The training of midwives to perform obstetric ultrasound scan in Africa for task shifting and extension of scope of practice: a scoping review.

INTRODUCTION: Ultrasound scan is one of the essential assessments that is crucial in the early identification of health risks during antenatal care. Its accessibility to women in low-and middle-income countries remains a serious challenge because ultrasound scans are not within the scope of practice for midwives. However, task shifting and extension of scope of practice aim to train midwives to assess pregnant women through an ultrasound scan. This paper aims to report the findings of a scoping review on the training of midwives to perform obstetric ultrasound scans in Africa. METHODS: The 6-step iterative framework for scoping reviews by Arksey and O'Malley was used to determine the extent of qualitative and quantitative evidence available on the training of midwives on obstetric ultrasound scans, which includes specifying the research question, identifying relevant studies, selecting studies, extracting and charting data, collating, summarising, and synthesising and reporting findings. RESULTS: A total of 12 articles from eight African countries were included in this scoping review. Three main themes and 13 sub-themes emerged and they are: obstetric ultrasound scan training, challenges experienced by midwives from task shifting and extension of scope of practice regarding obstetric ultrasound scan, and the value of task shifting and extension of scope of practice regarding obstetric ultrasound scan to midwives. DISCUSSION: Despite the available evidence that the training of midwives on obstetric ultrasound scans is essential to ensure the accessibility of quality antenatal health services, the training of midwives on obstetric ultrasound scans in some African countries remains a serious challenge. It is evident from this scoping review results that there is a need for African countries to incorporate obstetric ultrasound scans as part of the scope of practice of midwives. Task shifting necessitates prioritising the training of midwives on the use of obstetric ultrasound scans as one of the steps towards the achievement of the United Nations Sustainable Development Goal number 3 targets by 2030.

Improvement of the psychosocial support for frontline nurses in public hospitals during COVID-19 pandemic.

AIM: The aim of this study was to explore and describe the psychosocial support for frontline nurses during the COVID-19 pandemic in the Tshwane district, Gauteng Province, South Africa. BACKGROUND: The COVID-19 pandemic has brought a lot of psychosocial distress for frontline nurses taking care of COVID-19 patients. The frontline nurses were scared of being infected with COVID-19, or exposing their families and loved ones to the risk of infection. A high number of nurses were infected with COVID-19, and some died due to the virus. EVALUATION: This study followed a qualitative, explorative, and descriptive research design. Data were collected using semi-structured interviews and individual interviews were conducted. Seventeen participants, who consisted of all categories of nurses taking care of COVID-19 patients, were interviewed until data saturation was reached. Non-probability sampling method was used as a technique to select the participants. Data were analysed using Tesch's method of open coding. KEY ISSUES: The following five themes are identified: (1) acknowledgement, appreciation, and recognition of frontline nurses, (2) conducive managerial practices, (3) debriefing and training of frontline nurses, (4) human resources support, and (5) psychological and social support for frontline nurses and their families. CONCLUSION: The implementation of the psychosocial support for frontline nurses taking care of COVID-19 patients is critical in improving patient care. IMPLICATIONS FOR NURSING MANAGEMENT: The findings of this study should alert nurse managers to plan the best way to support frontline nurses caring for COVID-19 patients.

Challenges Related to the Structure of the Choice on Termination of Pregnancy Services in Public Health Facilities in the Tshwane District of Gauteng.

In 1997 South Africa legalised termination of pregnancy services for all women living within the country. It is now more than a decade since Choice on Termination of Pregnancy (CTOP) services have been implemented however, the state of the infrastructure of CTOP services in public health facilities is a cause for concern. The assessment of the quality of CTOP services in public health facilities has been seriously neglected. The objectives of the study were to assess, determine and evaluate the challenges related to the quality of the infrastructure of CTOP services in public health facilities. A quantitative, non- experimental cross-sectional survey design was used. The population comprised of facility/quality managers, registered professional nurses and midwives. A universal sampling method was used. Data was collected from healthcare professionals who were involved in procuring CTOP services. The public health facilities were assessed in terms of space adequacy, provision of privacy, availability of ablution facilities, rest room as well as human and material resources using the Donabedian model. It was found that insufficient provision was made to the infrastructure of public health facilities to accommodate the high demand for CTOP services. Structural challenges remain a barrier in meeting the objectives of the CTOP services. There is evidence of significant differences between the facility/quality managers versus the professional nurses regarding their response to space provided for rendering CTOP services. The study recommends the revitalisation of the structure of CTOP services to improve the quality rendered.