Hi Deborah,
a few comments that might help from my experience; issues such as this (discovering unsafe practice or lack of critical knowledge) have been discussed in my work in 'developing' countries with regards to an ethical obligation on the part of researchers.
We believed that such 'findings' which could induce future 'harm' needed to be addressed. One method was that at the end of an interview - if such findings were evident, the interviewer had a 'referral card', which could be then used for giving a simple explanation to the participant eg how to make oral rehydration solution. Alternatively, it was believed that the issues of concern, having been identified through the research, would be followed up in a more comprehensive manner by the local health workers. Maybe there are ethics experts out there who can make further comments. Including some form of 'participatory action research' in your proposal could be one way to address the negative findings in a positive, non-threatening way. Unfortunately I don't have references to hand here in Thailand, to share at this stage. I am happy for you to contact me directly (email below) at a later date.
By the way, I don't believe I have 'introduced' myself to the group - I'm just completing data collection/fieldwork in Thailand (with a special interest in the Northern area), for a PhD on the 'birthing transition', along with an investigation of current issues in birthing (especially for population subgroups eg rural, migrant, refugee). Would be glad to hear from anyone with experience of/comments on this. There is virtually no model of 'midwifery-led' care currently practiced in Thailand, where instead, along with the 'hospitalization and medicalization', a model of obstetric nursing has been adopted. Furthermore, it seems that there is minimal monitoring of birthing indicators/perinatal outcomes in the ever-lucrative private system, where the cesearean section rate can be over 50%. The aims of the study are to understand the main factors in the impressive reduction of maternal mortality in Thailand, and to identify potential future steps for further reducing mortality and morbidity. Additionally, to 'learn lessons' which may then be adopted by other countries of the region where MMRs are still high. My recent experience has been in implementing and evaluating projects to improve reproductive health, specifically in the area of maternal and child health. I'm sure you'll be hearing more from me in the near future...
best wishes,
Penny
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Penny Haora (RM MPH) PhD Candidate
The Australian National University
Canberra, Australia
-----Original Message-----
From: A forum for discussion on midwifery and reproductive health research. on behalf of Deborah Caine
Sent: Fri 9/29/2006 7:17 AM
To: [log in to unmask]
Cc:
Subject: unsafe practice
Dear All, is anyone aware of any guidance about dealing with unsafe practice
that has been unearthed in questionnaire research? I am at the proposal stage.
Thanks
Deborah
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