ABSTRACT
Background: The high maternal and neonatal deaths remain a global concern especially in Low- and Middle-Income Countries. This is largely attributed to the limited skilled workforce including midwives who are required to offer quality maternal and neonatal care. Advanced Practice Midwifery (APM) training has been highlighted as critical in achieving high-quality maternal and neonatal care in all settings and countries. In Kenya, the APM training is at the initial stages, having been launched in May 2022. This paper presents the results of a literature review regarding opportunities and challenges for the APM training and practice with a goal of availing information to any institution willing to begin the program in Kenya and other LMICs. Methodology: A descriptive overview was undertaken through a rapid literature review of the relevant local and international literature to highlight the opportunities and challenges for the APM training and practice based on the Kenyan Context. Results: The APM training and practice has expansive opportunities such as the increased demand for quality care and reduced cost services, supportive policies, advances in technology, profession recognition and regularisation of the training and availability of midwives trained at lower levels. The challenges that the APM training is likely to experience includes; Lack of expert trainers, technological challenges, workload challenges due to the high population in need of the services and clinical environment challenges. Conclusion: APM training and practice has enormous opportunities despite the challenges that may be experienced. Therefore, for any institution preparing to start the APM training, there is need to exploit the existing opportunities and address the likely challenges to ensure the APM training and practice meets the desired outcomes.

ABSTRACT
Background: An uncontrolled increase in population can increase the number of maternal deaths, the use of contraception is an activity to regulate pregnancy spacing and prevent complications in mothers during pregnancy, childbirth and postpartum. Several factors that can influence the decision-making for the choice of contraception are social support which consists of the support of husband, family, friends and health workers. While contraception has side effects, one of which is changes in body weight that can affect the nutritional status of women who accept contraception. Purpose: Determine the effect of social support on the nutritional status of women who accept contraception and the effect of social support on the decision making of contraceptive selection. Methods: the research design is cross sectional with the sampling technique using simple random sampling. The sample size is 225 respondents, data collection using questionnaires and observations using multiple logistic regression analysis. Findings: The results of the analysis of social support with contraception decision making showed that the family support variable had a p value of 0.04 and that of friends' support had a p value of 0.01. While the results of the analysis of social support with the nutritional status of contraceptive acceptors showed that the family support variable had a p value of 0.04. Conclusion: Social support from family support has a significant effect on the nutritional status of women who are contraceptive acceptors. Meanwhile, social support in the form of support from family and friends has a significant effect on decision making when choosing contraception.

ABSTRACT
Background: Postpartum is a critical transition period for a woman. Every day 810 women around the world die from causes related to pregnancy and childbirth, which 52% of them dying during the postpartum period. These deaths occur due to complications such as postpartum bleeding, hypertension disorders, and infection. Purpose: This study aims to determine the factors related to maternal eating behavior during postpartum in Jember Regency, East Java, Indonesia. Based on the Health Belief Model (HBM) conceptual framework, those factors are perceived susceptibility, perceived severity, perceived benefit, and perceived barrier. Methodology: This was an observational analytic study using a cross- sectional design. The population in this study was 2750 postpartum mothers and the sample size examined 123 postpartum mothers as respondents it was conducted by Multistage Random Sampling. Respondents were given informed consent before conducting research for Ethical Considerations. All variable was obtained using a questionnaire. A multiple logistic regression test was conducted to determine the influence dimensions of HBM on maternal eating behavior during postpartum. Findings: Based on the result of this study Perceived Susceptibility (p=0,00) and Perceived Benefit (p=0,000) have significant correlation with maternal eating behavior. Then perceived Severity (p=0.983) and Perceived Barrier (p=0,616) do not correlate with maternal eating behavior among postpartum in Jember Regency Indonesia Conclusion: This study concludes that the greater perceived susceptibility and perceived benefits will influence postpartum mothers to have healthy eating behavior. We recommend increasing nutrition education as well as collaboration with other sectors.

ABSTRACT
Labor pain has an impact on the barriers to the delivery process due to the lack of self-control of the mother on labor pain so that the mother's physical condition can be weak. So the risk of cesarean delivery. One method of reducing pain is by non-pharmacological methods. Some non-morphological methods that can be used are deep breath relaxation, murotal Al-Qur'an and the aroma of lavender therapy. The purpose of this study was to determine the effectiveness of breath relaxation techniques and murottal quran audio on delivery pain first stage in ingin jaya health center, aceh besar regency. This study is a quasi-experimental study with a two-group pre-posttest design using a randomized controlled trial. The population of maternity mothers in the Working Area of the Ingin jaya Health Center, Ingin jaya District, Aceh Besar regency. The sample selection is purposive sampling with inclusion and exclusion criteria, the sample is 70 people. The results showed that there were significant differences between before and after treatment with P value 0.00<0.05.Treatment with audio murotal and aromatherapy significantly reduced labor pain with P value 0.00 <0.05. Aromatherapy and Audio Murotal Al-Quran are effective in reducing pain in the first stage of labor in the work area of the Ingin jaya Public Health Center, Aceh Besar regency.

ABSTRACT
The prevalence of chronic kidney disease (CKD) is rising alarmingly throughout the world, and it is one of the major public health menace due to the significant morbidity and mortality it is associated with. The burden of CKD inexplicably affects low-income nations like Kenya, where the two main public health concerns for the CKD growth rate are hypertension and diabetes mellitus. The aim of this study was to identify the determinants of chronic kidney disease diabetes mellitus patients and also assess their awareness, perspectives and prevalence of CKD. A hospital based cross-sectional study design was conducted at a rural hospital in central Kenya among adult (≥18 years) diabetes mellitus patients. Sample size was determined using Yamane Taro formula. Informed written consent was obtained from each participant and data was collected by interview and chart review; Glomerular filtration rate (GFR) was estimated from serum creatinine using modification of diet in renal disease (MDRD) formula, while CKD was defined as eGFR of less than 60mls/min/1.73m2 for more than three months. Multivariate logistic regression was used to identify independent determinants of CKD and a p-value of <0.05 was considered to be statistically significant. Majority of the participants (43.42%) were aged between50-60 years and 95 (62.5%) of them were females. Participants with history of high blood pressure had a 129.4 %(AOR;1.29495% CI, 2.401-.698) risk of having CKD, while those who did not perform physical exercises were found to be 123.3% (AOR 1.233, 95% CL,1.889-.805) times more likely to have CKD Only 39 (25.8%) of the participants had average awareness about CKD and its risk factors. The overall unadjusted prevalence of CKD among diabetic patients was 78.2% (n= 119, 95% CI). The researcher found that existing history of hypertension, lack of physical exercises, family history of kidney disease, rural residency and low levels of education were independent determinants associated ......

ABSTRACT
Vaccines are critical in the control and prevention of infectious diseases’ transmission. The COVID-19 vaccine is a new innovation, for a relatively new virus. Therefore, in rolling it out, the government should bear in mind the Diffusion of Innovation theory, which places people on a spectrum, ranging from those who are open to innovation and those who are more conservative. Just as with the general public, nurses develop confidence at different rates and may be susceptible to misinformation about vaccines. This study aimed at appraising nurses’ perceptions and attitudes towards COVID-19 vaccines. We conducted a cross-sectional study in September 2021 at a sub-county hospital in Nyamira County, Kenya. Eligible nurses completed structured self-administered questionnaires anonymously. The Statistical Package for Social Sciences (SPSS), version 22, was used to code, enter, analyse, organize, present and store data from the study. Logistic regression was performed to test if perceptions and attitudes had any association with uptake of Covid-19 vaccine. The results showed that all the perceptions and attitudes were positively associated with uptake of Covid-19 vaccine except vaccine safety and the importance of the vaccine to one’s health. The study concluded that there was poor perceptions and negative attitudes towards COVID-19 vaccines which were significant factors for refusal to get vaccinated. It is therefore recommended that the management authorities and stakeholders should promote positive perceptions and attitudes through instituting targeted vaccination campaigns to improve the level of COVID-19 vaccine knowledge among the nurses in particular, and all health care workers in general, in order to achieve a better coverage among them, as well as to influence the patients, clients, their relatives, as well as the general public for ultimate positive vaccine acceptance and uptake.

ABSTRACT
The use of partograph in managing labour is imperative to decrease obstetric issues associated with child birth. Prolonged and obstructed labour is a major cause of maternal mortalityThe purpose of this study was to assess the level of utilization of partographs in providing care for…. among Obstetric care providers in healthcare centers in Orlu Local Government Area of Imo State, southeast Nigeria. A descripive design was adopted for the study. A semi-structured questionnaire was used to collect data from obstetric care giver; a structured validated proforma was also used to collect data from patient records in all the health centres. SPSS version 24 was used to analyze the data, and the results were presented in tables. Result showed that partograph utilization was poor as only only 1(0.6%) showed record of descent 2(1.3%) had record of cervical dilatation plotted four hourly apart. In none was the alert line reached nor any drug given. On the recordings for second stage of labour in the partograph table three showed information on maternal monitoring, it showed that blood pressure, pulse, and temperature were documented on the 3(1.90%) partographs, but no information on nature of urine (protein, acetone or volume) was done. The study suggests that the poor Partograph utilization by obstetric care givers could be due to some factors which will require investigation. It is however recommended that further training should be required to improve the use of partograph.