Development of intervention strategies to enhance implementation of maternal and neonatal referral system guidelines in Mopani district in the Limpopo Province

Abstract

English: INTRODUCTION : South Africa is experiencing maternal and neonatal mortality challenges due to pregnancy related conditions such as hypertension, obstetric haemorrhage and HIV in pregnancy. There are gaps when it comes to referral of obstetric emergencies, despite the availability of maternal and neonatal referral system guidelines. Therefore, appropriate measures need to be put in place to enhance the implementation of the maternal and neonatal referral system guidelines to assist the country in overcoming these challenges. AIM : To develop intervention strategies to enhance the implementation of maternal and neonatal referral system guidelines in the Mopani District of the Limpopo Province, to facilitate prompt referral of obstetric emergencies, to minimise obstetric complications and improve maternal and neonatal outcomes. This study was conducted in two (2) phases, namely, phase 1: Empirical phase and phase 2: Development phase) RESEARCH DESIGN AND METHODS : Descriptive phenomenological research design methods were used in phase one of this study. The population were three groups of participants, eleven (11) postnatal mothers, ten (10) registered midwives and four (4) supervisors/managers. Purposive sampling was used. Data collection in-depth individual face-to-face interviews. Data analysis, Colaizzi’s seven (7) procedural steps. A modified Delphi technique was employed in phase two, to validate the drafted intervention strategies. Population were a panel of twenty (20) experts in maternal and neonatal health fields. Purposive and snowballing sampling were used. Data collection and analysis were done in three rounds on a 4-point Likert scale questionnaire. FINDINGS : Phase one findings revealed six (6) essential meanings and thirty-four (34) constituents derived from those essential meanings. Four (4) essential meanings and fourteen (14) constituents emerged from the interviews with the postnatal mothers. Those essential meanings were: postnatal mothers’ positive experiences, postnatal mothers' challenging experiences, consequences of challenges and the essential meaning of experiences. Two essential meanings and twenty (20) constituents emerged from the interviews with the registered midwives and the supervisors/managers. Those essential meanings were: the essence of experiences and the essence of recommendations. From the findings, the researcher identified statements, constructs and words related to the relevant intervention strategies and formulated a framework to draft the eight (8) intervention strategies. During phase two of this study, the researcher consolidated feedback, suggestions and comments to refine the intervention strategies. The most reliable agreement was obtained in all three (3) rounds of validation. From the eight (8) developed intervention strategies, various intervention activities, sub-interventions and the rationale thereof were drawn, inter alia, provision of effective maternal healthcare and health education by effectively managing low-risk maternal conditions, provision of accessible maternal and neonatal healthcare services. 24/7 through 24-hour unrestricted access to promote improved operational functioning, Identification of the mothers’ obstetrical, medical, social, physical and psychological well-being. The health care providers listen and attend to the mothers' and relatives’ concerns, demands and needs to build mutual trust and empower them. MEASURES OF TRUSTWORTHINESS : To ensure trustworthiness the researcher adhered to the principles of credibility, dependability, confirmability, transferability, authenticity, bracketing, prolonged engagement and persistent observation, reflexivity, triangulation and member checking. ETHICAL CONSIDERATIONS : Ethical clearance was obtained from the University of Pretoria, Faculty of Health Sciences Research Ethics Committee (Ethics Reference No: 236/2021). Permission to access the research setting was obtained from the Limpopo Provincial Department of Health and Mopani District Health Department. From a maternity unit of a selected district hospital permission was obtained from the Chief Executive Officer (CEO) of the selected district hospital while at the selected primary healthcare facility permission was obtained from the Operational Manager of the selected primary healthcare facility. CONCLUSION OF THE STUDY OR SIGNIFICANCE OF THE STUDY : The study findings in phase one of this study highlighted referral system gaps which informed development of the eight (08) intervention strategies in phase two of this study to enhance implementation of the maternal and neonatal referral system guidelines in Mopani District, Limpopo Province. The eight (08) developed intervention strategies are aimed to be utilized in primary health care facilities and district hospitals in Mopani District, Limpopo Province to facilitate prompt referral of obstetric emergencies. In so doing obstetric complications may be minimized and maternal and neonatal outcome may be optimized. Key terms: expert; referral; referral system; maternal care; neonatal care

Sepedi: Matseno: Afrika Borwa e itemogela ditlhohlo tša mahu a bomma le masea a sa tšwago go belegwa ka lebaka la maemo ao a amanago le boimana a go swana le kgatelelo ya madi, go tšwa madi ga pelego le HIV ka boimana. Go na le diphapano ge go tliwa tabeng ya go romelwa ga maemo a tšhoganetšo a pelego, go sa šetšwe go ba gona ga ditlhahlo tša tshepedišo ya go fetišetša ga bomma le masea a sa tšwago go belegwa. Ka gona, magato a maleba a swanetše go bewa go godiša phethagatšo ya ditlhahlo tša tshepedišo ya go fetišetša bomme le masea a sa tšwago go belegwa go thuša naga go fenya ditlhohlo tše. Maikemišetšo: Go hlama maano a tsenogare go godiša phethagatšo ya ditlhahlo tša tshepedišo ya go fetišetša bomme le masea a sa tšwago go belegwa ka Seleteng sa Mopani sa Profense ya Limpopo, go nolofatša go fetišetšwa ka pela ga maemo a tšhoganetšo a pelego, go fokotša mathata a pelego le go kaonafatša dipoelo tša bomma le masea a sa tšwago go belegwa. Dinyakišišo tše di dirilwe ka dikgato tše pedi (2), e lego, kgato ya 1: Kgato ya diphihlelelo le kgato ya 2: Kgato ya tlhabollo) Tlhamo ya dinyakišišo le mekgwa: Mekgwa ya tlhamo ya dinyakišišo ya ponagalo ye e hlalošago e šomišitšwe kgatong ya mathomo ya dinyakišišo tše. Palo ya batho bao ba bego ba tsenetše dinyakišišo e be e le dihlopha tše tharo tša bakgathatema, bomma ba lesometee (11) ba sa tšwago go belega, babelegiši ba lesome (10) bao ba ngwadišitšwego le baokamedi/balaodi ba bane (4). Go ile gwa šomišwa mokgwa wa go dira sampole ka maikemišetšo. Kgoboketšo ya datha ye e tseneletšego dipoledišanong tša go lebanya ka mahlo. Tshekatsheko ya datha, dikgato tše šupa (7) tša tshepedišo ya Colaizzi. Thekniki ya Delphi ye e fetotšwego e šomišitšwe kgatong ya bobedi, go netefatša maano a tsenogare ao a ngwadilwego. Palo ya batho bao ba bego ba tsenetše dinyakišišo e be e le phanele ya ditsebi tše masomepedi (20) ka mafapheng a maphelo a bomma le masea a sa tšwago go belegwa. Go ile gwa šomišwa mokgwa wa go dira sampole ya go oketšega ge nako e eya le wa go dira sampole ka maikemišetšo. Kgoboketšo ya datha le tshekatsheko di dirilwe ka ditikologong tše tharo lenaneopotšišong la sekala sa Likert sa dintlha tše 4. Diphihlelelo: Diphihlelelo tša kgato ya pele di utollotše ditlhalošo tše bohlokwa tše tshela (6) le dikarolo tše masometharonne (34) tšeo di tšwago ditlhalošong tšeo tše bohlokwa. Ditlhalošo tše nne (4) tše bohlokwa le dikarolo tše lesomenne (14) di tšweletše dipoledišanong le bomme ba ka morago ga pelego. Ditlhalošo tšeo tše bohlokwa e be e le: maitemogelo a mabotse a bomme ba ka morago ga pelego, maitemogelo a hlohlago a bomme ba ka morago ga pelego, ditlamorago tša ditlhohlo le tlhalošo ye bohlokwa ya maitemogelo. Ditlhalošo tše pedi tše bohlokwa le bakgethi ba masomepedi (20) di tšweletše dipoledišanong le babelegiši bao ba ngwadišitšwego le baokamedi/balaodi. Ditlhalošo tšeo tše bohlokwa e be e le: mooko wa maitemogelo le mooko wa ditšhišinyo. Go tšwa go diphihlelo, monyakišiši o lemogile dipolelo, dipopego le mantšu ao a amanago le maano a maleba a tsenogare gomme a hlama tlhako ya go ngwala maano a seswai (8) a tsenogare. Nakong ya kgato ya bobedi ya dinyakišišo tše, monyakišiši o kopantše maikutlo, ditšhišinyo le ditshwayotshwayo go kaonafatša maano a tsenogare. Tumelelano ye e ka botwago kudu e hweditšwe ka ditikologong ka moka tše tharo (3) tša netefatšo. Go tšwa go maano a tsenogare a seswai (8) ao a hlamilwego, mediro ya tsenogare ye e fapafapanego, ditsenogare tše nnyane le mabaka a yona di tšerwe, gare ga tše dingwe, kabo ya tlhokomelo ya maphelo ya bomma ye e šomago gabotse le thuto ya maphelo ka go laola gabotse maemo a bomma ao a lego kotsing ya fase, kabo ya ditirelo tša tlhokomelo ya maphelo ya bomma le masea ao a sa tšwago go belegwa tše di fihlelelwago. 24/7 go fihla go phihlelelo ye e sa thibelwego ya diiri tše 24 go tšwetša pele tshepedišo ye e kaonafetšego ya tshepedišo, Tlhaolelo ya bophelo bjo bobotse bja bomme bja pelego, bja kalafo, bja leago, bja mmele le bja monagano. Baabi ba tlhokomelo ya maphelo ba theeletša le go hlokomela dipelaelo, dinyakwa le dinyakwa tša bomme le ba leloko go aga go tshepana le go ba matlafatša. Ditekanyo tša go botega: Go netefatša go botega monyakišiši o ile a obamela melawana ya go botega, go ithekga, go tiišetšwa, go fetišetšwa, go ba ga kgonthe, go tsenya maswaodikga, go tsenela nako ye telele le go lebelela ka go phegelela, go naganišiša, go dira khutlotharo le go hlahloba maloko. Dikakanyokgolo tša boitshwaro: Tumelelo ya boitshwaro e hweditšwe go tšwa Yunibesithing ya Pretoria, Komiti ya Maitshwaro ya Nyakišišo ya Saense ya Maphelo ya Legoro (Nomoro ya Tšhupetšo ya Maitshwaro: 236/2021). Tumelelo ya go fihlelela lefelo la nyakišišo e hweditšwe go tšwa go Kgoro ya Maphelo ya Profense ya Limpopo le Kgoro ya Maphelo ya Selete sa Mopani. Go tšwa go yuniti ya pelego ya sepetlele sa selete se se kgethilwego tumelelo e hweditšwe go tšwa go Mohlankedimogolophethiši (CEO) wa sepetlele sa selete seo se kgethilwego mola ka lefelong leo le kgethilwego la tlhokomelo ya maphelo ya mathomo tumelelo e hweditšwe go tšwa go Molaodi wa Tšhomišo wa lefelo la tlhokomelo ya maphelo ya mathomo leo le kgethilwego. Thumo ya dinyakišišo goba bohlokwa bja dinyakišišo: Diphihlelelo tša dinyakišišo mo kgatong ya pele ya nyakišišo ye di tšweleditše diphapano tša tshepedišo ya go fetišetša tšeo di tsebišitšego tlhabollo ya maano a tsenogare a seswai (08) mo kgatong ya bobedi ya nyakišišo ye go godiša phethagatšo ya ditlhahlo tša tshepedišo ya go fetišetša bomma le masea a sa tšwago go belegwa ka Seleteng sa Mopani, Profenseng ya Limpopo. Maano a seswai (08) a tsenogare ao a hlamilwego a ikemišeditše go šomišwa ka mafelong a tlhokomelo ya maphelo a mathomo le dipetleleng tša selete ka Seleteng sa Mopani, Profenseng ya Limpopo go nolofatša go romelwa ka pela ga maemo a tšhoganetšo a pelego. Ka go dira bjalo mathata a pelego a ka fokotšwa gomme mafelelo a bomma le a masea a sa tšwago go belegwa a ka lokišwa. Mareo a bohlokwa: setsebi; go fetišetšwa; tshepedišo ya go fetišetša; tlhokomelo ya bomme; tlhokomelo ya masea a sa tšwago go belegwa

Afrikaans: Inleiding: Suid-Afrika ervaar uitdagings met betrekking tot moeder- en neonatale mortaliteit as gevolg van swangerskapverwante toestande soos hipertensie, obstetriese bloeding en MIV tydens swangerskap. Daar is leemtes wat die verwysing van obstetriese noodgevalle betref, ten spyte van die beskikbaarheid van riglyne vir moeder- en neonatale verwysingstelsels. Daarom moet gepaste maatreëls ingestel word om die implementering van die riglyne vir moeder- en neonatale verwysingstelsels te verbeter om die land te help om hierdie uitdagings te oorkom. Doel: Om intervensiestrategieë te ontwikkel om die implementering van riglyne vir moeder- en neonatale verwysingstelsels in die Mopani-distrik in Limpopo te verbeter, om vinnige verwysing van obstetriese noodgevalle te fasiliteer, obstetriese komplikasies te minimaliseer, en moeder- en neonatale uitkomste te verbeter. Hierdie studie is in twee (2) fases uitgevoer, naamlik Fase Een: empiriese fase, en Fase Twee: ontwikkelingsfase. Navorsingsontwerp en -metodes: Beskrywende fenomenologiese navorsingsontwerpsmetodes is in Fase Een van hierdie studie gebruik. Die populasie was drie groepe deelnemers, elf (11) postnatale moeders, tien (10) geregistreerde vroedvroue, en vier (4) toesighouers en/of bestuurders. Doelgerigte steekproefneming is gebruik. Data-insameling: indringende individuele persoon-tot-persoon-onderhoude. Dataontleding: Colaizzi se sewe (7) prosedurele stappe. n Gewysigde Delphi-tegniek is in Fase Twee gebruik om die opgestelde intervensiestrategieë te valideer. Die populasie was 'n paneel van twintig (20) kundiges op die gebied van moeder- en neonatale gesondheid. Doelgerigte en sneeubalsteekproefneming is gebruik. Data-insameling en -ontleding is in drie rondes volgens 'n 4-punt-Likert-skaalvraelys gedoen. Bevindinge: Fase Een-bevindinge het ses (6) wesenlike betekenisse, en vier-en-dertig (34) komponente wat uit daardie wesenlike betekenisse afgelei is, aan die lig gebring. Vier (4) wesenlike betekenisse en veertien (14) komponente het uit die onderhoude met die postnatale moeders na vore gekom. Daardie wesenlike betekenisse was: postnatale moeders se positiewe ervarings, ervarings wat postnatale moeders as uitdagend ervaar het, die gevolge van die uitdagings, en die wesenlike betekenis van ervarings. Twee wesenlike betekenisse en twintig (20) komponente het na vore gekom uit die onderhoude met die geregistreerde vroedvroue en die toesighouers en/of bestuurders. Daardie wesenlike betekenisse was: die wese van ervarings en die wese van die aanbevelings. Uit die bevindinge het die navorser stellings, konstrukte, en woorde geïdentifiseer wat met die relevante intervensiestrategieë verband hou, en 'n raamwerk geformuleer om die agt (8) intervensiestrategieë op te stel. Tydens Fase Twee van hierdie studie het die navorser terugvoer, voorstelle en kommentaar gekonsolideer om die intervensiestrategieë te verfyn. Die mees betroubare ooreenstemming is in al drie (3) valideringsrondtes verkry. Uit die agt (8) intervensiestrategieë wat ontwikkel is, is verskeie intervensieaktiwiteite, subintervensies en die rasionaal daarvoor opgestel, waaronder die voorsiening van doeltreffende moedergesondheidsorg en gesondheidsopvoeding deur doeltreffende bestuur van laerisiko-toestande wat die moeder affekteer; die voorsiening van toeganklike moeder- en neonatale gesondheidsorgdienste; 24/7- tot 24-uur- onbeperkte toegang om verbeterde operasionele funksionering te bevorder; en identifisering van die moeders se obstetriese, mediese, sosiale, fisieke en sielkundige welstand. Die gesondheidsorgverskaffers luister na en gee aandag aan die moeders en familielede se bekommernisse, eise en behoeftes om wedersydse vertroue te bou en hulle te bemagtig. Maatstawwe van geloofwaardigheid: Om ongeloofwaardigheid te verseker, het die navorser die beginsels van geloofwaardigheid, betroubaarheid, bevestigbaarheid, oordraagbaarheid, outentisiteit, onbevooroordeeldheid, langdurige betrokkenheid en volgehoue waarneming, reflektiwiteit, triangulasie en lidkontrole nagekom. Etiese oorwegings: Etiese goedkeuring is verkry van die Navorsingsetiekkomitee van die Universiteit van Pretoria se Fakulteit Gesondheidswetenskappe (Etiekverwysingsnommer: 236/2021). Toestemming om toegang tot die navorsingsomgewing te bekom, is van die Limpopo Provinsiale Departement van Gesondheid en die Mopani Distriksgesondheidsdepartement verkry. Van 'n kraameenheid van 'n gekose distrikshospitaal is toestemming verkry van die hoof- uitvoerende beampte (HUB) van die gekose distrikshospitaal, terwyl toestemming by die gekose primêregesondheidsorgfasiliteit verkry is van die operasionele bestuurder van daadie gekose primêregesondheidsorgfasiliteit. Gevolgtrekking van die studie of betekenis van die studie: Die studiebevindinge van Fase Een van hierdie studie het leemtes in die verwysingstelsel uitgelig, wat aanleiding gegee het tot die ontwikkeling van die agt (08) intervensiestrategieë in Fase Twee van hierdie studie, wat moet lei tot beter implementering van die moeder- en neonatale verwysingstelselriglyne in die Mopani-distrik, Limpopo. Die agt (08) intervensiestrategieë wat ontwikkel is, is bedoel vir gebruik in primêregesondheidsorgfasiliteite en distrikshospitale in die Mopani-distrik, Limpopo, om vinnige verwysing van obstetriese noodgevalle te fasiliteer. Sodoende kan obstetriese komplikasies tot ’n minimum beperk word en ’n optimaal goeie uitkoms vir moeders en neonatale pasiënte bewerkstellig word. Sleutelterme: deskundige, verwysing, verwysingstelsel, moedersorg, neonatale sorg.

IsiZulu: Isingeniso: INingizimu Afrika ibhekene nezinselelo zokushona komama kanye nabantwana abasanda kuzalwa ngenxa yezimo ezihlobene nokukhulelwa ezifana nokuphakama komfutho wegazi, ukopha ngokuphathelene nokubeletha kanye ne-HIV ekukhulelweni. Kunezikhala uma kukhulunywa ngokudluliselwa ngokuphathelene nezimo eziphuthumayo zokubeletha, naphezu kokutholakala kwemihlahlandlela yohlelo lokudluliselwa komama kanye nabantwana abancane abasanda kuzalwa. Ngakho-ke, kudingeka kusetshenziswe izinyathelo ezifanele ukuze kuthuthukiswe ukuqaliswa kwemihlahlandlela yohlelo lokudluliselwa komama kanye nabantwana abasanda kuzalwa ukuze kusizwe izwe linqobe lezi zinselele. Inhloso: Ukuze kuthuthukiswe amasu okungenelela ukuze kuthuthukiswe ukusetshenziswa kwemihlahlandlela yohlelo lokudluliselwa komama kanye nabantwana abasanda kuzakalwa esifundeni saseMopani esifundazweni saseLimpopo, ukuze kulungiselelwe ukudluliselwa ngokushesha nayelana nezimo eziphuthumayo eziphathelene nokubeletha, ukuze kuncishiswe okungaba yinkinga ngokuphathelene nokubeletha kanye nokwenza ngcono imiphumela yomama kanye nabantwana abasanda kuzalwa. Ucwaningo lwenziwe ezigabeni ezimbili (2) - Iokuyilesi, isigaba 1: Isigaba esibheka okuthilee nesigaba 2: (Isigaba sokuthuthukisa) Idizayini yocwaninga kanye nezindlela: Izindlela zokuhlela ucwaningo oluchazayo zisetshenzisiwe esigabeni sokuqala salolu cwaningo. Inani labantu belingamaqembu amathathu ababambiqhaza, omama asebebelethile abayishumi nanye (11), ababelethisi abayishumi (10) ababhalisile kanye nezinduna zasemsebenzini/abaphathi abane (4). Kwasetshenziswa ukuthatha isampula okuhlosiwe. Ukuqoqwa kwedatha ngokujulile kwezingxoxo zomuntu ngamunye ubuso nobuso. Ukuhlaziywa kwedatha, izinyathelo eziyisikhombisa (7) zezinqubo zika-Colaizzi. Kusetshenziswe inqubo ye-Delphi eguquliwe esigabeni sesibili, ukuze kuqinisekiswe amasu okungenela angakabi awokugcina. Inani labantu laliyiqembu lochwepheshe abangamashumi amabili (20) emkhakheni wezempilo womama kanye nabantwana abasanda kuzalwa. Kwasetshenziswa amasampula anenhloso ne-snowballing. Ukuqoqwa nokuhlaziywa kwedatha kwenziwa ngemizuliswano emithathu ephepheni lemibuzo elinamaphuzu ama-4 lesikali se-Likert. Okutholakele: Okutholakele esigabeni sokuqala kuveza izincazelo eziyisithupha (6) ezibalulekile nezakhi ezingamashumi amathathu nane (34) ezithathwe kulezo zincazelo ezibalulekile. Izincazelo ezine (4) ezibalulekile nezakhi eziyishumi nane (14) zavela ezingxoxweni nomama ngemva kokubeletha. Lezo zincazelo ezibalulekile zaziyilezi: okuhlangenwe nakho okuhle komama ngemva kokubeletha, okuhlangenwe nakho okuyinselele komama ngemva kokubeletha, imiphumela yezinselele nencazelo ebalulekile yokwenzekile. Izincazelo ezimbili ezibalulekile nezakhi ezingamashumi amabili (20) zavela ezingxoxweni nababelethisi ababhalisiwe kanye nezinduna emsebenzini/abaphathi. Lezo zincazelo ezibalulekile zaziyilezi: umongo wokuhlangenwe nazo nomongo wezincomo. Kokusukela kokutholakele, umcwaningi wathola izitatimende, ukwakhiwa kanye namagama ahlobene namasu afanele okungenela futhi wasungula uhlaka lokusungula amasu ayisishiyagalombili (8) okungenela. Phakathi nesigaba sesibili salolu cwaningo, umcwaningi wahlanganisa umbiko, iziphakamiso kanye nokuphawula ukuze athuthukise amasu okungenelela. Isivumelwano esinokwethenjelwa kakhulu satholakala kuyo yonke imizuliswano emithathu (3) yokuqinisekisa. Ukusuka kumasu ayisishiyagalombili (8) okusunguliwe okungenela, imisebenzi ehlukahlukene yokungenelela, ukungenelela okuncane kanye nokucatshangelwayo kwadonswa, phakathi kokunye, ukuhlinzekwa kokunakekela kwezempilo okuphumelelayo komama kanye nemfundo yezempilo ngokwengamela ngokuphumelelayo izimo zomama ezinobungozi obuphansi, ukuhlinzekwa kwezinsiza zezempilo zomama kanye nomama kanye nabantwana abasanda kuzalwa. 24/7 kuya emahoreni angu-24 ukufinyelela okungavinjelwe ukukhuthaza ukusebenza okuthuthukisiwe kokusebenza, Ukuhlonza impilo yomama yokubeletha, yezokwelapha, yezenhlalo, ngokomzimba nangokwengqondo. Abahlinzeki bezokunakekelwa kwempilo balalela futhi banakekele ukukhathazeka komama kanye nezihlobo, izimfuno nokudinga ukwakha ukwethembana kanye nokubahlomisa. Izinyathelo zokwethembeka: Ukuqinisekisa ukwethembeka umcwaningi wanamathela ezimisweni zokwethembeka, okungathenjelwa kuko, ukuqinisekiswa, ukudluliselwa, ubuqiniso, ukubopha, ukuzibandakanya kwesikhathi eside nokuqaphela okuqhubekayo, ukucabanga, ukuhlukanisa kube ngunxantathu kanye nokuhlolwa kwamalungu. Ukucatshangelwa kokuziphatha: Imvume yokuziphatha itholwe e-University of Pretoria, e-Faculty of Health Sciences Research Ethics Committee (Ethics Reference No: 236/2021). Imvume yokungena esimweni socwaningo itholwe eMnyangweni Wezempilo Wesifundazwe saseLimpopo kanye noMnyango Wezempilo Wesifunda saseMopani. Kuyunithi yokubeletha yesibhedlela sesifunda esikhethiwe itholwe Kusikhulu Esingumlawuli Oyinhloko (CEO) wesibhedlela sesifunda esikhethiwe ngenkathi esesikhungweni sezokunakekelwa kwempilo esiyinhloko esikhethiwe itholwe kuMphathi Wokwenziwa Komsebenzi wesikhungo sezokunakekela kwempilo esiyinhloko esikhethiwe. Isiphetho socwaningo noma ukubaluleka kocwaningo: Okutholakele ocwaningweni esigabeni sokuqala salolu cwaningo kwaqokomisa izikhala ngokuphathelene nohlelo lokudluiselwa kwabanye ezazisa ukusungulwa kwamasu ayisishiyagalombili (08) okungenelela esigabeni sesibili salolu cwaningo ukuze kuthuthukiswe ukuqaliswa kwemihlahlandlela yohlelo lokudluliselwa komama kanye nabantwana abasanda kuzalwa eSifundeni saseMopani, esifundazweni saseLimpopo. Izindlela zokungenelela eziyisishiyagalombili (08) ezisunguliwe zihloselwe ukusetshenziswa ezikhungweni zokunakekela kwempilo eziyinhloko nasezibhedlela zeSifunda iMopani, eSifundazweni saseLimpopo ukusiza ukudluliselwa ngokushesha kwezimo eziphuthumayo eziphathelene nokukhulelwa. Ngokwenza kanjalo izinkinga eziphathelene nokukhulelwa zingase zincishiswe futhi umphumela womama kanye nabantwana abasanda kuzalwa ungase ube ngcono nakakhulu.. Amagama abalulekile: uchwepheshe; ukudluliselwa kwabanye; uhlelo lokudlulisela kwabanye; ukunakekelwa komama; ukunakekelwa kwabantwana abasanda kuzalwa