Exploring barriers to and facilitators of immediate postpartum and newborn care by midwives in Uganda

Ssemwanga, Nassifu

Exploring barriers to and facilitators of immediate postpartum and newborn care by midwives in Uganda

Thesis / Dissertation

2026

Publisher

University of Cape Town

Department

Department of Health and Rehabilitation Sciences

Faculty

Faculty of Health Sciences

Abstract

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.