Teaching Family Planning in Nursing and Midwifery Schools: A Constructivist Grounded Theory Study
Abstract
High maternal mortality remains a global health issue. In 2017, approximately 295,000 women worldwide died from complications related to pregnancy or childbirth, and 94% of these maternal deaths occurred in low-income countries. Evidence shows that family planning (FP) improves maternal health outcomes and significantly contributes to the reduction of maternal mortality. Low FP uptake is partly attributed to inadequate education of health care providers to provide FP services. The purpose of this study was to describe nurse/midwife educators' understanding and enactment of teaching FP methods with nursing/midwifery students in educational programs. More precisely, the aim of this study was to generate a substantive theory that explains how nurse/midwife educators introduce FP methods into their teaching practice to facilitate learning among nurse/midwifery students. This study was conducted following the constructivist grounded theory methodology as articulated by Dr. Kathy Charmaz. The primary source of data was individual semi-structured interviews with 25 nurse/midwife educators recruited from all the schools/faculties/departments of nursing and midwifery in Rwanda, augmented with written documents related to FP education in nursing/midwifery pre-service programs. The substantive theory that emerged from the data analysis indicated that the process of teaching FP in pre-service nursing/midwifery education has three phases: preparing, facilitating and evaluating. This theory also identified the influential factors that impact that process and the actions that nurse/midwife educators engage in to address the challenges related to those influential factors. These study findings generated valuable knowledge that can guide the improvement of teaching FP in pre-service nursing/midwifery programs in Rwanda and other limited-resource countries and contexts.