Midwives' Perspectives on the Adoption of a Digitalized Triage System in South African Maternity Units: Results from a Mixed-Methods Study.

Nursing and midwifery expertise exceeds the realms of clinical and biomedical knowledge. With the healthcare system transforming towards the Fourth Industrial Revolution (4IR), midwives are expected to broaden their knowledge and skills to provide quality care through the use of digital health technologies. However, there is a paucity of studies that look at the perceptions of midwives towards these digital health technologies. Hence, in this case, the authors sought to investigate the perceptions of the midwives towards the adoption of digitalized triage system in their maternity units, prior to designing and implementing the digitalized system. This was undertaken to avoid imposing a huge change upon the midwives which will consequently affect the widespread implementation of the proposed system. A sequential exploratory research design within a pragmatic paradigm underpinned this study to gain a comprehensive understanding of the midwives' perceptions on the adoption of a digitalized triage system in the maternity units. The qualitative phase embraced purposive sampling to select participants, and data saturation was reached at 20th midwife. Meanwhile, the quantitative phase embraced a stratified sampling technique and the sample size was 155. The mixed methodological analysis was conducted using a case-comparison analytical strategy. The study revealed that the midwives perceived that the adoption of a digitalized triage system would improve their skills and enhance positive health outcomes for the patients. However, they were concerned with implementation challenges such as the availability of resources and network connectivity. The findings suggested that midwives in this modern era are accepting of digital health interventions as they perceive them to be useful. However, the digital health intervention was also perceived to possibly be affected by external factors such as digital illiteracy, lack of resources and internet connectivity failures. Therefore, there is a need for the development of guidelines and a conceptual framework dedicated to facilitating the widespread implementation of digital triaging in maternity units in South Africa.