The utilisation of advanced midwives in the Free State province of South Africa

Abstract

Advanced midwives, thus midwives holding Master's degrees or post basic diplomas in advanced midwifery, might not be optimally utilised. As independent practitioners, they are readily available, cost-effective professionals that can provide midwifery services, especially if doctors are not easily accessible. The aim of this article is to report on the placement and utilisation of advanced midwifery practitioners. A non-experimental, descriptive design was used. After a thorough literature analysis as well as a focus group discussion, a questionnaire for data collection was compiled. Data collection was done after approval from the relevant authorities and the germane Ethics Committee had been received. The population comprised all practising advanced midwives who had trained at the University of the Free State (UFS) from 1995 to 2007 (inclusive). No sampling was done as 178 questionnaires were distributed during 2010. The findings indicated that the minority of participants were placed and utilised where their skills and competencies could be utilised optimally. The majority were neither placed nor utilised in areas where their advanced midwifery skills could be utilised. Those respondents whose advanced midwifery knowledge and skills had not been utilised, expressed a loss of self-confidence, lack of support, lack of recognition and an inability to demonstrate their expertise. The results confirmed that advanced midwifery practitioners were under-utilised, despite the global nursing shortage and healthcare crisis in South Africa. Ultimately these advanced midwives' skills and competencies could deteriorate due to a lack of clinical practice. To ensure that advanced midwives are retained in South Africa, they need to practise in the field of their speciality.