Effects of the shortage of midwives on performance and quality of care, in maternity ward, Rundu Intermediate hospital and Nyangana district hospital, Kavango East region
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Date
2021
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Publisher
University of Namibia
Abstract
Midwives play a vital role in improving maternal and neonatal health. An adequate number of professional midwives is associated with improved quality of care and decreased maternal and newborn mortality. An increased workload due to the shortage of staff exposes midwives to unnecessary pressure, which might affect the quality of care they provide to patients. Addressing barriers that hinder midwives from providing quality care is a step towards improving the health care deliverance and hence, a step towards achieving the Millennium Developmental Goal (MDG) 5 and the Standard Developments Goal (SDG) 3. The aim of this study was to assess the effects of the shortage of midwives on their performance and quality of care, in the maternity ward of Rundu Intermediate Hospital and Nyangana District Hospital, Kavango East Region, Namibia. A quantitative analytic descriptive cross-sectional study was conducted using a purposive, non-random sampling method on fourty (40) midwives, in which thirty-one (31) were from Rundu Intermediate Hospital and nine (9) from Nyangana District Hospital. A self-administered questionnaire was used. The results revealed that the major effects of the shortage of midwives on their performance were as follow: increases workload (100%), feelings of fatigue and emotional exhaustion (97.5%), increases stress levels (95%), causes burnout and moral distress (87.5%), increases job dissatisfaction (87.5%), decreases willingness to work (70%), causes high staff turnover (65%), decreases the ability to work (65%) and increases medical errors committed among midwives (60%). Moreover, late attendance to patients (95%), poor monitoring of patients’ conditions (92.5%), inadequate or poor patient care (90%), delay in treatment of patients (87.5%),
delay in initiating emergency interventions (82.5%) and lack of performance in the implementation of the EmOC (Emergency Obstetric Care) guideline (82.5%), were among the effects of the shortage of midwives on the quality of care. Other effects on the quality of care included increase in mortality rate (i.e. still birth, neonatal and maternal death) (77.5%), unnecessary complications that delay recovery (75%), negative attitude of health workers towards patients (67.5%) and medical errors committed by midwives (67.5%). The study concluded that the shortage of midwives has negative effects on both midwives’ performances and quality of care. The study recommended the followings: the MoHSS and the professional councils to come up with proper midwife-to-patient ratio to reduce workload pressure; the human resource of the MoHSS to make provision of recruiting adequate staff in maternity sections; and provide adequate equipment to enhance performance of few staff. In addition, the obstetric care trainings need to be provided to all midwife staff prior to allocation to maternity sections. The MoHSS should make provision of a service that provides the midwives with emotional and psychological support, to assist them on coping with stress from work-related pressures and help them deal with their emotions. The MoHSS should also create a conducive working environment to attract more staff, therefore, overcome staff shortage, and eventually, minimise effects of the shortage of midwives.
Description
A thesis submitted in partial fulfilment of the requirement for the degree of Master of Nursing Science
Keywords
Midwives, Standard developments goal, Millennium developmental goal