Professional nurses supporting learners during professional socialisation in Limpopo province.

Background: Professional nurses play a significant role in the professional socialisation of learner nurses during clinical placement. Clinical placements are areas of experiential learning as learner nurses come in contact with real-life experiences. Professional nurses are custodians of learners and need to offer them support. Aim: The study sought to explore the role of professional nurses in supporting learner nurses during professional socialisation. Setting: Four clinical health facilities in Limpopo province at different levels of care were purposely sampled to obtain information from different levels of care. Methods: An ethnonursing approach and qualitative, explorative design was used. Non-probability purposive sampling was used to select 25 professional nurses. The criteria were professional nurses with 3 years of experience in professional socialisation and working in institutions accredited for clinical placement of learner nurses registered in the undergraduate programme. Data were collected through a face-to-face interview until data saturation was reached. Tesch's open coding system was used to analyse data. Results: Professional nurses acknowledged that their responsibilities in supporting learners during professional socialisation are mentoring, teaching and being competent practitioners. Professional nurses were aware of their role in transferring ethical skills and knowledge to learners through professional socialisation. Conclusion: The effectiveness of professional socialisation of learner nurses depends on the support offered during clinical placements. Contribution: The study adds to the body of knowledge in nursing education and practice because when learners are offered support in the clinical areas, their learning journey will be of positive experience leading to competent practitioners.

Concept analysis: Community-based postnatal care.

BACKGROUND:  Community-based postnatal care is a valuable resource in the provision of maternal and neonatal care, specifically outside the hospital environment. However, its application in maternal and neonatal care is not clearly documented in relation to the rendering of services by primary caregivers. OBJECTIVES:  This study clarifies the concept of 'community-based postnatal care' by using the concept analysis method. METHOD:  To analyse the concept, relevant literatures were reviewed and analysed using the Walker and Avant method, namely, selecting a concept, determining the purpose of analysis, identifying all uses of the concept, defining attributes, identifying a model case, identifying borderline, related and contrary cases, identifying antecedents and consequences and identifying the empirical referents. Characteristics that repeatedly appeared throughout the literature were noted and categorised. RESULTS:  It was established from the concept analysis that 'community-based postnatal care' was complex and experienced ethnically. The analysis included that primary caregiver participation was based on home-levelled-skilled care, community participation and mobilisation, linkages of health services and community stakeholders. The attributes were influenced by antecedents and consequences. CONCLUSION:  The empirical referents of community based can be integrated within the midwifery guidelines to measure the concept. When concepts are understood, self-care on early detection, early management and referral during early postnatal care will be enhanced.Contribution: The results of this study will foster independence, confidence and a respectful relationship between primary caregivers and the health care facility staff. The results are expected to guide future research and enhance community-based postnatal care in midwifery practice.

Support needs of parents with preterm infants at resource-limited neonatal units in Limpopo province: A qualitative study.

BACKGROUND:  Preterm birth is often unexpected and life-threatening for the baby and/or the mother. When admitted to the hospital, midwives need to provide informational, instrumental, psycho-cultural and emotional support to enhance post-discharge care. OBJECTIVES:  This study aimed to explore and describe the support provided to parents of preterm infants in preparing for post-discharge care. The study was conducted in three district hospitals in the Mopani district, South Africa. METHOD:  A qualitative approach wherein explorative, descriptive and contextual designs were used. A non-probability, convenience sampling was used to select 23 midwives who were working in the maternity unit for at least 2 years. Data were collected through in-depth individual semi-structured interviews until data saturation was reached. The data were analysed through Tesch's open coding method. Trustworthiness was ensured through credibility, transferability and confirmability. Ethical principles adhered to were: informed consent, beneficence, right to self-determination, confidentiality and anonymity. RESULTS:  The findings revealed that parents need informational, instrumental direct supervision, and psycho-cultural and emotional support during preparation for discharge. CONCLUSION:  Parents were unsure of their ability to care for the preterm infants after discharge and manage their own needs. The provision of informational, instrumental, psycho-cultural and emotional support needs would play a vital role in their ability to cope with their parental roles and the relationship with their infant.Contribution: The support provided to parents could build parental confidence and act as an integral part of neonatal follow-up programmes.

Diagnosis of Epilepsy by Traditional Healers and Its Implications on Management in the Selected Rural Communities of Limpopo and Mpumalanga Provinces: A Qualitative Study.

Introduction: Epilepsy is a neurological disorder which causes seizures and may be accompanied by loss of unconsciousness and control of bowel or bladder function. However, other types of epilepsy are only characterised by rapid blinking or a few seconds of staring into space. Many people living with epilepsy in rural communities consult traditional healers as their first line of treatment for epilepsy. Second preference is given to medical practitioners which causes unnecessary delay in the early diagnosis and treatment of epilepsy. This study aimed to explore how traditional healers diagnose epilepsy and its implications on management in the selected rural communities of Limpopo and Mpumalanga Provinces. Methods: A qualitative approach using explorative, descriptive and contextual designs was adopted. Purposive sampling was used to sample six villages in Limpopo and Mpumalanga Provinces. Snowball sampling was used to sample twenty traditional healers. Data were collected through in-depth individual interviews at the participant's homes. Data were analysed using Tesch's eight steps of open coding data analysis. Results: This study found that traditional healers have varied beliefs and misconceptions regarding the causes and diagnosis of epilepsy, hence this greatly influencing the management. The misconceptions on the causes include a calling by ancestors, urine contents, snake in the stomach, contaminated digestive system and witchcraft. The management included using herbal plants, insects, foam excreted during seizures and urine of the person living with epilepsy. Recommendation: It is recommended that for effective management of epilepsy, there should be coordination between traditional healing and western medicine. Future research should look at the integration of traditional medicine and western medicine.

Midwives' Voices on Early Initiation of Antenatal Care Following a Positive Gravindex Test: A Qualitative Study.

Background: Early Antenatal Care (ANC) initiation is aimed at improving maternal and perinatal health outcomes through the identification of complications and determining the level of care needed. This study aimed to determine the voices of midwives on the provision of early initiation of ANC following positive gravindex. Materials and Methods: The phenomenology approach underpinned the study. The participants included midwives providing ANC at health facilities under Tshino-Mutsha local area in May-December 2020. Nonprobability, purposive sampling was used to select four clinics and to sample 20 midwives. Semistructured face-to-face, in-depth interviews were conducted using an interview guide. Data saturation was reached at Participant 15; however, the researcher continued until Participant 20. Trustworthiness was ensured and ethical principles were adhered to. Data analysis was done using Tesch's open coding approach. Results: Two themes and seven subthemes emerged, as challenges related to the provision of midwifery practice and to pregnant women. The seven subthemes were the shortage of resources, poor support of midwives, poor adherence to the available protocol for the provision of ANC, blaming of midwives by management and community, late ANC booking by pregnant women, denial of pregnancy by young women ignorance leading to a general resistance to ANC instructions, hence late booking. Conclusions: It was concluded that shortage of human and material resources hindered the initiation of early ANC to detect, prevent, and manage the existing and potential causes of maternal and newborn mortality and morbidity.

Management of epilepsy through indigenous traditional and Western approaches in Africa: A systematic review.

Background: Reaction to epilepsy management has been described as moulded by traditional beliefs, despite the reported progress of anti-epilepsy medication. In Africa, traditional healers are seen as essential in providing epilepsy care, yet little is known about their epilepsy care. Aim: This manuscript aimed to systematically review and summarise the various indigenous traditional and Western methods of epilepsy management and their effectiveness in Africa. Setting: This study is conducted in Africa. Methods: A systematic review was performed, searching MEDLINE (through PubMed), Google Scholar and ScienceDirect data from 2000 to December 2021. The search strategies used terms and medical subject headings 'traditional methods' AND 'epilepsy' AND 'management' AND 'Africa'. The bibliography of the included articles was manually searched. Critical Appraisal Skills Programme and systematic reviews of randomised controlled trials tool were used to identify the validity of studies. Results: The search generated 17 927 articles. After screening for titles and abstracts, duplicate entries were removed and full texts of 22 articles were reviewed. After reading full texts, 12 articles met the inclusion criteria. The themes identified from synthesised data were indigenous traditional and Western methods of epilepsy management. Conclusion: Traditional and faith-based healers were perceived to provide frontline care for people living with epilepsy resulting in considerable delays in seeking anti-epilepsy medication initiation. Furthermore, taking anti-epilepsy treatment was not adequately adhered to. Contribution: Findings would contribute to the body of essential information to create awareness and upskill the community that epilepsy is like any medical condition that needs medical care.

Developing and prioritising strategies to improve the implementation of maternal healthcare guidelines in South Africa: The nominal group technique.

BACKGROUND:  In South Africa, maternal healthcare guidelines are distributed to primary health care (PHC) facility for midwives to refer and implement during maternal healthcare services. Different training was offered for the use of maternal care guidelines. However, poor adherence and poor implementation of guidelines were discovered. AIM:  This study aimed to develop and prioritise strategies to improve the implementation of maternal healthcare guidelines at PHC facilities of Limpopo province, South Africa. METHOD:  Strengths, weaknesses, opportunities and threats analysis and its matrix together with the nominal group technique were used to develop the current strategy. Midwives, maternal, assistant and operational managers from PHC facilities of the two selected district of the Limpopo province were selected. Criterion-based purposive sampling was used to select participants. Data collection and analysis involved the four steps used in the nominal group technique. RESULTS:  Strategies related to strengths and weaknesses such as human resources, maternal health services and knowledge deficit were identified. Opportunities and threats such as availability of guidelines, community involvement and quality assurance as factors that influenced the provision of maternal healthcare services were identified. CONCLUSION:  Researchers formulated actions that could build on identified strengths, overcome weaknesses such as human resources, explore opportunities and mitigate the threats such as quality assurance. Implementation of the developed strategies might lead to the reduction of the maternal mortality rate.

Health literacy of mothers on factors associated to pre-rupture of membranes on perinatal outcomes in Vhembe district, South Africa.

Pre-rupture of membranes prior labour initiation could complicate approximately 5% of pregnancies and could be associated with a high incidence of perinatal morbidity and mortality complications. The major complications could be chorioamnionitis and cord compression resulting in hypoxia. This study aimed to assess the health literacy of mothers on perinatal outcomes following pre-rupture of membranes at Thulamela B clinics of Vhembe district. A quantitative research approach with a cross-sectional descriptive design was used. The study population comprised a total of 210 lactating mothers within 6 weeks following delivery, irrespective of the mode of delivery were purposively selected. Data were collected by the researchers through self-administered questionnaires. The Statistical Package for Social Sciences (SPSS) version 25 was used for data analysis. The results are presented in the form of tables and graphs based on probability allowing judgment to be made on variables. Validity and reliability were ensured. Ethical clearance was obtained from the University of Venda Research Ethics Committee and permission to access health facilities from the Limpopo Province Department of Health. Findings revealed that limited and inadequate health literacy towards pre-rupture of membranes contributes to perinatal morbidity and mortality, with associated factors like poor antenatal care attendance, delayed health seeking, defaulting, and loss of follow-up. Recommendations to emphasise the provision of preconception and antenatal care where health information on risks and danger signs of PROM to perinatal outcomes are given were made.

Exploring supportive relationship provided to newly qualified midwives during transition period in Limpopo province, South Africa.

Transition from midwifery training to professional practice is enhanced by positive support from experienced colleagues. The study explored experiences of newly qualified midwives regarding existence of supportive relationship during transition. The setting was a maternity unit of a selected hospital from each of the five districts of Limpopo province. Population was all midwives who completed a comprehensive nursing programme (R425 of 19 February 1985, as amended); and qualified as nurses (general, psychiatric and community) and midwives working in selected hospitals. Twenty-five participants selected from maternity units of the five selected hospitals using non-probability, purposive sampling method. In-depth individual interviews conducted until saturation was reached. Data analysed through Tesch's method. Ethical issues considered. Findings revealed negative unsupportive relationship experienced by participants resulting in poor performance. Graduates expressed dislike experienced from senior colleagues. Establishment and maintenance of positive relationship between experienced and newly qualified midwives should be enhanced to promote effective transition.

Managers' support on implementation of maternal guidelines, Limpopo province, South Africa.

BACKGROUND: The report of Saving Mothers indicated a decline of maternal mortality from 12.8% to 12.5% last triennium of 2017. This shows that regardless of availability of national maternal health guidelines, midwives and managers, 25% of maternal deaths were caused by preventable and avoidable factors. As such, support provided by managers is vital in promoting the utilisation of maternal guidelines. OBJECTIVES: The objective was to determine the support offered by managers to midwives during the implementation of maternal health guidelines. METHOD: The study design was cross-sectional descriptive in a quantitative domain. Simple random sampling was used to select 58 operational managers and two maternal managers. Data were collected using self-administered questionnaires and analysed using Statistical Package for Social Sciences version 23. Descriptive statistics provided by Microsoft Excel in the form of charts was used to describe data. Pearson's correlation test was used to describe relationships amongst variables. RESULTS: The results revealed that 83.3% respondents indicated a shortage of staff to attend pregnant women. Fifty-six per cent of managers indicated that shortage of material resources contributed to substandard implementation of maternal guidelines. Supervision and monitoring of implementation of maternal guidelines was difficult as indicated by 53.3%, and 63.3% indicated lack of supervision. CONCLUSION: Limited support in terms of monitoring and supervision by managers was strongly indicated as having a negative effect on implementation of maternal guidelines. Capacity building was offered; however, shortage of resources led to poor implementation of maternal guidelines by midwives.

Provision of Care to Preterm Infants at Resource Limited Health Facilities of Mopani District, South Africa.

Background: Inadequate neonatal facilities in rural areas is one of the challenges affecting the management of preterm infants. In low income countries with limited resources, over 90% of preterm babies die within few days of life. Purpose: The purpose of this study was to describe the challenges encountered by midwives when providing care to preterm infants at resource limited health facilities in Limpopo Province, South Africa. Methods: Qualitative research approach, using exploratory and descriptive design was used. Non-probability purposive sampling was used to select twenty three midwives who had an experience of two or more years in maternity. Data was collected using unstructured individual interviews, which were voice recorded and transcribed and data analysed qualitatively through the open-coding method. Findings: Revealed one theme, preterm condition and expected care; with sub-themes namely; perceived causes of preterm complications and deaths, preterm babies experience several difficulties which need specialised care, the need for constant individualised care and monitoring of preterm infants by midwives, functional relevant equipment needed for care of preterm infants, a need for constant training for midwives regarding care of preterm infants, and importance for a proper structure to house preterm infants which will lead to quality care provision. Conclusion: Preterm babies need simple essential care such as warmth, feeding support, safe oxygen use and prevention of infection. Lack of adequate resources and limited skills from midwives could contribute to morbidity and mortality. Health facility managers need to create opportunities for basic and advanced preterm care to equip the skills of midwives by sending them to special trainings such as Limpopo Initiative Neonatal Care (LINC), Helping Baby Breath (HHB) and Neonatal Intensive Care Unit (NICU). Operational managers should be involved in the identification, procurement and supply of required equipment. Continuous health education should be provided on the mothers about kangaroo mother care (KMC) and measures to prevent infections in the neonatal unit.

Can Women's Lives be saved from Hypertensive Disorders during Pregnancy? Experiences of South African Midwives.

A qualitative, descriptive phenomenological research design was conducted to explore and describe the experiences of midwives on the management of women diagnosed with hypertensive disorders during pregnancy in rural areas of Limpopo Province, South Africa. Non-probability sampling was used to select eighteen (18) midwives from primary health care facilities of Mopani and Vhembe districts in Limpopo Province. Data was collected through in-depth interview and analysed using eight steps of Tesch's open coding method. Ethical considerations were adhered to by ensuring confidentiality, anonymity, privacy and signing of informed consent by participants. Measures to ensure trustworthiness; credibility, transferability, dependability and lastly, confirmability were ensured. Findings of this study revealed three themes (with sub-themes) namely; management of pregnant women diagnosed with hypertensive disorders, support experienced when managing complications, challenges experienced by midwives when managing hypertensive disorders during pregnancy. In conclusion, poor support came up very strongly as a factor influencing good management of hypertensive disorders in pregnancy. Recruitment of more midwives that will support each other during management of pregnant women with hypertensive disorders is recommended.

Managing hypertensive disorders during pregnancy in low resource settings.

Background: Maternal deaths caused by hypertensive disorders are preventable. The purpose was to assess midwives' perceived knowledge and skills on the implementation of maternal health guidelines when managing hypertensive disorders during pregnancy. Methods: Quantitative, cross-sectional method was used. Population comprised of 200 midwives. Data was collected through self-report questionnaires and analysed through Statistical Package for Social Sciences 24. Results: Midwives (63.5%) possessed knowledge and skills of implementing maternal guidelines. While 77.5% experienced shortage of human and material resources. Non-compliance to ambulance services led to delayed initiation of treatment. Recommendations: Continuous in-service training and education must be conducted. More resources to be provided to implement guidelines accurately.

Experiences of auxiliary nursing trainees of poverty alleviation programme regarding nursing and nursing profession in Vhembe District, Limpopo Province.

BACKGROUND:  The Limpopo Department of Health and Social Development introduced a system to train children from poor families as auxiliary nurses as a poverty alleviation strategy in 2003. The programme targeted the needy families, those who depended on social grants, orphaned or child-headed families. The programme has been implemented for more than 10 years and the experiences of trainees were never explored. OBJECTIVES:  The purpose of this study was to explore the experiences of auxiliary nurse trainees of the poverty alleviation programme regarding nursing and the nursing profession. METHODS:  A qualitative approach was used. Purposive sampling was used to sample 15 auxiliary nurses who were trained under poverty alleviation programme in four of the seven hospitals of Vhembe District. Data were collected through in-depth individual interviews. One central question 'As a beneficiary of poverty alleviation programme, could you describe your experiences of training as a nurse and of the nursing profession in this hospital'. Data were collected until no new information emerged. Note taking and a voice recording was performed to capture all the information reported by the participants. Open coding method was used to analyse data. RESULTS:  Two themes emerged, namely experiences of being a nurse and about nursing as a profession, and interpersonal relationships between auxiliary nurses and the ward staff. CONCLUSIONS:  The Department of Health in Limpopo Province was commended and to be encouraged to develop other programmes as poverty alleviation strategy for other government departments, so that the affected children can have a wider career choice. The managers and supervisors in the wards to have moral and legal obligations to support initiatives that foster effective mentoring of neophyte nurses in the nursing profession.

Perceptions of Postpartum Mothers towards the Care Provided by Male Student Midwives at Labour Units in Limpopo Province, South Africa.

Student midwives should always provide cultural sensitive care and respect the rights of every woman when choosing health care providers during pregnancy and childbirth. The aim of this study was to describe and explore the perceptions of postpartum mothers towards the care provided by male student midwives during their midwifery practice. A qualitative explorative, descriptive, and contextual research design was used. A non-probability, convenience sampling method was used to sample 42 postpartum mothers who received care from male student midwives at the five district hospitals in Limpopo province, South Africa. Data was collected through in-depth individual interviews until data saturation was reached by repeating data. Open coding approach was used to analyse data. All ethical principles were adhered to. Results revealed that postpartum mothers, preferred care by male students' midwives; they were viewed to be respectful, sympathetic, and caring; however, they discussed their fears of midwifery practice with mothers. It is recommended that midwives should play a pivotal role in informing pregnant women during antenatal visits that male student midwives can conduct deliveries. The community awareness campaign should be strengthened that male student midwives are availability in maternity units.

Support provided by midwives to women during labour in a public hospital, Limpopo Province, South Africa: a participant observation study.

BACKGROUND: Physical presence during labour offer women opportunity of having positive childbirth experiences as well as childbirth outcomes. The study aimed to determine what support provided by midwives during intrapartum care at a public hospital in Limpopo Province. The study was conducted at a tertiary hospital in Limpopo Province. METHODS: A participant observation approach was used to achieve the objectives of the study. The population comprised of all women who were admitted with labour and for delivery and midwives who were providing midwifery care in the obstetric unit of a tertiary public hospital in Limpopo Province. Non-probability, purposive and convenience sampling were used to sample 24 women and 12 midwives. Data were collected through participant observations which included unstructured conversations with the use of observational guide, field notes of all events and conversations that occurred when women interact with midwives were recorded verbatim and a Visual Analog Scale to complement the observations. Data were analysed qualitatively but were presented in the tables and bar graphs. RESULTS: Five themes emerged as support provided by midwives during labour, namely; communication between women and midwives, informational support, emotional support activities, interpretation of the experienced labour pain and supportive care activities during labour. CONCLUSION: The communication between woman and midwife was occurring as part of midwifery care and very limited for empowering. The information sharing focused on the assistive actions rather than on the activities that would promote mothers' participation. The emotional support activities indicated lack of respect and disregard cultural preferences and this contributed to inability to exercise choices in decision-making. The study recommended the implementation of Batho Pele principles in order to provide woman-centred care during labour.

Expected clinical competence from midwifery graduates during community service placement in Limpopo province, South Africa.

BACKGROUND: Community service nurses are placed in a hospital within the first year after qualifying to obtain clinical experience under the supervision of experienced professional nurses. When placed in clinical environments, new midwifery graduates are expected to be job ready, demonstrate competence in the provision of evidence-based care, practise independently and assume accountability and responsibility for their own actions. AIM: The study aimed at exploring the expectations of experienced midwives of clinical competence of newly graduated midwives during transition. SETTING: The study was conducted at the training hospitals of the five districts in Limpopo province. METHOD: The researcher used a qualitative approach which is explorative and descriptive in nature. The population comprised all the professional midwives with experience of 5 years and above working at the selected hospitals in Vhembe, Mopani, Capricorn, Waterberg and Sekhukhune districts of Limpopo province, South Africa. From each selected hospital, five experienced midwives were selected using non-probability, purposive sampling method. An in-depth individual face-to-face interview was used to collect data from the participants, until saturation was reached. The open-coding, Tesch's eight-step process was used to analyse data. RESULTS: Results revealed that newly graduated midwives failed to meet the perceived expectations by experienced midwives; this was reflected in sub-themes: limited sense of independence, limited participation in task sharing and commitment and competence versus incompetence to patient care. CONCLUSION: The experienced midwives expected newly graduated midwives to function as professionals; unfortunately, they expressed disappointment as graduates did not meet their expectations. Newly graduated midwives lacked sense of independence, commitment to patient care and did not display ability in task sharing.

Effects of increased nurses' workload on quality documentation of patient information at selected Primary Health Care facilities in Vhembe District, Limpopo Province.

BACKGROUND: Recording of information on multiple documents increases professional nurses' responsibilities and workload during working hours. There are multiple registers and books at Primary Health Care (PHC) facilities in which a patient's information is to be recorded for different services during a visit to a health professional. Antenatal patients coming for the first visit must be recorded in the following documents: tick register; Prevention of Mother-ToChild Transmission (PMTCT) register; consent form for HIV and AIDS testing; HIV Counselling and Testing (HCT) register (if tested positive for HIV and AIDS then this must be recorded in the Antiretroviral Therapy (ART) wellness register); ART file with an accompanying single file, completion of which is time-consuming; tuberculosis (TB) suspects register; blood specimen register; maternity case record book and Basic Antenatal Care (BANC) checklist. Nurses forget to record information in some documents which leads to the omission of important data. Omitting information might lead to mismanagement of patients. Some of the documents have incomplete and inaccurate information. As PHC facilities in Vhembe District render twenty four hour services through a call system, the same nurses are expected to resume duty at 07:00 the following morning. They are expected to work effectively and when tired a nurse may record illegible information which may cause problems when the document is retrieved by the next person for continuity of care. OBJECTIVES: The objective of this study was to investigate and describe the effects of increased nurses' workload on quality documentation of patient information at PHC facilities in Vhembe District, Limpopo Province. METHODS: The study was conducted in Vhembe District, Limpopo Province, where the effects of increased nurses' workload on quality documentation of information is currently experienced. The research design was explorative, descriptive and contextual in nature. The population consisted of all nurses who work at PHC facilities in Vhembe District. Purposive sampling was used to select nurses and three professional nurses were sampled from each PHC facility. An in-depth face-to-face interview was used to collect data using an interview guide. RESULTS: PHC facilities encountered several effects due to increased nurses' workload where incomplete patient information is documented. Unavailability of patient information was observed, whilst some documented information was found to be illegible, inaccurate and incomplete. CONCLUSION: Documentation of information at PHC facilities is an evidence of effective communication amongst professional nurses. There should always be active follow-up and mentoring of the nurses' documentation to ensure that information is accurately and fully documented in their respective facilities. Nurses find it difficult to cope with the increased workload associated with documenting patient information on the multiple records that are utilized at PHC facilities, leading to incomplete information. The number of nurses at facilities should be increased to reduce the increased workload.

Woman-centred care in childbirth: A concept analysis (Part 1).

'Woman-centred care' in childbirth is a process in which a woman makes choices and is involved in and has control over her care and relationship with her midwife. The aim of this paper is to study the concept of woman-centred care through analysis in the context of childbirth. The attributes, antecedents and consequences of this concept are identified, and a model case, a borderline case and a contrary case constructed to achieve conceptual clarity. A concept analysis was undertaken as described by Walker and Avant (2011), with an extensive exploration of domain-specific literature and evidence from various disciplines.  It was established from the concept analysis that 'woman-centred care' was complex and experienced individualistically. The analysis indicated that mothers' participation is supposed to be based on a more collaborative relationship and partnership. Participation is exhibited by open communication and the mother's involvement in decision-making, consultation and collaboration with the attending midwife, further characterised by mutual respect and the midwife listening to the mother's views. There is also an exchange of complete and unbiased information, recognition and honouring of cultural diversity and making of informed choices. Through an inductive discovery approach and drawing on inferences, attributes were clustered in an attempt to identify the apparent essence of the concept.From the results of the concept analysis described in this study, the researchers recommend the formulation of criteria that could facilitate implementation and evaluation of woman-centred care and its empirical referents in the context of the Batho Pele principles (Part 2). 

Criteria to facilitate the implementation of woman-centred care in childbirth units of Limpopo Province, South Africa (Part 2).

BACKGROUND: Facilitation of mutual participation, respectful and egalitarian relationship between the mother and the midwife during childbirth is a critical aspect. This article delineated the criteria that would facilitate the implementation of woman-centred care in childbirth units of the Limpopo Province in South Africa, following a concept analysis described in Part 1. Empirical referents or indicators were used to measure the concept woman-centred care and to validate its existence in reality. These empirical referents were referred to as measurable properties that further verified the concept. OBJECTIVE: The objective of this article was to formulate criteria that would facilitate implementation of woman-centred care in childbirth units of Limpopo Province in South Africa. METHOD: Criteria to facilitate the implementation of woman-centred care were formulated by the gathering of information about the topic under review and the use of resources to define the key elements of the criteria which were integrated into the Batho Pele principles. The criteria were then validated by selecting with a vested interest in the successful development and implementation of the criteria. RESULTS: Criteria were formulated to facilitate the implementation of woman-centred care that was integrated within the framework of Batho Pele principles. CONCLUSION: These formulated criteria for woman-centred care will be used as an institutional self-evaluation tool to enhance implementation of the Batho Pele principles in childbirth units. These criteria will give direction and provide guidelines for the performance of midwifery staff and will also help supervisors to guide staff to improve performance.