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Faculty of Health Sciences

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    Utilisation of maternal health services and its impact on maternal mortality rate : a case for KwaZulu-Natal, South Africa
    (UNISA Press, 2023-01-01) Naranjee, Nellie; Naidoo, Vasanthrie; Krishna, Suresh Babu Naidu; Jinabhai, Champaklal C.; Sibiya, Maureen N.
    Despite several strategies in place in South Africa and globally to prevent maternal mortality and morbidity, maternal deaths remain high, especially in sub-Saharan Africa and lower to middle-income countries. The aim of the study was to identify the challenges that lead to pregnant women’s delays in seeking antenatal care (ANC) early and to find strategies to prevent such delays, contributing to a reduction of maternal deaths in South Africa. The study was conducted in two phases. Phase one analysed data on maternal deaths collected by the District Health Information System (DHIS) of the KwaZulu-Natal Department of Health from all 11 districts over a 10-year period (2009–2019). The data on maternal deaths revealed that there was a very high maternal mortality rate; between 800 and 1 780 per 100 000 live births. This correlated with very low antenatal visits; between 695–895 per 100 000 live births. In phase two, a literature review was conducted using several computer-assisted databases, bibliographies and websites to identify and source current policies. The literature review presents causes of delay in seeking ANC and strategies to prevent maternal deaths. Recommendations were made to consider strengthening education and awareness related to family planning; women empowerment through community health programmes and change in healthcare providers’ behaviours and attitudes; ensuring availability of maternal health resources; and developing strategies to ensure that the ANC services delivered are in line with the South African Department of Health Guidelines.
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    A practice framework to improve accessibility of maternal healthcare services for women with disabilities in KwaZulu-Natal, South Africa
    (2023-05-31) Mheta, Doreen; Sibiya, Maureen Nokuthula; Nkosi, Pauline Busisiwe
    Background Access to maternal healthcare services is a challenge in most low and middleincome countries. South Africa is one of the countries striving to improve the accessibility of maternal healthcare services. Although South Africa has put some interventions to improve the accessibility of maternal healthcare services, vulnerable women including women with disabilities are still facing numerous challenges when trying to access maternal healthcare services. Aim The aim of the study was to explore the factors that impact access to public maternal healthcare services for women with disabilities in KwaZulu-Natal with the ultimate goal of developing a practice framework to improve women with disabilities’ access to maternal healthcare services. Methodology An in-depth qualitative study was conducted using the case study method. Interviews and focus group discussions were used to collect data. Twelve women with disabilities (four with physical impairments, four with hearing impairments and four with visual impairments) were interviewed for this study. Focus group discussions were conducted with sixteen midwives and one-on-one interviews were conducted with four gynaecologists and one medical officer. Data were transcribed verbatim and analysed utilising the framework of assessing access to maternal healthcare services by Peters et al. 2008: 162. Findings Several factors impact access to maternal healthcare services for women with disabilities. They are classified into systemic, infrastructural and personal. These factors are interconnected to either positively or negatively impact access to maternal healthcare services for women with disabilities. Systemic factors include availability of human resources, training on handling pregnant women with disabilities and availability of sign language interpreters. Infrastructural factors include the design and layout of buildings, adjustable equipment, and assistive devices. Personal factors include attitudes of healthcare workers to pregnant women with disabilities, empowerment amongst women with disabilities, availability of a companion and the ability to read and write.