Browsing by Author "Gundo, Rodwell"

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    Midwives’ competence in interpretation of the intrapartum cardiotocograph at public hospitals in Gauteng: An explanatory sequential mixed-methods study
    (Elsevier Ltd, 2025) Lukhele, Sanele; Mulaudzi, Fhumulani Mavis; Gundo, Rodwell
    Background: Cardiotocograph (CTG) tracing is a routine intrapartum care procedure for women who have been diagnosed with high-risk pregnancy. The aim of the CTG is to identify fetuses that are at risk in order to expedite delivery. Purpose: To asssess midwives’ competence in the interpretation of the intrapartum cardiotocograph at public hospitals in Gauteng. Methods: An explanatory sequential mixed-methods approach was used. During phase one, 122 midwives in Johannesburg and Tshwane District filled in self-administered questionnaires, and during phase two, 30 midwives took part in semi-structured qualitative interviews. The data from both phases was analyzed separately and then integrated using the Pillar Integration Process. Results: The Pillar Integration Process led to the identification of six pillars: 1) substandard CTG interpretation training leads to a lack of understanding of key concepts; 2) absence of norms and standards pertaining to CTG interpretation training; 3) Essential Steps in Managing Obstetric Emergencies (ESMOE) training does not result in improved CTG interpretation scores; 4) lack of standardization of CTG interpretation guidelines causes confusion among interpreters; 5) level of knowledge of foundational concepts of CTG interpretation affects clinical judgment; and 6) CTG interpretation skill is a combination of understanding of CTG characteristics, fetal heart rate pattern, fetal physiology and clinical context. Conclusion: The results highlighted a knowledge deficit in CTG interpretation and shortfalls in the current CTG training programs. This can be remediated by the development of a CTG training program which is benchmarked with existing programs which have demonstrated good knowledge scores of participants over a long period.