Half the Sky: Use of Literature to Teach Undergraduate Nursing Students About Global Health Equity

Purpose:  This presentation describes qualtiative findings from a global health assignment which we have used with undergraduate maternal child nursing students for the past ten years. We developed this assignment as a way to encourage students to reflect upon literature as well as current evidence when considering the needs of vulnerable populations of migrant women whom they are likely to encounter in their clinical practice. Our university is situated with a distinctly urban setting in the northeastern United States. Our diverse but inherently financially priviledged student body is situated within an inner city where many residents live far below the poverty line. Upon graduation our students are expected to be able to provide care which takes into consideration a patient and family's psychosocial needs including how those factors influence health-related decisions. One example is the strong likelihood of encountering migrant women who are being trafficked when they seek care in our local emergency rooms. Thus, this assignment grew out of a desire to expose our students to experiences which are vastly different from those typically experienced in their own lives in a way which was compelling, relevant and safe.

For this assignment students are required to read two chapters from Half the Sky: Turning Oppression into Opportunity for Women Worldwide (Kristoff & WuDonn, 2009) and write a two page reflective essay describing what they felt what they learned about maternal child health as well as the assignment. They are asked to identify one compelling aspect of global women's health, review an evidence-based article addressing that health concern and synthesize the reading from Half the Sky with current nursing science.

Methods:  Qualitative data analysis of ten years of student reflective journals.

Results:  Three themes emerged from the students reflective journals:

Overcoming Resistance: Students discussed their reluctance to take the time to read Half the Sky which they felt wasn't relevant to this clinical course. They expressed feeling overwhelmed with the requirements of this high-stakes clinical course which they are taking in conjunction with other similarly challenging clinical courses and were thus unsure how this assignment would help them study for and pass their exams. In short, they didn't feel that it was relevant.

Growth of Compassion: Students expressed deep sadness at the situations endured by women in other parts of the world. Realizing that these same women could easily be part of patients for whom they would soon be assuming care was frightening particularly as they came to realize that the women might well be presenting to the emergency rooms with other related symptoms such as sexually transmitted illnesses or symptoms of physical and sexual assault.

Call to Committment: Being asked to find and review an article describing the current nursing science of care for this vulnerable population reinforced their understanding of the prevalence of this population. They reported feeling a renewed committment to provide compassionate, evidence-based care when encountering women (and children) who were at increased risk.

Conclusion:  Students completing this assignment reported increased understanding of the needs of vulnerable populations of women. Some students expressed interest in working in global health, others told of increased understanding that this population of patients can be encountered wherever care is provided.