Introduction: Maternal and child care is one of the priority health issues that have been identified as requiring urgent attention in South Africa. Despite various efforts, South Africa has not seen improvements in maternal and perinatal outcomes. It is therefore essential that services and practices in hospitals rendering maternity care be reviewed and audited, so that current services can be improved and new services developed if necessary. In Schweizer-Reneke Hospital the clinical outcomes and clinical practices at the maternity unit have never been clearly described. The aim of the study was to describe the clinical outcomes and the associated clinical practices in the maternity unit of the hospital from 1 January 2009 to 31 December 2009. Methodology: The study setting was the maternity unit of Schweizer-Reneke District Hospital, a level 1 district hospital in a rural district of the North West Province. It comprised of a retrospective review of data from the District Health Information System and of the delivery records, specifically the partogram from 1 January 2009 to 31 December 2009. The study also examined records of Perinatal Problem Identification Programme and Mortality and Morbidity Review meetings. The study population included all the patients who delivered at the maternity unit during the study period. The measurement tools for data collection were data capture sheets on excel spreadsheets. The source of the data was the maternity register, maternity case records, Perinatal Problem Identification Programme records, District Health Information System and Unit Administration files (for records of meetings). The researcher personally captured the data. Results: Out of 699 deliveries conducted at the hospital 80.1% were normal deliveries, 16.3% caesarean sections and 3.6% vacuum-assisted deliveries. The record review revealed errors in the number of caesarean sections and vacuum-assisted deliveries on the DHIS. The perinatal mortality rate was calculated to be 56 per 1000 live births during the study period. Again the record review identified more perinatal deaths (41) than what was reported on the DHIS. No maternal deaths were recorded during the study period. A total of 295 records were analysed for completeness of the partogram. Out of the 295 partograms analysed none of them had data completed according to standard. The analysis of the completion of the partogram show that there is a significant association between recording of certain aspects of the partogram (risk factors, parity, age, fetal heart, contractions, cervical dilatation, problems and management plan) and mode of delivery whereas with other aspects there is no significant association. The aspects of the partogram that were completed according to standard by the perinatal outcome were poorly recorded, ranging from 0% to 54%. The association between mode of delivery and perinatal outcome was found to be statistically significant (p value 0.000). All of the fresh stillbirths and 90% of macerated stillbirths were born by normal vertex delivery. For the period under study one MMR meeting was conducted. Conclusion: The study found that there were poor clinical practices and outcomes in the maternity unit of Schweizer-Reneke Hospital. There are signs of poor information management as indicated by the discrepancies between data on hospital records and the DHIS. The reasons for this could not be established. Perinatal Problem Identification Problem and Mortality and Morbidity Review meetings were not conducted regularly and therefore could not be used to improve clinical practices and outcomes. Recommendations: Major steps need to be taken to improve clinical governance within the maternity unit of Schweizer-Reneke Hospital. Strategies to recruit and retain Professional Nurses need to be developed. The high percentage of macerated stillbirths needs to be investigated at district level and antenatal care needs to be improved. Studies focusing on the direct effect of inadequate recording on mortality and morbidity and the causes or reasons for inadequate completion of the partogram are necessary.

Thesis (doctoral)--Universität Münster, 1933.

Thesis (doctoral)--Universität Münster, 1933.

Thesis (M.P.H.)--University of Hong Kong, 2008. / Includes bibliographical references (p. 38-41).

Thesis (Ph. D.)--University of Texas at Austin, 1998. / Vita. Includes bibliographical references (leaves 137-147). Available also in a digital version from Dissertation Abstracts.

Thesis (M.P.A.)--University of Hong Kong, 2001. / Includes bibliographical references. Also available in print.

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No description available.

Therapeutic intervention should take humans‟ daily routines into account or it is unlikely to be assimilated into everyday practice. This is particularly true for the mothers of young children. The purpose of this study was to examine the effect of a prone postural control programme, by inserting infant stimulation activities in to the activities of daily living of mothers. 30 mother-infant dyads were randomly assigned at eight weeks postpartum, to an intervention or usual care group. Following a four month period in which the intervention group followed a prone activity programme developed by the researcher, the infants were reassessed. The Peabody Developmental Motor Scales (2nd Ed) were used to evaluate the programme‟s efficacy and the results demonstrate a significant difference (p≤0.00) in the total motor development between the two groups post intervention. Thus a „prone playing‟ programme given to mitigate developmental delay associated with supine sleeping, was successful when embedded into the mother‟s daily routine.

A research project submitted to the School of Public Health in partial fulfilment of the requirement for the Degree of Master of Public Health, in the field of Social and Behaviour Change Communication. Date: June 2017 / Globally, access to maternal and child healthcare remains a fundamental human right for all, regardless of an individual’s migration status (1). People migrate for a variety of reasons, and this mobility brings forth implications for health provision, health care experiences and human rights, both for the migrants and their host population (2, 3). An increasing number of cross-border or international migrant women globally report difficulties in access to and use of healthcare services, including maternal and child health (4, 5). Little evidence in South Africa on these issues proposes that there is a need for deeper knowledge in this regard. South Africa is a signatory to a range of international commitments that place emphasis on the non-discriminatory provision of health services and a progressive health policy assuring health for all, including free access to antenatal care (ANC) (1). Despite this, South Africa’s maternal and child health outcomes continue to be poor - including that of migrants (6, 7). The increased number of migrants from neighbouring countries is perceived to have placed a burden on the South African healthcare system (4). The aim of this study was to explore the experiences and perceptions of Zimbabwean cross-border migrant mothers in accessing routine antenatal care, obstetric care and infant/child immunisation in public healthcare facilities in, Gauteng, South Africa (2015-2016). Through a qualitative study design, the researcher gathered data by means of 13 face-to-face interviews with a purposive and snowball sample of participants. Few participants gave positive reports on the quality of ANC and immunization services they had received. It is therefore important to ensure that this positive care is maintained across all public health facilities in order to instill confidence among health recipients. However, most of the study participants experienced barriers in accessing quality routine ANC and infant immunisation in the country’s public health facilities. These challenges include language barriers, discrimination and poor nurse-patient relationships. Based on these findings and conclusions, the researcher recommends that the South African National Department of Health addresses some of the challenges affecting cross-border migrant vi women in accessing maternal health care in public facilities nationally through the formulation, implementation and follow-up of policies. Furthermore, health care providers need to be continuously educated and motivated to respect the rights of all patients, regardless of an individual’s migration status, in order to instil positive attitudes and quality care. There is also a need to conduct further research in other provinces of the country, preferably with cross-border migrant women from other countries, and draw comparisons with South African women in order to take appropriate steps to address the challenges. / MT2017