Nolte A
Nurs RSA. 1994 Oct;9(10):9-12.
Part 1, of a two part series on the dilemma of the midwife in South Africa, deals with the practice of the midwife. It is difficult to estimate the number of practicing midwives, as they form part of the general nursing register. Also midwifery is part of the basic nurse training and is not taught as a separate entity. The midwife in South Africa practices in the areas of primary health care, hospitals, clinics, mobile clinics, homes and MOU's. The governments commitment to PHC will likely result in most midwives practicing in this area. Problems are high maternal deaths, shortages and maldistribution of midwives in an urban/rural context and the fragmentation and poor coordination of the health services. The safe motherhood initiative of the WHO has been adopted, there are recommendations that midwifery education be separated from general nurse education, and that clinical skills be strengthened. Midwifery services in South Africa do not fulfill the basic criteria for a PHC service.
关于南非助产士困境的系列文章分为两部分，第一部分论述助产士的执业情况。由于助产士是普通护士注册人员的一部分，因此很难估算执业助产士的数量。此外，助产术是基础护士培训的一部分，并非作为一个独立学科进行教授。南非的助产士在初级卫生保健机构、医院、诊所、流动诊所、家庭及医疗机构联合体中开展工作。政府对初级卫生保健的承诺可能会使大多数助产士在此领域执业。存在的问题包括孕产妇死亡率高、城乡助产士短缺及分布不均，以及卫生服务碎片化和协调不善。世界卫生组织的安全孕产倡议已被采纳，有人建议将助产士教育与普通护士教育分开，并加强临床技能。南非的助产服务不符合初级卫生保健服务的基本标准。
