DR. WAKASIAKA SABINA NYANCHERA MARKO

the partograph is a tool used globally to record labour progress. Although it has the potential to improve maternal and neonatal outcomes, some midwives struggle with using it in practice. Training in partograph use is limited, and the theory is often divorced from practice. Innovative ways of improving training are urgently required. We therefore aimed to determine whether the use of an e-learning tool is beneficial for learning partograph skills. an uncontrolled before-and-after study was conducted, informed by Kirkpatrick's four-stage model of evaluation; we report on the first two stages. We included a cohort of third and fourth year midwifery students who were studying at one university in Nairobi. The same hypothetical case scenario was used, pre- and post-implementation of the World Health Organization partograph e-learning tool, to assess students' partograph completion ability. Views on the tool were also sought, using semi-structured questionnaires. Data were analysed using standard statistical techniques and framework analysis. 92 (88%) students participated. Students expressed positive views about the e-learning tool. However, the mean post-intervention score (27.21) was less than half of the maximum obtainable score. There was some improvement in test scores; year three mean score pre-intervention was 21.39 (SD 5.72), which increased to 25.10 (5.41) post-intervention (paired-t=3.47, p=0.001); year four mean score pre-intervention was 24.39 (5.98) which increased to 29.30 (6.77) post-intervention (paired t=3.85, df=91, p<0.001). In the post-test, year four students scored higher than year three students (unpaired t=3.28, df=90, p=0.001). Students were unable to plot cervical dilatation correctly, once established labour had been confirmed. e-Learning training is acceptable to student midwives and has the potential to be an effective means of teaching the practical application of the partograph. However, in this study, their inability to correctly plot transference from the latent to active phase of labour suggests that the partograph itself may be too complicated. Modifications and further evaluation of the e-learning tool would be required before any widespread implementation. Furthermore, students need the clinical support to operationalise their learning; educating qualified midwives and obstetricians to be positive role models when completing the partograph would be one potential solution. Further research is required, taking on board the recommendations from our pilot study, to investigate the impact of partograph e-learning on practice and clinical outcomes.

With the persistent challenges towards controlling the HIV epidemic, there is an ongoing need for research into HIV vaccines and drugs. Sub-Saharan African countries - worst affected by the HIV pandemic - have participated in the conduct of clinical trials for HIV vaccines. In Kenya, the Kenya AIDS Vaccine Initiative (KAVI) at the University of Nairobi has conducted HIV vaccine clinical trials since 2001

Background: In Africa Health Care Providers form the primary source of information and service provision. Majority of the health work force are nurses/midwives with diverse training and experiences. This study focused on knowledge and Safe motherhood policy implementation.
Method: In a period of 12 months, participants were recruited from all the regions in Kenya. To be eligible for study, participants were required to have a midwife’s practicing license and member of National Midwives Association. A standardized tool was used to collect data regarding social demographics, professional training and practice. Information about uptake of Antenatal care, reasons for home deliveries and causes of infant mortality were also documented. Data was then entered and analyzed using Social Science Package for statistical analysis (SPSS).
Results: A total of 117 nurses participated in the study with a male: female ratio of 1:5. The mean age was 41 years with a minimum age of 24 and maximum 53 years. Abroad professional background was observed with a majority being KRCHN (97%}, BScN (2%) and MScN (1%). All the participants reported having seen the safe motherhood policy document but majority 74% said they had not read the document. Ninety-two percent had attended to mothers who had had a home delivery with 80% of the nurses having attended to one mother who had had FGM. Despite this impressive workload, almost two thirds (63%) had not read the policy on abortion and post abortal care (63%).
Conclusion: The midwife continues to serve communities with diligence and dedication, however practitioners neglect policy interpretation. To breach this gap, midwives need motivation to keep a breast with emerging issues in safe motherhood

The safety and immunogenicity of plasmid pTHr DNA, modified vaccinia virus Ankara (MVA) human immunodeficiency virus type 1 (HIV-1) vaccine candidates were evaluated in four Phase I clinical trials in Kenya and Uganda. Both vaccines, expressing HIV-1 subtype A gag p24/p17 and a string of CD8 T-cell epitopes (HIVA), were generally safe and well-tolerated. At the dosage levels and intervals tested, the percentage of vaccine recipients with HIV-1-specific cell-mediated immune responses, assessed by a validated ex vivo interferon gamma (IFN- ) ELISPOT assay and Cytokine Flow Cytometry (CFC), did not significantly differ from placebo recipients. These trials demonstrated the feasibility of conducting high-quality Phase 1 trials in Africa.