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      Midwifery workforce profile in Limpopo Province referral hospitals Translated title: Le profil de la pratique de sage-femme dans les hôpitaux de recours

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          Abstract

          BACKGROUD: In sub-Saharan Africa including South Africa, maternal mortality rates remain unacceptably high due to a shortage of registered nurses with advanced midwifery diplomas. OBJCTIVE: To determine the profile of registered nurses (RNs) involved in maternity care in public referral hospitals of the Limpopo Province, South Africa. METHOD: A cross-sectional descriptive study was conducted in all maternity units of Limpopo's public referral hospitals. The study population comprised of 210 registered nurses, who became the study sample. Data on their educational profile and work experience in midwifery was analysed using STATA version 9.0. RESULTS: The mean age of the 210 registered nurses was 44.5 ± 9.1 years (range 21 to 62). The majority (152/210; 70%) were 40 years and older, 56% (117/210) had been working for more than 10 years, and 63/210 (30%) were due to retire within 10 years. Only 22% (46/210) had advanced midwifery diplomas, i.e. after their basic undergraduate training. Only six (2.9%) of the RNs providing maternity care in these referral hospitals were studying for advanced midwifery diplomas at the time of the study. CONCLUSION: This study demonstrated a shortage of registered nurses with advanced midwifery training/diplomas in referral hospitals of the Limpopo Province. This has a potentially negative effect in reducing the high maternal mortality rate in the province.

          Translated abstract

          PRÉSENTATION: En Afrique subsaharienne, Afrique du Sud comprise, les taux de mortalité maternelle reste à des niveaux élevés inacceptables en raison d'un manque d'infirmières qualifiées disposant également d'un diplôme de sage-femme. OBJECTIF: Déterminer le profil des infirmières qualifiées (IQ) impliquées dans les soins de santé maternelle dans les hôpitaux de recours publics de la province du Limpopo, en Afrique du Sud. MÉTHODE: Une étude descriptive transversale a été réalisée dans tous les services de maternité des hôpitaux de recours publics de la province du Limpopo. La population de l'étude était composée de 210 infirmières qualifiées (IQ), qui ont constitué l'échantillon de l'étude. Les données relatives à leur profil éducatif et à leur expérience professionnelle dans la profession de sage-femme ont été analysées à l'aide du logiciel STATA version 9.0. RÉSULTAT: Les 210 infirmières qualifiées étaient en moyenne âgées de 44,5 ± 9,1 ans (fourchette allant de 21 à 62 ans). La majorité d'entre elles (152/210; 70%) était âgée de 40 ans et plus, 56% (117/210) d'entre elles exerçaient depuis plus de 10 ans, et 63/210 (30%) devaient prendre leur retraite dans les 10 années suivantes. Seules 22% (46/210) d'entre elles étaient titulaires de diplômes de sage-femme d'un niveau supérieur à leur formation de premier cycle de base. Seulement six (2.9%) IQ fournissant des soins de santé maternelle dans ces hôpitaux de recours suivaient des études pour obtenir leur diplôme de sage-femme au moment de l'étude. CONCLUSION: Cette étude a mis en avant un manque d'infirmières qualifiées disposant également d'une formation/d'un diplôme de sage-femme dans les hôpitaux de recours de la province du Limpopo. Ceci a un impact potentiellement négatif sur la réduction du fort taux de mortalité maternelle dans la province.

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          Job satisfaction of registered nurses in a community hospital in the Limpopo Province in South Africa.

          Nurses are confronted daily with the demands of an increased workload and insufficient facilities in the public healthcare sector in South Africa. The purpose of the study was therefore to determine the degree ofjob satisfaction of registered nurses in a community hospital in the Limpopo Province of South Africa. A quantitative descriptive design was used to meet the objectives of the study. The population was not sampled because of the small size of it. All the registered nurses who had one or more years experience in this hospital were included in the study. A self-administered questionnaire was used to collect data from them regarding the working conditions in the hospital including the emotional and social climate. The questionnaire was based on an instrument developed by Humphries and Turner (1989:303) to determine the degree of job satisfaction of nursing staff in a unit for elderly mentally retarded patients. The findings indicated that the majority of the respondents were dissatisfied about the working conditions and emotional climate in the hospital while they were fairly satisfied with the social climate. The workload and degree of fair remuneration, under the working conditions, were the most highly rated as dissatisfying (83% of the participants) while under the emotional climate they indicated that the pressure under which they worked was highly dissatisfying (82% of the participants). As the results indicated that the social climate was satisfactory; having a best friend at work and the chance to help other people while at work, were rated positively by 88% and 76% of the participants respectively. Recommendations made included that managers have to show the staff that their best interest is their number one concern. Leaders have to be available for the staff and being willing to buffer the stress caused by increased workload and insufficient resources. Greater visibility of supervisory staff should therefore be encouraged.
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            The Changes in Maternal Mortality in 1000 Counties in Mid-Western China by a Government-Initiated Intervention

            Background Since 2000, the Chinese government has implemented an intervention program to reduce maternal mortality and eliminate neonatal tetanus in accordance with the Millennium Development Goals 5. To assess the effectiveness of this intervention program, we analyzed the level, trend and reasons defining the maternal mortality ratio (MMR) in the 1,000 priority counties before and after implementation of the intervention between 1999 and 2007. Methodology/Principal Findings The data was obtained from the National Maternal and Child Health Routine Reporting System. The intervention included providing basic and emergency obstetric equipment and supplies to local medical hospitals, and also included providing professional training to local obstetric doctors, development of obstetric emergency centers and “green channel” express referral networks, reducing or waiving the cost of hospital delivery, and conducting community health education. Based on the initiation time of the intervention and the level of poverty, 1,000 counties, containing a total population of 300 million, were categorized into three groups. MMR significantly decreased by about 50%, with an average reduction rate of 9.24%, 16.06%, and 18.61% per year in the three county groups, respectively. The hospital delivery rate significantly increased. Obstetric hemorrhage was the leading cause of maternal deaths and significantly declined, with an average decrease in the MMR of 11.25%, 18.03%, and 24.90% per year, respectively. The magnitude of the MMR, the average reduction rate of the MMR, and the occurrence of the leading causes of death were closely associated with the percentage of poverty. Conclusions/Significance The intervention program implemented by the Chinese government has significantly reduced the MMR in mid-western China, suggesting that well-targeted interventions could be an efficient strategy to reducing MMR in resource-poor areas. Reduction of the MMR not only depends on conducting proven interventions, but also relies on economic development in rural areas with a high burden of maternal death.
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              Working conditions that contribute to absenteeism among nurses in a provincial hospital in the Limpopo Province.

              Absenteeism results in an increased workload for nurses who stand in for colleagues and can lead to situations in which a lack of motivation among nurses and a lowering of the quality of patient care may occur. The researcher observed that certain conditions, such as inflexible working schedules, were given as reasons for the absenteeism in units in a provincial hospital. A non-experimental, descriptive, quantitative study was undertaken. The purpose of the article was to describe the working conditions that contribute to absenteeism among the professional and sub-professional nurses at a provincial hospital in the Limpopo province of South Africa. The sample included 107 professional nurses and 163 sub-professional nurses who voluntarily agreed to participate in the study. A questionnaire was used to collect data, which was analysed by using descriptive and inferential statistics. The findings of this study indicated that personal and managerial characteristics, and organisational and working conditions may lead to absenteeism in the workplace. This article focuses on the working conditions that are constraints, namely inadequate group cohesion, inadequate delegation of autonomy, role ambiguity, ineffective routinisation and the effect of the workload in the workplace. Recommendations are made for improving working conditions to combat absenteeism among nurses. The limitations of this study are highlighted.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                phcfm
                African Journal of Primary Health Care & Family Medicine
                Afr. j. prim. health care fam. med. (Online)
                AOSIS Publishing (Cape Town )
                2071-2928
                January 2014
                : 6
                : 1
                : 1-4
                Affiliations
                [1 ] University of Limpopo South Africa
                [2 ] University of Limpopo South Africa
                Article
                S2071-29362014000100009
                d2109778-fbdd-469e-a759-14128584701c

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO South Africa

                Self URI (journal page): http://www.scielo.org.za/scielo.php?script=sci_serial&pid=2071-2936&lng=en
                Categories
                Biology
                Health Care Sciences & Services
                Medicine, General & Internal

                General life sciences,Internal medicine,Health & Social care
                General life sciences, Internal medicine, Health & Social care

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