 Alright, I'm going to go ahead and help Dr. Mohamed with his slides. So Dr. Mohamed is saying that most women in Nigeria give birth at home. And Prof says especially in the north and it is the preferred option in developing countries as he said it. However unplanned home birth attended by traditional attendance has been shown to increase maternal and newborn complications. Planned home birth, Dr. Mohamed we really can't hear you, it's really breaking up. Planned home birth increases access to midwives by 56% and it prevents a lot of complications such as maternal mortality and decreased deaths. Alright, so to continue the introduction here, the things that improve planned home birth, informed choice and shared decision making, respect of culture and preference, improve safety of home births and improve quality of home births. But they need midwives positive and I think that's a great point. Here is the problem statement. Unplanned home births are very prevalent, but they may result in complications. Alright, sorry, just had to let Dr. Mohamed know that his sound is very choppy. I'm sorry, Dr. Mohamed. So we do need to look at planned home birth interventions and I'm glad to see that you utilized one of my colleagues research here, Dr. Janelle Komarowski. But this rarely focuses on the midwives attitude to promote choice of birth. So objectives are to determine the effect of planned home birth educational intervention on midwives attitude towards planned home birth practice in Nigeria. Here's the methodology. We looked at the design, the randomised control trial. The study location was Sokoto, Nigeria. The population was midwives. Great, they had a 226 person sample. The instrument was a validated questionnaire and they use SPSS to achieve the data analysis. And Dr. Mohamed says, we design intervention to educate them on the need for planned home birth. This slide is quite small, but you can see the methodology continuing with the description of how the data was organised and how the midwives were placed in two different arms of the study with the intervention and the control study. And this video recording will be available with the slides for you to look through. And I'm sure Dr. Mohamed would be happy to put his email in the chat box so that anyone that wants to can follow up. So the intervention was planned home birth, promoting safe home births in the midwifery model of care. The investigator was a nurse midwife and here's the delivery method and this. So he says that randomisation was there to assist. Randomisation was to achieve a balanced group. Wonderful. Here are the learning objectives. So there was sessions on knowledge of planned home birth, including introduction to concept, evolving evidence, the midwife's role. And also demonstrating a positive attitude towards planned home birth. And I think we can all think back to when we've worked with colleagues that are not quite as confident or have as much self belief in planned home birth as we may. So Karen saying we used to run workshops for couples. And Dr. Mohamed says the intervention was to the midwife. So there was a very good over 200 sample of midwives that were involved in this study. So they had lectures, slides and quizzes to develop knowledge and attitudes that were positive towards planned home birth. Dr. Mohamed says the module focused on teaching what constituted an ideal planned home birth practice. Sorry, I skipped a slide. So here's the methodology continued. Talks about the post test, the follow up and three month follow up. And the trial flow chart was excellent. So that is really excellent. As somebody that's a doctoral lecturer, I'm impressed that you didn't have to exclude anyone from the study. So it worked on the consort design. So we can all look up the consort now and make sure we know what that is. Here's the data analysis that was prepared. There was an independent tea test and a chi square test. And then an independent tea test. And then there was a linear mixed effect model for the intention to practice planned home birth. And the data collection was at three time points says Dr. Mohamed. There was no significant differences between the intervention and the control group regarding socio demographics. So here's the age qualifications, ranks, health care, and the units. And at the baseline, next page, midwisened both groups showed a week to moderate but positive levels of attitude change towards planned home birth. That's fantastic. The results and discussion. Here we are. And this will also be obviously in our recording. This is just demonstrating that there was a week to moderate change. So well done. Oh, that's very impressive research right there. That's a lot of work for you and your team. And here's the results and discussion. And as I said, this will all be recorded. So you'll be able to look at this at your leisure and maybe think about instituting something like this where you live. Here we go. The tests within groups. There was a significant change in the mean attitude within the intervention group, but not in the control group, but there was no difference in three months follow up. So participants in the intervention were more favorable towards planned home birth compared to the control group, compared to the control group at the immediate post intervention and three months follow up. So between the two groups, the participants in the intervention arm were more favorable towards planned home birth practice compared to the control group. That is really excellent. So well done for that. The summary of the findings were that the midwives in both groups showed a week to moderate, but positive level of attitude towards planned home birth practice at the baseline. Planned home birth education in so-called Nigeria was effective in promoting a positive change in the attitude towards planned home birth practice within the intervention group and between the group. And then a wallow says midwives in the planned home birth group were more favorable than planned home birth towards the control. Yeah, we saw that from your data. That's excellent. In conclusion, Dr. Muhammad would like to say the findings of the study indicate that planned home birth is effective. Sorry, planned home birth education is effective in promoting a positive attitude towards planned home birth practice among midwives in Sokoto, Nigeria. Midwives who receive planned home birth education in the form of interactive lectures about evidence and the benefits of planned home birth, the midwifery model of care and vignettes on the consequences of neglecting women's choice of birthplace demonstrates a more positive attitude towards planned home birth practice compared to the baseline score and against those in the control group. Practicing midwives were offered the opportunity to learn and share their experiences in planned home birth practice. The randomized control trial and interventions used in the study may be replicated by other researchers. The findings will inform the health service administrators and policymakers on the strategies to promote attitude note change and foster cultural acceptance for planned home birth practice. And Dr. Muhammad says, planned home birth education is effective in promoting a positive change in attitude. And I think that really brings together when we heard yesterday from the World Health Organization, that's exactly what we heard from them. When women's choice or given choices and midwives are educated, then it really makes a really big change in families' lives and knowledge sharing. And exactly Dr. Muhammad, this RCT could be replicated wherever we live across the world. So further research on home birth, planned home birth should include all providers with all maternity caregivers. And planned home birth education requires an ongoing follow-up training to sustain its effect for future planned home birth practice. And exactly without informing policymakers, this is not going to change. I know we heard a lot in the chat while we were waiting for the microphone test about all the differences all over the world where sometimes home birth could be illegal, or it's normal, or there's such a wide range of attitudes towards women's choices and families' choices and shared decision-making. So planned home birth is a collaborative practice and we should incorporate into the continuing education of all midwives. Here are Dr. Muhammad's references. And I don't know if you saw my question. Dr. Muhammad, could you put your email in the chat box now so that I'm sure some of the wonderful listeners would like to hear about this from you as well. And Prof says, of course, I support Dr. Muhammad's conclusion. And yes, we've got your references here, but could you include your email if people have got more questions for you? Oh, and more references. Excellent. And I know a lot of the people that you're referencing here. So these are some wonderful references that you have. If you could put your email in the chat, that would be fantastic. And I think Baptiste has a question if he can type in the box. And Dr. Muhammad, thanks you. And thank you so much, Owalo. We're very sorry about your sound conditions. And I'm going to hand back to Elisa so she can finish up the questions and then the rest of the slideset. And thank you so much for your patience with this Scottish American midwife interpreting your data. Dr. Muhammad, a grateful praise for you. And I'm sorry about the internet. Thank you, Jane, for the assistance. And thank you to Owalo. And yeah, the questions Baptiste had a question earlier. And I'm going to fast it in chat again. How do you manage the complication in especially the second stage of labor, of labor in home birth? You can use public chat, Dr. Owalo to answer. Owalo, I don't know if you can type in the questions. Baptiste says to be able to practice home birth, is it due to civilized setting or other method? I need some clarification for its effectiveness. And Ethel asked about the education. How does it include one, two and three delay? And Karen asks what complications you are talking about? Dr. Owalo replies, plant home birth is part of community midwifery practice, sometimes called the midwifery. And Elisa, did you see the comment from Karen? At 36 weeks all women have a home assessment. That's fantastic. They look at the home setting. And Dr. Muhammad said to reply to Ethel included measures to minimize the effects of delay. We lost the feedback. So just so I think everyone know, we're going to wrap up in a few minutes. And I'm going to, at the moment, thank everyone. And apologies again for the sound. And thank you Dr. Owalo for the presentation. And to Jane for the assistance. Thank you very much. Please send your selfies to info at vidm.org for the slideshow at the end. Thank you, everyone.