RESUMEN
Background: Historically and to date, women still give birth at home with the support of elderly, experienced women who live within their communities. In Lesotho, traditional birth attendants (TBAs) are sometimes the only option for pregnant women living far from facilities. Women are vulnerable during the third stage of labour; therefore, correct management is crucial to limit undesirable outcomes. Postpartum haemorrhage and postpartum sepsis remain the leading direct causes of maternal mortality. Aim: This study aimed to explore and describe how Basotho TBAs manage the third stage of labour. Setting: The study was conducted in Lesotho, at Bolahla and Sejakhosi. These villages have the highest number of women giving birth at home. Methods: An explorative and descriptive design with a qualitative approach was used. Semistructured interview guide was utilised to conduct individual in-depth interviews about how the TBAs manage the third stage of labour and their support needs concerning this phase. The TBAs were purposively sampled. The data were analysed thematically. Results: Four themes emerged: challenges TBA experience in the management of the third stage of labour, management of the placenta by Basotho traditional birth attendants, support during the management of the placenta by Basotho traditional birth attendants, and management during emergencies. Conclusion: This study demonstrated that if TBAs are supported, they can contribute to the health of the mother and baby. Contribution: This study's findings can be valuable to healthcare professionals to understand better how TBAs in Lesotho manage the third stage of labour and the support they need.
RESUMEN
BACKGROUND: According to a Cochrane review, continuous support during childbirth increases the mother's chances of a vaginal birth without identified adverse effects. However, this evidence-based practice is not universally implemented. The objective of the study was to identify challenges encountered in implementing continuous support during childbirth in public hospitals in the North West Province of South Africa. METHOD: An explorative, descriptive and contextual qualitative approach was used. The data were collected during 2013 by conducting focus group interviews with 33 registered midwives who had worked in maternity units in three selected public hospitals in the North West Province for at least two years. RESULTS: Midwives identified challenges that negatively impacted the implementation of continuous support during childbirth at organisational and interpersonal levels. At the organisational level, challenges included human resources, policies and guidelines as well as the architectural outlay of the maternity units. The personal challenges related to communication and attitudes of nurses, patients and their families. CONCLUSIONS: Organisational and personal challenges had a negative impact on the provision of continuous care during childbirth.
RESUMEN
This study was undertaken to address the lack of support for poverty-stricken people living with HIV that was identified in the Potchefstroom district in the North-West Province in South Africa. A qualitative phenomenological design was used to explore the experience, identify the support needs, and formulate guidelines for effective support for poverty-stricken people living with HIV. A total of 25 in-depth interviews guided by two central questions resulted in the following themes: facilitative and impeding experiences of poverty-stricken people living with HIV, basic needs, psychosocial needs, cultural-spiritual needs, and self-actualization needs. The experience of poverty-stricken people living with HIV in the Potchefstroom district is closely related to their support needs. To address these needs holistically and to enhance the quality of life of poverty-stricken people living with HIV, the needs should first be addressed individually. Following that, the collective needs can be addressed by a support system.
