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
dc.contributor.advisor | Kaura, Doreen K. | en_ZA |
dc.contributor.author | Baron, Justine Carla | en_ZA |
dc.contributor.other | Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery. | en_ZA |
dc.date.accessioned | 2020-02-24T13:12:26Z | |
dc.date.accessioned | 2020-04-28T12:27:33Z | |
dc.date.available | 2020-02-24T13:12:26Z | |
dc.date.available | 2020-04-28T12:27:33Z | |
dc.date.issued | 2020-03 | |
dc.description | Thesis (MNur)--Stellenbosch University, 2020. | en_ZA |
dc.description.abstract | 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. | en_ZA |
dc.description.abstract | AFRIKAANSE OPSOMMING : Agtergrond: Voorgeboorte sorg is belangrik om moederlike en neonatale siektes en sterftes te verminder. Met hierdie diens, ontvang die vroue vitamien aanvullings, gereelde ondersoeke vir komplikasies en wanneer komplikasies ontstaan, word die komplikasies hanteer. Daarom, moet die gebruik van die diens verbeter word deur die hindernisse vir die gebruik van voorgeboortesorg te identifiseer. Die vermindering en verbetering van voorgeboortesorg hindernisse, kan lei tot verbeterde benutting van voorgeboortesorg. Die doel van die studie was om die kontekstuele realiteite binne die voorgeboortekliniek te verken en te beskryf wat wagtye beinvloed en tot onderbenutting van die voorgeboorte dienste binne 'n verloskundige eenheid (MOU) in die Kaapse Metropool in die Wes-Kaap lei. Metode: Die studie het 'n kwalitatiewe beskrywende enkelegevallestudie-ontwerp met drie ingebedde analise-eenhede gebruik. Drie databronne, naamlik navorser waarneming, vroedvroue en swanger vroue was gebruik. Semi-gestruktureerde onderhoude is met twaalf swanger vroue en twee vroedvroue uitgevoer. Ongestruktureerde werkvloei en pasiëntvloei waarneming is deur die navorser uitgevoer. Die studie het doelgerigte steekproefneming gebruik om die swanger vroue en die vroedvroue wat in die voorgeboortekliniek werk te verwerf. Etiese en institusionele goedkeuring is verkry voor die insameling van data. Data is met behulp van die raamwerkmetode ontleed. Resultate: Die eerste eenheid van analise het twee temas naamlik, voorgeboortesorg en wagtye onthul. Dit het bestaan uit die beskrywing van die werkvloei met voorgeboortesorg aktiwiteite en die wagtye van pasiënte. Die algemene waarneming was dat daar lang wagtye was. Die tweede eenheid van analise het vier temas onthul, naamlik wagtye, benutting van voorgeboortesorg, hindernisse vir wagtye en fasiliteerders van wagtye. Die pasiënte het gemengde persepsies van wagtye gehad, en die vroue het die voorgeboortesorg bygewoon ten spyte van die lang wagtye. Die vroue het verplig gevoel om die voorgeboortesorg by te woon en het die belangrikheid van die diens erken. Die hindernisse vir wagtye was verwant aan personeelfaktore, operasionele funksionering, gebrek aan kommunikasie en toerusting en infrastruktuurprobleme. Fasiliteerders van wagtye was verwant aan operasionele faktore en personeelfaktore. Die derde eenheid van analise het drie temas onthul, naamlik die benutting van voorgeboortesorg, hindernisse vir wagtye en fasiliteerders van wagtye. Voorgeboortesorg benutting het pasiëntehindernisse geopenbaar, naamlik, vroue wat voorgeboortesorg laat in hul swangerskap benut en gesondheidsorg hindernisse. Die hindernisse vir die wagtye, soos geopenbaar deur die vroedvroue hou verband met die tekort aan personeel en toerusting, swak infrastruktuur, onderrig van studente, werkvloei, pasiënt komplikasie en bestuursfunksies. Die fasiliteerders van wagtye was doeltreffende dokumentasie, die getalle van personeel en toerusting, die verbetering van infrastruktuur en 'n afspraak besprekingstelsel. Slotsom: Verlengde wagtye in die voorgeboortekliniek was waargeneem. Die lang wagtye het egter nie die vrou se besluit beïnvloed om voorgeboorte sorg te benut nie. Daar was baie faktore wat die wagtye in die voorgeboortekliniek beïnvloed het, soos 'n ongeorganiseerde pasiëntvloeistelsel, die hantering van opvolg afspaake eerste, toerustingtekort en personeelfaktore. Die wagtye in die voorgeboortekliniek kan verminder word indien toepaslike oplossings geïmplementeer word. | af_ZA |
dc.description.version | Masters | en_ZA |
dc.format.extent | xii, 156 pages ; illustrations, includes annexures | |
dc.identifier.uri | http://hdl.handle.net/10019.1/108245 | |
dc.language.iso | en_ZA | en_ZA |
dc.publisher | Stellenbosch : Stellenbosch University | en_ZA |
dc.rights.holder | Stellenbosch University | en_ZA |
dc.subject | Maternal health services -- Western Cape (South Africa) | en_ZA |
dc.subject | Patients waiting time -- Western Cape (South Africa) | en_ZA |
dc.subject | UCTD | |
dc.title | 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 | en_ZA |
dc.type | Thesis | en_ZA |