Limited Obstetrics Ultrasound by Midwifes in Gauteng, South Africa: Benefit of Service-oriented Competency Development in Primary Healthcare Delivery: A Pilot Study

Tshililo Mashamba; Akpan Eyo; Olakunle Towobola; Anele Busakwe; Sikhonjiwe Masilela

doi:doi:10.11648/j.jgo.20221002.14

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Limited Obstetrics Ultrasound by Midwifes in Gauteng, South Africa: Benefit of Service-oriented Competency Development in Primary Healthcare Delivery: A Pilot Study

Tshililo Mashamba, Akpan Eyo, Olakunle Towobola, Anele Busakwe, Sikhonjiwe Masilela

Published in Journal of Gynecology and Obstetrics (Volume 10, Issue 2)

Received: 10 January 2022 Accepted: 28 February 2022 Published: 15 March 2022

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Abstract

In South Africa advanced midwifes are expected to independently provide comprehensive midwifery care from prenatal to postnatal stage. The integration of obstetric ultrasound diagnostics capability into routine pregnancy care delivery by the first healthcare responders will augment clinical decision making and appropriate case management action. The current PHC service delivery has not integrated basic ultrasound capability into routine pregnancy care service. Advanced midwifes were trained on basic obstetric ultrasound and make a care management decision based on ultrasound findings performed. Midwifes could accurately diagnose morbidity related complications. We conclude that advance midwifes care management plan is augmented when competence and provision of limited obstetrics ultrasound is integrated as a routine pregnancy care service in a maternity outpatient unit and community health centre. Because close to fifty percent of women from the community who attend these clinics could not accurately recall their last menstrual period, it is appropriate, and should become an expectation for these first responders to utilise ultrasound to offset potential morbidity induced by uncertainty of gestational age and weight estimation. These should be an integral component where this program is transferred or reproduced.

Published in	Journal of Gynecology and Obstetrics (Volume 10, Issue 2)
DOI	10.11648/j.jgo.20221002.14
Page(s)	75-81
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Ultrasound, Advance Midwife, Primary Healthcare PHC, Referral, Antenatal Care

References

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[2]	Avortri, G. S., & Modiba, L. M. (2018). Women's perspective of facility-based childbirth services in Ghana: A qualitative study. African journal of primary health care & family medicine, 10 (1), 1-8.
[3]	Bennett, R., Marcus, T. S., Abbott, G., & Hugo, J. F. (2018). Scaling community-based services in Gauteng, South Africa: A comparison of three workforce-planning scenarios. African journal of primary health care & family medicine, 10 (1), 1-7.
[4]	FIGO Working Group on Best Practice in Maternal–Fetal Medicine. (2015). Best practice in maternal–fetal medicine. International Journal of Gynecology & Obstetrics, 128 (1), 80-82.
[5]	Goemaes, R., Beeckman, D., Goossens, J., Shawe, J., Verhaeghe, S., & Van Hecke, A. (2016). Advanced midwifery practice: An evolutionary concept analysis. Midwifery, 42, 29-37.
[6]	Jaeger, F. N., Bechir, M., Harouna, M., Moto, D. D., & Utzinger, J. (2018). Challenges and opportunities for healthcare workers in a rural district of Chad. BMC health services research, 18 (1), 7.
[7]	Kozuki, N., Mullany, L. C., Khatry, S. K., Ghimire, R. K., Paudel, S., Blakemore, K.,... & Katz, J. (2016). Accuracy of home-based ultrasonographic diagnosis of obstetric risk factors by primary-level health workers in rural Nepal. Obstetrics and gynecology, 128 (3), 604.
[8]	Lesia, N. G. (2011). A Description of the practice of advanced midwives (Doctoral dissertation, University of the Free State).
[9]	Moosa, S., Derese, A., & Peersman, W. (2017). Insights of health district managers on the implementation of primary health care outreach teams in Johannesburg, South Africa: a descriptive study with focus group discussions. Human resources for health, 15 (1), 7.
[10]	Nathan, R., Swanson, J., Marks, W., Goldsmith, N., Vance, C., Sserwanga, B.,... & Mwenechanya, M. (2014). Screening obstetric ultrasound training for a five-country cluster randomized controlled trial. Ultrasound quarterly, 30 (4), 262.
[11]	Ndirima, Z., Neuhann, F., & Beiersmann, C. (2018). Listening to their voices: understanding rural women’s perceptions of good delivery care at the Mibilizi District Hospital in Rwanda. BMC women's health, 18 (1), 38.
[12]	Ross, A. B., DeStigter, K. K., Rielly, M., Souza, S., Morey, G. E., Nelson, M.,... & Kawooya, M. G. (2013). A low-cost ultrasound program leads to increased antenatal clinic visits and attended deliveries at a health care clinic in rural Uganda. PloS one, 8 (10), e78450.
[13]	Shah SP, Epino H, Bukhman G, Umulisa I, Dushimiyimana JM, Reichman A, et al. Impact of the introduction of ultrasound services in a limited resource setting: rural Rwanda 2008. BMC Int Health Hum Rights 2009; 9: 4.16. Geerts L, Theron.
[14]	Shirzad, M., Shakibazadeh, E., Betran, A. P., Bohren, M. A., & Abedini, M. (2019). Women’s perspectives on health facility and system levels factors influencing mode of delivery in Tehran: a qualitative study. Reproductive health, 16 (1), 15.
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[16]	Ultrasound Obstet Gynecol 2013 Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/uog.13208 isuog.org RECOMMENDATIONS.

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APA Style

Tshililo Mashamba, Akpan Eyo, Olakunle Towobola, Anele Busakwe, Sikhonjiwe Masilela. (2022). Limited Obstetrics Ultrasound by Midwifes in Gauteng, South Africa: Benefit of Service-oriented Competency Development in Primary Healthcare Delivery: A Pilot Study. Journal of Gynecology and Obstetrics, 10(2), 75-81. https://doi.org/10.11648/j.jgo.20221002.14

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ACS Style

Tshililo Mashamba; Akpan Eyo; Olakunle Towobola; Anele Busakwe; Sikhonjiwe Masilela. Limited Obstetrics Ultrasound by Midwifes in Gauteng, South Africa: Benefit of Service-oriented Competency Development in Primary Healthcare Delivery: A Pilot Study. J. Gynecol. Obstet. 2022, 10(2), 75-81. doi: 10.11648/j.jgo.20221002.14

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AMA Style

Tshililo Mashamba, Akpan Eyo, Olakunle Towobola, Anele Busakwe, Sikhonjiwe Masilela. Limited Obstetrics Ultrasound by Midwifes in Gauteng, South Africa: Benefit of Service-oriented Competency Development in Primary Healthcare Delivery: A Pilot Study. J Gynecol Obstet. 2022;10(2):75-81. doi: 10.11648/j.jgo.20221002.14

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@article{10.11648/j.jgo.20221002.14,
  author = {Tshililo Mashamba and Akpan Eyo and Olakunle Towobola and Anele Busakwe and Sikhonjiwe Masilela},
  title = {Limited Obstetrics Ultrasound by Midwifes in Gauteng, South Africa: Benefit of Service-oriented Competency Development in Primary Healthcare Delivery: A Pilot Study},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {10},
  number = {2},
  pages = {75-81},
  doi = {10.11648/j.jgo.20221002.14},
  url = {https://doi.org/10.11648/j.jgo.20221002.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20221002.14},
  abstract = {In South Africa advanced midwifes are expected to independently provide comprehensive midwifery care from prenatal to postnatal stage. The integration of obstetric ultrasound diagnostics capability into routine pregnancy care delivery by the first healthcare responders will augment clinical decision making and appropriate case management action. The current PHC service delivery has not integrated basic ultrasound capability into routine pregnancy care service. Advanced midwifes were trained on basic obstetric ultrasound and make a care management decision based on ultrasound findings performed. Midwifes could accurately diagnose morbidity related complications. We conclude that advance midwifes care management plan is augmented when competence and provision of limited obstetrics ultrasound is integrated as a routine pregnancy care service in a maternity outpatient unit and community health centre. Because close to fifty percent of women from the community who attend these clinics could not accurately recall their last menstrual period, it is appropriate, and should become an expectation for these first responders to utilise ultrasound to offset potential morbidity induced by uncertainty of gestational age and weight estimation. These should be an integral component where this program is transferred or reproduced.},
 year = {2022}
}

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TY  - JOUR
T1  - Limited Obstetrics Ultrasound by Midwifes in Gauteng, South Africa: Benefit of Service-oriented Competency Development in Primary Healthcare Delivery: A Pilot Study
AU  - Tshililo Mashamba
AU  - Akpan Eyo
AU  - Olakunle Towobola
AU  - Anele Busakwe
AU  - Sikhonjiwe Masilela
Y1  - 2022/03/15
PY  - 2022
N1  - https://doi.org/10.11648/j.jgo.20221002.14
DO  - 10.11648/j.jgo.20221002.14
T2  - Journal of Gynecology and Obstetrics
JF  - Journal of Gynecology and Obstetrics
JO  - Journal of Gynecology and Obstetrics
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EP  - 81
PB  - Science Publishing Group
SN  - 2376-7820
UR  - https://doi.org/10.11648/j.jgo.20221002.14
AB  - In South Africa advanced midwifes are expected to independently provide comprehensive midwifery care from prenatal to postnatal stage. The integration of obstetric ultrasound diagnostics capability into routine pregnancy care delivery by the first healthcare responders will augment clinical decision making and appropriate case management action. The current PHC service delivery has not integrated basic ultrasound capability into routine pregnancy care service. Advanced midwifes were trained on basic obstetric ultrasound and make a care management decision based on ultrasound findings performed. Midwifes could accurately diagnose morbidity related complications. We conclude that advance midwifes care management plan is augmented when competence and provision of limited obstetrics ultrasound is integrated as a routine pregnancy care service in a maternity outpatient unit and community health centre. Because close to fifty percent of women from the community who attend these clinics could not accurately recall their last menstrual period, it is appropriate, and should become an expectation for these first responders to utilise ultrasound to offset potential morbidity induced by uncertainty of gestational age and weight estimation. These should be an integral component where this program is transferred or reproduced.
VL  - 10
IS  - 2
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Author Information

Tshililo Mashamba

Department of Obstetrics and Gynaecology, Sefako Makgatho University Pretoria, Pretoria, South Africa
Akpan Eyo

Department of Obstetrics and Gynaecology, Sefako Makgatho University Pretoria, Pretoria, South Africa
Olakunle Towobola

Department of Obstetrics and Gynaecology, Sefako Makgatho University Pretoria, Pretoria, South Africa
Anele Busakwe

Prestige Health Technologies (PTY) Ltd, Johannesburg, South Africa
Sikhonjiwe Masilela

Directorate of Reproductive Health, Gauteng Department of Health, Johannesburg, South Africa

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APA Style

Tshililo Mashamba, Akpan Eyo, Olakunle Towobola, Anele Busakwe, Sikhonjiwe Masilela. (2022). Limited Obstetrics Ultrasound by Midwifes in Gauteng, South Africa: Benefit of Service-oriented Competency Development in Primary Healthcare Delivery: A Pilot Study. Journal of Gynecology and Obstetrics, 10(2), 75-81. https://doi.org/10.11648/j.jgo.20221002.14

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ACS Style

Tshililo Mashamba; Akpan Eyo; Olakunle Towobola; Anele Busakwe; Sikhonjiwe Masilela. Limited Obstetrics Ultrasound by Midwifes in Gauteng, South Africa: Benefit of Service-oriented Competency Development in Primary Healthcare Delivery: A Pilot Study. J. Gynecol. Obstet. 2022, 10(2), 75-81. doi: 10.11648/j.jgo.20221002.14

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AMA Style

Tshililo Mashamba, Akpan Eyo, Olakunle Towobola, Anele Busakwe, Sikhonjiwe Masilela. Limited Obstetrics Ultrasound by Midwifes in Gauteng, South Africa: Benefit of Service-oriented Competency Development in Primary Healthcare Delivery: A Pilot Study. J Gynecol Obstet. 2022;10(2):75-81. doi: 10.11648/j.jgo.20221002.14

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@article{10.11648/j.jgo.20221002.14,
  author = {Tshililo Mashamba and Akpan Eyo and Olakunle Towobola and Anele Busakwe and Sikhonjiwe Masilela},
  title = {Limited Obstetrics Ultrasound by Midwifes in Gauteng, South Africa: Benefit of Service-oriented Competency Development in Primary Healthcare Delivery: A Pilot Study},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {10},
  number = {2},
  pages = {75-81},
  doi = {10.11648/j.jgo.20221002.14},
  url = {https://doi.org/10.11648/j.jgo.20221002.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20221002.14},
  abstract = {In South Africa advanced midwifes are expected to independently provide comprehensive midwifery care from prenatal to postnatal stage. The integration of obstetric ultrasound diagnostics capability into routine pregnancy care delivery by the first healthcare responders will augment clinical decision making and appropriate case management action. The current PHC service delivery has not integrated basic ultrasound capability into routine pregnancy care service. Advanced midwifes were trained on basic obstetric ultrasound and make a care management decision based on ultrasound findings performed. Midwifes could accurately diagnose morbidity related complications. We conclude that advance midwifes care management plan is augmented when competence and provision of limited obstetrics ultrasound is integrated as a routine pregnancy care service in a maternity outpatient unit and community health centre. Because close to fifty percent of women from the community who attend these clinics could not accurately recall their last menstrual period, it is appropriate, and should become an expectation for these first responders to utilise ultrasound to offset potential morbidity induced by uncertainty of gestational age and weight estimation. These should be an integral component where this program is transferred or reproduced.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Limited Obstetrics Ultrasound by Midwifes in Gauteng, South Africa: Benefit of Service-oriented Competency Development in Primary Healthcare Delivery: A Pilot Study
AU  - Tshililo Mashamba
AU  - Akpan Eyo
AU  - Olakunle Towobola
AU  - Anele Busakwe
AU  - Sikhonjiwe Masilela
Y1  - 2022/03/15
PY  - 2022
N1  - https://doi.org/10.11648/j.jgo.20221002.14
DO  - 10.11648/j.jgo.20221002.14
T2  - Journal of Gynecology and Obstetrics
JF  - Journal of Gynecology and Obstetrics
JO  - Journal of Gynecology and Obstetrics
SP  - 75
EP  - 81
PB  - Science Publishing Group
SN  - 2376-7820
UR  - https://doi.org/10.11648/j.jgo.20221002.14
AB  - In South Africa advanced midwifes are expected to independently provide comprehensive midwifery care from prenatal to postnatal stage. The integration of obstetric ultrasound diagnostics capability into routine pregnancy care delivery by the first healthcare responders will augment clinical decision making and appropriate case management action. The current PHC service delivery has not integrated basic ultrasound capability into routine pregnancy care service. Advanced midwifes were trained on basic obstetric ultrasound and make a care management decision based on ultrasound findings performed. Midwifes could accurately diagnose morbidity related complications. We conclude that advance midwifes care management plan is augmented when competence and provision of limited obstetrics ultrasound is integrated as a routine pregnancy care service in a maternity outpatient unit and community health centre. Because close to fifty percent of women from the community who attend these clinics could not accurately recall their last menstrual period, it is appropriate, and should become an expectation for these first responders to utilise ultrasound to offset potential morbidity induced by uncertainty of gestational age and weight estimation. These should be an integral component where this program is transferred or reproduced.
VL  - 10
IS  - 2
ER  -

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