Abstract
Background: The six to eight weeks following delivery constitute the post-natal period, which begins with the afterbirth of the baby and placenta. A woman and her baby should both be healthy and happy during the postnatal phase, and inadequate postnatal care may result in the deaths of both the mother and the child. Midwives are important parts of the healthcare team, and their involvement in putting maternal care standards for post-natal care services into practice may help lower preventable deaths and improve health outcomes.
Aim: The study’s goal was to investigate and explain the midwives' functions and the midwives’ managers' perspectives in putting maternal care recommendations for postnatal care services in South Africa into practice and to create an intervention model. The intervention model may enhance the application of postnatal policy and patient accessibility to postnatal care services.
Methods: The study formulated, described, and evaluated a model aimed at enhancing the functions of midwives and the perspectives of midwives’ managers in providing postnatal care services to mothers using a qualitative, exploratory, descriptive, and phenomenological research method. The study was conducted in phases, including an empirical phase, a conceptual phase, a phase for developing the model, and a phase for model evaluation. In the empirical phase, the first three objectives were covered in this phase, this phase aimed to investigate the midwives’ function in carrying out maternal care standards on postnatal care, define determinants (barriers and facilitators) affecting midwives in applying maternal care principles on postnatal care, as well as examine and describe the perspectives of midwives’ managers in executing maternal care recommendations on postnatal care. The results from the first phase’s three objectives are combined during the conceptualization stage to form a category that guides the model development. An intervention model to promote midwives’ roles and midwives’ managers' views in implementing the maternal care guidelines related to postnatal care in South Africa” was created and reviewed in phases three and four. The study participants were licensed midwives and their managers, who are currently employed at a district hospital in South Africa and who were responsible for the postnatal care of women. Participants’ responses to the main questions were gathered through interviews up until data saturation. Based on the goals of the study, the data obtained were analyzed thematically using some frameworks: Ritchie, Lewis, Nicholls, Ormston, Braun and Clarke and Arksey and O’Malley framework. The district hospital and the University of Johannesburg both granted their approval in terms of ethics. Reliability, dependability, transferability, and confirmability standards were applied to ensure trustworthiness. Considering the results, the theory was developed to provide a framework for advancing nursing practice and informing postnatal care policy.
Findings: Regardless of the significant role that midwives play, the results showed that the maternal care principles are not being implemented well, especially during the postnatal stage. A lack of staff, inadequate resources, support, and information were contributing factors.
Conclusions: To increase patient satisfaction with postnatal care services and to promote health outcomes, consistent efforts should be made to promote midwives’ roles in delivering top-notch postnatal care to moms and babies, as recommended by the mother and newborn standards.
Keywords: Implementation, midwives’ managers perspectives, midwives’ roles, postnatal care, South African maternal care guideline