Elucidating challenges and solutions in the maternal healthcare, identified by medical doctors in northern South Africa: a qualitative study

Abstract

Introduction as South Africa's maternal mortality ratio increased between 1990 and 2015, the country failed to reach the United Nations millennium development goal 5a. The maternal mortality ratio of Limpopo province is higher than the national average and previous studies report shortages of manpower and medical equipment in Limpopo province. The overall study aim was to elucidate views and experiences of medical doctors regarding maternal healthcare by identifying the challenges they experience and solutions they suggest. Methods a qualitative interview-based study was performed with ten medical doctors as participants. Manifest content analysis was used to analyze the data. Results the main findings were categorized as lack of material and human resources, feelings of experienced isolation and solution-focused expressions. The challenges identified included logistical issues, staffing issues, demographic characteristics of the patient population, poor interinstitutional communication and lack of support from the administration. The solutions included revision of resource allocation and improvement of the interinstitutional cooperation. For example, participants suggested that exchange programs between hospitals could be arranged, that the emergency medical service personnel could triage patients and that private practitioners could be contracted to work at public institutions. Conclusion most identified challenges were related to a lack of resources. Based on their inside experience, the participants suggested several solutions. These firsthand accounts of the local medical doctors highlight the need for intervention and should be taken into account when it comes to improving the provincial healthcare and working toward achieving the healthcare-related sustainable development goals by 2030.

Dimensions of patient-centred care from the perspective of patients and healthcare workers in hospital settings in sub-Saharan Africa: A qualitative evidence synthesis

“…Poor interprofessional cooperation and continuity of care were reported by healthcare providers in seven of the included studies [ 31 – 33 , 38 , 41 , 42 , 53 ]. In particular, the lack of proper handover of clinical duties (as stated above) and responsibilities between and among interprofessional teams was considered a predictor of quality of care.…”

“…In addition, healthcare workers based in the peripheral hospitals faced challenges providing quality care to patients as it was difficult getting second opinions from doctors (who rarely responded to phone calls) based in more resourced urban referral hospitals [ 42 ].…”

“…Studies reported inadequate and inconsistent staffing as a cause for long waiting times, lack of supervision and hence increased numbers of adverse events in patients [ 42 , 43 , 45 , 53 ]. High patient volumes and low staffing levels meant that the staff were often overworked and burned out [ 22 ].…”

“…Adequate infrastructure. Infrastructure was referred to as a critical dimension of PCC [20,21,23,26,34,38,40,42,[45][46][47][50][51][52]. In multiple studies, participants longed for a consistent supply of medications, reliable equipment, water and electricity and a generally hygienic environment befitting of a hospital [21,40,[53][54][55]].…”

“…Studies reported inadequate and inconsistent staffing as a cause for long waiting times, lack of supervision and hence increased numbers of adverse events in patients [42,43,45,53]. High…”