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

Thanyani G Lumadi,Mosehle S Matlala

doi:10.4102/curationis.v42i1.1952

Abstract

BackgroundMidwifery 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.ObjectivesThis study aims to explore the perceptions of midwives on the shortage and retention of staff at a public institution.MethodThe 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.ResultsThe 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.ConclusionMidwives 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.

Highlights

Midwives are important members of the healthcare team who contribute in ensuring that quality maternity services are rendered to patients
According to the Pretoria News newspaper (Hospital Maternity Staff Quit in Numbers 2016:1), it was reported that the selected public hospital in Tshwane District had an alarming turnover of midwives
The midwifery staffing of the units appears to be subminimum as there is evidence of consistent reliance on the agency staff to cover daily shifts

Summary

Introduction

Midwives are important members of the healthcare team who contribute in ensuring that quality maternity services are rendered to patients. The hospital serves as a referral institution providing the highest level of care for high-risk conditions. Besides other disciplines of healthcare services provided in this hospital, the focus of this research study was mainly on maternity healthcare services with midwives taking a central focus. The maternity services provided are high-risk antenatal, high-risk labour, postnatal and neonatal care. Neonatal care was excluded as the main research question was on the maternity staff. The institution is a teaching hospital with doctors who have specialised in obstetrics and gynaecology, trainee doctors, midwifery students and other health disciplines. The shortage of staff in maternity units is a crisis faced by many countries worldwide, including South Africa

Objectives

Discussion

Conclusion