google Scholar was performed. It was decided to also review peer reviewed research, grey literature and descriptive papers. Papers were included in the review if they were written in English, published between 2000 and 2014 and addressed building knowledge and/or skills in teaching and/or clinical practice in midwifery educators who work in training institutions in LMIC. The Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) was used to guide the reporting process. The quality of papers was appraised in discussion with all authors. The findings sections of the research papers were analysed to identify successful elements of capacity building approaches. Findings: eighteen (six research and 12 discursive) papers were identified as related to the topic, meeting the inclusion criteria and of sufficient quality. The findings were themed according to the key approaches used to build capacity for midwifery education. These approaches are: skill and knowledge updates associated with curriculum review, involvement in leadership, management and research training and, participation in a community of practice within regions to share resources. Key conclusions: the study provides evidence to support the benefits of building capacity for midwifery educators. Multilevel approaches that engaged individuals and institutions in building capacity alongside an enablin...
Dawson, A, Daniels, J & Clapham, K 2015, 'The Contribution of Focus Group Discussions to Aboriginal Australian Health Service Research: a Content Analysis of Practice and Experience', International Journal of Critical Indigenous Studies, vol. 7, no. 2, pp. 1-15.View/Download from: UTS OPUS
Focus Group Discussions (FGDs) are a common way of gathering qualitative data in Aboriginal health services research; however there have been no studies on the
question of whether they are appropriate research tools in such contexts, nor are there are specific guidelines available to ensure that FGDs are delivered to collect data in ways that are consistent with Aboriginal approaches to consultation, ownership and ways of knowing. Furthermore, there is a lack of clarity concerning the theoretical and methodological perspectives that could be operationalised by FGDs to gather data, guide analysis and interpretation in ways that are culturally appropriate, ethically sound and rigorous. We undertook a content analysis of Aboriginal health services research studies using FGDs to determine their use and elements that may provide insight into good practice. A framework is proposed to help guide future FGD research with Aboriginal people.
Dawson, AJ, Nkowane, AM & Whelan, A 2015, 'Approaches to improving the contribution of the nursing and midwifery workforce to increasing universal access to primary health care for vulnerable populations: a systematic review.', Human Resources for Health, vol. 13, no. 97, pp. 1-23.View/Download from: UTS OPUS or Publisher's site
Despite considerable evidence showing the importance of the nursing and midwifery workforce, there are no systematic reviews outlining how these cadres are best supported to provide universal access and reduce health care disparities at the primary health care (PHC) level. This review aims to identify nursing and midwifery policy, staffing, education and training interventions, collaborative efforts and strategies that have improved the quantity, quality and relevance of the nursing and midwifery workforce leading to health improvements for vulnerable populations.We undertook a structured search of bibliographic databases for peer-reviewed research literature using a focused review question and inclusion/exclusion criteria. The quality of retrieved papers was appraised using standard tools. The characteristics of screened papers were described, and a deductive qualitative content analysis methodology was applied to analyse the interventions and findings of included studies using a conceptual framework.Thirty-six papers were included in the review, the majority (25) from high-income countries and nursing settings (32). Eleven papers defined leadership and governance approaches that had impacted upon the health outcomes of disadvantaged groups including policies at the national and state level that had led to an increased supply and coverage of nursing and midwifery staff and scope of practice. Twenty-seven papers outlined human resource management strategies to support the expansion of nurse's and midwives' roles that often involved task shifting and task sharing. These included approaches to managing staffing supply, distribution and skills mix; workloads; supervision; performance management; and remuneration, financial incentives and staffing costs. Education and training activities were described in 14 papers to assist nurses and midwives to perform new or expanded roles and prepare nurses for inclusive practice. This review identified collaboration between nur...
Doab, A, Fowler, C & Dawson, A 2015, 'Factors that influence mother–child reunification for mothers with a history of substance use: A systematic review of the evidence to inform policy and practice in Australia', International Journal of Drug Policy, vol. 26, no. 9, pp. 820-831.View/Download from: UTS OPUS or Publisher's site
Lam, W, Dawson, A & Fowler, C 2015, 'The Health Literacy of Hong Kong Chinese Parents with Preschool Children in Seasonal Influenza Prevention: A Multiple Case Study at Household Level', PLoS One, vol. 10, no. 12, pp. e0143844-e0143844.View/Download from: UTS OPUS or Publisher's site
Lam, Y, Dawson, A & Fowler, CM 2015, 'Health promotion interventions to prevent early childhood human influenza at the household level: a realist review to identify implications for programmes in Hong Kong', Journal of Clinical Nursing, vol. 24, no. 7-8, pp. 891-905.View/Download from: UTS OPUS or Publisher's site
Aims and objectives. To identify factors affecting the delivery of health promotion interventions to prevent early childhood human influenza at the household level.
Varol, N, Turkmani, S, Black, K, Hall, J & Dawson, A 2015, 'The role of men in abandonment of female genital mutilation: a systematic review', BMC Public Health, vol. 15, no. 1034.View/Download from: UTS OPUS or Publisher's site
Background: Men in their roles as fathers, husbands, community and religious leaders may play a pivotal part in
the continuation of female genital mutilation (FGM). However, the research on their views of FGM and their
potential role in its abandonment are not well described.
Methods: We undertook a systematic review of all publications between 2004 and 2014 that explored men's
attitudes, beliefs, and behaviours in regards to FGM, as well as their ideas about FGM prevention and
Results: We included twenty peer-reviewed articles from 15 countries in the analysis. Analysis revealed ambiguity
of men's wishes in regards to the continuation of FGM. Many men wished to abandon this practice because of the
physical and psychosexual complications to both women and men. Social obligation and the silent culture
between the sexes were posited as major obstacles for change. Support for abandonment was influenced by
notions of social obligation, religion, education, ethnicity, urban living, migration, and understanding of the
negative sequelae of FGM. The strongest influence was education.
Conclusion: The level of education of men was one of the most important indicators for men's support for
abandonment of FGM. Social obligation and the lack of dialogue between men and women were two key issues
that men acknowledged as barriers to abandonment. Advocacy by men and collaboration between men and
women's health and community programs may be important steps forward in the abandonment process.
Rossiter, C, Power, T, Fowler, C, Jackson, D, Hyslop, D & Dawson, A 2015, 'Mothering at a Distance: What Incarcerated Mothers Value About a Parenting Program', Contemporary Nurse, vol. 50, no. 2-3, pp. 238-255.View/Download from: UTS OPUS or Publisher's site
Background: Children with incarcerated mothers experience adverse health, social and emotional circumstances, and are a particularly vulnerable group. Mothers in custody face significant challenges in parenting their children.
Aims: The study aimed to identify participants' views on impact of a parenting support programme for incarcerated mothers in NSW Australia.
Methods: The mixed-methods study examined 134 responses to open and closed questions on a questionnaire for programme participants.
Results: Participants found the programme worthwhile, engaging and relevant. It enhanced their parenting knowledge and confidence. Open-ended responses highlighted program elements which participants valued, specifically support for their parenting role in complicated circumstances, greater understanding of child development and perspectives, and practical strategies for facilitating connections with their children during their incarceration.
Conclusions: The study informs nurses working with women who have experienced incarceration and their children, both in custodial and community settings.
Dawson, A, Homer, CS, Turkmani, S, Black, K & Varol, N 2015, 'A systematic review of doctors' experiences and needs to support the care of women with female genital mutilation.', International Journal of Gynecology and Obstetrics, vol. 131, no. 1, pp. 35-40.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: Female genital mutilation (FGM) involves partial or complete removal of the external female genitalia or other injury for non-therapeutic reasons. Little is known about the knowledge and skills of doctors who care for affected women and their practice in relation to FGM. OBJECTIVES: To examine the FGM experiences and educational needs of doctors. SEARCH STRATEGY: A structured search of five bibliographic databases was undertaken to identify peer-reviewed research literature published in English between 2004 and 2014 using the keywords "female genital mutilation," "medical," "doctors," "education," and "training." SELECTION CRITERIA: Observational, quasi-experimental, and non-experimental descriptive studies were suitable for inclusion. DATA COLLECTION AND ANALYSIS: A narrative synthesis of the study findings was undertaken and themes were identified. MAIN RESULTS: Ten papers were included in the review, three of which were from low-income countries. The analysis identified three themes: knowledge and attitudes, FGM-related medical practices, and education and training. CONCLUSIONS: There is a need for improved education and training to build knowledge and skills, and to change attitudes concerning the medicalization of FGM and reinfibulation.
Dawson, A, Turkmani, S, Fray, S, Nanayakkara, S, Varol, N & Homer, C 2015, 'Evidence to inform education, training and supportive work environments for midwives involved in the care of women with female genital mutilation: A review of global experience', Midwifery, vol. 31, no. 1, pp. 229-238.View/Download from: UTS OPUS or Publisher's site
to identify how midwives in low and middle income countries (LMIC) and high income countries (HIC) care for women with female genital mutilation (FGM), their perceived challenges and what professional development and workplace strategies might better support midwives to provide appropriate quality care.
an integrative review involving a narrative synthesis of the literature was undertaken to include peer reviewed research literature published between 2004 and 2014.
10 papers were included in the review, two from LMIC and eight from HIC. A lack of technical knowledge and limited cultural competency was identified, as well as socio-cultural challenges in the abandonment process of the practice, particularly in LMIC settings. Training in the area of FGM was limited. One study reported the outcomes of an education initiative that was found to be beneficial.
professional education and training, a working environment supported by guidelines and responsive policy and community education, are necessary to enable midwives to improve the care of women with FGM and advocate against the practice.
Implications for practice
improved opportunities for midwives to learn about FGM and receive advice and support, alongside opportunities for collaborative practice in contexts that enable the effective reporting of FGM to authorities, may be beneficial and require further investigation.
Dawson, AJ, Turkmani, S, Varol, N, Nanayakkara, S, Sullivan, E & Homer, CS 2015, 'Midwives' experiences of caring for women with female genital mutilation: Insights and ways forward for practice in Australia.', Women and Birth, vol. 28, no. 3, pp. 207-214.View/Download from: UTS OPUS or Publisher's site
Female genital mutilation (FGM) has serious health consequences, including adverse obstetric outcomes and significant physical, sexual and psychosocial complications for girls and women. Migration to Australia of women with FGM from high-prevalence countries requires relevant expertise to provide women and girls with FGM with specialised health care. Midwives, as the primary providers of women during pregnancy and childbirth, are critical to the provision of this high quality care.To provide insight into midwives' views of, and experiences working with, women affected by FGM.A descriptive qualitative study was undertaken using focus group discussions with midwives from four purposively selected antenatal clinics and birthing units in three hospitals in urban New South Wales. The transcripts were analysed thematically.Midwives demonstrated knowledge and recalled skills in caring for women with FGM. However, many lacked confidence in these areas. Participants expressed fear and a lack of experience caring for women with FGM. Midwives described practice issues, including the development of rapport with women, working with interpreters, misunderstandings about the culture of women, inexperience with associated clinical procedures and a lack of knowledge about FGM types and data collection.Midwives require education, training and supportive supervision to improve their skills and confidence when caring for women with FGM. Community outreach through improved antenatal and postnatal home visitation can improve the continuity of care provided to women with FGM.
Dawson, A, Tran, NT, Westley, E, Mangiaterra, V & Festin, M 2015, 'Workforce interventions to improve access to emergency contraception pills: a systematic review of current evidence in low- and middle-income countries and recommendations for improving performance', BMC Health Services Research, vol. 15, no. 180.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: Emergency contraceptive pills (ECP) are one of the 13 essential commodities addressed by the UN Commission on Life-Saving Commodities for Women and Children. Although ECP have been available for 20 years, a number of barriers still limit women's access ECP in low and middle-income countries (LMIC). The workforce who prescribe or dispense ECP are diverse reflecting the varied contexts where ECP are available across the health, commercial and justice sectors and in the community. No reviews currently exist that examine the roles and experiences of the workforce that provide ECP in LMIC. METHOD: We present a narrative synthesis of research to: identify provider factors that facilitate and constraint access to ECP; assess the effectiveness of associated interventions and; explore associated health system issues in LMIC. A search of bibliographic databases, meta-indexes and websites was undertaken to retrieve peer reviewed and grey literature. Literature was screened and identified documents examined to appraise quality. RESULTS: Thirty-seven documents were included in the review. Studies focused on formal health workers revealing knowledge gaps concerning the role of private sector and non-health providers who increasingly provide ECP. Data from the findings section in the documents were coded under 4 themes: provider knowledge; provider attitudes and beliefs; provider practice and provider training. The analysis revealed provider knowledge gaps, less than favourable attitudes and practice issues. The findings provide limited insight into products prescribed and/or dispensed, the frequency of provision, and information and advice offered to consumers. Pre and in-service training needs were noted. CONCLUSION: As the provision of ECPs shifts from the clinic-based health sector to increasing provision by the private sector, the limited understanding of provider performance and the practice gaps revealed in this review highlight the need to further examine pr...
Tran, N-T, Dawson, A, Meyers, J, Krause, S, Hickling, C & Inter-Agency Working Group (IAWG) on Reproductive Health in Crisis 2015, 'Developing Institutional Capacity for Reproductive Health in Humanitarian Settings: A Descriptive Study', PLoS One, vol. 10, no. 9, pp. e0137412-e0137412.View/Download from: UTS OPUS or Publisher's site
Hung, TT, Chiang, VC, Dawson, A & Lee, RL 2014, 'Understanding of factors that enable health promoters in implementing health-promoting schools: a systematic review and narrative synthesis of qualitative evidence.', PLoS ONE, vol. 9, no. 9, pp. 1-13.View/Download from: UTS OPUS or Publisher's site
Health-promoting schools have been regarded as an important initiative in promoting child and adolescent health in school settings using the whole-school approach. Quantitative research has proved its effectiveness in various school-based programmes. However, few qualitative studies have been conducted to investigate the strategies used by health promoters to implement such initiatives. In this study, the researchers conducted a systematic review and narrative synthesis of the qualitative literature to identify important enablers assisting the implementation of health-promoting schools from the perspectives of health promoters. Five enablers have been identified from the review: (a) Following a framework/guideline to implement health-promoting schools; (b) Obtaining committed support and contributions from the school staff, school board management, government authorities, health agencies and other stakeholders; (c) Adopting a multidisciplinary, collaborative approach to implementing HPS; (d) Establishing professional networks and relationships; and (e) Continuing training and education in school health promotion. This highlights the importance of developing school health policies that meet local health needs, and socio-cultural characteristics that can foster mutual understanding between the health and education sectors so as to foster health promotion in children and adolescents.
Maher, LM, Dawson, A, Wiley, K, Hope, K, Torvaldsen, S, Lawrence, G & Conaty, S 2014, 'Influenza vaccination during pregnancy: a qualitative study of the knowledge, attitudes, beliefs, and practices of general practitioners in Central and South-Western Sydney', BMC Family Practice, vol. 15, no. 102.View/Download from: UTS OPUS or Publisher's site
Nagaya, Y & Dawson, A 2014, 'Community-Based Care of the Elderly in Rural Japan: A Review of Nurse-Led Interventions and Experiences', Journal of Community Health, vol. 39, no. 5, pp. 1020-1028.View/Download from: UTS OPUS or Publisher's site
Nurses play a critical role in delivering care to elderly people at primary health care level but there is no synthesis of research knowledge to guide community nursing practice in Japan. This review aims to identify nurse-led interventions that have been found to improve elder health at village level; the barriers and constraints that service providers face when delivering care to the elderly; and the experiences of elderly people and their caregivers. The electronic databases such as MEDLINE, CINAHL and Google Scholar were searched to retrieve peer-reviewed primary research literature.
Dawson, A, Pritchard, C, Dean, S & Jackson, D 2014, 'Trauma Informed Treatment for women with SUD and PTSD: Evidence to inform NGO programs in Australia', The International Journal of Interdisciplinary Social and Community Studies, vol. 8, pp. 67-91.View/Download from: UTS OPUS
Dawson, A, Pritchard, C, Dean, S & Jackson, DE 2014, 'Towards Gender-responsive, Trauma-informed Care for Substance Use Disorders and PTSD: Evidence to Inform Non-government Services in Australia', The International Journal of Interdisciplinary Social and Community Studies, vol. 8, no. 1, pp. 67-91.View/Download from: UTS OPUS
Trauma-informed care assumes an understanding of trauma is integrated in all aspects of service delivery and care. In women with substance use disorders (SUD) and post-traumatic stress disorder (PTSD), the disorders are treated simultaneously. Existing evidence in this sector points to the need for a gender-specific program approach to drug and alcohol disorders and health workers who have the knowledge, skills, expertise, and confidence to deliver these programs for women. The objective of this review is to identify characteristics associated with outcomes for SUD and PTSD and the experiences and needs of women in treatment contexts. A narrative synthesis of peer-reviewed literature from 2003 to 2013 was undertaken, with retrieved documents assessed using an inclusion/exclusion criterion and quality appraisal guided by critical assessment tools. Concepts were analysed thematically. Eleven papers were found that related to the topic under study. This review found that trauma-informed care models can lead to reduced alcohol and drug severity symptoms, improved abstinence rates, and reduced PTSD symptoms. However, a trauma-informed approach may be the most beneficial for women with severe SUD and PTSD symptoms. Trauma-informed care appears to be a promising treatment for women with SUD and PTSD. However, this appears to be mediated by client baseline characteristics and treatment program composition. This highlights the need for proper baseline assessment and flexible treatment programming delivered by a well-supported workforce.
Dawson, A, Buchan, J, Duffield, CM, Homer, CS & Wijewardena, K 2014, 'Task shifting and sharing in maternal and reproductive health in low-income countries: a narrative synthesis of current evidence', Health Policy and Planning, vol. 29, no. 3, pp. 396-408.View/Download from: UTS OPUS or Publisher's site
Reducing maternal mortality and providing universal access to reproductive health in resource poor settings has been severely constrained by a shortage of health workers required to deliver interventions. The aim of this article is to determine evidence to optimize health worker roles through task shifting/sharing to address Millennium Development Goal 5 and reduce maternal mortality and provide universal access to reproductive health. A narrative synthesis of peer-reviewed literature from 2000 to 2011 was undertaken with retrieved documents assessed using an inclusion/exclusion criterion and quality appraisal guided by critical assessment tools. Concepts were analysed thematically. The analysis identified a focus on clinical tasks (the delivery of obstetric surgery, anaesthesia and abortion) that were shifted to and/or shared with doctors, non-physician clinicians, nurses and midwives.
Dawson, A, Brodie, PM, Copeland, FH, Rumsey, M & Homer, CS 2014, 'Collaborative approaches towards building midwifery capacity in low income countries: A reviewof experiences', Midwifery, vol. 30, no. 4, pp. 391-402.View/Download from: UTS OPUS or Publisher's site
Dawson, A, Stasa, H, Roche, MA, Homer, CS & Duffield, CM 2014, 'Nursing churn and turnover in Australian hospitals: nurses perceptions and suggestions for supportive strategies', BMC Nursing, vol. 13, no. 11.View/Download from: UTS OPUS or Publisher's site
Background This study aimed to reveal nurses' experiences and perceptions of turnover in Australian hospitals and identify strategies to improve retention, performance and job satisfaction. Nursing turnover is a serious issue that can compromise patient safety, increase health care costs and impact on staff morale. A qualitative design was used to analyze responses from 362 nurses collected from a national survey of nurses from medical and surgical nursing units across 3 Australian States/Territories. Method A qualitative design was used to analyze responses from 362 nurses collected from a national survey of nurses from medical and surgical nursing units across 3 Australian States/Territories. Results Key factors affecting nursing turnover were limited career opportunities; poor support; a lack of recognition; and negative staff attitudes. The nursing working environment is characterised by inappropriate skill-mix and inadequate patient-staff ratios; a lack of overseas qualified nurses with appropriate skills; low involvement in decision-making processes; and increased patient demands. These issues impacted upon heavy workloads and stress levels with nurses feeling undervalued and disempowered. Nurses described supportive strategies: improving performance appraisals, responsive preceptorship and flexible employment options. Conclusion Nursing turnover is influenced by the experiences of nurses. Positive steps can be made towards improving workplace conditions and ensuring nurse retention. Improving performance management and work design are strategies that nurse managers could harness to reduce turnover.
Dawson, A, Tran, NT, Westley, E, Mangiaterra, V & Festin, M 2014, 'Improving access to emergency contraception pills through strengthening service delivery and demand generation: a systematic review of current evidence in low and middle-income countries.', PLoS ONE, vol. 9, no. 10, pp. 1-11.View/Download from: UTS OPUS or Publisher's site
Emergency contraception pills (ECP) are among the 13 essential commodities in the framework for action established by the UN Commission on Life-Saving Commodities for Women and Children. Despite having been on the market for nearly 20 years, a number of barriers still limit women's access to ECP in low- and middle-income countries (LMIC) including limited consumer knowledge and poor availability. This paper reports the results of a review to synthesise the current evidence on service delivery strategies to improve access to ECP.A narrative synthesis methodology was used to examine peer reviewed research literature (2003 to 2013) from diverse methodological traditions to provide critical insights into strategies to improve access from a service delivery perspective. The studies were appraised using established scoring systems and the findings of included papers thematically analysed and patterns mapped across all findings using concept mapping.Ten papers were included in the review. Despite limited research of adequate quality, promising strategies to improve access were identified including: advance provision of ECP; task shifting and sharing; intersectoral collaboration for sexual assault; m-health for information provision; and scale up through national family planning programs.There are a number of gaps in the research concerning service delivery and ECP in LMIC. These include a lack of knowledge concerning private/commercial sector contributions to improving access, the needs of vulnerable groups of women, approaches to enhancing intersectoral collaboration, evidence for social marketing models and investment cases for ECP.
Dawson, A, Wijewardena, K & Black, E 2013, 'Health and education provider collaboration to deliver adolescent sexual and reproductive health in Sri Lanka', South East Asia Journal of Public Health, vol. 3, no. 1, pp. 42-49.View/Download from: UTS OPUS or Publisher's site
The complex nature of adolescent sexual and reproductive health (ASRH) determinants demands a multidisciplinary and intersectoral approach. Collaborative approaches are central to the delivery of quality health care and services but the focus is often health sector specific. Few research studies have explored the views and experiences of health workers and teachers and examined how ASRH services and information are provided by professionals across the education and health sector. Sri Lanka has made considerable progress towards addressing the Millennium Development Goals (MDG), however, there are still gaps reflected in adolescent health, social indicators, and the delivery of services. Enhancing the collective efforts of teachers and health professionals may help to improve the quality and use of services and ASRH knowledge. This study aimed to identify the experiences, needs, knowledge, attitudes and practices of primary healthcare and education professionals and the strategies that best support them to deliver sexual and reproductive health information, education, counseling and clinical services to Sri Lankan adolescents. Qualitative and survey data were gathered from 65 nurses, midwives, public health inspectors, medical officers, teachers, counselors and principals in the district of Kalutara. Knowledge, attitudes and service gaps were identified in relation to contraception and policy guiding practice. Participants highlighted concerns with confidence, roles and training that were said to affect student access to appropriate health services. ASRH Collaborative practices were noted across the sectors and strategies suggested for improvement. Findings suggest that inter-professional educa-tion and training may provide opportunities to enhance collaboration supported and guided by appropriate policy, supervision and job descriptions (i.e. roles and responsibilities).
Lee, K, Dawson, A & Conigrave, K 2013, 'The role of an Aboriginal women's group in meeting the high needs of clients attending outpatient alcohol and other drug treatment', Drug and Alcohol Review, vol. 32, no. 6, pp. 618-626.View/Download from: UTS OPUS or Publisher's site
Introduction and Aims. Support groups are typically offered as part of specialist alcohol or other drug treatment. However, their usefulness with Indigenous Australians has not been examined. This paper provides a profile of Aboriginal women attending an inner city outpatient alcohol and other drug treatment service, insight into how effective women and staff perceive the support group to be at meeting their needs and suggestions for improvements.
Dawson, A & Jackson, DE 2013, 'The primary health care service experiences and needs of homeless youth: A narrative synthesis of current evidence', Contemporary Nurse, vol. 44, no. 1, pp. 62-75.View/Download from: UTS OPUS or Publisher's site
Homeless youth are a growing, vulnerable population with specific primary health care (PHC) requirements. There are no systematic reviews of evidence to guide the delivery of PHC interventions to best address the needs of homeless youth in Australia. We present a narrative synthesis of peer reviewed research designed to determine: (1) the PHC services homeless youth access; (2) experiences of services, reported outcomes and barriers to use; and, (3) the PHC service needs of homeless youth. Findings show that homeless youth access a variety of services and delivery approaches. Increased PHC use is associated with youth who recognise they need help. Street-based clinic linked services and therapy and case management alongside improved housing can positively impact upon mental health and substance use outcomes. Barriers to service use include knowledge; provider attitudes, financial constraints and inappropriate environments. Findings support targetted, co-ordinated networks of PHC and housing services with nurses working alongside community workers.
Dawson, A, Brookes, L, Carter, B, Larman, G & Jackson, DE 2013, 'Stigma, health and incarceration: Turning the tide for children with a parent in prison', Journal Of Child Health Care, vol. 17, no. 1, pp. 3-5.View/Download from: UTS OPUS or Publisher's site
Dawson, A, Brooks, L, Carter, B, Larman, G & Jackson, DE 2013, 'Stigma, health and incarceration: Turning the tide for children with a parent in prison', Journal of Child Health Care, vol. 17, no. 1, pp. 3-5.
Children affected by parental imprisonment are vulnerable to a range of suboptimal health and social outcomes. The incarceration of a parent has a profound effect on children who may have already been exposed to a range of life adversity issues. Parental imprisonment is a growing global concern, not least because of the impact of social, economic and ethnic inequities upon incarceration but because the influence of mass imprisonment `extends far beyond parents to entire families and neighborhoods (Wakefield and Wildeman, 2011: 806). Parental incarceration results in enforced separation of parents and children, infrequent and restricted contact and inconsistent caregiving arrangements that may pose further risk to child outcomes (Kobak and Madsen, 2008). This separation is not associated with the level of community support provided for other forms of separation such as the death of a parent (Phillips and Gates, 2011). Indeed, loss associated with parental imprisonment not only separates the child from their parent but often separates them from friends and community. It is a loss that extends well beyond the parent simply being absent (Geller et al., 2012).
Dawson, A, Jackson, DE & Cleary, M 2013, 'Mothering on the Margins: Homeless Women with an SUD and Complex Mental Health Co-Morbidities', Issues in Mental Health Nursing, vol. 34, no. 4, pp. 288-293.View/Download from: UTS OPUS or Publisher's site
Substance use disorder (SUD) and co-morbid mental health conditions are a serious and growing issue associated with 14% of the global health burden, and affecting family social wellness and the future potential of children (World Health Organization [WHO], 2008). Women with co-occurring substance use and mental health disorders are at particular risk as they may have dependent children and are vulnerable to poverty, family dysfunction, violence, and homelessness. In 2001, the World Health Report called for interconnected primary health and community-based interventions and human resource development to address mental health and SUD (WHO, 2001). Gender-based approaches have been highlighted as essential in order to engage women in treatment tailored to their needs (United Nations Of?ce on Drugs and Crime [UNODC], 2004). In this column, we provide an epidemiological overview of this vulnerable group of mothers and examine current progress and opportunities for improving health and social outcomes for these women.
Maher, LM, Hope, K, Torvaldsen, S, Lawrence, G, Dawson, A, Wiley, K, Thomson, D, Hayen, A & Conaty, S 2013, 'Influenza vaccination during pregnancy: Coverage rates and influencing factors in two urban districts in Sydney', Vaccine, vol. 31, no. 47, pp. 5557-5564.View/Download from: UTS OPUS or Publisher's site
Background: Pregnant women have an increased risk of complications from influenza. Influenza vaccination during pregnancy is considered effective and safe; however estimates of vaccine coverage are low. This study aimed to determine influenza vaccination
Dawson, A & Homer, CS 2013, 'How does the mining industry contribute to sexual and reproductive health in developing countries? A narrative synthesis of current evidence to inform nursing practice', Journal Of Clinical Nursing, vol. 22, no. 23-24, pp. 3597-3609.View/Download from: UTS OPUS or Publisher's site
Aims and objectives. The aim of this review was to explore client and provider experiences and related health outcomes of sexual and reproductive health interventions that have been led by or that have involved mining companies. Background. Miners, and those living in communities surrounding mines in developing countries, are a vulnerable population with a high sexual and reproductive health burden. People in these communities require specific healthcare services although the exact delivery needs are unclear. There are no systematic reviews of evidence to guide delivery of sexual and reproductive health interventions to best address the needs of men and women in mining communities.
Dawson, A & Homer, CS 2013, 'Managing the International Humanitarian and Development Health Workforce: a review of experiences and needs', Asia Pacific Journal of Health Management, vol. 8, no. 1, pp. 14-23.View/Download from: UTS OPUS
The overseas development and humanitarian assistance provided by high income nations includes considerable investment directed at improving health in low and middle income countries. Governments, non-government organisations and consulting companies employ international health staff in low and middle income countries to deliver health interventions, manage programs and provide technical assistance. There are no reviews of evidence to guide the management, support and training of these staff, especially in relation to capacity building. We undertook a narrative synthesis of research to examine the needs and experiences of international health personnel engaged in development and humanitarian work. We found that altruism and a desire for professional and personal development motivated most international workers, however their roles are not always clear, affecting the delivery of quality care and services. Staff supply and skill-mix, short contracts, remuneration, leadership and workload were highlighted as issues. A lack of preparedness was also noted and staff identified strategies for coping in the field. Current efforts towards the professionalisation of health development and humanitarian staff may provide mechanisms to better support the workforce to respond and be accountable to the needs of countries. A performance management framework may need to be developed requiring research and validation
Background: Consideration of the needs of pregnant women and their ability and willingness to attend maternal services and pay for them is central to the provision of accessible and acceptable maternal care.
Ith, P, Dawson, A, Homer, CS & Whelan, AK 2013, 'Practices of skilled birth attendants during labour, birth and the immediate postpartum period in Cambodia', Midwifery, vol. 29, no. 4, pp. 300-307.View/Download from: UTS OPUS or Publisher's site
Maternal and perinatal morbidity and mortality rates in Cambodia are high. The provision of quality care by skilled birth attendants (SBAs )in a supportive working environment is an important strategy to reduce morbidity and mortality.There has been little emphasis on examining this issue in Cambodia.
Introduction: Job stress and job satisfaction play a key role in the work environment of an organization. These influence the behaviour of a doc- tor towards his or her co-workers, administration and, most importantly towards the patients.
Dawson, A 2012, 'Improving the quality of Human Resources for Health information', Pacific Health Dialog: Journal of Community Health and Clinical Medicine for the Pacific, vol. 18, no. 1, pp. 65-82.
Islam, M, Topp, L, Day, C, Dawson, A & Conigrave, K 2012, 'Primary healthcare outlets that target injecting drug users: Opportunity to make services accessible and acceptable to the target group', International Journal of Drug Policy, vol. 23, pp. 103-110.View/Download from: Publisher's site
Six experts from different regions of the world commented on our original paper (Islam, Topp, Day, Dawson, & Conigrave, 2012) and despite their different opinions and perspectives, all agree that providing anonymous, non-judgmental and free-of-charge services under a harm reduction framework can increase the accessibility and acceptability of primary healthcare (PHC) for injecting drug users (IDUs).
Islam, M, Topp, L, Day, C, Dawson, A & Conigrave, K 2012, 'The accessibility, acceptability, health impact and cost implications of primary healthcare outlets that target injecting drug users: A narrative synthesis of literature', International Journal of Drug Policy, vol. 23, no. 2, pp. 94-102.View/Download from: UTS OPUS or Publisher's site
Injecting drug users (IDUs) are at increased risk of health problems ranging from injecting-related injuries to blood borne viral infections. Access to primary healthcare (PHC) is often limited for this marginalised group. Many seek care at emergency departments and some require hospital admission due to late presentation. The costs to both the individual and the health system are such that policymakers in some settings have implemented IDU-targeted PHC centres, with a number of models employed. However, there is insufficient evidence on the effectiveness of these centres to inform health service planning. A systematic review examining such interventions is not possible due to the heterogeneous nature of study designs. Nevertheless, an integrative literature review of IDU-targeted PHC may provide useful insights into the range of operational models and strategies to enhance the accessibility and acceptability of these services to the target population.
Islam, M, Topp, L, Day, CA, Dawson, A & Conigrave, KM 2012, 'Primary healthcare outlets that target injecting drug users: opportunity to make services accessible and acceptable to the target group.', International Journal of Drug Policy, vol. 23, no. 2, pp. 109-110.View/Download from: Publisher's site
Maher, LM, Brown, AM, Torvaldsen, S, Dawson, A, Patterson, JA & Lawrence, G 2012, 'Eye health services for Aboriginal people in the western region of NSW, 2010', NSW Public Health Bulletin, vol. 23, no. 3-4, pp. 81-86.View/Download from: UTS OPUS or Publisher's site
Aim: To assess the availability, accessibility and uptake of eye health services for Aboriginal people in western NSW in 2010. Methods: The use of document review, observational visits, key stakeholder consultation and service data reviews, including number of cataract operations performed, to determine regional service availability and use. Results: Aboriginal people in western NSW have a lower uptake of tertiary eye health services, with cataract surgery rates of 1750 per million for Aboriginal people and 9702 per million for non-Aboriginal people. Public ophthalmology clinics increase access to tertiary services for Aboriginal people. Conclusion: Eye health services are not equally available and accessible for Aboriginal people in western NSW. Increasing the availability of culturally competent public ophthalmology clinics may increase access to tertiary ophthalmology services for Aboriginal people. The report of the review was published online, and outlines a list of recommendations.
Maher, LM, Phelan, C, Lawrence, G, Dawson, A, Torvaldsen, S & Wright, C 2012, 'The Early Childhood Oral Health Program: Promoting Prevention And Timely Intervention Of Early Childhood Caries In NSW Through Shared Care', Health Promotion Journal of Australia, vol. 23, no. 3, pp. 171-176.View/Download from: UTS OPUS or Publisher's site
Issue addressed: Early childhood caries (ECC) continues to have high prevalence worldwide, despite being largely preventable. The Early Childhood Oral Health (ECOH) Program was established in New South Wales (NSW) using a model of shared responsibility f
Dawson, A, Jackson, DE & Nyamathi, A 2012, 'Children of incarcerated parents: Insights to addressing a growing public health concern in Australia', Children and Youth Services Review, vol. 34, no. 12, pp. 2433-2441.View/Download from: UTS OPUS or Publisher's site
In Australia, the children of incarcerated parents are a growing and vulnerable population at risk for life adversity and social inequity. There is little understanding of these children's experiences, perceived risks, reported outcomes and needs. There is also a lack of knowledge regarding evidence-based interventions that can address the multiple risk factors to which these children may be exposed. The aim of this study was to provide insight into the multiple perspectives of children with incarcerated parents, their carers, parents and service providers so that social and health programs may be tailored to best serve their needs. We undertook an integrative literature review of qualitative research studies using a narrative synthesis methodology to explore the effect of parental incarceration upon the social and health outcomes of children and perceptions of interventions designed to support them. Findings revealed that children of incarcerated parents grieved their parent's absence which they reported had a profound effect on their behavior and resulted in exposure to discrimination, violence and abuse. However, resiliency was manifested by a number of coping strategies that could be harnessed to better support the children and young adults of incarcerated parents. Rigorous and innovative intervention studies are required to better inform comprehensive evidence-based policy and practice.
Ith, P, Dawson, A & Homer, CS 2012, 'Challenges to Reaching MDG5: A Qualitative Analysis of the Working Environment of Skilled Birth Attendants in Cambodia', International Journal of Childbirth, vol. 2, no. 3, pp. 153-162.View/Download from: UTS OPUS or Publisher's site
Objective: To explore the working environment of skilled birth attendants (SBAs) in one region in Cambodia and the factors affecting their motivation and performance.
Ith, P, Dawson, A & Homer, CS 2012, 'Quality of maternity care practices of skilled birth attendants in Cambodia', International Journal of Evidence-Based Healthcare, vol. 10, no. 1, pp. 60-67.View/Download from: UTS OPUS or Publisher's site
The World Health Organization's recommended package of interventions for the integrated management of pregnancy and childbirth provides guidance for the use of evidence-based interventions to ensure the best outcomes for mother and newborn. However, the extent to which skilled birth attendants (SBAs) follow evidence-based guidelines is not known. There are few studies into childbirth practices of SBAs in Cambodia. The aim of this study was to observe practices of SBAs during labour, birth and the immediate post-partum period and their consistency with evidence-based guidelines. Methods: A structured non-participant observation study was undertaken. Data were collected using an observational checklist of evidence-based practices adapted from the Cambodian clinical assessment tools for associate degree in midwifery. Maternity care settings in one provincial hospital, two district referral hospitals and two health centres in one province of Cambodia were purposively selected. Results: Twenty-five SBAs who attended 40 women during labour, birth and the postnatal period were observed. The results showed that the use of the partograph was low; birth companions were not permitted; cleanliness during birth was lacking; management of the third stage of labour was inappropriate; monitoring of mother and baby in the early postnatal period was lacking; the SBAs lacked skills in neonatal resuscitation; skin-to-skin contact with the newborn and early breastfeeding were rare; and intramuscular injection of vitamin K varied. Conclusion: The findings suggest that the current SBA practices during labour, birth and the immediate postpartum period in one province of Cambodia are not consistent with evidence-based guidelines. Service improvements that address evidence-based practices are likely to have an impact on clean and safe childbirth, thereby enhancing outcomes for Cambodia women.
Dushianthan, A, Owen, C, Dawson, A, Edwards, JH & Harrison, NK 2010, 'Summer-type relapsing fever (hypersensitivity pneumonitis) secondary to Cladosporium herbarum in the domestic environment', Respiratory Medicine CME, vol. 3, no. 2, pp. 95-97.View/Download from: Publisher's site
'Summer-type relapsing fever' is the most prevalent form of hypersensitivity pneumonitis in Japan. It is usually caused by hypersensitivity to Trichosporon cutaneum - a seasonal mould which thrives in homes with damp, decayed wood, damp mats and bedclothes. The disease has been rarely described outside Japan. We report the first documented case of summer-type hypersensitivity pneumonitis in Europe - in this case caused by hypersensitivity to the mould Cladosporium herbarum. © 2009 Elsevier Ltd.
Jones, RM, Dawson, A, Evans, EN & Harrison, NK 2009, 'Co-existence of organising pneumonia in a patient with Mycobacterium Avium Intracellulare pulmonary infection', Monaldi Archives for Chest Disease - Pulmonary Series, vol. 71, no. 2, pp. 76-80.
Co-existence of organising pneumonia in a patient with Mycobacterium Avium Intracellular pulmonary infection. R.M. Jones, A. Dawson, E.N. Evans, N.K. Harrison. Non-tuberculous mycobacterias (NTMs) have many clinical manifestations in humans, depending on the underlying immunological status. We present a patient with Mycobacterium avium intracellular pulmonary infection and co-existing, biopsy proven non-granulomatous organising pneumonia in distinct regions within the lungs. Treatment consisting of anti-mycobacterial therapy and corticosteroids led to clinico-radiological resolution. This case represents a potential broader clinico-pathological manifestation of Mycobacterium avium intracellulare.
Jones, RM, Dawson, A, Jenkins, GH, Nicholson, AG, Hansell, DM & Harrison, NK 2008, 'Sarcoidosis-related pulmonary veno-occlusive disease presenting with recurrent haemoptysis', European Respiratory Journal, vol. 34, no. 2, pp. 517-520.View/Download from: Publisher's site
Dawson, A & Joof, B 2005, 'Seeing, thinking and acting against Malaria: a new approach to health worker training for community empowerment in rural Gambia', Rural Remote Health, vol. 5, no. 4.View/Download from: UTS OPUS
Dawson, A & Joof, BM 2005, 'Seeing, thinking and acting against malaria - A new aprroach to health worker training in rural Gambia', Education for Health: Change in Learning and Practice, vol. 18, no. 3, pp. 387-394.View/Download from: Publisher's site
Context: In the Gambia, West Africa, Malaria is a major cause of death among children in rural areas. It has been estimated that in one division in the country malaria accounts for 40% of all deaths in children aged between one and 4 years. Most malaria cases are managed at home assisted by primary healthcare workers. The strategic plan of Gambia's National Malaria Control Programme includes improved training and supervision of all health care providers, at all levels, and increased community awareness in order to reduce the malaria burden by 50% before 2007. Issue: A malaria in-service training program for Community Health Nurses (CHNs) working at village level was piloted in 2004. The program includes a computer-based training (CBT) package, the first of its kind for health professionals in Gambia. The education program is part of a larger initiative, funded by the Gates Malaria Partnership, that aims to increase community involvement in malaria control. The objective of the course is to enable CHNs to facilitate the change process. The curriculum was informed by a reference group and stakeholder input. Interviews and evaluation forms were used to gather information about learner experience and learning preferences. Analysis: The CBT package was well received. Learners reported wanting more computer instruction, but felt they had gained confidence. There was resistance from other health professionals regarding the development of information technology skills in CHNs. This related to the perceived role and status of CHNs, as well as confidence in their ability. Some modifications of the CBT package were necessary, including the reworking of some activities and language. Lessons learned: There are issues related to sustainability and resource implications that need to be addressed. Opportunities exist to expand e-learning in the Gambia for preservice CHNs and other professionals. An investigation into the viability of reproducing this module as a generic planning...
Joof, B, Palmer, A, Dawson, A, Dibba, A, Yehuenou, S, Devanney, B, Ocran, C, Kasse, Y & Milligan, P 2005, 'Peer health education for promoting knowledge and practice of malaria prevention among school children and their families [MIM-AP-59778]', ACTA TROPICA, vol. 95, pp. S275-S275.
Ryman, NG, Burrow, L, Bowen, C, Carrington, C, Dawson, A & Harrison, NK 2005, 'Good's syndrome with primary intrapulmonary thymoma', Journal of the Royal Society of Medicine, vol. 98, no. 3, pp. 119-120.View/Download from: Publisher's site
Dawson, A & Ijumba, J 2003, 'Malaria and the Media Advocating health policy and practice in Sub Saharan Africa', Tanzania Health Research Bulletin, vol. 5, no. 1, pp. 30-31.
Clapham, K, Digregorio, KD, Dawson, A & Hughes, I 1997, 'The Community as Pedagogy: innovations in Indigenous health worker education', Journal of Higher Education Policy and Management, vol. 19, no. 1, pp. 35-43.View/Download from: Publisher's site
Pritchard, C, Cox, M & Dawson, A 1997, 'Suicide and 'violent' death in a six-year cohort of male probationers compared with pattern of mortality in the general population: Evidence of accumulative socio-psychiatric vulnerability', JOURNAL OF THE ROYAL SOCIETY OF HEALTH, vol. 117, no. 3, pp. 180-185.View/Download from: Publisher's site
Dawson, A 2019, 'Evaluation Research in Public Health' in Liamputtong, P (ed), Handbook of Research Methods in Health Social Sciences, Springer, Germany.View/Download from: UTS OPUS or Publisher's site
Doab, A, Dawson, A & Nicholls, R 2016, 'Access to abortion in Australia: insights from health care professionals', International Federation of Abortion and Contraception Associates, Lisbon, Portugal.View/Download from: UTS OPUS
Dawson, A, Turkmani, S, Varol, N, Sullivan, E & Homer, C 2015, 'Midwives' experiences of caring for women with female genital mutilation: Insights and ways forward for practice in Australia', Super Midwives - Making a Difference, Australian College of Midwives, 19th Biennial Conference, Gold Coast, Australia.View/Download from: UTS OPUS or Publisher's site
Dawson, A & Dean, S. 2014, 'A new building capacity model for the co-production of research between health academics and NGOs', the International Conference on Interdisciplinary Social Science, University of British Columbia, Vancouver, Canada.
In today's high pressure academic research environment there is the expectation that researchers not only carry out high impact work but that this is translated into practice to improve health and social outcomes. This is more often than not a criterion for funding.
NGO's who provide health services are increasingly keen to ensure that their programs are evidence-based in order to maximise client outcomes. This requires building workforce capacity to monitor and evaluate their programs in order to assess their merit. In reality, budget constraints, limited skills and funding opportunities constrains NGOs ability to carry out intervention research. In addition on-going efforts to secure funding for operation needs restricts an NGOs ability to deliver services.
Over the years university engagement with NGO's has involved contract research or NGOs have often provided the primary data for university researchers. However, in recent times there has been an impetus for changing the way universities and NGO's work together, that demands collaboration and joint partnership.
This paper reviews the different models of research partnership and examines a case study where university researchers worked with an NGO to analyse existing client outcome data in a residential drug and alcohol program in Australia. This involved building research skills and developing a plan for longitudinal research that will be used to provide an evidence –base to ensure program effectiveness. We present a framework based upon this experience that could be used for future collaborations that can guide genuine efforts towards, research co-productions.
Dawson, A & Turkmani, S 2014, 'Evidence to inform education, training and supportive work environments for midwives involved in the care of women with female genital mutilation', Australian College of Midwives NSW Branch State Conference, Novotel Sydney Brighton Beach NSW.View/Download from: UTS OPUS
Female genital mutilation (FGM) is a practice that is carried out on young girls and women in 29 countries in Africa and the Middle East, as well as some Asian countries (WHO, 2008). Migration from these countries to Australia has led to an increasing number of midwives caring for women with FGM and educating families in order to prevent this harmful and illegal practice. However very little is known about the challenges midwives face in delivering care and education and what professional development and workplace strategies might better support midwives.
This presentation reports on a synthesis of the peer reviewed literature published between 2004 and 2014 undertaken to identify the knowledge, experiences and needs of midwives globally with respect to FGM. This review forms part of a larger research project funded by the Department of Health and Aging to examine the obstetric outcomes of women who have FGM and midwives experiences in Australia. Ten papers were included in the review, two from lower-middle income counties and eight from high income countries.
The findings indicate that midwives lack technical knowledge and cultural competency to adequately care for women. Midwives, particularly those in lower-middle income counties where FGM was traditionally practiced were found to face significant challenges in their efforts to advocate for the abandonment of the practice. Training for midwives in the area of FGM was limited. Only one study reported the outcomes of an education initiative that was found to be beneficial. Professional education and training, a working environment supported by guidelines and responsive policy and community education, were suggested are necessary to enable midwives to improve the care of women with FGM and advocate against the practice.
Implications for midwifery in NSW include the need for specialised education and training for midwives on FGM, alongside opportunities for collaborative practice in contexts that support the eff...
Doab, A, Fowler, C & Dawson, A 2014, 'Factors that influence mother-child reunification for mothers with a history of substance use:A systematic review of the evidence to inform policy and practice in Australia.', Australasian Professional Society on Alcohol and Drugs, Adelaide.
Issues: Child abuse and neglect are of national concern in Australia and increasing reports to authorities are placing statutory child protection services under pressure Given the current increases in the number of Australian children in out of home care (OOHC) care, and that a large proportion of children in OOHC are have a parent with a substance use disorder (SUD), it is worthwhile examining the literature to provide evidence to inform the development of preventative and remedial interventions.
Approach: Using a narrative synthesis design, this review explores programs and maternal characteristics that either facilitate or act as a barrier to mother-child reunification in mothers with SUD
Key Findings: Outcomes regarding treatment modality and reunification were mixed. Factors such as presence of a mental health disorder and using opiates and were among several barriers to reunification.
Implications: This has implications for health care planning and delivery for women who use opiates and a have a mental health issue.
Conclusion: Women with SUDs who have a child in out of home care have multiple unmet needs. More comprehensive and integrated care services as well as greater access to primary health care must be considered if we are to improve outcomes and address issues for these women, as well as their children and potential future generations.
Implications for Practice or Policy: Practice and policies that better support mothers with a SUD including reduction of stigma, removal of barriers for treatment access, and increased treatment retention are required. Furthermore, treatment for mental health issues must be better integrated into SUD treatment settings.
Progress towards MDG5 cannot be achieved without midwives and midwifery organisations coming together to support midwifery education, regulation and professional association efforts in low and middle income countries. Capacity building is critical to scaling up the midwifery workforce and improving maternal and child health. A number of symposia have sought to develop ways to build midwifery capacity through collaboration. This includes the 2010 meeting of the Global Advisory Group for Nursing and Midwifery Development that focused on developing policy and technical guidance in key areas including inter-professional collaboration. Other forums have emphasised partnership through pairing organizations (twinning), networking as well as bilateral and global collaboration. However, despite considerable effort towards building midwifery capacity through collaboration there is little high level evidence about the effectiveness of such strategies.
The aim of this paper is to provide an overview of approaches to collaboration documented in peer-reviewed research papers that were examined as part of a meta-synthesis study. We will discuss the complexities of collaborative efforts between midwifery organizations from different nations and describe a framework to guide practice. The presentation will present experiences of international midwifery collaboration from the literature that have sought to build capacity through the provision of tools, training midwives to develop appropriate clinical or research skills, building adequate numbers of skilled midwives, supervisor networks and incentives, establishing appropriately managed facilities as well as systems to facilitate effective decision making, information gathering and accountable midwifery care. We will examine these efforts in the light of social theory, including power relations, concepts of reciprocity and empowerment. This paper will present an innovative framework for the design and evaluation of midwifery coll...
Dawson, A 2013, 'Influenza Vaccination during Pregnancy: What do General Practioners' Think?', Communicable Disease Network Australia's, Communicable Disease Control (CDC) Conference Australian Society for Infectious Diseases (ASID) Annual Scientific Meeting, Hyatt Hotel, Canberra.
Dawson, A, Conigrave, K, Lee, K, Holme, E, Blaszczyk, J, Perry, J, Demirkol, A & Freeburn, B 2013, 'Improving Access for Indigenous Australians to Evidence-based Options to Substance Use', Drug and Alcohol Review Special Issue: Abstracts of the Australasian Professional Society on Alcohol and other Drugs Conference, 24-27 November 2013, Melbourne, Australia, Australasian Professional Society on Alcohol & other Drugs APSAD Conference, Australasian Professional Society on Alcohol & other Drugs, Brisbane, pp. 13-13.
Aim of Abstract: This symposium will explore efforts to improve
access of Aboriginal andTorres Strait Islander (Indigenous) Australians
to evidence-based approaches to address substance use.
Nature of Interactive Element: An interactive discussion will
occur at four points in the symposium. Three of these will be
co-chaired by Professor Conigrave, an experienced addiction medicine
specialist. Mr Jimmy Perry (an Aboriginal health professional
experienced in both remote and urban settings) will provide commentary on each presentation and lead a discussion.
Dawson, A, Meyers, J, Tran, N-T & Krause, S 2013, 'Capacity assessment of humanitarian organizations to implement the MISP and comprehensive reproductive health: Global review', The American Public Health Association Annual Meeting, Boston, USA.
Introduction. Institutions play a central role in advancing the field of reproductive health in humanitarian settings (RHHS), yet little is known about organizational capacity to deliver RHHS and how this has developed over the past decade. This study aimed to document the current institutional experiences and capacities related to RHHS.
Materials and methods. Descriptive study using an online questionnaire tool.
Results. Respondents represented 82 institutions from 48 countries, of which two-thirds originated from low-and middle-income countries. RHHS work was found not to be restricted to humanitarian agencies (25%), but was also embraced by development organizations (25%) and institutions with dual humanitarian and development mandates (50%). Agencies reported working with refugees (81%), internally-displaced (87%) and stateless persons (20%), in camp-based settings (78%), and in urban (83%) and rural settings (78%). Sixty-eight percent of represented institutions indicated having an RHHS-related policy, 79% an accountability mechanism including humanitarian work, and 90% formal partnerships with other institutions. Seventy-three percent reported routinely appointing RH focal points to ensure coordination of RHHS implementation. There was reported progress in RHHS-related disaster risk reduction (DRR), emergency management and coordination, delivery of the Minimum Initial Services Package (MISP) for RH, comprehensive RH services in post-crisis/recovery situations, gender mainstreaming, and community-based programming. Other reported institutional areas of work included capacity development, program delivery, advocacy/policy work, followed by research and donor activities. Except for abortion-related services, respondents cited improved efforts in advocacy, capacity development and technical support in their institutions for RHHS to address clinical services, including maternal and newborn health, sexual violence prevention and response, HIV prevention, managem...
Dawson, A, Tran, N-T, Wesley, E, Festin, M & Mangiaterra, V 2013, 'Access to ECP in Low and Middle income Countries: What do we know and what do we need to know?', International Emergency Contraception Jamboree,, New York City, Baruch College.
Objective 10.1 of the ECP work plan of the UN Commission on Life-Saving Commodities (UNCoLS) consists of conducting a systematic review of the literature on strategies to expand access to ECP in high-burden countries. A face-to-face meeting to share research findings and set a research agenda on ECP in developing countries was part of the activities under this objective.
Methods of work
The systematic review of the literature was launched in September 2013 and preliminary results were presented by Angela Dawson and Nguyen-Toan Tran in a special session chaired by Mario Festin during the 2013 EC Jamboree. This annual meeting was organized by the International Consortium on Emergency Contraception (ICEC) on 21-22 October 2013 in New York. A group of more than 30 international experts from both developed and developing countries attended the special session. After the interactive presentation of the preliminary findings and possible future research questions, experts were invited to form eight small working groups based on the six WHO health system building blocks plus a group on women, men and users, and another group on community and partnership. Nominal group technique was applied to generate first reflection and inputs from each participant. The individual research themes were then presented and prioritized in each working group, before being presented for discussion in the plenary.
The results of the different working groups are presented in the table below.
Integration and contextualization. There was a common understanding that research questions from each building block need to be built on the questions from the other building blocks. Although ECP has its specific market delivery models and barriers, participants highlighted the importance of integrating ECP into other FP, GBV, and post-abortion care programs and services. The research questions need to be contextualized to the country situation, such as the definition of different hea...
Dawson, A, Waters, C, Dignam, D & Setiwan, A 2013, 'Enhancing care access: Reducing infant mortality in Indonesia through Community Case Management', 4th International Congress on Paediatric Nursing, Australian College of Children & Young People's Nurses, International Congress on Paediatric Nursing, Melbourne.
Aim: Indonesia is striving to achieve the Millennium Development Goal of no more than 30 infant deaths per 1000 live births in 2015. In order to reach this target, a new model of care called Community Case Management (CCM), developed by international non-government organizations and introduced by the Ministry of Health in three districts in the country in 2011. This paper reports on a study investigating the implementation of CCM in Indonesia from the perspective of Community Health Workers(CHWs) (community nurses, village midwives and community volunteers); and from the families who received care.
Method: A Qualitative approach was used to gain insight into participants' perceptions and experiences. The data were collected following the training of CHWs and the initial phase of implementation. Interviews and FGDs were conducted with CHWs, families and key informants. CHWs were observed while delivering intervention to families.
Result: CHWs reported that the program had increased their knowledge of and confidence, to deliver evidenced-based practice, alongside improved clinical reasoning. They reported improved access to care, family compliance with care plans, less need to refer to health facilities, and an increase in the capacity of families to learn about caring for sick children. Some implementation barriers and constraints and cultural concerns to were identified.
Conclusion and 'take home message': Despite the reported success of the CCM program a number of cultural concerns highlight the need for programs to be more tailored to the socio-cultural context. Recommendations are made to overcome these barriers.
Dawson, A, Pritchard, C, Dean, S, Robertson, J & Jackson, DE 2013, 'Collaborative approaches to addressing the complex needs of women with post traumatic stress disorder and substance use disorder.', PHAA National Social Inclusion and Complex Needs Conference, PHAA National Social Inclusion and Complex Needs Conference, Public Health Association, Canberra, ACT, Australia, pp. 28-28.
In Australia, the health, social and economic burden of alcohol and drug dependence is profound. Women's substance use problems are highly stigmatized and often not acknowledged. Pregnant and parenting women face particular societal condemnation and encounter multiple systemic barriers that delay treatment seeking with women fearing consequences for them and their children. Rates of comorbid post-traumatic stress disorder (PTSD) and substance use disorder (SUD) are higher for women than men and are associated with trauma related to sexual abuse and family violence. Little research has been undertaken internationally or in Australia to determine the most effective treatment for women with PTSD and SUD. Given the high incidence of PTSD co morbidity, it is critical that treatment models accommodate the complex needs of these women and draw upon integrated services requiring multiple service providers and professionals. This paper reports on the trial of a unique program for women with SUD and PTSD at Jarrah House, a residential medical detoxification and rehabilitation NGO program for women and their children. Early findings show encouraging increases in client quality of life scores and insight into how the program has empowered women to make life changes and plan their recovery supported by various providers.
Dean, S, Dawson, A & Jackson, DE 2013, 'Towards gender responsive treatment for substance abuse disorder: issues for consideration when providing services.', 8th International Conference on Interdisciplinary Social Sciences., Prague, Czech Republic..
In Australia the health, social and economic burden of female alcohol and drug dependence is profound. Women's substance use problems are more stigmatized, less likely to be acknowledged than men's, pregnant and parenting women face particular societal condemnation and encounter multiple systemic treatment barriers and they often delay seeking treatment services for fear of the consequences for them and their children. This particularly applies for Government agencies and women often feel more supported in seeking treatment programs in the NGO sector. International studies have documented high rates of comorbid post-traumatic stress disorders (PTSD) and substance abuse disorders for men and for women although the rates appear to be higher for women and typically stem from different trauma. The relationship between PTSD and substance abuse disorders tells us very different stories in men and women and the social determinants and coocurring life problems are often very different with women experiencing issues with children more frequently than men. There is very little research internationally or Australia to determine what is the best type of treatment for women with PTSD and substance use disorders. Given the high incidence of this comorbidity, treatment models that do not address this critical issue may not be successful. This paper reports on a unique program being trialled in a residential medical detoxification and rehabilitation program for women and their children in NSW. Jarrah House is part of the NGO sector and it's mission is to promote the empowerment, health and well-being of women and children by providing an effective and therapeutic gender responsive drug and alcohol treatment service. The program being trialled is an integrated program addressing both trauma and substance use and is the focus of this paper.
Dawson, A, Homer, C, Brodie, P, Rumsey, M & Copeland, F 2013, 'We kam longwe so far: Building Midwifery Capacity in Papua New Guinea. Innovative approaches for women's health. Are the current initiatives adequate?', Pacific Society of Reproductive Health Biennial Conference, Honiara, The Solomon Islands.
In early 2012, the AusAID funded WHO PNG Maternal and Child Health Initiative (MCHI) was established to improve maternal health outcomes in Papua New Guinea in close partnership with the PNG National Department of Health. The WHO Collaborating Centre at UTS is subcontracted by WHO PNG to deliver a range of activities focused on improving the standard of midwifery clinical teaching and practice in four teaching sites. This has included the placement of 8 clinical midwifery facilitators to work alongside PNG midwifery educators, 2 obstetricians providing clinical care and education in rural areas, the provision of learning resources and training and education and capacity building workshops. Two obstetricians were also placed in two rural hospitals to assist in the delivery of obstetric care and training.
Multiple data collection tools are being used to collect both qualitative and qualitative data. These include In-country visits where interviews and focus groups were conducted with various stakeholders. Additionally surveys and reports were collected from educators, students, and faculty staff to the contribution that this capacity building initiative is making to the strengthening of teaching and learning and regulation.
The findings are currently being presented to WHO PNG and AusAID as part of a Mid Term Review. The findings will be presented at the PSRH Conference.
The MCHI is a new, and solid beginning towards the scale up of midwifery in PNG but only through on-going investment and development can the impact that can be made by midwives at population level be fully realized.
Homer, CS, Rumsey, M, Brodie, PM, Dawson, A, Copeland, FH & Daly, J 2013, 'Helping build foundations for improved maternal health in PNG', International Council of Nurses 25th Quadrennial Congress, Melbourne.
Dawson, A & Wijiwardena, K 2012, 'Delivering Adolescent Reproductive Health Services in the Estate Sector in Sri Lanka', Lanka International Confederation of Midwives Asia Pacific Regional Conference, Hanoi, Viet Nam.
Managing and building the capacity of primary health care staff to deliver care, services and information to unique populations is challenging and requires strategies specially tailored to such contexts. The vast, privately owned tea and rubber plantations in Sri Lanka are home to half a million Tamils whose health outcomes and socio-economic status are the poor. The adolescent fertility rate in the estate sector is nearly double that of the non-estate sector not including the Northern Province (DoCS 2008). Youth on Estates are marginalised with high unemployment and school dropout rates. Health care on private estates is managed by plantation owners and midwives provide free preventative reproductive health services. There is little available information concerning the training, management and development needs of these staff and how they can be better supported to deliver adolescent reproductive health (ARH). This paper outlines the results of a case study examining estate midwives perceptions of ARH service needs and the barriers to the provision of such services.
Focus group discussions were held with 20 Estate Midwives from tea and rubber estates across the Kalutara District in the Western Province. Data was analysed using the constant comparative method resulting in 5 main themes. Midwives report that they are increasingly attending to pregnant unmarried girls and assisting with sexual abuse cases. However, many of their activities are directed by the estate superintendent to whom they report. Training varied and was not consistent with Ministry of Health requirements. Estate midwives depend upon public health care workers outside the Estate for assistance as they feel they lack adequate knowledge and skills. Resources for promotion and preventative activities are limited and poor roads and transport affect the ability of adolescents to access other services. Midwives reported poor referral and follow up of adolescents.
Improving infrastructure, estate mid...
Dean, S, Jackson, DE & Dawson, A 2012, 'The Impact of Short Term Residential Treatment Programs for Women Withdrawing from Alcohol and Other Drugs in Australia', International Council on Women's Health Issues (ICOWHI), Bangkok, Thailand..
Objectives: To determine the impact of short term residential treatment programs for women withdrawing from alcohol and other drugs in Australia. Methods: In this first phase of a longitudinal study of women (n=80) in a residential treatment program in NSW women were invited to complete questionnaires to measure quality of life, psychological health and confidence in their ability to abstain at the commencement of the 21 day program following a physical detoxification; after the 21 day program had concluded; and again at 42 days if they repeated the program cycle. The women completed questionnaires on quality of life, WHO-8: EUROHIS, psychological health Kessler -10 Plus and confidence to abstain from alcohol and other drugs. Results: Preliminary results indicate that outcomes were positive on all scales after completing the 21 day program with no marked difference when women repeated the program and remained in the program for a further 21 days. Conclusion: Residential treatment programs specifically for women withdrawing from alcohol and other drugs are scarce in Australia and in fact internationally. There are huge waiting lists for these types of services. Given the long waiting lists for treatment services, the chance of relapse following women making the initial call to self refer to a program and the long wait for admission to a service, the fact that women are often separated from their children, communities and social supports, taken out out of employment, the high cost of residential treatments particularly if they involve clinical input for detoxification, it would seem pertinent that more data are available on time in treatment as a predictor of outcomes. Whilst some literature seems to suggest that the longer time spent in treatment is a good predictor of good outcomes for some client groups there is little information available on the impact of short term programs as a predictor of good outcomes (Ross et al 2004). Results from this study will be use...
Dawson, A, Ith, P & Homer, C 2012, 'Quality of maternity care practices of skilled birth attendants during labour, birth and the immediate postpartum period in Cambodia', International Confederation of Midwives Asia Pacific Regional Conference, Hanoi, Viet Nam.
The proportion of births attended by skilled birth attendants (SBAs) has been used as a proxy indicator to monitor progress towards achievement of Millennium Development Goal five which aims to reduce maternal mortality by three quarters by 2015. However, there has been little emphasis on examining the provision of quality of maternity care practices in Cambodia. The objective of this study was to seek to understand SBAs' perceptions and practices and the factors affecting their practice during labour, birth and the immediate postpartum.
A qualitative design was employed using in-depth interviews and focus group discussions with midwives, nurses-midwives and doctors with midwifery skills in two health centres and three referral hospitals in one province of Cambodia. Data were analysed using a thematic approach.
SBA practice is not always consistent with evidence-based standards known to reduce morbidity and mortality. Eight inter-related themes emerged which described patterns of SBA practice.. These were: skills in the care of labouring women; provision of support in labour; interventions in the second stage of labour; management of the third stage of labour; lack of policy and authority; fear of litigation; workload and lack of human resources; and, financial incentives and socioeconomic influences.
A gap exists between evidence-based standards and current SBA practice during labour, birth and the immediate postpartum care. This is largely driven by the lack of a supportive working environment. The findings of this research provide maternal health services, workforce planners and policy makers with valuable information to improve maternal health. Recommendations for decision makers are made that maybe transferrable to other developing country contexts.
Dawson, A, Joof, B, Palmer, A, Dibba, A, Yehuenou, S, Devanny, B, Ocran, C, Kasse, Y, Milligan, P & Cheun, Y 2007, 'Peer health education for promoting knowledge andpractice of malaria prevention among school childrenand their families', Tropical Medicine and International Health, Multilateral Initiative on Malaria, Blackwell Publishing, Younde, Cameroon, pp. 175-175.
Introduction: Health promotion in schools aims to
improve the health and well being of students by
empowering them with the knowledge, skills and confidence
to take responsibility for their own health. We
incorporated a malaria component to an established
peer health education programme in schools in The
Gambia, and evaluated its impact on knowledge attitudes
and practice of school students and their families.
Methods: The intervention comprised training of peer
health educators, teacher coordinators, and members of
drama troupes, in key malaria messages and principles
of health education, over a 10-week period. The peer
educators then conducted a rolling programme of presentations
to children and youth in their own schools
using drama, puppetry, small group and in-class presentations
about malaria, as well as community outreach
programs targeting out-of-school youth and the general
public. The programme was evaluated by KAP surveys
of school children and mothers/carers of children under
5 in the community in a randomized design. Twelve
communities including 18 schools were randomized to
receive the programme immediately or after a delay of
Results: The intervention and evaluation methods
were piloted in 10 schools. The value of a preintervention
interview was investigated to determine
whether this would influence the person's test score
when interviewed for the second time. Methods to
assess schoolchildren's comprehension of malaria messages
that did not rely on literacy were developed
using photographs to prompt students explanations of
their knowledge and experience of malaria, while the
interviewer checks the key malaria messages stated.
The repeatability and inter-interviewer agreement of
these assessment methods was investigated by repeat
interviews. Twelve school communities were pairmatched
on urban/rural location and school type,
and one community in each pair randomly selected
to receive the intervention. In each school a systematic
Rumsey, M, West, F & Dawson, A WHO Collaborating Centre for Nursing, Midwifery and Health Development, University of Technology, Sydney 2015, Building Midwifery Educator Capacity in Teaching and Practice in Low and Lower-Middle Income Countries: A review of the literature.
Dawson, A 2014, Access to emergency contraceptive pills in low- and middle-income countries: A narrative synthesis of current evidence for the Technical Resource Team for Emergency Contraceptive Pill of United Nations Commission on Life-Saving Commodities.View/Download from: UTS OPUS
Beek, KM, Whelan, A & Dawson, A 2013, Stories and Strategies - Public Health Emergencies: Lessons Learned from Pilot Phase of the SPRINT Initiative in Asia Pacific Region..View/Download from: UTS OPUS
Inadequate human resourcesboth in numbers and qualityare a well documented limitation to effective responses to public health emergencies. Although significant progress has been made in the past 15 years, the literature reveals that the lack of trained health workers continues to exacerbate the marginalised emergency response to sexual and reproductive health (SRH) needs. A comprehensive response to public health, including SRH care, is essential to minimise death, illness and disability in an emergency.
Dawson, A The Inter-Agency Working Group on Reproductive Health in Crisis 2013, Institutional Capacity for Reproductive Health in Humanitarian SettingsReport of a global online survey - 2013 for The Inter-Agency Working Group on Reproductive Health in Crisis.View/Download from: UTS OPUS
Dawson, A University of New South Wales 2012, Health and Education Sector Collaboration In Adolescent Sexual And Reproductive Health In Sri Lanka A situational analysis and case study of the Kalutara District.View/Download from: UTS OPUS
Dawson, A University of New South Wales 2011, Human resources for health in maternal, neonatal and reproductive health at community level: A profile of Lao People's Democratic Republic, pp. 1-24, Sydney.View/Download from: UTS OPUS
Dawson, A, Howes, T, Grey, N & Kennedy, E University of New South Wales 2011, Human resources for health in maternal, neonatal and reproductive health at community level: A profile of Bangladesh, pp. 1-22, Sydney.View/Download from: UTS OPUS
This technical report series has been produced by the Human Resources for Health Knowledge Hub of the School of Public Health and Community Medicine at the University of New South Wales.
Dawson, A, Howes, T, Grey, N & Kennedy, E University of New South Wales 2011, Human resources for health in maternal, neonatal and reproductive health at community level: A profile of Cambodia, pp. 1-12, Sydney.View/Download from: UTS OPUS
This technical report series has been produced by the Human Resources for Health Knowledge Hub of the School of Public Health and Community Medicine at the University of New South Wales.
Dawson, A, Howes, T, Grey, N & Kennedy, E University of New South Wales 2011, Human resources for health in maternal, neonatal and reproductive health at community level: A profile of Fiji, pp. 1-19, Sydney.View/Download from: UTS OPUS
This profile provides baseline information that can inform policy and program planning by donors, multilateral agencies, non-government organisations and international health practitioners.
Dawson, A, Howes, T, Grey, N & Kennedy, E University of New South Wales 2011, Human resources for health in maternal, neonatal and reproductive health at community level: A profile of Indonesia, pp. 1-20, Sydney.View/Download from: UTS OPUS
This technical report series has been produced by the Human Resources for Health Knowledge Hub of the School of Public Health and Community Medicine at the University of New South Wales.
Dawson, A, Howes, T, Grey, N & Kennedy, E University of New South Wales 2011, Human resources for health in maternal, neonatal and reproductive health at community level: A profile of Papua New Guinea, pp. 1-24, Sydney.View/Download from: UTS OPUS
Dawson, A, Howes, T, Grey, N & Kennedy, E University of New South Wales 2011, Human resources for health in maternal, neonatal and reproductive health at community level: A profile of Philippines, pp. 1-20, Sydney.View/Download from: UTS OPUS
Dawson, A, Howes, T, Grey, N & Kennedy, E University of New South Wales 2011, Human resources for health in maternal, neonatal and reproductive health at community level: A profile of Solomon Islands, pp. 1-13, Sydney.View/Download from: UTS OPUS
Dawson, A, Howes, T, Grey, N & Kennedy, E University of New South Wales 2011, Human resources for health in maternal, neonatal and reproductive health at community level: A profile of Timor-Leste, pp. 1-19, Sydney.View/Download from: UTS OPUS
Dawson, A, Howes, T, Grey, N & Kennedy, E University of New South Wales 2011, Human resources for health in maternal, neonatal and reproductive health at community level: A profile of Vanuatu, pp. 1-14, Sydney.View/Download from: UTS OPUS
Dawson, A 2010, Human Resources for health in maternal, neonatal and reproductive health at community level: A synthesis of literature with a focus on the Asia and Pacific Regions, University of New South Wales.View/Download from: UTS OPUS
Dawson, A UNSW Human Resources for Health Knowledge Hub 2010, Improving the Quality of HR Information: Discussion Paper 1, pp. 1-24, UNSW 2052.
A focus on the providers of maternal, neonatal and reproductive health care and services in Asia and Pacific countries.
Dawson, A Human Resources for Health Knowledge Hub of the School of Public Health and Community Medicine 2010, Improving the quality of HRH information: A focus on the providers of maternal, neonatal and reproductive health care and services at community level in selected Asia and Pacific countries - Discussion paper 1, pp. 1-25, University of New South Wales, Sydney.View/Download from: UTS OPUS
Accurate, accessible and quality information about the providers of maternal, neonatal and reproductive health (MNRH) care at community level, how they are performing as well as how they are managed, trained and supported, is central to workforce planning, personnel administration, performance management (PM) and policy making. A number of documents have identified the need for timely, reliable, detailed and consistent workforce data in order to provide evidence to justify requests for both new and ongoing investment in human resources for health (HRH) development (WHO 2008a; Dal Poz et al. 2009). This information is critical to quality service delivery, and at the community level this includes health workers delivering evidence-based packages of care to women and newborns and making emergency referrals to facilities beyond the communit
Dawson, A Human Resources for Health Knowledge Hub of the School of Public Health and Community Medicine 2010, Towards a comprehensive approach to enhancing the performance of health workers in maternal, neonatal and reproductive health at community level: Learning from experiences in the Asia and Pacific regions Discussion paper 2, pp. 1-29, University of New South Wales, Sydney.
This discussion paper presents a comprehensive approach to the assessment of individual health worker, team and HRH management performance in the context of health system strengthening and the achievement of Millennium Development Goal 5 (MDG 5). The paper focuses on health workers who deliver maternal, newborn and reproductive health care to households or provide outreach services from specific points in a community. Human resources in this context include nursing and midwifery professionals, community health workers, and traditional or cultural practitioners. These cadres do not only provide care at critical locations that vulnerable populations need to access, but they can also facilitate community empowerment which is central to primary health care.
Dawson, A UNSW Human Resources for Health Knowledge Hub 2010, Towards a comprehensive approach to enhancing the performance of Health Workers: Discussion Paper 2, pp. 1-28, UNSW, 2052.View/Download from: UTS OPUS
A technical report in maternal, neonatal and reproductive health at community level: Learning from experiences in the Asia and Pacific regions.
Dawson, A & Whelan, A 2014, 'Nursing and midwifery workforce and universal health coverage Background paper WHO Global Forum for Government Chief Nursing and Midwifery Officers'.View/Download from: UTS OPUS
As the deadline for achieving the Millennium Development Goals approaches, the concept of universal health coverage is increasingly becoming a rallying point for post-2015 Millennium Development Goals. The purpose of this paper is to stimulate discussion at the 2014 Global Forum for Government Chief Nursing and Midwifery Officers, on the role of nurses and midwives in carrying forward the universal health coverage (UHC) agenda. The paper takes into account the three thematic areas of the Global Forum which include: Leadership and policy direction for universal health coverage (UHC) Quantity, quality and relevance of the nursing and midwifery workforce Collaborative partnerships Nurses and midwives are frontline workers in the health service delivery system and are therefore critical in working towards and achieving Universal Health Coverage. This background literature demonstrates where nurses and midwives have played a role, in terms of leadership and improving the quantity, quality and relevance of midwifery and nursing workforce, towards universal health coverage. The paper also clarifies the concept of Universal Health Coverage (UHC) in order to establish a common understanding among the participants to this Global Forum. Examples advanced in this paper provide a starting point for discussion on the way forward with regards to nursing and midwifery and the contributions that nursing and midwifery national leadership could make towards universal health coverage.