Abstract
Background:Inadequate neonatal facilities in rural areas is one of the challenges affecting the management of preterm infants. In low income countries with limited resources, over 90% of preterm babies die within few days of life.Purpose:The purpose of this study was to describe the challenges encountered by midwives when providing care to preterm infants at resource limited health facilities in Limpopo Province, South Africa.Methods:Qualitative research approach, using exploratory and descriptive design was used. Non-probability purposive sampling was used to select twenty three midwives who had an experience of two or more years in maternity. Data was collected using unstructured individual interviews, which were voice recorded and transcribed and data analysed qualitatively through the open-coding method.Findings:Revealed one theme, preterm condition and expected care; with sub-themes namely; perceived causes of preterm complications and deaths, preterm babies experience several difficulties which need specialised care, the need for constant individualised care and monitoring of preterm infants by midwives, functional relevant equipment needed for care of preterm infants, a need for constant training for midwives regarding care of preterm infants, and importance for a proper structure to house preterm infants which will lead to quality care provision.Conclusion:Preterm babies need simple essential care such as warmth, feeding support, safe oxygen use and prevention of infection. Lack of adequate resources and limited skills from midwives could contribute to morbidity and mortality. Health facility managers need to create opportunities for basic and advanced preterm care to equip the skills of midwives by sending them to special trainings such as Limpopo Initiative Neonatal Care (LINC), Helping Baby Breath (HHB) and Neonatal Intensive Care Unit (NICU). Operational managers should be involved in the identification, procurement and supply of required equipment. Continuous health education should be provided on the mothers about kangaroo mother care (KMC) and measures to prevent infections in the neonatal unit.
Highlights
The Perinatal Problem Identification Programme (PPIP) produced reports which highlighted the preventable deaths in South Africa
According to a study conducted in Limpopo Province in 2003 by UNICEF to ascertain the status and availability of new-born care services and infrastructure, it was found that none of the health facilities had level 2 new-born care units, few nursing staff were trained in new-born care and many health facilities had inadequate equipment to provide standard quality of care to new-borns [7]
The findings of the study revealed that midwives who are working at resource limited health facilities were encountering challenges when providing care to preterm babies. This was due to staff shortage and lack of necessary and appropriate equipments when caring for preterm babies, Due to inadequate equipments, the standard of care was compromised
Summary
The Perinatal Problem Identification Programme (PPIP) produced reports which highlighted the preventable deaths in South Africa. According to a study conducted in Limpopo Province in 2003 by UNICEF to ascertain the status and availability of new-born care services and infrastructure, it was found that none of the health facilities had level 2 new-born care units, few nursing staff were trained in new-born care and many health facilities had inadequate equipment to provide standard quality of care to new-borns [7] These factors lead to midwives’ challenges as reflected in the Saving Babies 2012–2013 report [8]. Purpose: The purpose of this study was to describe the challenges encountered by midwives when providing care to preterm infants at resource limited health facilities in Limpopo Province, South Africa. Continuous health education should be provided on the mothers about kangaroo mother care (KMC) and measures to prevent infections in the neonatal unit
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