Safety versus accessibility in maternal and perinatal care

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dc.contributor.author Pattinson, Robert Clive
dc.date.accessioned 2015-06-30T10:11:11Z
dc.date.available 2015-06-30T10:11:11Z
dc.date.issued 2015-04
dc.description.abstract This article adds to the debate on appropriate staffing in maternity units. My starting point for assessing staffing norms is the staff required to provide a safe maternity unit. A survey in 12 districts showed that their health facilities were not adequately prepared to perform all the essential emergency services required. Lack of staff was often cited as a reason. To test this notion, two norms (World Health Organization (WHO) and Greenfield) giving the minimum staff required for the provision of safe maternity services were applied to the 12 districts. Assuming the appropriate equipment is available and the facility is open 24 hours a day 7 days a week, at a minimum there need to be ten professional nurses with midwifery/advanced midwives to ensure safety for mother and baby in every maternity unit. The norms indicate that the units should do a minimum of 500 - 1 200 deliveries per year to be cost-effective. All 12 districts had sufficient staff according to the WHO. When the numbers of facilities with maternity units were compared with Council for Scientific and Industrial Research and WHO norms for number of health facilities per population, a large excess of facilities was found. Per district there were sufficient personnel to perform the number of deliveries for that district using the WHO or Greenfield formulas, but per site there were insufficient personnel. In my view there are sufficient personnel to provide safe maternity services, but too many units are performing deliveries, leading to dilution of staff and unsafe services. A realignment of maternity units must be undertaken to provide safe services, even at the expense of accessibility. en_ZA
dc.description.librarian am2015 en_ZA
dc.description.uri http://www.samj.org.za en_ZA
dc.identifier.citation Pattinson, RC 2015, 'Safety versus accessibility in maternal and perinatal care', South African Medical Journal, vol. 105, no. 4, pp. 261-265. en_ZA
dc.identifier.issn 0256-9574 (print)
dc.identifier.issn 2078-5135 (online)
dc.identifier.other 10.7196/SAMJ.9182
dc.identifier.uri http://hdl.handle.net/2263/45818
dc.language.iso en en_ZA
dc.publisher Health and Medical Publishing Group en_ZA
dc.rights © 2015 Health & Medical Publishing Group. This work is licensed under a Creative Commons Attribution-NonCommercial Works License (CC BY-NC 3.0). en_ZA
dc.subject Safety en_ZA
dc.subject Maternity units. en_ZA
dc.subject Emergency services en_ZA
dc.subject Staffing en_ZA
dc.title Safety versus accessibility in maternal and perinatal care en_ZA
dc.type Article en_ZA


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