Okeke Ngozichika, Ngunyulu Roinah
Department of Nursing, University of Johannesburg, Johannesburg, South Africa.
Prim Health Care Res Dev. 2025 Feb 28;26:e16. doi: 10.1017/S1463423625000015.
The implementation of South Africa's maternal care guidelines is still subpar, especially during the postnatal periods, despite midwives playing a key part in postnatal care for women and their newborns. This article aimed to pinpoint the obstacles to and enablers of midwives' roles in putting South Africa's maternal care recommendations for postnatal health into practice.
A scoping review was conducted following Arksey and O'Malley method. Systematic searches were conducted using the PsycINFO, Nursing and Allied Health (CINAHL), PubMed, EBSCOhost web, and Google Scholar. The screening was guided by the inclusion and exclusion criteria. Data were analyzed using the Braun and Clarke method for thematic content analysis and included 22 articles. The quality of included studies was determined by Mixed Method Appraisal Tool and these were reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analysis for Scoping Review.
There is a gap between inadequate postnatal care services provision and suboptimal implementation of maternal recommendations. Owing to a lack of basic knowledge about the guidelines, an absence of midwives in the maternity units, inadequate facilities and resources, a lack of drive and support, inadequate training of midwives in critical competencies, and poor information sharing and communication. Maintaining qualified midwives in the maternity units and providing them with training to increase their capacity, knowledge, and competencies on the guidelines' critical information for managing postnatal complications and providing high-quality care to women and their babies is necessary to effectively implement the recommendations.
The relative success in implementing maternal care guidelines in South Africa lies in the contextual consideration of these factors for the development of intersectoral healthcare packages, strengthening health system collaborations, and stakeholder partnerships to ameliorate maternal and newborn morbidity and mortality.
尽管助产士在产妇及其新生儿的产后护理中发挥着关键作用，但南非产妇护理指南的实施情况仍然不尽人意，尤其是在产后阶段。本文旨在找出助产士在将南非产后健康产妇护理建议付诸实践过程中的障碍和推动因素。
按照阿克西和奥马利方法进行了一项范围综述。使用PsycINFO、护理与联合健康（CINAHL）、PubMed、EBSCOhost网络和谷歌学术进行系统检索。筛选以纳入和排除标准为指导。使用布劳恩和克拉克方法进行主题内容分析对数据进行分析，共纳入22篇文章。纳入研究的质量由混合方法评估工具确定，并根据系统评价和范围综述的系统评价与元分析优先报告项目进行报告。
产后护理服务提供不足与产妇建议的实施不理想之间存在差距。原因包括对指南缺乏基本知识、产科病房助产士短缺、设施和资源不足、缺乏动力和支持、助产士在关键能力方面的培训不足，以及信息共享和沟通不畅。为有效实施这些建议，有必要在产科病房留住合格的助产士，并为他们提供培训，以提高他们在管理产后并发症和为产妇及其婴儿提供高质量护理方面的能力、知识和技能。
南非在实施产妇护理指南方面取得的相对成功在于在制定跨部门医疗保健套餐、加强卫生系统合作以及利益相关者伙伴关系时对这些因素进行背景考虑，以改善孕产妇和新生儿的发病率和死亡率。
