- Title
- Perspectives of South African women and midwives on clinical practice in public maternity units: facilitating the scaling-up of such clinical practices
- Creator
- Wibbelink, Margreet
- Subject
- Physician practice patterns
- Subject
- Midwives -- South Africa -- Attitudes Pregnant women -- South Africa -- Attitudes Midwifery -- South Africa
- Date Issued
- 2019
- Date
- 2019
- Type
- Thesis
- Type
- Doctoral
- Type
- DCur
- Identifier
- http://hdl.handle.net/10948/44422
- Identifier
- vital:37168
- Description
- Despite a steady drop globally in maternal and newborn deaths since 1990, thousands of women and newborns still die each year during pregnancy and childbirth. South Africa, together with other countries, failed to achieve the Millennium Development Goal of reducing maternal mortality by three quarters by 2015. This is despite the positive efforts made in the country towards achieving these goals. However, much more still needs to be done. For that reason, proper and safe care of labouring women remains the identified major focus to prevent these deaths. The current study was the culmination of an investigation into the problem of poor performance regarding maternal and perinatal outcomes as identified by the researcher. The aim of this research study was to understand the experiences and perceptions of the women and the midwives regarding the clinical practices in public maternity units in South Africa in order to facilitate the scaling-up of the midwifery practice. A mixed-methods (sequential exploratory) design was used to answer the research question and objectives, and the study was conducted in three phases. In Phase One, a qualitative research design was implemented. The population were all the midwives in the Eastern Cape who had been working in public maternity units and women who had delivered in those settings. Non-probability purposive sampling with inclusion criteria assisted in selecting a suitable sample. Data collection was done using semi-structured audio-recorded interviews from eleven public sector midwives and eleven women receiving care from the midwives in the Eastern Cape, a province of South Africa. On data analysis, three themes emerged, namely participants had diverse experiences of the midwifery practice, midwives highlighted the burden with regard to the shortage of skilled midwives, and midwives identified managerial issues that affect their performance. Phase Two of the study comprised the quantitative research. The population was the midwives in South Africa who were working in public maternity units and nonprobability purposive sampling criteria were used to select participants. Data collection was done by means of a survey that used a tool adapted from the Hennessy-Hicks Training Needs Analysis Questionnaire. Questions for the survey tool were based on the results of Phase One. A total number of 314 questionnaires were completed, returned and analysed. Phase Three of the study comprised the integration of the results of the first two phases. The study found that midwives were committed to provide quality care but major factors needed to be addressed to facilitate scaling-up of clinical midwifery practices. The midwifery profession needed to be strengthened and an enabling working environment provided. Based on the results of the study as well as the theoretical, conceptual and contextual framework, two strategies were developed: Strategy 1: Empowering midwives to deliver woman-centred care in public sector maternity units Strategy 2: Creating an enabling work environment in order to deliver womancentred care in public sector maternity units.
- Format
- xviii, 300 leaves
- Format
- Publisher
- Nelson Mandela University
- Publisher
- Faculty of Health Sciences
- Language
- English
- Rights
- Nelson Mandela University
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