Masters Degrees (Nursing and Midwifery)

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Browsing Masters Degrees (Nursing and Midwifery) by Author "Baron, Justine Carla"

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    Exploration of the influence of waiting times in an antenatal clinic on the utilisation of basic antenatal care (Banc) in a midwifery obstetric unit : descriptive case study in the Western Cape, South Africa
    (Stellenbosch : Stellenbosch University, 2020-03) Baron, Justine Carla; Kaura, Doreen K.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY : Background: Antenatal care (ANC) is important to reduce maternal and neonatal morbidity and mortality. Through the service, the women receive vitamin supplementation, they are regularly screened for complications, and when complications arise, the service manages the complications. Therefore, utilisation of the service needs to be improved through the identification of the barriers to ANC utilisation. Reducing and improving ANC barriers could result in improved ANC coverage. The aim of the study was to explore and describe the contextual realities within the antenatal clinic that influence waiting times and lead to underutilisation of the BANC services within an MOU in the Cape Metropole in the Western Cape. Methods: The study used a qualitative descriptive single case study design with three embedded units of analysis. Three data sources were used, namely researcher observation, and interviews with midwives and pregnant women. Semi-structured interviews were held with 12 pregnant women and two midwives. Unstructured workflow and patient flow observations were done by the researcher. Purposive sampling was used to recruit the pregnant women and the midwives working in the antenatal clinic for the study. Ethical and institutional approval was acquired prior to data collection. Data were analysed using the framework method. Results: The first unit of analysis revealed two themes which were ANC and waiting times. This consisted of the description of the workflow with ANC activities and the patients’ waiting times. The overall observation was that there were long waiting times. The second unit of analysis revealed four themes which were waiting times, ANC utilisation, barriers to waiting times and facilitators of waiting times. The patients had mixed perceptions of waiting times, and the women attended ANC despite long waiting times. The women felt obligated to attend ANC and recognised the importance of the service. The barriers to waiting times were related to staff factors, operational functioning, lack of communication, and equipment and infrastructure problems. Facilitators of waiting times were related to operational factors and staff factors. The third unit of analysis had three themes that emerged, namely ANC utilisation, barriers to waiting times and facilitators of waiting times. ANC utilisation revealed patient barriers, women seeking care late in the pregnancy and healthcare barriers. The barriers to waiting times, according to the midwives, were related to shortage of staff and equipment, poor infrastructure, teaching students, workflow and patient acuity, and management functions. The facilitators of waiting times were having an efficient means of documentation, increasing staff numbers and equipment, improving the infrastructure and using a booking system for appointments. Conclusion: Long waiting times were noted in the antenatal clinic, but the long waiting times did not influence the women’s decision to seek ANC. There were many factors that influenced waiting times in the antenatal clinic such as a disorganised patient flow system, attending to follow-up appointments first, equipment shortage and staff factors. The waiting times in the antenatal clinic can be reduced if appropriate solutions are implemented.