M.Cur. / The standard of care in midwifery services improves all the time. Because of this reason mothers are experiencing more of midwifery services and also of antenatal preparation services. This can be seen in the increasing demand for active birth, plychoprophlaxis and preparation for delivery. The higher the standard of antenatal preparation, the more positive the influence on the birthing process. Because of the isolation of the nuclear family from the traditional family and its recourcee, more pressure is put on professional people and other recources for formal antenatal preparation programs. Standards are therefore essential for effective antenatal preparation to ensure optimal care.

D.Cur. / Health care professionals, in all settings, have become increasingly aware of the consumers' legitimate right to participate in decision-making regarding care to be received. Health professionals have also being criticised for planning and delivering care that does not take into consideration the client's perceived needs, wishes and expectations of such care. This study is undertaken primarily to explore and describe the expectations of both the care-givers (midwives, student-midwives and doctors) and the health care consumers (mothers and fathers). The focus of the study is the care to be provided to mothers by midwives during labour. It is the aim of the researcher to ameliorate lapses in the provision of comprehensive health care. The study design is exploratory, descriptive, qualitative and contextual in nature. The main purpose of this study is to formulate guidelines for implementation by the midwife during labour. In order to accomplish this purpose, the research study followed six (6) distinct phases in which different objectives were addressed. In Phase 1, the expectations of mothers and partners/fathers concerning the care to be provided by the midwives during labour were explored. These were described after conducting in-depth qualitative interviews with both the mothers and partners/fathers. In Phase 2, focus group discussions were conducted with the midwives and studentmidwives, to explore and describe their expectations concerning the care to be provided by the midwives during labour. In Phase 3, narratives were gathered from selected doctors, in which they explored and described their expectations concerning the care to be provided to the mothers by midwives during labour. The results of the interviews, focus group discussions and narratives were subsequently analysed based on categories of "Theory for Health Promotion in Nursing (Department of Nursing Science, RAU, 1998)". The results were also contextualised. A concept analysis was conducted in Phase 4 in order to identify the characteristics of the concept "Caring" using different situations where caring takes place, from literature sources (uses of the concept) as well as the two main themes which emerged from the research results. Thereafter, the identified characteristics of Caring were placed in comparison with the research results obtained from Phase 1, 2 and 3 and were reduced under the following headings: Prerequisites, Process and Consequences. From this process the concept "Caring" was defined. In Phase 5 of the study, a conceptual framework was developed out of all the characteristics determined from the concept analysis and was discussed in three phases namely, the initial, integration and termination. In the final phase, that is Phase 6, the guidelines for operationalising caring during labour were formulated from all the characteristics determined from the concept analysis and the following headings were maintained that is, Prerequisites, Process and Consequences. These guidelines were evaluated and refined by the midwives and student-midwives from the specific hospital where data was collected. The conclusions and trustworthiness of this study were discussed. Recommendations were made in terms of highlighting the possibilities of application of the guidelines for operationalising caring during labour in nursing education, nursing practise and nursing research.

D.Cur. / The overall objective of this study was to describe the model and criteria for woman-centered care that will serve as a theoretical framework for implementing the Batho-Pele Principles in order to facilitate mutual participation between mothers and attending midwives during childbirth at one hospital of the Capricorn district in the Limpopo Province. The phases followed in this study were as follows: Phase 1: Concept Identification The concept identification was achieved through the use of a qualitative research approach which was exploratory, descriptive, contextual and inductive. A sample of 24 mothers and 12 attending midwives participated in the study. Different data collection methods were utilized. Data obtained from unstructured in-depth interviews were analyzed according to the protocol by Tesch (1990; cited in Cresswell, 1994:155). Data analysis from participant observation using semistructured observation and VAS were performed quantitatively by using frequency distribution. The results of interviews indicated experiences that foster/promote dependency in midwifery care. Woman-centered care was identified as a core category and as a central approach that would enhance mutual participation during childbirth. To ensure valid results, a model of trustworthiness as proposed by Lincoln and Guba (1985: 301-318) was utilized. Phase 2: Concept Analysis Following the concept identification, the concept analysis of a core category ‘woman-centered care’ was conducted using the framework as described by Walker and Avant (1995). Phase 3: Development of the Model and Criteria This phase dealt with the description of the structure and process of the model. Strategies were proposed, described and recommended to implement the model where there is interaction of a mother (patient) and a midwife (nurse). Evaluation of the model was done by having dialogue with experts and by utilizing Chinn and Kramer’s (1995:134-135) guidelines for evaluating theory. The criteria for womancentered care were formulated. A unique contribution of this study is the concept analysis of woman-centered care, the development and description of the womancentered childbirth model and the formulation of criteria for woman-centered care.

Globally, nearly 40% of under-five deaths occur in the first 28 days after birth. Neonatal mortality is concentrated in sub-Saharan Africa and South Asia with an estimated 80% of all neonatal deaths occurring in the two regions. Low quality of care has been associated with poor health outcomes in low-and middle-income countries (LMICs). Low quality of intrapartum care has been shown to be strongly associated with poor newborn outcomes. Improving access to high-quality neonatal care for small and sick newborns is crucial to reducing preventable deaths in the immediate newborn period. Over the last two decades, significant advances have been made in measuring the coverage, quality and equity of maternal health services. However, few studies to-date have explored the quality of care for small and sick newborns in resource-constrained settings. Those studies conducted in low-and middle-income settings demonstrate that in-patient service readiness for small and sick newborns is low. While there have been increasing efforts to develop and standardize metrics for measuring facility readiness for this population, few studies to-date have explored the effective coverage – a term used to denote utilization adjusted for quality – of services for emergency newborn care in such settings. Recommendations for intervention packages for small and sick newborns have largely focused on secondary and tertiary levels of care, leaving the role of community and peripheral facilities under-explored. Central to the agenda of improving the coverage of high-quality services for small and sick newborns is also strengthening the capacity of health workforce that participate in their care. A plethora of training packages and supervision strategies have been tried and tested in LMICs for improving emergency obstetric care with the focus on emergency newborn limited to a few complications. These human resources initiatives have been criticized for being fragmented in implementation. Little is known about the quality of training and supervision for emergency newborn care competencies for the rural health workforce in under-resourced settings. This dissertation is presented in three papers to help evaluate specific components of quality and coverage for the small and sick newborn population in LMICs. Paper one identifies and describes the breadth of strategies used to successfully translate evidence-based community interventions for the management of newborns with possible serious bacterial infections (PSBI), enabling the generation of a common and consistent taxonomy for practitioners and researchers in this domain. Paper two uses quantitative methods to examine the service readiness and effective coverage of services for small and sick newborns at the sub-district and district levels in rural Ghana. Paper three, using a mixed-methods design, assesses health worker perceptions of the quality and gaps in training, supervision and tele-mentoring activities for emergency obstetric and newborn care in rural Ghana.

No description available.

This study is a qualitative, cross-cultural research on advice giving for mothers in maternity and child health services in Scotland and Finland. It has been accomplished through local case studies using ethnographic methods. The main objective is to analyse how in these service systems motherhood, women's daily life, and their responsibilities for children's welfare and health are defined and organised, and how these definitions vary across social and cultural contexts. Methodologically, referring to the feminist methodology by Dorothy E. Smith, it is emphasised that beginning from the local and particular, from the everyday practices of health professionals, can provide more general understanding of the social relations that organise motherhood in the two societies. Empirical results of the study are presented under six substantial themes: The first theme discusses different professional groups as service providers and the relationships between them. Second theme concentrates on the clinic and the home as the physical settings of service provision and their professional and cultural meanings. Third section discusses the relationship and interaction between health professionals and their clients. Next two themes are related to the standards of motherhood: expectations for proper motherhood, child care, and family relations of the mothers. The last theme analyses possible conflicts between women's everyday experience and professional expertise in motherhood. The general conclusions drawn from the research suggest that motherhood is socially organised at four different but interrelated levels, named in this study as interactional level, institutional level, welfare state level, and socio-cultural leveL. Advice giving for mothers in maternity and child health care is related to family policy measures, social class and gender systems, historical and cultural tradition, customs, and ways of thinking in a certain society. This complexity underlines the relevance of qualitative approach in comparative research.

Thesis (M.P.H.)--University of Michigan, 1946.

Thesis (M.S.P.H.)--University of Michigan, 1940.

Thesis (Ph. D.)--West Virginia University, 2008. / Title from document title page. Document formatted into pages; contains viii, 132 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 77-84).

Thesis equivalent (M.P.H.)--University of Michigan, 1947.