Being qualified as a midwife specialist had the added benefit to address the maternal and child m... more Being qualified as a midwife specialist had the added benefit to address the maternal and child mortality in South Africa, and meet the requirements of the re-engineered primary health care system amid staff shortages (Maree, Yazbek & Leech 2018). It was proposed that midwife specialists would have the knowledge and skills to curb the shortage of physicians in rural parts of South Africa (Sewnunan & Puckree, 2022). The midwife specialist qualification signifies a specialised field in nursing, comprising expanded and expert roles, knowledge, skills and competencies of the midwife to improve maternal health, reproductive and genetic counselling and neonatal health (SANC 2014). South Africa is not the only country that pursued expansion of knowledge and skills of midwives; countries such as Liberia and Uganda train their midwives in advanced obstetric skills (Dolo et al. 2016). Yet, like South Africa, current practice regulations in these countries are also not restructured to support midwife specialists expanded knowledge and skills (Dolo et al. 2016). Background: Midwifery specialisation was introduced in 1993 as a response to escalating maternal and neonatal mortalities and shortage of physicians in rural parts of South Africa. Basic midwives enrolled into a postgraduate midwifery qualification to extend their knowledge and skills which enabled them to manage complicated obstetric conditions. The postgraduate midwifery qualification rendered them midwife specialists upon completion of the course. Yet, MS remain underutilised in clinical facilities due to limiting practice regulations and fear of medico-legal litigations, leading to forfeiture of skills. Aim: The study aimed to explore and describe midwife specialist' experiences of optimal utilisation of their knowledge and skills in public health facilities in South Africa. Setting: Public health facilities based in seven provinces in South Africa where MS were employed, formed part of the research setting. Methods: A qualitative, descriptive and explorative research design was followed using phenomenological approach. Sixteen purposefully sampled midwife specialists participated in four focus group interviews. Data were analysed using Collaizi's descriptive method. Findings: Three themes, each with categories, were derived from the data. Research results confirmed midwife specialist' limited utilisation of knowledge and skills in public facilities. This was associated with the existing practice regulations, restricting midwife specialists to basic midwifery roles. Conclusion: The lack of practice regulations, particularly for midwife specialists hinders optimal utilisation of their knowledge and skills in the public health facilities. Contribution: This study highlighted midwife specialist' barriers in optimally embracing their expert knowledge and skills. Barriers may guide formulation of strategies to facilitate midwife specialist' knowledge and skills utilisation.
Background: The obstetric triage tool (OBTT) is used to record the clinical findings following ob... more Background: The obstetric triage tool (OBTT) is used to record the clinical findings following obstetric triage (OBT). The recorded OBTT provides midwives with clinical information leading to diagnosis of existing and potential maternal and foetal problems that may lead to intrapartum complications, planning of specific midwifery care and communication among the midwifery team about the woman in labour.Aim: This study aimed to explore and describe midwives’ experiences of the OBTT used during admission of women in labour in the Bojanala district.Setting: This study was conducted in the two selected facilities in Bojanala district in North West province.Methods: This study is a derivative of a major study, entitled ‘Midwives’ experiences of OBT by midwives in the Bojanala district’. A qualitative, explorative and descriptive research design was followed. Nine purposefully sampled midwives with over 5 years of clinical midwifery experience, employed in the Bojanala district, attended ...
'reducing the global maternal mortality ratio to less than 70 per 100 000 live births' and to 'en... more 'reducing the global maternal mortality ratio to less than 70 per 100 000 live births' and to 'end preventable deaths of newborns and children under five years of age and reduce neonatal mortality to at least 12 per 1000 births'. Despite efforts since 2015 to meet WHO SDGs, maternal Background: The Perinatal Problem Identification Programme (PPIP) is used to rule out the avoidable and nonavoidable causes of negative maternal and perinatal outcomes through file audits. Perinatal Problem Identification Programme serves as a tool for midwives and obstetricians to pinpoint missed opportunities that could prevent avoidable causes of negative perinatal outcomes. Aim: The study aimed to describe and explore the avoidable causes of negative perinatal outcomes in Bojanala District through the lens of the midwife. Setting: This study was conducted in the two selected facilities in the Bojanala District in the North West Province of South Africa. Methods: The study derived from a larger study that focused on midwives' experiences of obstetric triage in the Bojanala District. A qualitative, exploratory and descriptive research design was used with purposive sample of nine midwives. Participants had over 5 years of clinical midwifery experience and were employed in the Bojanala District. Semi-structured interviews were utilised with data analysed using Colaizzi's descriptive method of data analysis. Results: Three major themes with eight subthemes emerged. Midwives noted space constraints, medicine and medical supply constraints, and constraints in availability of medical equipment. Access to identified constraints would enable prompt and appropriate management. Conclusion: The study highlighted the experience of midwives in accessing needed space, medicines, medical supplies and equipment, potentially impacting negative perinatal outcomes. Contribution: This study provides insight into administratively related avoidable causes of negative perinatal outcomes through the lens of frontline maternity care providers-midwives. Findings should be of particular utility to health service managers working to reduce maternal mortality and morbidity.
This study aimed to explore and describe midwives' experiences with OBT in Bojanala district. Set... more This study aimed to explore and describe midwives' experiences with OBT in Bojanala district. Setting: This study was conducted in Bojanala district of the North West Province. Two public healthcare facilities were selected where midwifery care and OBT services are rendered. Methods: A qualitative, descriptive, explorative research design was followed. Nine purposefully sampled midwives participated in a one-on-one in-depth interview. Data were analysed using Collaizi's descriptive method based on the themes and categories that emerged. Results: Three themes emerged. Midwives experienced the OBT tool to be inadequate; and that the low staff number contributes to an imbalance in the midwife-patient ratio. Midwives were also dissatisfied with less support they receive from their management. Conclusion: The study highlighted midwives' experiences of the use of OBT, as presented through their lived experiences. The midwives experienced challenges, which hindered them from practicing OBT to the best of their abilities. Contribution: The study highlighted challenges experienced by midwives regarding OBT, which directly influence the outcomes of pregnancy and labour.
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