Experiences of midwives and accoucheurs in implementation of pregnancy HIV guidelines in Limpopo province, South Africa

Abstract

Introduction: Each year, about 43,000 pregnant women and mothers die world-wide due to pregnancy-related birth conditions. Most of these deaths are avoidable and preventable. An update on the maternal mortality of 2017 indicated that 976 pregnant women died between 2014 and 2016, despite being initiated on anti-retroviral drugs. Although, an improvement on human immunodeficiency virus (HIV) in pregnancy guidelines implementation was achieved, with 35% of maternal deaths occurring due to HIV infections, therefore there is a need to investigate the experience of midwives/accoucheurs regarding the implementation of HIV guidelines during pregnancy. The purpose of this study was to investigate and describe the experience of midwives/accoucheurs in implementing pregnancy HIV guidelines in the Limpopo province of South Africa. Material and methods: This was a qualitative study using exploratory-descriptive design, and included professional nurses with midwifery qualification. Non-probability, purposive sampling was used for 18 participants based on data capacity. Data was collected through an in-depth, unstructured face-to-face interview and analyzed using Tesch’s open coding method. Measures to ensure dependability, conformability, transferability, and credibility were applied. Results: Three main subjects emerged from raw data, namely: experiences of midwives/accoucheurs during provision of care to HIV-positive pregnant women, management of pregnant HIV-positive women as per guidelines, and challenges experienced by midwives caring for pregnant HIV-positive women. Conclusions: Midwives implemented the HIV guidelines during pregnancy; however, shortage of nurses during pregnant women’s first visit resulted in prolonged waiting time for other patients. The prolonged time for patients’ results and shortage of consulting rooms affected the implementation of HIV guidelines. The completion of different records was not accurately done. Non-adherence amongst clients affected the overall provision of HIV care.