Midwifery staffing: Variation and mismatch in demand and capacity

Yelland, Andrew; Winter, Cathy; Fox, Robert

doi:10.12968/bjom.2013.21.8.579

Cited by 9 publications

(9 citation statements)

References 29 publications

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“…Similarly, Christine et al (2011) assessed the association between nursing staffing and patient outcomes and reported that inappropriate nursing staffing was linked to negative patient outcomes [ 58 ]. Other studies have also documented the effect of staff shortage on adverse events and increased medical costs [ 56 , 59 – 61 ]. Moreover, Sosa et al (2018) proposes the availability of a one midwife to one woman ratio for all women in labour [ 62 ].…”

Section: Discussionmentioning

confidence: 99%

Context specific realities and experiences of nurses and midwives in basic emergency obstetric and newborn care services in two district hospitals in Rwanda: a qualitative study

et al. 2022

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Background In low and middle-income countries, nurses and midwives are the frontline healthcare workers in obstetric care. Insights into experiences of these healthcare workers in managing obstetric emergencies are critical for improving the quality of care. This article presents such insights, from the nurses and midwives working in Rwandan district hospitals, who reflected on their experiences of managing the most common birth-related complications; postpartum hemorrhage (PPH) and newborn asphyxia. Rwanda has made remarkable progress in obstetric care. However, challenges remain in the provision of high-quality basic emergency obstetric and newborn care (BEmONC). This study is a qualitative part of a broader research project about implementation of an mLearning and mHealth decision support tool in BEmONC services in Rwanda. Methods In this exploratory qualitative aspect of the research, four focus group discussions (FGDs) with 26 nurses and midwives from two district hospitals in Rwanda were conducted. Each FGD was made up of two parts. The first part focused on the participants’ reflections on the research results (from the previous study), while the second part explored their experiences of delivering obstetric care services. The research results included: survey results reflecting their knowledge and skills of PPH management and of neonatal resuscitation (NR); and findings from a six-month record review of PPH management and NR outcomes, from the district hospitals under study. Data were analyzed using hybrid thematic analysis. Results The analysis revealed three main themes: (1) reflections to the baseline research results, (2) self-reflection on the current practices, and (3) contextual factors influencing the delivery of BEmONC services. Nurses and midwives felt that the presented findings were a true reflection of the reality and offered diverse explanations for the results. The participants’ narratives of lived experiences of providing BEmONC services are also presented. Conclusion The insights of nurses and midwives regarding the management of birth-related complications revealed multi-faceted factors that influence the quality of their obstetric care. Even though the study was focused on PPH management and NR, the resulting recommendations to improve quality of care could benefit the broader field of maternal and child health, particularly in low and middle-income countries.

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Section: Discussionmentioning

confidence: 99%

Context specific realities and experiences of nurses and midwives in basic emergency obstetric and newborn care services in two district hospitals in Rwanda: a qualitative study

et al. 2022

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“…For midwives, the ever increasing dedication and crisis management can seem to be the only response to rising workloads, whereas staffing deficits may contribute to poor clinical outcomes and may affect midwives’ health, morale and retention. Staffing levels models using birth rate plus have been adopted successfully in other European countries such as the UK, England and others to evaluate staffing needs (Yelland et al 2013:579).…”

Section: Literature Reviewmentioning

confidence: 99%

Perceptions of midwives on shortage and retention of staff at a public hospital in Tshwane District

Matlala

Lumadi

2019

Curationis

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Background: Midwifery is the backbone of women and child healthcare. The shortage of staff in maternity units is a crisis faced by many countries worldwide, including South Africa.Objectives: This study aims to explore the perceptions of midwives on the shortage and retention of staff at a public institution.Method: The study was conducted at one of the tertiary hospitals in Tshwane District, Gauteng Province. A total of 11 midwives were interviewed through face-to-face and focus group interviews. An explorative, descriptive generic qualitative design method was followed, and a non-probability, purposive sampling technique was used. Thematic coding analysis was followed for analysing data.Results: The impact of shortage of midwives was reported to be directly related to poor provision of quality care as a result of increased workload, leading to low morale and burnout. The compromised autonomy of midwives in the high obstetrics dependency units devalues the status of midwives.Conclusion: Midwives are passionate about their job, despite the hurdles related to their day-to-day work environment. They are demoralised by chronic shortage of staff and feel overworked. Staff involvement in decision-making processes is a motivational factor for midwives to stay in the profession. The midwives need to be in the centre of the decision-making processes related to their profession. The revision of the scope of practice and classification of midwifery profession away from general nursing complex by the South African Nursing Council (SANC) could place midwifery in its rightful status.

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“…A study by Dani et al (2020) found that healthy term infants' neonatal outcome is negatively associated with a low midwife-to-infant ratio [53]. Similarly, Christine et al (2011) assessed the association between nursing sta ng and patient outcomes and reported that inappropriate nursing sta ng was linked to negative patient outcomes [54]. Other studies have also documented the effect of staff shortage on adverse events and increased medical costs [52,[55][56][57].…”

Section: Contextual Factors In Uencing the Delivery Of Bemonc Servicesmentioning

confidence: 99%

Context Specific Realities and Experiences of Nurses and Midwives in Basic Emergency Obstetric and Newborn Care Services in Two District Hospitals in Rwanda

Nishimwe

Conco

Nyssen

et al. 2021

Preprint

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Background In low and middle-income countries, nurses and midwives are the frontline healthcare workers in obstetric care. Insights into the experiences of these healthcare workers in managing obstetric care emergencies are critical for improving quality of care. This article presents such insights, from the nurses and midwives working in Rwandan district hospitals, who reflected on their experiences of managing the most common birth-related complications; postpartum hemorrhage (PPH) and newborn asphyxia. This is a qualitative part of a broader research about implementation of an mLearning and mHealth decision support tool (Safe Delivery Application), in basic emergency obstetric and newborn care services in Rwanda. Methods In this exploratory qualitative aspect of the research, the first author facilitated four focus group discussions with 26 nurses and midwives from two district hospitals in Rwanda. Each focus group discussion was made up of two parts. The first part focused on the participants’ reflections on the research results, while the second part explored their experiences of delivering obstetric care services in their respective district hospitals. The research results included: survey results reflecting their knowledge and skills of PPH management and of neonatal resuscitation (NR); and findings from a six-month record review of PPH management and NR outcomes, from the district hospitals under study. Data were analyzed using hybrid thematic analysis. Results Nurses and midwives felt that the presented findings were a true reflection of the reality and offered diverse explanations for the results. The participants’ narratives of lived experiences of providing BEmONC services are presented under two broad themes: (1) self-reflections on their current practices and (2) contextual factors influencing the delivery of BEmONC services. Conclusion The insights of nurses and midwives regarding the management of birth related complications revealed multi-faceted factors that influence the quality of their obstetric care. Even though the study was focused on their management of PPH and NR, the resulting recommendations to improve quality of care could benefit the broader field of maternal and child health particularly in low and middle income countries.

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Midwifery staffing: Variation and mismatch in demand and capacity

Cited by 9 publications

References 29 publications

Context specific realities and experiences of nurses and midwives in basic emergency obstetric and newborn care services in two district hospitals in Rwanda: a qualitative study

Context specific realities and experiences of nurses and midwives in basic emergency obstetric and newborn care services in two district hospitals in Rwanda: a qualitative study

Perceptions of midwives on shortage and retention of staff at a public hospital in Tshwane District

Context Specific Realities and Experiences of Nurses and Midwives in Basic Emergency Obstetric and Newborn Care Services in Two District Hospitals in Rwanda

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