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- Title
The COVID-19 pandemic and disruptions in a district quality improvement initiative: Experiences from the CLEVER Maternity Care programme.
- Authors
Oosthuizen, Sarie J.; Bergh, Anne-Marie; Silver, Antonella; Malatji, Refilwe E.; Mfolo, Vivian; Botha, Tanita
- Abstract
Background: Many health systems were poorly prepared for the coronavirus disease 2019 (COVID-19) pandemic and found it difficult to protect maternity and reproductive health services. The aim of the study was to explore the influence of the COVID-19 pandemic on the ability of maternity healthcare providers to maintain the positive practices introduced by the CLEVER Maternity Care programme and to elicit information on their support needs. Methods: This multimethod study was conducted in midwife-led obstetric units (MOUs) and district hospitals in Tshwane District, South Africa and included a survey questionnaire and qualitative reports and reflections by the CLEVER implementation team. Two five-point Likert-scale items were supplemented by open-ended questions to provide suggestions on improving health systems and supporting healthcare workers. Results: Most of the 114 respondents were advanced midwives or registered nurses (86%). Participants from MOUs rated the maintenance of quality care practices significantly higher than those from district hospitals (p = 0.0130). There was a significant difference in perceptions of support from the district management between designations (p = 0.0037), with managers having the most positive perception compared with advanced midwives (p = 0.0018) and registered nurses (p = 0.0115). The interpretation framework had three main themes: working environment and health-system readiness; quality of patient care and service provision; and healthcare workers' response to the pandemic. Health-facility readiness is described as proactive, reactive or lagging. Conclusion: Lessons learned from this pandemic should be used to build responsive health systems that will enable primary healthcare workers to maintain quality patient care, services and communication.
- Subjects
SOUTH Africa; MATERNAL health services; MIDWIVES; WORK environment; MEDICAL quality control; SOCIAL support; NURSES' attitudes; RESEARCH methodology; ATTITUDES of medical personnel; MEDICAL personnel; EXECUTIVES; MEDICAL care; SURVEYS; QUALITATIVE research; EMERGENCY management; QUALITY assurance; PSYCHOSOCIAL factors; HOSPITAL wards; PUBLIC hospitals; QUESTIONNAIRES; NURSES; DESCRIPTIVE statistics; MEDICAL practice; COVID-19 pandemic; MEDICAL needs assessment
- Publication
South African Family Practice, 2022, Vol 64, Issue 1 Patr 2, p1
- ISSN
2078-6190
- Publication type
Article
- DOI
10.4102/safp.v64i1.5359