Midwives’ descriptions of policies on access to maternity health services in North West Province, South Africa

Abstract

The study sought to explore and describe the various policies regarding access to Maternity health care services in the North West Province, South Africa, through the lens of midwives.  Legal and ethical frameworks guide maternity healthcare services to ensure such a service's quality, safety, and standardization. A qualitative, descriptive, explorative research design was followed. Nine purposefully sampled midwives participated in a one-on-one in-depth interview. Data were analyzed using Collaizi's descriptive method based on the emerging themes and categories. One overarching theme with six categories emerged from the data. From the overarching perspective, it was evident that midwives were dissatisfied with the ambiguity of various policies guiding patients' access to Maternity healthcare services. To a certain extent, the admission policy was inconsistent with the patient's rights and constitution of the land on access to health. The ambiguity of admission position led to uncontrolled movements of self-referred patients to clinical facilities. The ambiguity of the transfer policy contributed to challenges during interfacility transfers of referred patients from lower levels of care facilities and vice versa. In addition, the policy on escorts of patients was unspecific about the healthcare personnel required to escort complicated patients in transit, which caused care interruptions. The study findings highlight the Midwives' concerns regarding various policies of access to maternity health services, and the marked ineffectiveness of controlling patients' movement into facilities could be the reason for overcrowding, inadvertently causing a decline in the quality of maternity healthcare services. The study findings may alert policymakers to be cautious and ensure that policies are succinct and consistent with other related laws.