The purpose of this study was to conduct evaluation research on the implementation of the Baby and Mother Friendly Initiative in Namibia in order to identify its successes and failures, as well as to develop guidelines for the strengthening of the programme. An evaluation research design using a sequential mixed-methods approach to collect qualitative and quantitative data was conducted. In phase 1, qualitative data were collected through face-to-face interviews. Participants were the chief health programme officer for nutrition at national level and nurse managers in charge of the baby and mother friendly hospitals. In phase 2, quantitative data were collected from 391 registered and enrolled nurses/midwives working in the baby and mother friendly hospitals through a self-administered questionnaire. Both phases 1 and 2 indicated partial implementation of the Baby and Mother Friendly Initiative programme. Factors influencing the implementation positively or negatively were identified. The integrated findings formed the basis of guidelines to strengthen the programme. Nine guidelines were developed and validated. / Health Studies / D.Litt. et Phil. (Health Studies)

The development ofNursing and Nursing Education in Venda is intimately related to the work of the early missionaries, Western education and medical developments. The growth of nursing and health services had a reciprocal relationship. One was not possible without the other, viz the history of missionary education, hospitals, health services, sociocultural and political development. Each stage ofthese developments was an important step in laying the foundation of modem professional nursing and nursing education. Before contact with Western medicine, health and midwifery services were provided by traditional healers, nurses and midwives. Divination was used to: diagnose disease, identify the witch, determine medicines to cure the disease. Western nursing developed through stages of: lay nursing, hospital certificated, auxiliary nurses and midwives, registered nurses and midwives, comprehensive general nurse and midwife. The history of Nursing and Nursing Education is thus part and parcel of the social developments of the country it serves. / Health Studies / M.A. (Nursing Science)

1 ABSTRACT The issue of births outside a medical facility is currently a controversial topic between specialists as well as in the public sector. While the specialists concur in refusing home births, the society is divided. There are voices that refuse home births but there are also plenty of people who support the right of mothers to give birth outside of a medical facility. Very sensitive topic is the legal and ethical aspects of the protection of unborn children and the issue of a safely conducted delivery. In the last decades, the life value of an unborn child has been seen as an ethical problem. The right to life is one of the fundamental human rights, which is enshrined in the constitutional system of the Czech Republic and also in the international human rights conventions. Because there are different opinions regarding this issue, it is necessary to establish a view that is widely accepted so that legal standards can be approved provided that the opinions of minorities are being respected. The main objective of this presented dissertation was to ascertain why are people losing confidence in a doctor's role during delivery and what is the reason for some of the mothers being unsatisfied with current institutional system of obstetrics. On the basis of these factual findings, which emerged during the...

The scourge of HIV and AIDS can no longer be underestimated. Its devastating effects have been translated into immeasurable monetary and human costs. Women and children, particularly among the rural communities, have borne most of the brunt accruing from the devastating socio-economic consequences of the disease. PURPOSE This study is intended to highlight the plight of rural communities who are constantly besieged by the demand and supply disequilibrium in the provision of primary health care and preventive interventions. OBJECTIVES To describe, compare and analyse HIV / AIDS health care services provided by fixed and mobile clinics in the Madibeng Sub-District of the North West Province. POPULATION The sampled participants were selected from a universal population among pregnant women. SAMPLING A sample of 100 pregnant women from the fixed and mobile clinics participated in answering the questionnaires during their antenatal care visits. RESEARCH SETTING The Madibeng Sub-District in the North West Province been selected as a suitable research site, as it met most of the selection criteria developed by the researcher's judgement sampling. RESEARCH DESIGN The data recorded on the questionnaires by the participants was used to compare and analyse the pregnant women's feelings about HIV / AIDS services of fixed and mobile clinics. Group discussions were also held prior self completion of questionnaires. Questionnaires were administered by the researcher and the two health promoters. FINDINGS It was found that participants in both mobile and fixed clinic have attended HIV / AIDS health care services. Fixed clinic and mobile clinic are respectively viewed as offering better health care services to pregnant women. CONCLUSIONS The research results from this study indicate that HIV / AIDS services provided at both the fixed clinic and mobile service points, including antenatal or prenatal care, are almost similar. RECOMMENDATIONS It is recommended for improving HIV / AIDS health care services that health care providers at Jericho mobile clinic and Jericho fixed clinic intervene by slowing the progression of HIV infection because it has a negative impact on the lives of women. The Jericho clinic and mobile clinic staff should be encouraged to adopt the perspective that HIV / AIDS is not a death sentence, but a preventable disease, not withstanding its deadly consequences on families and communities. The staff at these clinics is also to be motivated to adopt co-operative health care and psycho-social strategies, in which team work and the involvement and participation of all relevant stakeholders is viewed as an integral part of the struggle against HIV / AIDS and its devastating spread. / Health Studies / M.A. (Health Studies)

The purpose of the study was to describe the knowledge, attitudes and practices of nurse-midwives related to obstetric care at Thaba-Tseka, Lesotho. A quantitative, descriptive, cross-sectional research design was used. Data were collected using structured questionnaire from 45 nurse-midwives. The findings revealed that nurse-midwives had mean knowledge score of 10.5(80.7%) out of a possible 13(Standard Deviation (SD) 1.31) on obstetric care issues. However, the majority of nurse-midwives (n=28, 62.2%) did not have knowledge on the steps of the active management of third stage of labour according to the WHO. The mean scores on practice were 34.5(86.2%) against a possible 40(SD 5.43) for antenatal care, 39.2(89%) against a possible of 44(SD 4.66) and 22.4(93.3%) against a possible of 24(SD 2.18) for postnatal care. The study revealed that nurse-midwives had positive attitudes towards obstetric care practices with mean score for attitudes was 23.4(86.7%) against a possible score of 27(SD 3.02) / Health Studies / M.A. (Public Health)

The purpose of the study was to explore and describe the experiences of male community service officers during midwifery clinical training. A qualitative, explorative, descriptive and contextual design was used in order to achieve the study objectives. Data was collected by means of semi-structured interviews. Data analysis elucidated analogous themes and categories which translated into the overall experiences of the participants. The study found that whilst the experience was described as beneficial, there were overwhelming challenges in providing intimate care to female clients, dealing with ethno-cultural aspects, meeting clinical practice requirements and the right to choose to be part of midwifery clinical training. Recommendations to nurse educators, clinical midwives and midwifery clinical supervisors with regard to better support for male nurses during midwifery clinical training emanated from the study findings / Health Studies / M.A. (Health Studies)

Studier har visat att hud-mot-hud har flera positiva effekter för modern och det nyfödda barnet. Trots detta upplever barnmorskor hinder för kontinuerlig hud-mot-hud under föräldraparens BB-vistelse.  Syftet med arbetet var att beskriva barnmorskors tankar kring hinder och möjligheter för kontinuerlig hud-mot-hud på barnbördshus (BB). Forskning finns om hud-mot-hud men inga specifika studier om barnmorskors tankar kring vilka hinder och möjligheter som finns för kontinuerlig hud-mot-hud under BB-vistelsen.  En intervjustudie utfördes och materialet bearbetades med kvalitativ innehållsanalys för att lyfta fram de viktigaste aspekterna. Resultatet som framkom belyser barnmorskors tankar om hinder och möjligheter vid implementering av kontinuerlig hud-mot-hud under barnets första dygn på BB. Resultatet av studien visade att barnmorskorna största hinder var brist på riktlinjer, förekomsten av barnsängar, bristande föräldrainformation, platsbrist, samt föräldrarnas kulturella bakgrund och personalens attityder. De möjligheter som lyftes fram var enkelrum, bärhjälpmedel såsom tubtopp eller bärsjal, samt att utbilda föräldrarna under graviditeten. Vårdhandlingen införlivas lättast om de blivande föräldrar deltar i förberedande föräldrakurser under graviditeten, samt att personalen är välutbildade och uppmuntrar till hud-mot-hud. / Studies have shown that skin-to-skin care has several positive effects for both the mother and the newborn. Despite this, midwifes experience that it can be difficult to get parents to implement the skin-to-skin care continuously during its stay the maternity ward.  The aim of the thesis is to describe midwives’ thoughts on the obstacles and opportunities for continuous skin-to-skin care at the maternity ward. There are studies on skin-to-skin care but no specific studies regarding midwives’ thoughts on the obstacles and opportunities for continuous skin-to-skin care during maternity stay. An interview study was conducted, and the material was processed using qualitative content analysis to highlight the main points. The result highlighted midwives’ thoughts on the obstacles and opportunities in the implementation of continuous skin-to-skin contact during the child's first days in the maternity ward. The results of the study showed that midwives biggest obstacles are the hospital baby beds, as well as lack of guidelines, parental information, private rooms, and the parents' cultural background and the staff attitudes. The opportunities that arouse were private rooms, aids such as tube tops or slings, and prenatal parental training during pregnancy. Skin-to-skin care can most easily be implemented when parents participate in preparatory parenting training, and when the staff is well trained and encourage implementing skin-to-skin care.

Bakgrund: Ungdomars sexuella och reproduktiva hälsa och rättigheter (SRHR) är ett viktigt folkhälsoarbete och barnmorskan har en central roll när det kommer till att nå ungdomarna med kunskap och information. Det förefaller finnas få studier om barnmorskors uppfattningar om vad ungdomar behöver veta mer om när det kommer till deras sexuella och reproduktiva hälsa och rättigheter. Syfte: Syftet med denna studie var att beskriva barnmorskors uppfattningar om vad ungdomar behöver veta mer om inom området sexuell och reproduktiv hälsa och rättigheter. Metod: Kvalitativ intervjustudie med åtta semistrukturerade intervjuer med barnmorskor. Datamaterial analyserades med en kvalitativ innehållsanalys med induktiv ansats. Resultat: Barnmorskorna uppfattade att ungdomarna hade behov av att veta mer om kroppsutveckling. Även mer om sexuellt överförbara infektioner (STI) och preventivmedel samt att killarna behövde veta mer om deras reproduktiva ansvar. Ungdomarna behövde också veta mer om sexuella relationer och rättigheter, innefattande bland annat lagar och homosexualitet. Barnmorskorna ser idag en ökning av sexuella problem bland ungdomarna och barnmorskorna hade en gemensam uppfattning om att det beror på pornografikonsumtion. Slutsats: Barnmorskor har insikt i vad ungdomar behöver veta mer om inom SRHR. Det finns fortfarande brister i undervisning och utbildning till ungdomar inom SRHR och det är angeläget att fokusera och investera i arbeten för att stärka och främja ungdomars SRHR. Klinisk tillämpbarhet: Denna studie lyfter barnmorskors uppfattningar om vad ungdomar behöver veta mer om inom ämnet SRHR. Studien kan användas i klinisk verksamhet till förbättringsarbeten för olika yrkeskategorier som arbetar med ungdomar gällande SRHR. / Background: The sexual and reproductive health and rights (SRHR) of young people is an important public health work and the midwife has a central role in reaching the young people with knowledge and information. There seem to be few studies on midwives' perceptions about what young people need to know more about when it comes to their sexual and reproductive health and rights. Purpose: The purpose of this study was to describe the views of midwives about what young people need to know more about in the area of sexual and reproductive health and rights. Method: Qualitative interview study with eight semi-structured interviews with midwives. The data material was analyzed with a qualitative content analysis with inductive approach. Result: The midwives perceived that the young people needed to know more about body development. In addition, more about sexually transmitted infections (STIs) and contraceptives and that the young men needed to know more about their reproductive responsibilities. The youth also needed to know more about sexual relations and rights, including, among other things, laws and homosexuality. The midwives today see an increase in sexual problems among young people and the midwives had a common view that this is due to pornography consumption. Conclusion: Midwives have insight into what young people need to know more about in SRHR. There are still shortcomings in education for young people within SRHR, and it is important to focus and invest in work to strengthen and promote young people's SRHR. Clinical application: This study highlights the views of midwives on what young people need to know more about in the subject of SRHR. The study can be used in clinical activities for improvement work for various occupational categories that work with young people regarding SRHR.

Summaries in English, Afrikaans and Tswana / The purpose of this study was to explore and develop understanding of nurses and midwives’ perceptions and attitudes towards the implementation of CPD, aiming to provide them with a platform to make recommendations to enhance the attendance of CPD.The study was conducted in a public regional hospital in Limpopo Province, South Africa. The purposive exploratory descriptive qualitative research method was used. Data was collected through Focus Group Discussions. Participants comprised of three focus group discussions. A semi-structured guide with open –ended questions was used and discussions were recorded with an audio recorder which were transcribed verbatim. Content analysis of the data was done. The study yielded themes, sub-themes and codes during analysis. Participants perceived CPD to have benefits to keep nurses updated with knowledge, skills and improvement of attitudes. It improves quality patient care. However, they identified staff shortage, time constraints and lack of internet connection as the major challenges. / Die doel van hierdie studie was om ‘n begrip van die houdings en persepsies teenoor die implementering van voortgesette professionele ontwikkeling (VPO) van verpleegkundiges en vroedvroue te verken, ten einde ‘n platform vir aanbevelings daar te stel om die bywoning van VPO te bevorder. Die studie was in 'n openbare streekshospitaal in die provinsie Limpopo, Suid-Afrika gedoen. ‘n Kwalitatiewe, doelgerigte, verkennende en beskrywende navorsingsmetode was gebruik om data is deur middel van drie fokusgroepbesprekings in te samel. ‘n Semi-gestruktureerde onderhoudegids met oop vrae was gebruik om klankopnames van gesprekke, verbatim te transkribeer. Data was ontleed deur middel van inhoudsanalise. Temas, subtemas en kodes is tydens die analise geïdentifiseer. Die deelnemers het VPO as voordelig beskou in terme van die opdatering van verpleegkundiges se kennis, vaardighede en houdings. Gehalte pasiëntsorg word sodoende verbeter. Hulle het egter personeeltekort, 'n gebrek aan tyd, en toegang tot die internet as ‘n struikelblok geïdentifiseer. / Maikaelelo a dipatlisiso tse (research), e ne e le go sekaseka le go tlhabolola kutlwisiso ya baoki le babelegisi ka ga tebo le maikutlo a bona mabapi le tshimololo ya go thlabolola dithuto bale tirong “CPD”. Maikaelelo e ne e le go ba neela tšhono ya go dira ditshwaelo go oketsa dipalo tse di tsenang dithuto tsa CPD. Dipatlisiso tse di diretswe kwa dipetleleng tsa kgaolo tsa botlhe, Porofenseng ya Limpopo mo Aforikaborwa. Go dirisitswe mokgwa wa dipatlisiso wa ‘purposive exploratory descriptive qualitative research’ mo di patlisisong tse. Dikitso di kgobokantswe go ya ka mokgwa wa lekgotla ‘Focus Group Discussion’. Batsayakarolo ba ne ba arogantswe ka ditlhopha tse tharo tsa ‘focus group discussions’. Kaedi e e rulagantsweng e e nang le dipotso tsa boitlhalosi- ka- botlalo e dirisitswe mme dipuisano tsa gatiswa ka rekhoto ya kgatiso-modumo morago tsa kwalwa fatshe ka mokgwa o di builweng. Tshekatsheko ya diteng tsa dikitso tse e dirilwe ka go latela mokgwa wa ‘content analysis’. Dipatlisiso tse dineetse molaetsa mogolo, melaetsanyana le melao ka nako ya ditshekatsheko. Batsayakarolo ba bone gothlabolola dithuto bale tirong ‘CPD’ go nale mosola mo tsweletsong ya go neela baoki kitso, bokgoni le tokafatso ya maitshwaro. E tokafaditse boleng ba tlhokomelo ya balwetse. Le fa go ntse jalo, ba supile fa tlhaelo ya baoki, dinako tsa go dira le go tlhoka kgokelelo ya enthanete e le dikgwetlho tse kgolo. / Health Studies / M.A. (Nursing Science)

<p>Men’s violence against women is a universal issue affecting health, human rights and gender-equality. In pregnancy, violence is a risk for both the mother and her unborn child.</p><p>The overall aims were: to determine the prevalence of such violence in a Swedish pregnant population, to investigate pregnant women’s attitudes to questioning about exposure to violence, and to evaluate experience gained by antenatal care midwives having routinely questioned pregnant women regarding violence.</p><p>All women registered for antenatal care in Uppsala, Sweden, during 6 months were assessed regarding acts of violence. The Abuse Assessment Screen (AAS) was used twice during pregnancy and again after delivery when the women were asked an open-ended written question regarding attitudes to questioning about violence. Midwives’ experiences regarding routine assessment were evaluated in focus group discussions.</p><p>The AAS questions were answered by 93% (1,038) of those eligible. Physical abuse by a partner or relative during or shortly after pregnancy was reported by 1.3%, and by 2.8% when the year preceding pregnancy was included. Lifetime sexual abuse was reported by 8.1%. Repeated questioning increased the abuse detection rate. Abused women reported more previous ill-health, and women physically abused during pregnancy more pregnancy terminations than did non-abused women. Abuse assessment was found entirely acceptable by 80%, both acceptable and unacceptable/disagreeable by 5% and solely unacceptable/ disagreeable by 3%, while 12% were neural. Abused and non-abused women did not differ regarding disinclination to answer the abuse questions. According to the midwives the delicacy of the subject and the male partners’ presence were the most prominent remaining obstacles to routine determination of violence. </p><p>Routines are required to make questioning about violence an integral part of antenatal care. This would necessitate a private appointment for the woman, knowledge among care providers about the nature of men’s violence, and awareness of referral options.</p>