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The knowledge of basic neonatal resuscitation among midwives at district hospitals

Ndzima-Konzeka, Florence Fezeka (2017-03)

Thesis (MCur)--Stellenbosch University, 2017.

Thesis

ENGLISH SUMMARY : Background:Globally there is an increase of neonatal deaths resulting in part from intra-partum asphyxia or hypoxia related to ineffective neonatal resuscitation at birth. Midwives can play a pivotal role in reducing neonatal deaths. The researcher was concerned about an increasing rate of early neonatal deaths, in the Chris Hani Health District, Eastern Cape. Consequently, a multi-pronged approach was put into place by the district, to address neonatal mortality by means of training midwives in basic neonatal resuscitation. The resulting question was whether the Chris Hani Health District midwives have the ability to conduct deliveries with the required knowledge in neonatal resuscitation, which could improve neonatal outcomes. Aim and objectives: The study aimed to determine the knowledge level of registered midwives with regards to basic neonatal resuscitation, in the Chris Hani Health District Hospitals in the Eastern Cape. The focus was on the identification of midwives’ training, qualifications and experience in neonatal resuscitation; determining the knowledge of midwives on neonatal resuscitation at birth; and describing the relationships among the afore-mentioned. Methods: A quantitative approach with a descriptive correlational design was adopted. The sample included 110 registered midwives allocated in the maternity wards of the 13 district hospitals of the Chris Hani Health District. A structured self-administered questionnaire was developed specifically to determine the extent of midwives knowledge with regards to the resuscitation of neonates at birth. Data was analysed with STATA (version 13) programme. Results: The knowledge score of the participants ranged from 63% to 97%, with a mean of 79% (SD 7.8). An acceptable knowledge level was 80% or more. Though there were no relationships found between midwives’ training, qualifications and their knowledge; years of experience as a midwife were found to be associated with knowledge of basic neonatal resuscitation. Although the knowledge scores were high, some midwives did not have adequate knowledge on critical components of neonatal resuscitation. Conclusion: The study underpins knowledge in empowering midwives to carry out basic neonatal resuscitation. Recommendations of the study include a retention strategy for advanced midwives; equipping advanced and / or experienced midwives to train and mentor young midwives in the profession; and a review of the need for training of midwives on neonatal resuscitation and its impact on their knowledge. These study findings and recommendations may strengthen the health systems that are in place to end preventable neonatal deaths; through imparting updated basic neonatal resuscitation knowledge to midwives.

AFRIKAANSE OPSOMMING : Agtergrond: Daar is wereldwyd ‘n toename in neonatale sterftes, gedeeltelik as gevolg van intrapartum asfiksie of hipoksie wat met oneffektiewe resussitasie by geboorte verband hou. Vroedvroue kan ‘n deurslaggewende rol in die vermindering van neonatale sterftes speel. Die navorser was besorg oor die toenemende aantal vroee neonatale sterftes in die Chris Hani Gesondheidsdistrik in die Oos-Kaap. Gevolglik is ‘n multi-ledige benadering deur die distrik in plek gestel om die neonatale sterftes by wyse van die opleiding van vroedvroue in basiese neonatale resussitasie aan te spreek. Die vraag wat hieruit voortvloei, is of vroedvroue van die Chris Hani Gesondheidsdistrik die nodige kennis in neonatale resussitasie het om verlossings te kan doen wat neonatale uitkomste sal verbeter. Doel en doelstellings: Die doel van die studie was om die kennisvlak van geregistreerde vroedvroue aangaande basiese neonatale resussitasie in die hospitale van die Chris Hani Gesondheidsdistrik in die Oos-Kaap te bepaal. Die fokus was op die identifisering van vroedvroue se opleiding, kwalifikasies en ervaring in neonatale ressusitasie; die bepaling van vroedvroue se kennis aangaande neonatale resussitasie met geboorte; en om die verband tussen bogenoemde te beskryf. Metode: ‘n Kwantitatiewe, korrelasionele en beskrywende benadering was gevolg. Die steekproef het 110 geregistreerde vroedvroue geallokeer in die kraamsale van die dertien hospitale van die Chris Hani Gesondheidsdistrik ingesluit. ‘n Gestruktureerde self-geadministreerde vraelys is spesifiek ontwikkel om die omvang van vroedvroue se kennis ten opsigte van die resussitasie van neonate by geboorte te bepaal. Data is met die STATA (weergawe 13) program geanaliseer. Resultate: Die deelnemers se kennisvlak was tussen 63% en 97%, met ‘n gemiddelde kennisvlak van 79% (SD 7.8). 'n Aanvaarbare kennisvlak was 80% of meer. Hoewel daar geen verhoudings gevind is tussen vroedvroue se opleiding, kwalifikasies en hul kennis nie; is gevind dat jare van ondervinding as 'n vroedvrou verband hou met kennis van basiese neonatale resussitasie. Alhoewel tellings vir kennis hoog was, het sommige vroedvroue nie die nodige kennis aangaande sekere kritiese komponente van neonatale resussitasie gehad nie. Slotsom: Die studie rugsteun kennis ter bemagtiging van vroedvroue om basiese neonatale resussitasie uit te voer. Aanbevelings van die studie sluit in ‘n retensie-strategie vir gevorderde en/of ervare vroedvroue; hierdie kaders behoort toegerus te word om ander vroedvroue en die vroedvroue met minder ervaring te mentor in die beroep op te lei; en ‘n oorsig van die behoefte vir die opleiding van vroedvroue oor neonatale resussitasie en die impak daarvan op hulle kennis. Die studie se bevindings en aanbevelings mag die gesondheidsisteme wat in plek is om die voorkombare neonatale sterftes te rugsteun, versterk deur opgedateerde basiese neonatale resussitasie kennis aan vroedvroue oor te dra.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/101236
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