Catalogue Search | MBRL
Are you sure you want to remove the book from the shelf?
{{itemTitle}}
218
result(s) for
"Midwifery South Africa."
Sort by:
Privileges of birth : constellations of care, myth and race in South Africa
\"Focussing ethnographically on private sector maternity care in South Africa, Privileges of Birth attends to the ways healthcare and childbirth are shaped by South Africa's racialised history. Birth is one of the most medicalised aspects of the life-cycle across all sectors of society and is also deeply divided between what the privileged can afford compared with the rest of the population. Examining the ethics of care in midwife-attended birth, the author situates the argument in the context of a growing literature on care in anthropological and feminist scholarship, offering a unique account of birthing care in the context of elite care services\"-- Provided by publisher.
Book
Skilled Birth Attendants: Who is Who? A Descriptive Study of Definitions and Roles from Nine Sub Saharan African Countries
Availability of a Skilled Birth Attendant (SBA) during childbirth is a key indicator for MDG5 and a strategy for reducing maternal and neonatal mortality in Africa. There is limited information on how SBAs and their functions are defined. The aim of this study was to map the cadres of health providers considered SBAs in Sub Saharan Africa (SSA); to describe which signal functions of Essential Obstetric Care (EmOC) they perform and assess whether they are legislated to perform these functions.
Key personnel in the Ministries of Health, teaching institutions, referral, regional and district hospitals completed structured questionnaires in nine SSA countries in 2009-2011. A total of 21 different cadres of health care providers (HCP) were reported to be SBA. Type and number of EmOC signal functions reported to be provided, varied substantially between cadres and countries. Parenteral antibiotics, uterotonic drugs and anticonvulsants were provided by most SBAs. Removal of retained products of conception and assisted vaginal delivery were the least provided signal functions. Except for the cadres of obstetricians, medical doctors and registered nurse-midwives, there was lack of clarity regarding signal functions reported to be performed and whether they were legislated to perform these. This was particularly for manual removal of placenta, removal of retained products and assisted vaginal delivery. In some countries, cadres not considered SBA performed deliveries and provided EmOC signal functions. In other settings, cadres reported to be SBA were able to but not legislated to perform key EmOC signal functions.
Comparison of cadres of HCPs reported to be SBA across countries is difficult because of lack of standardization in names, training, and functions performed. There is a need for countries to develop clear guidelines defining who is a SBA and which EmOC signal functions each cadre of HCP is expected to provide.
Journal Article
Quality midwifery care during childbirth at a midwife obstetric unit: A qualitative study
Background Globally, there is an increasing focus on enhancing the quality of midwifery care. In public institutions, primary care midwifery is provided at a midwife obstetric unit (MOU). Midwives at MOUs are the first contact that pregnant women have when accessing midwifery care. There exists a notable disparity in the perception of quality midwifery care between midwives and women. In South Africa, there has been a scarcity of research examining the perspectives of midwives and women, regarding the quality of midwifery care provided during childbirth. Objectives The objective of this study was to explore and describe women’s and midwives’ perceptions of the quality of midwifery care during childbirth, at a MOU in Cape Town in the Western Cape, South Africa. Method A qualitative exploratory descriptive design was utilised. Four women and five midwives were selected through purposive sampling. Semi-structured interviews were undertaken, transcribed and analysed utilising Tesch’s eight-step approach to qualitative data analysis. Results Three themes emerged: (1) understanding of quality midwifery care, (2) experiences of women during childbirth and (3) support received by women and midwives. Conclusion The quality of midwifery care remains compromised within the MOU setting due to various challenges encompassing limitations of both human and physical resources. It is imperative to establish a shared understanding of what constitutes quality midwifery care, as women and midwives often perceive it differently. Contribution Midwifery care during childbirth requires the engagement of all stakeholders, including women, to enhance the quality of midwifery care provided.
Journal Article
Midwifery hurdles: Navigating tuberculosis screening challenges in South Africa
Background In South Africa, screening for tuberculosis during pregnancy is a serious challenge. Tuberculosis is one of the leading indirect causes of mortality in pregnant women. Objectives The objective of the study was to explore the challenges experienced by midwives regarding tuberculosis in pregnant women. Method A qualitative exploratory research method was used to conduct the study. The study population comprised midwives who worked at primary healthcare clinics in the selected local area, Capricorn District, Limpopo province. Purposive non-probability sampling was used to select 10 participants. Data from participants were acquired using in-depth individual semi-structured interviews. Data analysis was carried out using manual thematic analysis following Tesch’s technique. Results The outcomes of this study included midwives knowing their roles regarding tuberculosis screening among pregnant women. They further highlighted their challenges while screening tuberculosis in pregnant women, such as shortage of screening tools, withholding of tuberculosis information, and language barrier. Conclusion Midwives should have the necessary equipment and be trained in various languages used in the province to improve tuberculosis screening among all pregnant women. Contribution Infected pregnant women and their unborn children’s health can be improved by tuberculosis screening.
Journal Article
Systematic review of burnout among healthcare providers in sub-Saharan Africa
Background
Burnout is characterized by physical and emotional exhaustion from long-term exposure to emotionally demanding work. Burnout affects interpersonal skills, job performance, career satisfaction, and psychological health. However, little is known about the burden of burnout among healthcare providers in sub-Saharan Africa.
Methods
Relevant articles were identified through a systematic review of PubMed, Web of Science (Thomson Reuters), and PsycINFO (EBSCO). Studies were selected for inclusion if they examined a quantitative measure of burnout among healthcare providers in sub-Saharan Africa.
Results
A total of 65 articles met our inclusion criteria for this systematic review. Previous studies have examined burnout in sub-Saharan Africa among physicians (
N
= 12 articles), nurses (
N
= 26), combined populations of healthcare providers (
N
= 18), midwives (
N
= 2), and medical or nursing students (
N
= 7). The majority of studies assessed burnout using the Maslach Burnout Inventory. The highest levels of burnout were reported among nurses, although all healthcare providers showed high burnout. Burnout among healthcare providers is associated with their work environments, interpersonal and professional conflicts, emotional distress, and low social support.
Conclusions
Available studies on this topic are limited by several methodological challenges. More rigorously designed epidemiologic studies of burnout among healthcare providers are warranted. Health infrastructure improvements will eventually be essential, though difficult to achieve, in under-resourced settings. Programs aimed at raising awareness and coping with burnout symptoms through stress management and resilience enhancement trainings are also needed.
Journal Article
Midwifery educators’ knowledge of antenatal exercises in selected Nigerian midwifery schools
Background: Exercise during pregnancy is beneficial to both the pregnant woman and the foetus. Midwifery educators play a crucial role in ensuring that midwifery students receive the knowledge and training needed to demonstrate antenatal exercises. To ensure that their students understand and deliver adequate antenatal care, midwifery educators should be highly knowledgeable in pregnancy-related exercises.Objectives: The study was conducted to determine the knowledge of midwifery educators about antenatal exercise.Method: A descriptive cross-sectional study was conducted of the knowledge about antenatal exercises by midwifery educators. A purposive total population of 54 midwifery educators from three midwifery schools in Cross River State, Nigeria, was included in the study. Questionnaires were used for data collection, and Statistical Package for Social Sciences (SPSS) version 27 was used for data analysis. Ethical issues and rigour were maintained.Results: The study revealed that antenatal exercises are included in the midwifery curriculum and exercise demonstration were mainly done by midwifery educators and clinical instructors. The majority (n = 34, 66.7%) of the respondents were knowledgeable about World Health Organization (WHO) guidelines for exercise during pregnancy and had an average knowledge of the ideal antenatal exercises.Conclusion: Midwifery educators have average knowledge of the ideal antenatal exercises, which prompts the development of an exercise programme to guide midwifery training and practice. Midwifery educators should collaborate with exercise specialists to teach and demonstrate antenatal exercises.Contribution: The study highlighted the need for midwifery educators to obtain more information on antenatal exercises to adequately prepare midwifery students for evidence-based exercise care for pregnant women.
Journal Article
Application of the random forest algorithm to predict skilled birth attendance and identify determinants among reproductive-age women in 27 Sub-Saharan African countries; machine learning analysis
Introduction
Maternal mortality refers to a mother’s death owing to complications arising from childbirth or pregnancy. This issue is a forefront public health challenge around the globe which is pronounced in low- and middle-income countries, particularly in the sub-Saharan African regions where the burdens remain significantly high. Moreover, this problem is further complicated in developing countries due to limited access to antenatal care and the shortage of skilled birth attendants. So far, considerable improvements in the health status of many populations have been reported in developing countries. Nonetheless, the MDGs to reduce maternal and newborn mortality unmet in many SSA nations. Leveraging machine learning approaches allows us to better understand these constraints and predict skilled birth attendance among reproductive age women, providing actionable insights for policy and intervention.
Objective
This study aimed to predict skill birth attendance and identify its determinants among reproductive age women in 27 SSA countries using machine learning algorithm.
Methods
Using data from the Demographic and Health Surveys (2016–2024) across 27 SSA countries, we analyzed responses from 198,707 reproductive age women. The Random Forest classifier, complemented by SHAP for feature interpretability, was employed for prediction and analysis. Data preprocessing included K-nearest neighbor imputation for missing values, SMOTE for handling class imbalance, and Recursive Feature Elimination for feature selection. Model performance was evaluated using metrics such as accuracy, recall, F1 score, and AUC-ROC.
Results
The Random Forest model demonstrated robust performance, achieving an AUC-ROC of 92%, recall of 96%, accuracy of 92%, precision of 93 and F1 score of 93%. The SHAP analysis identifies key predictors of skilled birth attendance, including facility delivery, maternal education, higher wealth index, urban residence, reduced distance to healthcare facilities, media exposure, and internet use.
Conclusion and recommendations
The findings highlight the potential of machine learning to identify critical predictors of skilled birth attendance to inform targeted interventions. Addressing socioeconomic and educational disparities, enhancing healthcare access, and implementing tailored cessation programs are crucial to enhance skilled birth attendance in this vulnerable population.
Journal Article
Pre-service midwifery education in sub-Saharan Africa: A scoping review
In response to a global call for more midwives, maternal health stakeholders have called for increased investment in midwifery pre-service education. Given the already long list of challenges and the increasing burden on health care systems due to the COVID-19 pandemic, the need to prioritize investment is acute, particularly in sub-Saharan Africa. An important first step is to examine the current evidence.
We conducted a scoping review of the peer-reviewed literature about pre-service midwifery education in sub-Saharan Africa. A search of studies published between 2015 and 2021 in French or English was conducted using six databases (PubMed, CINAHL, Embase, Scopus, Web of Science and African Index Medicus).
The search yielded 3061 citations, of which 72 were included. Most were a mix of qualitative and quantitative cross-sectional, country-specific studies. Organized by pre-service educational domain, the literature reflected a misalignment between international standards for midwifery education and what schools and clinical sites and the larger administrative systems where they operate, reliably provide. Inadequate infrastructure, teaching capacity in school and clinical settings and clinical site environment were factors that commonly impede learning. Literature related to faculty development and deployment were limited.
Schools, faculty and clinical sites are overwhelmed yet recommendations by key stakeholders for change are substantive and complex. Efforts are needed to help schools map their current status by pre-service education domain and prioritize where scarce resources should be directed. These results can inform research and investments in pre-service midwifery education in sub-Saharan Africa.
Journal Article
Do in-service training materials for midwifery care providers in sub-Saharan Africa meet international competency standards? A scoping review 2000–2020
Background
Levels of maternal and neonatal mortality remain high in sub-Saharan Africa, with an estimated 66% of global maternal deaths occurring in this region. Many deaths are linked to poor quality of care, which in turn has been linked to gaps in pre-service training programmes for midwifery care providers. In-service training packages have been developed and implemented across sub-Saharan Africa in an attempt to overcome the shortfalls in pre-service training. This scoping review has aimed to summarize in-service training materials used in sub-Saharan Africa for midwifery care providers between 2000 and 2020 and mapped their content to the International Confederation of Midwives (ICM) Essential Competencies for Midwifery Practice.
Methods
Searches were conducted for the years 2000–2020 in Cumulative Index of Nursing and Allied Health Literature, PubMed/MEDLINE, Social Science Citation Index, African Index Medicus and Google Scholar. A manual search of reference lists from identified studies and a search of grey literature from international organizations was also performed. Identified in-service training materials that were accessible freely on-line were mapped to the ICM Essential Competencies for midwifery practice.
Results
The database searches identified 1884 articles after removing duplicates. After applying exclusion criteria, 87 articles were identified for data extraction. During data extraction, a further 66 articles were excluded, leaving 21 articles to be included in the review. From these 21 articles, six different training materials were identified. The grey literature yielded 35 training materials, bringing the total number of in-service training materials that were reviewed to 41. Identified in-service training materials mainly focused on emergency obstetric care in a limited number of sub-Saharan Africa countries. Results also indicate that a significant number of in-service training materials are not readily and/or freely accessible. However, the content of in-service training materials largely met the ICM Essential Competencies, with gaps noted in the aspect of woman-centred care and shared decision making.
Conclusion
To reduce maternal and newborn morbidity and mortality midwifery care providers should have access to evidence-based in-service training materials that include antenatal care and routine intrapartum care, and places women at the centre of their care as shared decision makers.
Journal Article
Midwives’ compliance with post-exposure prophylaxis guidelines in Tshwane District, South Africa
Background: Human immunodeficiency virus (HIV) remains a major public health concern. Midwifery practitioners as frontline healthcare workers (HCWs) remain susceptible to occupational exposure to infections while performing their routine duties. It is estimated that 90% of occupational exposures occur because of a lack of awareness and training regarding prevention and measures to be taken in case of accidental exposure.Objectives: The study aimed to assess the knowledge, attitudes and compliance of midwifery practitioners regarding post-exposure prophylaxis (PEP) guidelines.Method: Concurrent mixed-methods research approach with qualitative nested in quantitative design was followed. A random simple sampling technique was used to collect quantitative data from 71 midwifery practitioners. Simultaneously, a purposive non-probability sampling technique was used for the qualitative approach with two occupational health and safety (OHS) practitioners and 13 midwifery practitioners. Data were collected through questionnaires and semi-structured interviews. Quantitative data were analysed with SPSS version 24 and presented in tables and figures, and thematic analysis was employed for the qualitative strand.Results: The midwifery practitioners have good knowledge about PEP for HIV. However, the study revealed the underreporting of accidental exposures to blood and body fluids (BBFs) and the underutilisation of available PEP services.Conclusion: Maternity units are high-risk clinical environments. Underreporting of incidents of exposure remains prevalent among midwifery practitioners.Contribution: The findings will inform policy development structures and hospital management regarding knowledge and implementation gaps related to PEP guidelines in the specific hospitals. Strategies to improve compliance with PEP among midwifery practitioners were developed as a derivative from study findings.
Journal Article