Browsing by Subject "Midwives"

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    Engagement/involvement of staff from public medical Institutions with pregnant women experiencing intimate partner violence - a systematic review of African & South African literature
    (2025) Adams, Faseegah; Artz, Lillian; Holtzhausen, Leon
    This study explores how staff at public health care institutions respond to intimate partner violence (IPV) experienced by pregnant women living in South Africa and Africa. This study aimed to investigate what protocols/pathways staff at public health care institutions (PHCI) use to identify, screen, report, record and refer instances of IPV. The motivation for this study was to bring awareness of IPV during pregnancy. Since learning the high statistics of IPV during pregnancy, the researcher was prompted to investigate what PHCI are doing to identify, screen, report, record and refer cases of IPV. In addition, the researcher hopes that this research can facilitate policy development for staff at PHCI on how best to respond to pregnant women experiencing IPV. The methodology used in this study was a systematic literature review, that reviewed 14 qualitative journal articles. PICo was used to identify the study participants, the Cochrane systematic review methodology was used and the PRISMA flow diagram. Using thematic analysis, the researcher used Dey and Tesch to analyse the data. The findings indicate that there are no pathways/protocols for identifying, screening, reporting recording and refereeing instances of IPV in South Africa or Africa. There were also no direct policies or frameworks established at PHCI to manage intimate violence during pregnancy. The research identifies some of the main barriers/challenges to IPV enquiry which are lack of privacy at public health care institutions, training and awareness of IPV during pregnancy, staff agency, staff safety and cultural beliefs. These results contribute to the research regarding how PHCI in South Africa and Africa respond to IPV. Thus shifting focus away from the criminal justice system and more toward PHCI as IPV during pregnancy has grave health implications. This study provides new insights on how to build and improve protocol/pathways at PHCI. This study highlights the daily challenges that staff at PHCI face when enquiring about IPV. It concludes by discussing how The National Council on Gender-Based Violence Femicide can use information on the challenges/barriers to enquiry to achieve the goals and aims set out in The National Strategy Plan addressing gender-based violence and femicide in South Africa and Africa.
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    Exploring barriers to and facilitators of immediate postpartum and newborn care by midwives in Uganda
    (2026) Ssemwanga, Nassifu; Clow, Sheila; Walker, Sonja
    Background: The postnatal period is a critical phase in the lives of mothers and newborn babies, and almost half of the maternal and neonatal deaths occur in the first 24 hours after birth. However, the barriers and facilitators to immediate postpartum and newborn care by midwives have received little attention, most especially in developing countries, including Uganda. This study explored the barriers to and facilitators of immediate postpartum and newborn care by midwives in Central Uganda. Methods: This was a qualitative descriptive study conducted among purposively sampled midwives at Gombe District Hospital, Central Uganda. Information was gathered through three focus group discussions and four key informant interviews. Data were analysed using the inductive thematic approach of Colaizzi. Results: All participants were females aged between 23 and 59 years. Three themes emerged: “Optimising birth outcomes”, which reflects midwives understanding of the components of immediate postpartum and newborn care; “Overwhelming experience”, which highlights barriers such as a disabling work environment, demotivating conditions, and an uninformed practice; and “Comprehensive support system”, which encompasses facilitators such as an enabling work environment, effective leadership and management, and professional competence. An overarching theme, “Contradictions in Perspectives”, highlights the inconsistencies between the viewpoints of frontline midwives, who deal with daily realities, and midwifery managers, whose perspectives seem more aspirational. Conclusion: These findings emphasise the need for specific interventions to address barriers and strengthen facilitators, enhancing the overall quality of maternal care and birth outcomes.
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    Stepped care for maternal mental health: a case study of the perinatal mental health project in South Africa
    (Public Library of Science, 2012) Honikman, Simone; van Heyningen, Thandi; Field, Sally; Baron, Emily; Tomlinson, Mark
    Common mental disorders such as anxiety and depression are the third leading causes of disease burden globally for women between 14 and 44 years of age [1]. By 2030, these are expected to rise to first place, ranked above heart disease and road traffic injuries [2]. A recent systematic review reveals that maternal mental disorders are approximately three times more prevalent in low- and middle-income countries (LMICs) than in high-income countries (HICs), where the related burden of disease estimates range between 5.2% and 32.9% [3],4. In HICs, maternal suicide is the leading cause of death during the perinatal period, and while there is a relative dearth of information about maternal suicide in LMICs, the estimates are similarly high [5],[6]. Untreated maternal mental illness affects infant and child growth [7] and the quality of child care [8], resulting in compromised child development [4],[9]. Community-based epidemiological studies in South Africa have shown high prevalence rates of depressed mood amongst pregnant and postnatal women. In a low-income, informal settlement outside of Cape Town, 39% of pregnant women screened positive on the Edinburgh Postnatal Depression Scale (EPDS) for depressed mood [10] and 34.7% of postnatal women were diagnosed with depression [11]. In a rural area of KwaZulu-Natal province with high HIV prevalence, 47% of women were diagnosed with depression in their third trimester of pregnancy [12].